Outcomes following reverse total shoulder arthroplasty vs operative fixation for proximal humerus fractures: a systematic review and meta-analysis.

Introduction: Proximal humerus fractures are common in the older population. A consensus on the optimal management of complex fractures requiring surgery has yet to be reached. A systematic review and meta-analysis was performed to compare clinical outcomes between reverse total shoulder arthroplasty (RTSA) and open reduction and internal fixation (ORIF).

Comparison of Arterial and Venous Interposition Grafting for Arterial Defects in a Rat Model.

Background:  Interposition microvascular grafting may be required to bridge arterial defects during digital replantation or revascularization and has traditionally been performed utilizing a venous autograft. Arterial interposition grafting has been shown to be superior in maintaining patency in large vessel surgery; there are case reports of its use in microsurgery.

Methods:  Six fellowship-trained hand and microsurgeons performed arterial and venous interposition grafts on the femoral arteries of 40 Wistar rats.

Patient outcomes following arthroscopic distal clavicle excision: a prospective case series.

Background: Distal clavicle excision for acromioclavicular joint (ACJ) pathology is currently the mainstay of surgical management in patients with symptoms refractory to nonoperative treatment. There have been few high quality studies outlining the efficacy of arthroscopic excision of the distal clavicle as a single procedure in patients with isolated disease.

Aim: To characterize function and pain outcomes in patients undergoing arthroscopic distal clavicle excision by utilizing stringent inclusion criteria to isolate ACJ pathology.

Flexor Digitorum Superficialis Excision for Trigger Finger - A Systematic Literature Review.

Division of one or more slips of the flexor digitorum superficialis (FDS) tendon has been posited as an effective surgical modality for advanced or recurrent trigger finger. This may be an effective approach among patients with diabetes or rheumatoid arthritis, or in those with fixed flexion deformities who have poor outcomes from A1 pulley release alone. However, there is limited evidence regarding the effectiveness of this procedure.

Opponensplasty for Nerve Palsy: A Systematic Review.

Opposition is an essential function of the human thumb to enable fine pinch and grip strength. Loss of opposition can be caused by both congenital and acquired pathology resulting in significant disability. This systematic review aims to compare the different techniques available to restore opposition.

A qualitative study of clinicians' perspectives on reasons for delays in clozapine initiation.

Objectives: To elicit mental health clinicians' views on the reasons for delayed initiation of clozapine treatment.

Method: Thematic analysis of transcripts from a semi-structured interview of 15 mental health clinicians.

Results: Four major themes emerged from data analysis: Patient and Carer Factors, Medication factors, Protocol factors, and Prescriber factors.

Trends in management of adult tarsometatarsal joint injuries in a contemporary Australian context: a nationwide study of claims data over 20 years.

Background: Traumatic tarsometatarsal joint (TMTJ) injuries are uncommon, but can cause significant morbidity due to delayed or missed diagnosis. Recent evidence highlights the importance of achieving anatomical reduction via operative management. This study aims to analyse trends in rates of open reduction internal fixation (ORIF) for Lisfranc injuries in Australia according to Nationwide claims data.

Under-representation of Women as Proceduralists and Patients in TAVR and TMVr Procedures: Data, Implications and Proposed Solutions.

Women are under-represented among transcatheter aortic valve replacement (TAVR) and transcatheter mitral valve repair (TMVr) operators. This review assesses the representation of women as patients and as proceduralists and trial authors in major structural interventions. Women are under-represented as proceduralists in structural interventions: only 2% of TAVR operators and 1% of TMVr operators are women.

Reverse Instrumentation for Headless Compression Screw Fixation of Basal Proximal Phalangeal Fractures.

Intramedullary headless compression screw fixation of proximal phalangeal fractures permits semirigid stabilization through a minimally invasive approach with negligible tendon disturbance, allowing early mobilization and rehabilitation. Antegrade insertion is preferred for basal fractures, but various concerns and technical difficulties have been identified with both intra- and transarticular instrumentation. We describe a technical tip to facilitate easier guidewire insertion and instrumentation with a screw via an intra-articular approach.

The Medial Femoral Trochlea Osteochondral Flap for Scaphoid Reconstruction: A Systematic Review.

