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Hand: Official Journal of the American Association for Hand Surgery

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https://read.qxmd.com/read/30897954/increasing-multidrug-antibiotic-resistance-in-mrsa-infections-of-the-hand-a-10-year-analysis-of-risk-factors
#1
Justin M Kistler, Colin M Vroome, Frederick V Ramsey, Asif M Ilyas
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is the most common pathogen isolated from hand abscesses. The purpose of this study was to understand trends and changes in longitudinal antibiotic resistance profiles and risk factors for these infections to better guide empiric treatment of hand infections. METHODS: We performed a retrospective review of culture-positive hand infections over a 10-year period at an urban academic institution from 2005 to 2014...
March 22, 2019: Hand: Official Journal of the American Association for Hand Surgery
https://read.qxmd.com/read/30897950/surgery-and-conservative-management-of-camptodactyly-in-pediatric-patients-a-systematic-review
#2
Annie M Q Wang, Min Kim, Emily S Ho, Kristen M Davidge
BACKGROUND: Camptodactyly is a pediatric hand condition, the treatment of which remains controversial. The authors' aim was to improve patient care through clarifying the definition of camptodactyly and indications for surgical and/or conservative management, summarizing outcomes, and defining risks. METHODS: A systematic review was conducted of articles in all languages on outcomes following surgical and/or conservative management of idiopathic camptodactyly in children using MEDLINE (Medical Literature Analysis and Retrieval System Online), PubMed, EMBASE (Excerpta Medica database), AMED (Allied and Complementary Medicine), and CINAHL (Cumulative Index of Nursing and Allied Health Literature) (until January 2017)...
March 22, 2019: Hand: Official Journal of the American Association for Hand Surgery
https://read.qxmd.com/read/30895820/congenital-thumb-index-web-space-deficiency
#3
Tiffany Wu, Adam Walchak, Ghazi M Rayan
BACKGROUND: There are several congenital hand differences that cause thumb-index (TI) web space deficiency. There is a knowledge gap in the literature about the hand differences that are associated with TI web space deficiency. We aimed to identify these congenital differences and the various specific reconstructive surgical procedures that are used for these conditions. METHODS: We conducted a retrospective chart review of children treated operatively over a period of 30 years for congenital TI web space deficiency by the senior author (G...
March 21, 2019: Hand: Official Journal of the American Association for Hand Surgery
https://read.qxmd.com/read/30895819/initial-debridement-of-dorsal-hand-abscesses-in-the-operating-room-does-not-improve-outcomes
#4
John D Jennings, Colin Vroome, Justin A Ly, Joseph Thoder
BACKGROUND: Hand infections frequently involve the dorsal aspect of the hand and often develop secondary to some traumatic mechanism. Although Staphylococcus aureus is most commonly isolated, anaerobic and polymicrobial infections are not uncommon. To date, treatment is largely anecdotal, with some surgeons preferring a formal debridement in the operating room, while others opt for an initial debridement at the bedside. The goals of this study were to compare outcomes between treatment modalities and to identify the most common causative organisms...
March 21, 2019: Hand: Official Journal of the American Association for Hand Surgery
https://read.qxmd.com/read/30895817/a-prospective-pilot-study-of-vascular-assessment-of-the-upper-extremity-with-laser-angiography
#5
Helen G Hui-Chou, Madhuli Y Thakkar, Kenneth R Means, James P Higgins
BACKGROUND: Our goal was to investigate patients' upper extremity tissue perfusion changes using an indocyanine green laser angiography imaging system for various pathologic states and interventions. METHODS: This prospective observational study used Spy Elite/LUNA laser angiography to evaluate perfusion in patients with upper extremity vascular compromise. All patients had Spy Elite/LUNA imaging as well as clinical and handheld Doppler examinations preintervention, intraoperatively, if applicable, and at 1 week, 2 weeks, and 2 months postintervention...
