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Pediatr Emerg Care 2021 May 18. Epub 2021 May 18.

From the University of Ottawa Divisions of Plastic Surgery Emergency Medicine, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.

Objectives: The aims of this study were to assess emergency department (ED) physician perception of hand injuries and improve their understanding and confidence in treating these injuries.

Methods: Combined didactic and hands-on workshops for ED physicians were developed and run by a team of medical students, plastic surgeons, and ED physicians. The workshops consisted of a short review by a hand surgeon followed by hands-on sessions involving radiograph assessment, administration of local anesthetic, closed reduction, and splinting. Read More

JBJS Case Connect 2021 Jun 11;11(2). Epub 2021 Jun 11.

Schulich School of Medicine and Dentistry, University of Western Ontario, Department of Orthopaedics, London, ON, Canada.

Case: A 29-year-old right-hand dominant woman with thrombocytopenia-absent radii syndrome was surgically treated for a right olecranon fracture. Given her forearm deformity and short lever arm, a custom-modified corrective elbow flexion splint was used during rehabilitation. Radiographic union was achieved. Read More

J Hand Surg Am 2021 Jun 7. Epub 2021 Jun 7.

Department of Orthopaedics, Edinburgh Orthopaedic Trauma Unit, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom.

Purpose: The aim of this study was to identify psychological factors associated with pain intensity and disability following distal radius fracture.

Methods: We prospectively followed 216 adult patients with distal radius fracture for 9 months. Demographics, injury and treatment details, and psychological measures (Hospital Anxiety and Depression Score [HADS], Pain Catastrophizing Scale, Posttraumatic Stress Disorder Checklist-Civilian, Tampa Scale for Kinesiophobia, Illness Perception Questionnaire Brief [IPQB], General Self-Efficacy Scale, and Recovery Locus of Control [RLOC]) were collected at enrollment. Read More

J Hand Surg Am 2021 Jun 7. Epub 2021 Jun 7.

Department of Orthopedic Surgery, Shriners Hospitals for Children, Philadelphia, PA.

Purpose: The purpose of this study was to describe a technique of end-to-end rigid fixation of the distal radius to the proximal ulna. The shortening and radioulnar overlap in this technique yield a high union rate, large corrections, and few complications.

Methods: This retrospective chart review from 2 centers was undertaken in 39 patients (40 forearms) who underwent one-bone forearm operations between 2005 and 2019. Read More

PLoS One 2021 10;16(6):e0252667. Epub 2021 Jun 10.

Department of Orthopaedics and Traumatology, Unit of Hand Surgery, Universidade Federal de São Paulo (Unifesp -EPM), São Paulo, Brazil.

Purpose: For displaced distal radius fracture, this trial aimed to compare an above-elbow (AE) and below-elbow (BE) cast at the end of a 24-week follow-up using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire as a primary outcome.

Methods: This is a clinical trial with parallel groups (1:1) and a blinded evaluator. There are two non-surgical interventions: AE and BE. Read More

Disabil Rehabil 2021 Jun 10:1-10. Epub 2021 Jun 10.

Health & Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand.

Purpose: The study aimed to explore perceptions and experiences about how engaging in daily activities and occupations influenced recovery in the first eight weeks after surgical treatment of a distal radius fracture.

Methods: Twenty-one adults completed an online activity and exercise log then participated in a semi-structured interview between weeks 6 and 8 postoperatively. Interviews were transcribed and analysed using reflexive thematic analysis. Read More

Unfallchirurg 2021 Jun 10. Epub 2021 Jun 10.

Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland.

Background: The goal of surgery for spinal injuries is fracture reduction, fixation and stable healing in a physiological position. Several open and minimally invasive surgical techniques are available.

Objective: The extent of open reduction and the fixation potential achieved by the AOSpine (AT) and Kluger (KT) techniques were compared. Read More

Orthop Surg 2021 Jun 10. Epub 2021 Jun 10.

Department of Orthopaedic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.

Objective: Complex base fractures of the fifth metacarpal bone and dislocation of the fifth carpometacarpal joint are more prone to internal rotation deformity of the little finger sequence after fixation with a transarticular plate. In the past, we have neglected that there is actually a certain angle of external rotation in the hamate surface of transarticular fixation. This study measured the inclination angle of the hamate surface relative to the fifth metacarpal surface for clinical reference. Read More

J Wrist Surg 2021 Jun 22;10(3):229-233. Epub 2021 Jan 22.

Department of Hand and Wrist Surgery, Rothman Orthopaedic Institute, Philadelphia, Pennsylvania.

 Spanning plates are being increasingly used for the treatment of complex fractures of the distal radius. The traditional recommendation is to leave the hardware in place for at least 12 weeks.  This study assesses the comparative outcomes of spanning plates removed at or before 10 weeks. Read More

J Wrist Surg 2021 Jun 23;10(3):216-223. Epub 2021 Jan 23.

Department of Orthopaedic Surgery, Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece.

