The Effect of Age and Sex on Early Postoperative Outcomes after Surgical Treatment of Distal Radius Fractures.

We aim to evaluate the impact of advanced age and sex on postoperative complications and radiographic outcomes after open reduction with internal fixation of distal radius fractures (DRF). We conducted a retrospective chart review, including all patients who underwent open reduction with internal fixation of a DRF between 2012 and 2018 at a single level 1 trauma centre. We recorded patient age, sex, fracture classification (Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association [AO/OTA]), time from injury to surgical date, surgical duration, diabetes status, tobacco use, illicit drug use, history of osteoporosis, use of adjuvants, fixation type, postoperative radiographic restoration of normal parameters and early complications including loss of reduction within 30 days postoperatively.

The Effect of Radial Inclination on the Stage of Kienbock Disease at the Time of Initial Diagnosis.

Background: Negative ulnar variance is a widely accepted risk factor for the development of Kienbock disease (KD). Variation in radial inclination has been proposed as a risk factor, but evidence thus far has been inconclusive. We aim to clarify the relationship between radial inclination and KD.

Single-Incision Endoscopic Trigger Finger Release.

Trigger finger surgery is a commonly performed open procedure with known potential complications of infection, stiffness, pain, nerve injury, bowstringing, and incomplete release of the A1 pulley. We present a novel single-incision endoscopic trigger finger release technique that moves the incision from the palm to the palmar-digital crease, leading to less pain, scarring, and stiffness. We believe that this technique is technically simple, fast, and may decrease the risk of complications commonly encountered with open trigger finger release.

The Outcomes of Extensor Tendon Repair Based on Timing of Repair.

Little is known regarding the effect timing of repair has on extensor tendon repair results. The purpose of this study is to determine if a relationship exists between the time of extensor tendon injury to extensor tendon repair and patient outcomes. A retrospective chart review was conducted on all patients that underwent extensor tendon repair at our institution.

Static and Dynamic Stabilization of the Shoulder After Total Scapulectomy in an Electric Burn Patient.

An otherwise healthy 49-year-old man experienced a high-voltage electrical injury to the left shoulder resulting in total scapulectomy, partial calviculectomy, and a substantial soft tissue defect. The majority of the muscles around his shoulder were debrided because of necrosis, with only the pectoralis and latissimus dorsi muscles remaining attached to the humerus. Surprisingly, the patient's brachial plexus remained intact, and his left elbow, wrist, and hand function were preserved.

Extensor Tendon Repair Outcomes Based on Zone of Injury.

Background: The purpose of this study was to examine the clinical outcomes of extensor tendon repairs based on zone of injury.

Methods: A retrospective chart review was conducted on all patients who underwent primary extensor tendon repair at our institution. Extensor tendon repairs were performed using a multiple figure-of-8 suture technique for extensor zones 1-4 and a modified Kessler suture technique for extensor zones 5-8.

Iliac Crest Bone Graft With Intramedullary Headless Implant for Metacarpal Bone Loss.

Abstract: Metacarpal bone loss presents a challenging reconstructive dilemma for hand surgeons. While multiple bone grafting techniques have been described, complications including nonunion, graft resorption, fixation requiring prolonged immobilization, stiffness, and the need for multiple procedures are well-documented. We present a technique for managing metacarpal bone loss utilizing a tri-cortical iliac crest graft and an intramedullary metacarpal nail for the treatment of metacarpal fractures and nonunions that is technically simple, fast, and allows for early initiation of motion to decrease postoperative complications.

Midcarpal Instability: A Historical and Etymological Review.

Although midcarpal instability was first described almost 45 years ago, this uncommon condition is still poorly understood by most clinicians today. Adding to the confusion, it is known by 2 different names: midcarpal instability and carpal instability nondissociative. In this article, we describe the history of the recognition of instability of the midcarpal joint, including its pathomechanics, classification, and treatment.

Non-surgical management for air injection injury to the hand, a case report.

