Expectations and limitations due to brachial plexus injury: a qualitative study
Conclusions
BPI is a life-altering event affecting physical function, mental well-being, financial situation, relationships, self-image, and plans for the future. This study contributes to clinical practice by highlighting topics to address to provide comprehensive BPI patient-centered care. (Source: Hand)
Source: Hand - May 1, 2015 Category: Surgery Source Type: research
Attitudes and self-reported practices of hand surgeons regarding prescription opioid use
Conclusion
Hand surgeons have become aware of the extent and public health implications of the prescription opioid epidemic, and many are taking an active role by reducing their reliance on these drugs. Additional research using pharmacy data is needed to confirm the extent to which hand surgeons’ reliance on prescription opioids is actually decreasing. (Source: Hand)
Source: Hand - May 1, 2015 Category: Surgery Source Type: research
Patients’ preferences regarding the delivery of health care in a hand surgical practice
Conclusions
The results of our study indicate that patients prefer typed information as opposed to e-mail or websites regarding their health care. Our study also suggests that patients are willing to endure longer wait times if they can be given a sooner appointment, and most prefer a specialist for their problems. These results will provide some guidance to the physician regarding what patients find most appealing. (Source: Hand)
Source: Hand - May 1, 2015 Category: Surgery Source Type: research
What factors are associated with a second opioid prescription after treatment of distal radius fractures with a volar locking plate?
Conclusions
One measure of fracture severity (dorsal displacement) was independently associated with a second opioid prescription, but alone it accounted for 3.3 % of the variation. Other factors such as the patient’s expectation prior to surgery, in particular the realization that injury and surgery hurt, might be addressed in future research.
Level of Evidence
Prognostic II (Source: Hand)
Source: Hand - April 30, 2015 Category: Surgery Source Type: research
The use of a single volar locking plate for AO C3-type distal radius fractures
Conclusions
The majority (89.6 %) of AO C3-type fractures treated with a single volar locking plate come to union without loss of reduction.
Level of evidence: Level IV. (Source: Hand)
Source: Hand - April 30, 2015 Category: Surgery Source Type: research
The influence of subluxation on the severity of symptoms, disability, and the results of operative treatment in TMC osteoarthritis with total joint arthroplasty
Conclusions
This study indicates that radial subluxation may not be an important factor in symptoms and function in patients with symptomatic TMC osteoarthritis without severe scaphotrapezio (ST) joint degeneration. In addition, preoperative subluxation seems not to be important for the result after total joint arthroplasty. (Source: Hand)
Source: Hand - April 28, 2015 Category: Surgery Source Type: research
Incidental signal changes in the extensor carpi ulnaris on MRI
Conclusions
ECU signal changes on MRI are common and often asymptomatic. (Source: Hand)
Source: Hand - April 28, 2015 Category: Surgery Source Type: research
Surgeon personality is associated with recommendation for operative treatment
Conclusions
A recommendation for discretionary surgery for musculoskeletal injury was related to surgeon personality. Surgeon self-awareness of how their work style can influence their recommendations might make them more receptive to techniques that ensure patient values have more influence than surgeon preferences on treatment decisions. (Source: Hand)
Source: Hand - April 23, 2015 Category: Surgery Source Type: research
Extraskeletal osteosarcoma of the hand: the role of marginal excision and adjuvant radiation therapy
Conclusion
For extraskeletal osteosarcoma of the hand, we recommend a treatment approach with the goal of preservation of form and function using limb-sparing surgery and planned postoperative radiation. (Source: Hand)
Source: Hand - April 17, 2015 Category: Surgery Source Type: research
Achieving the optimal epinephrine effect in wide awake hand surgery using local anesthesia without a tourniquet
Conclusions
Waiting roughly 30 min after injection of local anesthesia with epinephrine as oppose to the traditionally taught 7 min, achieves an optimal epinephrine effect and vasoconstriction. In the hand, this will result in roughly a threefold reduction in bleeding—making wide awake local anesthesia without tourniquet (WALANT) possible. This knowledge has allowed our team to expand the hand procedures that we can offer using WALANT. The benefits of WALANT hand surgery include reduced cost and waste, improved patient safety, and the ability to perform active intraoperative movement examinations. (Source: Hand)
Source: Hand - April 14, 2015 Category: Surgery Source Type: research
The Cup of Diogenes: a fixed anatomical landmark for carpal tunnel surgery
Discussion
Based on our results, we feel the apex of the Cup of Diogenes is a consistent, fixed anatomical marker for the distal extent of the transverse carpal ligament, marking a safe zone in the palm for surgical planning of incisions.
Level of Evidence
Level V - Therapeutic (Source: Hand)
Source: Hand - April 8, 2015 Category: Surgery Source Type: research
Evolving paradigm in treatment of Merkel cell carcinoma of the digit from ray resection to wide local excision and flap coverage
Conclusion
We suggest that the paradigm of ray amputation of a digit affected by MCC should evolve to initial treatment with a sentinel lymph node biopsy (SLNB) with subsequent local excision with wide margins and local flap coverage. (Source: Hand)
Source: Hand - April 7, 2015 Category: Surgery Source Type: research
Relationship of age on enjoyment of physical activity in upper extremity illness
Conclusions
Enjoyment of physical activity does not decrease with age. Patient-specific expectations, goals and preferences for physical activity should be assessed prior to decision-making on treatment.
Level of Evidence: Level IV, Prognostic Study case series (Source: Hand)
Source: Hand - April 7, 2015 Category: Surgery Source Type: research
Surgical correction of distal radius malunions using an anatomic radial locking plate
Conclusions
Careful mobilization of the branches of the lateral antebrachial cutaneous nerve and the superficial branch of the radial nerve is required. This technique affords the surgeon excellent access to three sides of the radius to help perform this complex surgery. (Source: Hand)
Source: Hand - April 3, 2015 Category: Surgery Source Type: research
Modified brachioradialis wrap for stabilizing the distal radioulnar joint: case report
Abstract
Distal radioulnar joint (DRUJ) stability requires competent static and dynamic soft tissues. Multiple DRUJ techniques have been described in the literature. Our method is a novel modification of the Gupta method of DRUJ stabilization used in a revision reconstruction on a patient with a total wrist arthroplasty. A brachioradialis graft is harvested and tunneled through Parona’s space volar to the pronator quadratus and through the muscle body. The tendon is then brought dorsal between the radius and ulna to the dorsal side of the distal ulna and sutured to the floor of the 5th extensor compartm...
Source: Hand - March 18, 2015 Category: Surgery Source Type: research