 Minimally displaced scaphoid fractures can be challenging to diagnose and treat. Cannulated scaphoid screws have made percutaneous stabilization highly effective.  Would minimally invasive operative treatment of minimally displaced scaphoid fractures yield faster return to work when compared with patients treated conservatively? How do functional and patient satisfaction scores compare between the two groups at 12-months follow-up?  Records from 18 patients (mean age 28. Read More

BMC Musculoskelet Disord 2021 Jun 9;22(1):531. Epub 2021 Jun 9.

Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany.

Background: Surgical site infection (SSI) occurs in 3-10 % of patients with surgically treated tibial plateau fractures. This study aimed to evaluate the impact of SSI on patients' outcome after fixation of tibial plateau fractures.

Methods: We conducted a retrospective multicenter study in seven participating level I trauma centers between January 2005 and December 2014. Read More

J Hand Surg Eur Vol 2021 Jun 9:17531934211021521. Epub 2021 Jun 9.

Department of Anatomy, Kocaeli Üniversity, İzmit, Turkey.

We carried out a prospective randomized study to compare the clinical and radiological results of metacarpal diaphyseal fractures treated with retrograde intramedullary headless cannulated screws (IHCS) and plates. Fractures were fixed with IHCS in 34 patients (37 metacarpals) and locked miniplates in 35 patients (40 metacarpals). The mean age was 33 years (range 18-61) in the IHCS group and 32 years (range 17-68) in plate group. Read More

Eur J Orthop Surg Traumatol 2021 Jun 9. Epub 2021 Jun 9.

Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, 301 E 17th Street, Suite 1402, New York, NY, 10003, USA.

Introduction: The purpose of this study is to compare patient outcomes between the Equinoxe® (Exactech, Gainesville, Fla) proximal humerus locking plate and the PHILOS® (Synthes, Paoli, PA) proximal humerus locking plate.

Methods: Two hundred and seventy-one patients with a displaced proximal humerus fracture presented to our academic medical center between February 2003 and October 2020. Functional outcomes assessed included the Disabilities of the Arm, Shoulder, and Hand questionnaire and shoulder range of motion. Read More

Hand (N Y) 2021 Jun 9:15589447211017239. Epub 2021 Jun 9.

Brigham and Women's Hospital, Boston, MA, USA.

Background: The purpose of this study was to evaluate the impact of pronator quadratus (PQ) repair on reoperation rates after distal radius open reduction internal fixation (ORIF) using a volar locking plate.

Methods: A retrospective study of all patients undergoing distal radius ORIF with a volar locking plate between January 2012 and December 2016 at 2 urban, academic level I trauma centers was performed. Patient demographics, fracture and procedure characteristics, surgeon subspecialty, PQ repair, and reoperations were recorded. Read More

Hand (N Y) 2021 Jun 9:15589447211017224. Epub 2021 Jun 9.

Columbia University Irving Medical Center, New York, NY, USA.

Background: Unstable extra-articular proximal phalanx fractures are common injuries to the hand that are often treated by closed reduction and percutaneous pinning. Fracture-induced shortening of the proximal phalanx leads to an extensor lag at the proximal interphalangeal joint. We describe a biomechanical study in cadaver hands to compare the ability of each of three different pin configurations to resist shortening in unstable fractures. Read More

Case Reports Plast Surg Hand Surg 2021 May 19;8(1):76-80. Epub 2021 May 19.

Department of Hand Surgery and Microsurgery, Azienda Ospedaliero Universitaria Modena, Modena, Italy.

Complete dislocations of the trapezoid are very uncommon injuries. The authors present a case of open palmar trapezoid fracture-dislocation with significant displacement of the fracture, acute carpal tunnel syndrome and other concomitant carpometacarpal injuries. A review of the literature search for palmar trapezoid dislocations and treatments was performed. Read More

Case Reports Plast Surg Hand Surg 2021 May 19;8(1):72-75. Epub 2021 May 19.

Plastic Surgery, The Royal London Hospital, London, UK.

The mechanism for growth plate fusion is not fully understood yet. We present the first reported Seymour fracture (Salter Harris I) in an adult with failed growth plate fusion. The management of Seymour fractures should be according to radiological bone age rather than actual age. Read More

Spine (Phila Pa 1976) 2021 Jul;46(13):E743-E749

Department of Orthopedics, Trauma Surgery and Hand Unit, Helios Klinikum Krefeld, Krefeld, Germany.

Study Design: Case report and literature review.

Objective: We present a case of a pathologic unstable fracture of the odontoid process due to vertebral osseous sarcoidosis. The surgical management of this unreported pathology is described and a review of the literature is given. Read More

Clin Orthop Relat Res 2021 06 8. Epub 2021 Jun 8.

D. Zhang, B. Earp, Hand and Upper Extremity Surgery, Brigham and Women's Hospital, Boston, MA, USA.

Background: Medial clavicle fractures are uncommon, occurring in older and multiply injured patients. The management of these fractures and the factors that predispose toward poor outcomes are controversial. Furthermore, the functional outcomes of treatment are not well characterized or correlated with fracture patterns. Read More

Ann Plast Surg 2021 Jun;86(6S Suppl 5):S470-S472

College of Medicine, Medical University of South Carolina.