March 21, 2019: Hand: Official Journal of the American Association for Hand Surgery
https://read.qxmd.com/read/30895813/trends-in-primary-proximal-interphalangeal-joint-system-and-revisions-for-osteoarthritis-of-the-hand-in-the-medicare-database
#6
Michael O Madden, Joseph R Palmer, Bijan J Ameri, Rushabh M Vakharia, Jacob Landes, Martin W Roche
BACKGROUND: Proximal interphalangeal arthroplasty (PIPA) has been indicated for patients suffering from osteoarthritis (OA) or rheumatoid arthritis of the hand. Although there is extensive literature showing the outcomes of PIPA, there is paucity in the literature regarding trends of PIPA in patients with OA of the hand. The purpose of this study was to determine annual primary utilization and revision PIPA trends within the Medicare population with the use of an administrative database...
March 21, 2019: Hand: Official Journal of the American Association for Hand Surgery
https://read.qxmd.com/read/30894030/subcutaneous-transposition-of-the-flexor-pollicis-longus-does-it-provide-increased-length-for-tendon-repair-a-cadaveric-study
#7
Chia H Wu, Seth Shoap, Robert J Strauch
BACKGROUND: Flexor pollicis longus (FPL) tendon lacerations typically occur via sharp mechanisms such as knife injury. When the injury is chronic, it may be difficult to perform a tension free repair, and tendon lengthening may be required. This article proposes a technique that transposes the proximal tendon stump over the thenar eminence subcutaneously, out of the carpal tunnel, in an attempt to gain additional tendon length by eliminating the sharp turn the FPL takes. METHODS: A total of 17 cadaveric hands were used...
March 20, 2019: Hand: Official Journal of the American Association for Hand Surgery
https://read.qxmd.com/read/30894028/low-rate-of-complications-following-intramedullary-headless-compression-screw-fixation-of-metacarpal-fractures
#8
William J Warrender, David E Ruchelsman, Michael G Livesey, Chaitanya S Mudgal, Michael Rivlin
BACKGROUND: There has been a recent increase in the use of headless compression screws for fixation of metacarpal neck and shaft fractures as they offer several advantages, and minimal complications have been reported. This study aimed to evaluate the clinical complications and their solutions following retrograde intramedullary headless compression screw fixation of metacarpal fractures. We describe complications and the approach to their management. METHODS: We performed a multicenter case series through retrospective review of all patients treated with intramedullary headless screw fixation of metacarpal fractures by 3 fellowship-trained hand surgeons...
March 20, 2019: Hand: Official Journal of the American Association for Hand Surgery
https://read.qxmd.com/read/30880517/firework-injuries-of-the-hand-an-analysis-of-treatment-and-health-care-utilization
#9
Ricardo Ortiz, Sezai Ozkan, Neal C Chen, Kyle R Eberlin
BACKGROUND: Firework injuries to the hand can be devastating due to the explosive and ballistic nature of these devices. The aim of this study was to describe the injury and treatment characteristics of patients requiring surgery for firework-related hand injuries and to investigate which factors are associated with an increased utilization of health care resources. METHODS: A retrospective chart review of patients undergoing surgery for firework-related hand injuries at two American College of Surgeons level I trauma centers between 2005 and 2016 was performed...
March 17, 2019: Hand: Official Journal of the American Association for Hand Surgery
https://read.qxmd.com/read/30880489/trapeziometacarpal-fusion-with-and-without-distal-scaphoid-excision-a-cadaveric-model-comparing-thumb-range-of-motion
#10
Katherine C Faust, Gary M Lourie
PURPOSE: To describe the biomechanical changes seen after thumb carpometacarpal (CMC) fusion with distal scaphoid excision (DSE), a surgical technique used for pantrapezial disease in high-demand individuals. METHODS: A cadaveric study with 13 fresh-frozen cadaveric specimens was conducted. Fluoroscopic measurements in posteroanterior (PA) and lateral planes were performed. Thumb CMC fusion was then simulated. The same images were taken after fusion. The distal scaphoid was excised, and the measurements were obtained again...