We present a case a high pressure air injection injury to the index finger with air extension proximal to the elbow. This patient was treated non-surgically with close observation. At 3 year follow-up, no lasting deficits or complications were noted and radiographs revealed complete resolution of the air tissue dissection.

Preiser's Disease as a Consequence of Scaphoid Hypoplasia After Remote Index Finger Repositioning: A Case Report.

Case: We present the case of a patient who developed scaphoid avascular necrosis in the setting of scaphoid hypoplasia, 37 years after an index finger repositioning for thumb agenesis, due to Holt-Oram syndrome.

Conclusion: To the best of our knowledge, this is a unique case of scaphoid avascular necrosis in a patient with Holt-Oram syndrome with scaphoid hypoplasia who underwent index finger repositioning 37 years earlier. Her wrist pain was successfully treated with scaphoid excision and intercarpal fusion.

Precision Medicine for Kienböck Disease in the 21st Century.

One of the most popular treatment algorithms for Kienböck disease is based on a progression of successive radiographic changes that was developed in the 1970s. Since then, 2 other important classifications systems have been introduced. One is centered on contrasted magnetic resonance imaging findings and the other, articular cartilage degeneration.

Risk Factors and Reasons for Emergency Department Visits Within 30 Days of Elective Hand Surgery: An Analysis of 3,261 Patients.

The frequency of hand and elbow surgeries occurring in outpatient and elective settings is on the rise. Emergency department (ED) visits in the postoperative period are increasingly used as quality measures for surgical care. The aim of this study is to determine the number of postoperative ED visits, the primary reason for these visits, and to identify risk factors associated with these visits.

Knotless Webspace Reconstruction Technique for Central Metacarpal Ray Resections.

Ray amputations of the hand are procedures performed for traumatic injuries, infection, neoplasm, and certain deformities. When performed for the central digits, the gap created between the remaining digits can significantly impact hand function. Multiple deep transverse metacarpal ligament reconstruction techniques and bone transposition have been described to address this issue.

Percutaneous Fixation of Pediatric Fractures of the Proximal Phalanx Neck: A Novel Technique.

Introduction: Proximal phalanx neck fractures occur almost exclusively in children. Fractures of the proximal phalanx neck can be difficult to treat nonoperatively given the anatomic location and associated extrinsic forces. A divergent or crossed pin configuration is often utilized for the stabilization of these fractures.

Erratum: Addendum: Kienböck Disease: A New Algorithm for the 21st Century.

[This corrects the article DOI: 10.1055/s-0036-1593734.].

Kienböck Disease: A New Algorithm for the 21st Century.

 It has been over 100 years since the initial description of avascular necrosis of the lunate. Over the last two decades, there has been the introduction of advanced information regarding the etiology, natural history, classification, and treatment options for lunate osteonecrosis. There have been new classifications developed based on advanced imaging, perfusion studies of lunate viability, and arthroscopic assessment of the articular cartilage.

Asymptomatic Migration of a Kirschner Wire from the Proximal Aspect of the Humerus to the Thoracic Cavity: A Case Report.

Case: A 78-year-old man presented with an open fracture of the proximal aspect of the humerus and an axillary artery laceration; the fracture was treated provisionally with Kirschner wires (K-wires). Forty-five days postoperatively, he presented with pin prominence at the lateral aspect of the arm, and was incidentally noted to have migration of a separate K-wire to the left lung. He underwent successful thoracotomy and lung wedge resection for wire removal.

Kienböck Disease: Moving Forward.

Over the past decade, a plethora of new information has been reported regarding etiology, natural history, classification, and treatment options for lunate osteonecrosis. New disease classifications have been described based on advanced imaging determination of lunate viability as well as a cartilage-based arthroscopic classification. Here we review the newest literature regarding Kienböck disease and present a new treatment algorithm that incorporates the traditional osseous classification system with a perfusion/viability classification and an articular cartilage-based classification.