ACR Appropriateness Criteria® Acute Elbow and Forearm Pain.

Acute elbow pain can be the result of traumatic and atraumatic processes. Pathologic processes include osseous, ligamentous, and tendinous etiologies. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel.

Vehicles for Consolidation and Expansion of Physician Practices: Private Equity, Medical Services Organizations, and Strategic Partnerships.

As reimbursements decline and the health care sector experiences consolidation, running a small practice is increasingly difficult. The past 15 years has seen a significant rise in practice consolidation, private equity investment, and regional health system affiliation. In a rapidly changing health care landscape, positioning one's practice for the future is challenging.

Gender Differences in Self-Description: A Linguistic Analysis of Orthopedic Surgery Residency Application Personal Statements.

Objective: The purpose of this study is to assess differences in language characteristics in personal statements written by male and female applicants to an orthopedic surgery residency program.

Design: This is a blinded retrospective analysis of personal statements from all applicants to an orthopedic surgery residency training program during 1 application cycle. Language characteristics were analyzed using a linguistic analysis software.

Catastrophic Sports Injuries: Causation and Prevention.

➤ Catastrophic injuries in U.S. high school and college athletes are rare but devastating injuries.

ACR Appropriateness Criteria® Chronic Shoulder Pain: 2022 Update.

Chronic shoulder pain is an extremely common presenting complaint. Potential pain generators include the rotator cuff tendons, biceps tendon, labrum, glenohumeral articular cartilage, acromioclavicular joint, bones, suprascapular and axillary nerves, and the joint capsule/synovium. Radiographs are typically the initial imaging study obtained in patients with chronic shoulder pain.

Procedure Costs of Peripheral Nerve Graft Reconstruction.

Unlabelled: Peripheral nerve injuries not repaired in an effective and timely manner may lead to permanent functional loss and/or pain. For gaps greater than 5 mm, autograft has been the gold standard. Allograft has recently emerged as an attractive alternative, delivering comparable functional recovery without risk of second surgical site morbidities.

ACR Appropriateness Criteria® Chronic Elbow Pain.

Chronic elbow pain can be osseous, soft tissue, cartilaginous, and nerve related in etiology. Imaging plays an important role in differentiating between these causes of chronic elbow pain. This document provides recommendations for imaging of chronic elbow pain in adult patients.

Acute Compartment Syndrome as a Complication of Radial Artery Catheterization.

Acute compartment syndrome is a rare complication of radial artery catheterization. If not identified and treated emergently, it can lead to profound disability or limb loss. Here, we discuss a rare case of acute compartment syndrome in the forearm of a 54-year-old man after transradial catheterization and anticoagulation for myocardial infarction, which ultimately required emergent fasciotomies and prolonged hospital care.

Report on the Evidence-Based Practice Committee's Survey on Dupuytren Disease.

Purpose: The Evidence-Based Practice Committee of the American Society for Surgery of the Hand (ASSH) set out to assess the membership's practice patterns (PPs) and knowledge of evidence-based principles for Dupuytren disease (DD).

Methods: A 21-item multiple-choice survey was distributed to all ASSH members via email in June 2020. Questions were divided into 2 types: evidence-based practice (EBP) and PPs.

High Utility of the 1st Metatarsal Phalangeal Joint Fusion.

Fusion of the first metatarsophalangeal joint has been used by foot and ankle surgeons as a reproducible and useful means of treating end-stage arthritis of the great toe. However, the overall utility and successful outcomes of this procedure have led to its incorporation into the treatment of more significant bunion deformities, reconstruction forefoot, and salvage procedures. The authors review surgical fixation methods, offer insightful technical pearls for challenging cases and share examples of complex reconstructive and salvage procedures.

Safety Profile of Synthetic Elastic Degradable Matrix for Soft Tissue Reconstruction in Foot & Ankle Surgery.

