Anatomic and Reverse Total Shoulder Arthroplasty for Osteoarthritis: Outcomes in Patients 80 Years Old and Older.

Background: There has been an increase in both primary anatomic (aTSA) and reverse total shoulder arthroplasty (rTSA) over the last decade, with rates peaking for patients aged 75 years and older. Despite aTSA being the mainstay of treatment for patients with glenohumeral arthritis in the absence of rotator cuff insufficiency, there has been an upward trend of rTSA utilization in the elderly due to concerns about rotator cuff integrity, regardless of deformity. The purpose of this study is to evaluate outcomes including pain, function, range of motion, satisfaction, and complications in patients 80 years or older following primary anatomic and reverse total shoulder arthroplasty for osteoarthritis without full thickness rotator cuff tears.

Morphological changes to peripheral joints supporting thumb trapezial metacarpal osteoarthritis.

The present study aims to determine if morphological differences of the scaphoid, trapezoid, and second metacarpal are associated with thumb osteoarthritis by comparing three-dimensional bone models of healthy controls and osteoarthritis patients. Fifty-eight patients with moderate to severe thumb osteoarthritis (modified Eaton ≥ II) and 35 healthy controls from a larger completed investigation were examined. To quantify morphological variations, a statistical shape model was created that classified binary with respect to the Eaton grading system: non-osteoarthritis or moderate/severe osteoarthritis (II-IV).

Opioid-Sparing Protocols in Hand Surgery: Successes and Opportunities.

The opioid epidemic has been a defining crisis in American health care. Many attempts to address the epidemic have focused on issues around opioid prescribing. Legislation at the state and federal levels has been passed; however, the results from these policies have been mixed.

Kinesiophobia and Its Correlation with Upper Limb and Hand Functionality Among Individuals with Wrist/Hand Injury: A Cross-Sectional Study.

: Wrist/hand injury incidences in the general population are high and contribute to a significant health problem. Fear of pain from movement can impact physical recovery, contributing to prolonged disability and impaired function in an upper limb after wrist/hand injury. The study's objectives are (1) to evaluate the relationship between kinesiophobia, pain catastrophizing, DASH, and Patient-Rated Wrist Evaluation and (2) to evaluate the data regarding the influence that basal kinesiophobia may have on upper limb functionality after wrist/hand immobilization.

Middle Ear Mechanics in the Barn Owl.

The barn owl is a common research subject in auditory science due to its exceptional capacity for high frequency hearing and superb sound source localization capabilities. Despite longstanding interest in the auditory performance of barn owls, the function of its middle ear has attracted remarkably little attention. Here, we report the middle ear transfer function measured by laser Doppler vibrometry and direct measurements of inner ear pressures.

Efficacy of an online self-management program for chronic burn pain: A randomized controlled trial of the Take Charge of Burn Pain program.

This randomized controlled trial investigated the effectiveness of an online self-management program, "Take Charge of Burn Pain (TCBP)," for 96 individuals living with chronic burn pain. Participants were randomly assigned to either the 7-week TCBP program integrating cognitive-behavioral therapy techniques, pain education, and self-management strategies or an attention control group focused on general burn recovery information. Assessments conducted at baseline, post-treatment, and 2- and 5-month follow-ups included measures of pain severity, pain interference, pain self-efficacy, posttraumatic stress disorder symptoms, and depression.

Readability of Patient-reported Outcome Measures Used in Plastic Surgery.

Background: Patient-reported outcomes are essential to understanding success in plastic surgery procedures, many that aim to improve quality of life. Patient-reported outcome measures (PROMs) should be written at or below the sixth-grade reading level recommended by the American Medical Association. This study aimed to evaluate the readability of plastic surgery PROMs.

Unicortical Versus Bicortical Proximal Locking Screw for Prevention of Peri-Implant Fracture: A Biomechanical Analysis of an Osteoporotic Distal Radius Model.

Purpose: Osteoporotic patients are at risk of peri-implant fractures after distal radius fixation. A unicortical screw in the proximal hole of the plate can theoretically decrease stress riser formation by eliminating the hole in the far bone cortex. This construct has been proposed in orthopedic literature to prevent peri-implant fractures but has not been tested in an osteoporotic distal radius model.

Scaphoid Fractures and Nonunion: A Survey-based Review of Hand Surgeon's Practice and the Evidence.

Purpose: The Evidence-Based Practice Committee of the American Society for Surgery of the Hand set out to assess the membership's practice patterns (PPs) and familiarity with evidence-based principles for scaphoid fracture and nonunion management.

Methods: Using a consensus-generated 25-item online survey, all the American Society for Surgery of the Hand members were invited to participate via email in September 2023. Two question types were used including evidence-based practice (EBP) and PPs.

A Comprehensive Review of Topography and Axon Counts in Upper-Extremity Peripheral Nerves: A Guide for Neurotization.

Purpose: Currently, no comprehensive database detailing topography and axon counts exists. This study aims to review the axon counts and topography of the major peripheral motor nerves of the upper extremity to allow for optimal surgical planning for peripheral nerve reconstruction via neurotization.

Methods: Peer-reviewed journal articles were identified through PubMed, ScienceDirect, Google Scholar, and CENTRAL.