Background: The medial femoral trochlea flap has been used to resurface scaphoids with recalcitrant proximal pole fractures or avascular necrosis, providing vascularized osteochondral tissue with similar morphological characteristics. This article aims to review the contemporary literature on its use for scaphoid reconstruction.

Methods: A systematic review of Embase, PubMed, Cochrane Central Register of Controlled Trials, and MEDLINE assessed the use of medial femoral trochlea flaps in scaphoids.

Surgical management of clavicle fractures in Australia: an analysis of Australian Medicare Benefits Schedule database from 2001 to 2020.

Background: There is no consensus on the optimal management of clavicle fractures, with advocates of both operative and non-operative management. The objective of this study is to assess the trends in the management of clavicle fractures in Australia over the past two decades.

Methods: The incidence of surgical fixation of clavicle fractures from 2001 to 2020 was analysed using the Australian Medicare Benefits Schedule database, reflective of operations performed on privately insured patients, thus excluding public patients and compensable cases.

Acute Mallet Finger Injuries-A Review.

Acute disruptions of the terminal extensor tendon are common and can result in significant dysfunction if not recognized and treated appropriately. This article provides a topical review of the contemporary literature concerning acute mallet finger injuries. It also proposes a modification to the Doyle classification to make it more encompassing and less prone to interobserver error.

Traumatic peripheral nerve injuries: diagnosis and management.

Purpose Of Review: To review advances in the diagnostic evaluation and management of traumatic peripheral nerve injuries.

Recent Findings: Serial multimodal assessment of peripheral nerve injuries facilitates assessment of spontaneous axonal regeneration and selection of appropriate patients for early surgical intervention. Novel surgical and rehabilitative approaches have been developed to complement established strategies, particularly in the area of nerve grafting, targeted rehabilitation strategies and interventions to promote nerve regeneration.

The Efficacy of Antegrade Homodigital Neurovascular Island Flaps in Distal Fingertip Reconstruction: A Systematic Literature Review.

Background: Antegrade homodigital neurovascular island flaps (AHIFs) are a heterogeneous group of pedicled flaps used for reconstruction of traumatic digital detipping injuries. While numerous single-center studies have documented their use, there are no large or multicentre studies validating their efficacy, applicability, and functional outcomes. We performed a systematic review of the contemporary literature to establish the safety and functional outcomes of this technique.

Radio-isotope occult lesion localization (ROLL) techniques to identify the clipped node for targeted axillary dissection (TAD) in breast cancer.

Background: Breast cancer patients having neoadjuvant systemic therapy (NAST) who have a positive (clipped) lymph node (CN) at presentation must have that CN removed to assess pathologic response at later surgery. Multiple techniques for localizing the CN have been described. We describe a novel ROLL-based approach.

Representation of Women in Internal Medicine Specialties in North America, the United Kingdom, and Australasia: Cardiology's Outlier Status and the Importance of Diversity.

Decades of research demonstrate the value of workplace diversity. Reports from individual countries show that women are underrepresented in internal medicine workforces. However, large pooled international studies are not available.

Medication Regimen Complexity and Risk of Bleeding in People Who Initiate Oral Anticoagulants for Atrial Fibrillation: A Population-Based Study.

Background: Oral anticoagulants (OACs) are high-risk medications often used in older people with complex medication regimens. This study was the first to assess the association between overall regimen complexity and bleeding in people with atrial fibrillation (AF) initiating OACs.

Methods: Patients diagnosed with AF who initiated an OAC (warfarin, dabigatran, rivaroxaban, apixaban) between 2010 and 2016 were identified from the Hong Kong Clinical Database and Reporting System.

Anatomic Variations of the Musculocutaneous Nerve and Clinical Implications for Restoration of Elbow Flexion.

Purpose: The restoration of elbow flexion is of primary importance in the management of patients with brachial plexus injuries. Superior functional outcomes via fascicle transfer from the ulnar and median nerves have resulted in this transfer being considered the mainstay of recovery of elbow flexion in patients with intact C8 and T1 function. An understanding of the anatomy of the musculocutaneous nerve (MCN) and its branching pattern is key while performing these transfers.