Background: Augmentation of soft tissue repairs has been helpful in protecting surgically repaired tissues as they heal. FlexBand (Artelon, Marietta, Georgia) is a synthetic, degradable, polycaprolactone-based polyurethane urea (PUUR) matrix that has been investigated and used for soft tissue repair in a variety of settings. The purpose of this study was to evaluate the safety profile of a PUUR matrix in a large cohort of patients undergoing soft tissue repairs about the foot and ankle.

Rate of Delayed Union With Early Weightbearing Following Intramedullary Screw Fixation of Jones Fractures.

Background: Jones fractures of the proximal fifth metatarsal are predisposed to delayed union and nonunion due to a tenuous blood supply. Solid intramedullary (IM) screw fixation is recommended to improve healing, traditionally followed by delayed weightbearing (DWB). However, early weightbearing (EWB) postoperatively may facilitate functional recovery.

Short- to Midterm Follow-up of Cemented Total Ankle Replacement Using the INBONE II: A Retrospective Chart Review.

Total ankle arthroplasty is a viable option for the treatment of end stage ankle arthritis. The purpose of this study is to report on the mid-term results with a cemented total ankle prosthesis, the Inbone™ II implant over a 5 year period. A retrospective, single-center chart and radiographic review of all patients with end stage ankle arthritis treated with Inbone™ II TAR) as the primary index procedure from 12/1/2012 to 3/1/2017.

Physician Reimbursement: Fee-for-Service, Accountable Care, and the Future of Bundled Payments.

In 1992, the use of relative value units to link a particular payments with specific services was initiated to replace traditional fee for service. The system incentivizes volume rather than quality. In 1997, initiatives were formalized to emphasize quality measures.

Outcomes and Incidence of Complications Following Endoscopic Gastrocnemius Recession: A Systematic Review.

Equinus contracture of the ankle can lead to a multitude of foot and ankle pathologies. The gastrocnemius recession has been used to address equinus deformity via various methods, including either an open or an endoscopic approach. Open techniques require increased intraoperative time and complication risks of sural nerve injury, wound complications, and poor cosmesis.

Structures at Risk During Percutaneous Extra-Articular Chevron Osteotomy of the Distal First Metatarsal.

Minimally invasive surgery of the forefoot has regained popularity as an alternative to traditional open procedures. Minimally invasive hallux valgus surgery has been shown to be effective and reproducible for the treatment of mild to moderate hallux valgus. The aim of this study is to identify vital structures that are at risk for iatrogenic damage while performing a minimally invasive distal chevron osteotomy due to limited direct visualization.

Maintenance of Correction of the Modified Lapidus Procedure With a First Metatarsal to Intermediate Cuneiform Cross-Screw Technique.

Background: Recurrence of deformity remains a concern when fusing the first tarsometatarsal joint for correction of hallux valgus (HV). A recently described construct adds an additional point of fixation from the plantar medial first metatarsal to the intermediate cuneiform. The purpose of this study was to determine the maintenance of correction of the first and second intermetatarsal angle, hallux valgus angle, and tibial sesamoid position after undergoing a first tarsometatarsal joint arthrodesis using the proposed construct.

Intramedullary Fixation for Proximal Humeral Fractures.

Proximal humeral fractures are a commonly encountered injury; however, no consensus has been reached for the ideal treatment. Current surgical fixation options include plate, plate with fibular strut allograft, intramedullary fixation, pinning, suture constructs, and external fixation. Each of these options possesses distinct advantages and disadvantages.

Preoperative Estimated Width of the Patellar Tendon for Anterior Cruciate Ligament Reconstruction.

This study aims to compare the actual patellar tendon width with the skin and magnetic resonance imaging (MRI) measurements and to describe a more accurate method to predict the actual patellar tendon width before anterior cruciate ligament reconstruction (ACLR).Thirty-nine patients undergoing primary ACLR were identified. Patients with patellar tendon width of less than 30 mm by skin or MRI measurements were excluded from the study.