March 17, 2019: Hand: Official Journal of the American Association for Hand Surgery
https://read.qxmd.com/read/30880479/hand-corticosteroid-injections-in-patients-on-blood-thinners
#11
Ajith Malige, Kristofer S Matullo
BACKGROUND: Our study aims to identify any influence that anticoagulation and antiplatelet ("blood thinner") medications have on hand and wrist corticosteroid injection complication rates. METHODS: This retrospective chart review looked at patients between the ages of 18 and 89 years who received corticosteroid injections in the hand or wrist between 2013 and 2017, noting anticoagulation and antiplatelet use, demographics, injection placement, and surgical intervention...
March 17, 2019: Hand: Official Journal of the American Association for Hand Surgery
https://read.qxmd.com/read/30880471/clinical-outcomes-of-limited-open-intramedullary-headless-screw-fixation-of-metacarpal-fractures-in-91-consecutive-patients
#12
Gilad Eisenberg, Jason B Clain, Natanya Feinberg-Zadek, Matthew Leibman, Mark Belsky, David E Ruchelsman
BACKGROUND: The objective of the study is to evaluate clinical and radiographic outcomes in patients treated with limited-open retrograde intramedullary headless screw (IMHS) fixation for metacarpal neck and shaft fractures. METHODS: Retrospective review of 91 consecutive patients (79 men; 12 women), mean age 28 (range =15-69) years, treated with IMHS fixation for acute displaced metacarpal neck (N = 56) and shaft (N = 35) fractures at a single institution. Mean follow-up was 10 (range = 1-71, median = 3) months...
March 17, 2019: Hand: Official Journal of the American Association for Hand Surgery
https://read.qxmd.com/read/30880470/comparison-of-local-only-anesthesia-versus-sedation-in-patients-undergoing-staged-bilateral-carpal-tunnel-release-a-randomized-trial
#13
Garrhett G Via, Andrew R Esterle, Hisham M Awan, Sonu A Jain, Kanu S Goyal
PURPOSE: Carpal tunnel syndrome is a common disease treated operatively. During the operation, the patient may be wide-awake or sedated. The current literature has only compared separate cohorts. We sought to compare patient experience with both local-only anesthesia and sedation. METHODS: Staged bilateral carpal tunnel release utilizing open or endoscopic technique was scheduled and followed through to completion of per-protocol analysis in 31 patients. Patients chose initial hand laterality and were randomized regarding initial anesthesia method: local-only or sedation...
March 17, 2019: Hand: Official Journal of the American Association for Hand Surgery
https://read.qxmd.com/read/30857433/a-comparison-of-conservative-and-operative-management-of-thumb-ulnar-collateral-ligament-avulsion-fractures-in-children
#14
Minh N Q Huynh, Ken Tang, Kevin Cheung
BACKGROUND: The optimal management of pediatric thumb ulnar collateral ligament (UCL) avulsion fractures remains poorly defined. The purpose of this study was to elucidate patient outcomes based on initial management and fracture characteristics. METHODS: A retrospective study of all patients younger than 18 years of age presenting with a thumb UCL avulsion fracture was performed. Patients were grouped by their initial management. The primary outcome of the study was time to return to full activity...
March 12, 2019: Hand: Official Journal of the American Association for Hand Surgery
https://read.qxmd.com/read/30857423/ultrasound-evaluation-for-incomplete-carpal-tunnel-release
#15
Jacob E Tulipan, Amir Reza Kachooei, Jonathan Shearin, Yvonne Braun, Mark L Wang, Michael Rivlin
BACKGROUND: Ultrasound can provide evaluation of the anatomy of the carpal tunnel in a convenient, noninvasive office setting. This study is intended to determine the accuracy and diagnostic performance of ultrasound, used by surgeons, for the evaluation of completeness of carpal tunnel release (CTR). METHODS: Ten cadaver arms underwent randomized sectioning of 0%, 25%, 50%, 75%, or 100% of the transverse carpal ligament. Following a brief training session, a blinded observer used ultrasound to evaluate the percentage of the transverse carpal ligament release...