Return to Swimming After Shoulder Arthroplasty.

Background: Swimming is one of the most common sporting activities in the United States, and often popular among shoulder arthroplasty patients. While return to sport has become a popular topic recently, the literature focused on swimming is limited. The purpose of this study is to report the rate of return to swim after primary shoulder arthroplasty and evaluate changes in performance after surgery.

The Induced Membrane Technique for Bone Defects in the Hand and Upper Extremity: A Case Series.

Background: We present a series of cases in which the induced membrane technique (IMT) was used to treat segmental bone defects from trauma and chronic infection nonunion in the hand and upper extremity. The aims of the study were to present the rates of union and complications using this technique.

Methods: Our institutional database was queried between 2012 and 2018.

Infection Rates in Open Hand Fractures: Can Surgical Treatment Be Delayed?

The authors hypothesized that the infection rates of open hand fractures treated in a delayed manner would not be higher than those treated immediately. The authors performed a retrospective chart review of patients treated between January 2008 and July 2014 at a Level 1 Trauma Center. Delayed (> 24 hours) versus early (< 24 hours) surgical treatment groups were identified for comparison to determined infection rates.

Dorsal Cortical Screw Penetration in Volar Distal Radius Plating: Comparison of 3 Fluoroscopic Views.

Background: The skyline or dorsal tangential view (DTV) and the carpal shoot-through (CST) have been developed to enhance the intraoperative examination of the distal radius's dorsal cortex during open reduction and internal fixation with volar plates. This study aimed to assess the lateral view (LV), DTV, and CST's effectiveness in showcasing screws that penetrate the dorsal cortex.

Methods: Eighty patients, comprised of 42 women and 38 men with an average age of 53 years, underwent volar locking plate fixation for displaced distal radius fractures.

A Case Report of Trauma-induced Coagulopathy in the Setting of an Isolated Humeral Shaft Fracture.

Introduction: Humeral shaft fractures are common orthopedic injuries often resulting from high-energy trauma in young patients and low-energy trauma in the elderly. Non-operative management has traditionally been the mainstay of treatment for isolated and low-energy humeral shaft fractures, with operative management reserved for severe cases often involving neurovascular compromise. This case describes a rare, yet catastrophic complication of a humeral shaft fracture where the patient developed trauma-induced coagulopathy (TIC), resulting in amputation of the affected extremity, systemic inflammatory response syndrome (SIRS), and ultimately death.

Treatment of Distal Radioulnar Joint in Rheumatoid Arthritis.

Arthritis of the distal radioulnar joint is a frequent source of pain and disability for patients with rheumatoid arthritis despite advances in medical treatment. Treatment options include distal ulna resection, distal radioulnar joint fusion, and distal radioulnar joint arthroplasty. Before surgery, careful evaluation should be performed for concurrent pathology, including extensor tendon rupture and involvement of the cervical spine.

Assessment of Progressive Hand and Wrist Deformities in the Rheumatoid Patient.

This article focuses on hand and wrist deformities arising from rheumatoid arthritis. The pathogenesis is synovitis and pannus formation, leading to direct tissue invasion and mass effect resulting in stretching and attenuation of ligaments. The typical deformity of a rheumatoid wrist is a dorsal subluxation of the ulna head (or more aptly, volar translation of the radius given that the ulna is fixed in position), with volar subluxation, ulnar translocation and supination of the carpus, eventually leading to carpal collapse.

Conceptual Framework in Assessing the Rheumatoid Patient with Hand Deformities.

Rheumatoid arthritis (RA) is a common autoimmune condition affecting approximately 0.5% to 1% of the global population. A significant percentage of these patients will develop hand deformities and dysfunction.

Long-Term Surgical Success in Treating Vohwinkel Syndrome: A Case Report.

Case: Vohwinkel syndrome is a rare, inherited condition marked by defective keratinization. The disorder may feature digital constriction bands (pseudoainhum) which can lead to autoamputation. Surgical excision is the only treatment of pseudoainhum; however, it is fraught with recurrence.

Targeted Muscle Reinnervation Compared to Standard Peripheral Nerve Management Following Amputation: A Systematic Review and Meta-Analysis.

Background: Chronic pain remains a significant challenge for individuals following limb amputation, with incidence of painful neuromas, phantom limb pain (PLP), and residual limb pain (RLP). Targeted muscle reinnervation (TMR) is a surgical technique designed to restore motor control information lost during amputation by redirecting residual nerves to new muscle targets. This systematic review and meta-analysis aims to compare patient-reported and functional outcomes following amputation with either TMR or standard neurological treatment (SNT).

New strategy for shortening the consolidation period in distraction lengthening of phalanges or metacarpal bone.

Distraction lengthening of digits enhances hand function in patients with congenital phalangeal defects or traumatic hand amputations. Although callotasis is a useful distraction lengthening method, it is challenging and often results in various complications and prolonged fixation. Based on our experiences, we attempted to develop innovations to reduce the fixation period.

The Effect of Forearm Shortening on Finger Flexion: A Biomechanical Study.

Purpose: Surgeons may shorten the forearm for many indications. We quantified the impact of shortening on finger flexion with a cadaver model.

Methods: Ten fresh cadaver proximal forearms were pinned to a static block.