March 12, 2019: Hand: Official Journal of the American Association for Hand Surgery
https://read.qxmd.com/read/30854901/a-comparison-of-6-diagnostic-tests-for-carpal-tunnel-syndrome-using-latent-class-analysis
#16
William L Wang, Timothy Hanson, John R Fowler
BACKGROUND: Nerve conduction studies (NCS), ultrasonography (US), Carpal Tunnel Syndrome 6 (CTS-6), Wainner, Lo, and Kamath are clinical diagnostic tools that can be used to diagnose carpal tunnel syndrome (CTS). Latent class analysis (LCA) is a proven statistical technique that can be used to evaluate diagnostic tests in a lack of a reference standard. Given that there is no accepted reference standard, we elected to perform an LCA to evaluate the 6 clinical diagnostic tests. METHODS: One hundred eighty-seven wrists were prospectively evaluated by a board-certified hand surgeon using US, the CTS-6, Wainner, Lo, and Kamath...
March 10, 2019: Hand: Official Journal of the American Association for Hand Surgery
https://read.qxmd.com/read/30845843/nonunion-and-reoperation-after-ulna-shortening-osteotomy
#17
Svenna H W L Verhiel, Sezai Özkan, Kyle R Eberlin, Neal C Chen
BACKGROUND: The primary purpose of our study was to identify factors associated with reoperation after ulna shortening osteotomy. Our secondary aims were to determine the rate and type of reoperation procedures. METHODS: In this retrospective study, we included patients older than 18 years of age who underwent an ulna shortening osteotomy between January 2003 and December 2015. Medical records of patients were assessed for our explanatory variables, reoperations, and reporting of symptoms...
March 8, 2019: Hand: Official Journal of the American Association for Hand Surgery
https://read.qxmd.com/read/30845842/fowler-central-slip-tenotomy-or-spiral-oblique-retinacular-ligament-reconstruction-a-cadaveric-biomechanical-study-in-swan-neck-deformity
#18
Christian Deml, Aslan Baradaran, Neal Chen, Michael Nasr, Amir R Kachooei
BACKGROUND: The goal of this study is to biomechanically compare Fowler central slip tenotomy with spiral oblique retinacular ligament (SORL) reconstruction in correcting a chronic mallet deformity as part of a swan-neck deformity. METHODS: We used 24 human cadaver fingers from 6 hands. Mallet finger and swan-neck deformities were created; then, Fowler tenotomy was done on one group including 3 hands with 12 fingers, and SORL reconstruction was done on the others...
March 8, 2019: Hand: Official Journal of the American Association for Hand Surgery
https://read.qxmd.com/read/30829063/determination-of-the-optimal-location-for-bone-graft-harvest-in-the-distal-radius
#19
Andrew P Matson, Andrew E Federer, Erin M Meisel, Stephen R Barchick, David S Ruch, Marc J Richard
BACKGROUND: The distal radius is commonly used as a bone graft donor site for surgery in the hand and wrist. The aim of this study was to evaluate the volume and relative density of cancellous bone in the distal radius. METHODS: Thirty-four consecutive computed tomographic scans of the wrist in 33 patients without distal radius pathology were included. For each subject, 6 spherical regions of interest (ROIs) were identified within the distal radius. In each ROI, volumetric measurements and mean Hounsfield unit (HFU) values were recorded by 2 observers using a 3-dimensional imaging reconstruction software...
March 2, 2019: Hand: Official Journal of the American Association for Hand Surgery
https://read.qxmd.com/read/30819026/ulnar-wrist-deviation-in-children-with-obstetric-brachial-plexus-palsy-a-descriptive-study-of-clinical-and-radiological-findings-of-impaired-ulnar-growth-and-associated-incongruence-of-the-distal-radioulnar-joint
#20
Jörg Bahm, Sarra Bouslama, Elisabet M Hagert, Jonny K Andersson
Backround: Some children with obstetric brachial plexus palsy (OBPP) present later on with an ulnarly deviated wrist. The aim of this study was to present a retrospective analysis of a subgroup of OBPP children with ulnarly deviated wrists and to describe their morphologic wrist deformity in terms of clinical and radiological appearance. METHODS: We present a retrospective analysis of the records of 27 children with an ulnarly deviated wrist as a consequence of OBPP. Radiographs of the affected wrist were performed when the ulnar deformity became clinically manifest and merited investigation, at a mean age of 15 (range: 6...
February 28, 2019: Hand: Official Journal of the American Association for Hand Surgery
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