Purpose: The purpose of our study was to compare postoperative outcomes between patients receiving closed reduction percutaneous pinning (CRPP) to open reduction internal fixation (ORIF) following metacarpal and phalanx fractures.

Methods: A retrospective chart review was performed at a single academic center for all patients suffering a metacarpal or phalanx fracture and receiving either CRPP or ORIF between 2012 and 2018. Patients were divided into fracture mechanism, high-energy mechanism of injury, low-energy mechanism of injury, or unknown, and treatment of fracture with either ORIF or CRPP. Read More

Hand (N Y) 2021 Jun 8:15589447211014623. Epub 2021 Jun 8.

Australian Research Collaboration on the Hand, Mudgeeraba, QLD, Australia.

Intra-articular fracture dislocations of the base of the middle phalanx are complex and debilitating injuries that present a management conundrum when nonreconstructable. Hemi-hamate arthroplasty (HHA) is a treatment modality of particular use in the setting of highly comminuted fractures. This systematic review aims to summarize the reported outcomes of HHA in this context. Read More

J Elder Abuse Negl 2021 Jun 6:1-9. Epub 2021 Jun 6.

The Orthopedics B Department, Hillel Yaffe Medical Center, Hadera, Israel Hillel Yaffe Medical Center, Hadera, Israel.

Searching for clinical manifestations of elder abuse may help healthcare professionals identify cases of elder abuse. The aim of the present study was to explore characteristics of older patients with fractures that increase the likelihood that the fracture was associated with abuse. This is a retrospective chart review study of 1,000 patients aged 65 and older who presented to an emergency department in northern-central Israel with a fracture during 2019. Read More

Cureus 2021 May 1;13(5):e14793. Epub 2021 May 1.

Orthopedic Surgery, Mayo Clinic, Jacksonville, USA.

A 28-year-old man presented to our clinic with persistent left wrist pain. Three months earlier, he had fallen on an outstretched hand while snowboarding. Initial radiographs showed no fractures or dislocations; however, magnetic resonance imaging revealed evidence of a dorsal projection from the scaphoid waist. Read More

Clin Orthop Surg 2021 Jun 1;13(2):252-260. Epub 2021 Apr 1.

Department of Orthopedic Surgery, Regional Rheumatoid and Degenerative Arthritis Center, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea.

Backgroud: We hypothesized that concurrent temporary fixation of scapholunate ligament (SL) injury during volar locking plate (VLP) fixation of distal radius fractures (DRFs) would improve restoration outcomes based on both radiological and clinical results. Here, we performed a prospective, comparative study investigating the effectiveness of temporary percutaneous reduction/pinning during VLP fixation in DRFs.

Methods: The first 43 consecutive SL injuries were treated concurrently after VLP fixation by closed pinning (group 1); the next 36 consecutive injuries were treated nonoperatively (group 2). Read More

J Pain Res 2021 27;14:1457-1464. Epub 2021 May 27.

Department of Hand Surgery, Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou, Fujian, 350004, People's Republic of China.

Background: Bone loss at the metacarpophalangeal joint (MCP) after trauma is difficult to treat.

Objective: We aimed to investigate the effectiveness of Swanson's arthroplasty and the reason for implant fracture.

Methods: We retrospectively analyzed the data of 175 patients who underwent emergency MCP arthroplasty between 2013 and 2016. Read More

J Hand Surg Eur Vol 2021 Jun 6:17531934211021042. Epub 2021 Jun 6.

Department of Trauma Surgery, Maasstad Hospital, Rotterdam, The Netherlands.

The aim of this study was to compare extra-articular radiographic parameters of distal radial fractures measured on plain radiographs and CT scans. Two researchers independently measured four extra-articular radiographic parameters (dorsal tilt, carpal alignment, radial inclination and ulnar variance) on both radiographs and CT scans in 85 patients. Inter-observer reliability for both techniques was assessed, along with the agreement between CT scans and radiographs using the intraclass correlation coefficient and Bland-Altman plots. Read More

Eur J Orthop Surg Traumatol 2021 Jun 5. Epub 2021 Jun 5.

Department of Traumatology and Hand Surgery, St. Vincentius Clinic, Teaching Hospital Albert-Ludwigs-University Freiburg, Karlsruhe, Germany.

Background: Locked dislocations of the glenohumeral joint are disabling and often painful conditions and the treatment is challenging. This study evaluates the functional outcome and the different prosthetic treatment options for chronic locked dislocations of the glenohumeral joint and a subclassification is proposed.

Methods: In this single-center retrospective case series, all patients with a chronic locked dislocation treated surgically during a four-year period were analyzed. Read More

Medicine (Baltimore) 2021 Jun;100(22):e26235

Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

Rationale: Degloving foot injuries are challenging to treat and associated with life-long sequelae for patients. An appropriate debridement of ischemic soft tissues with maximal preservation of glabrous skin is key during the reconstruction of these injuries. Indocyanine green (ICG) fluorescence angiography is an established technique for the intraoperative evaluation of tissue perfusion. Read More

Oper Orthop Traumatol 2021 Jun 3. Epub 2021 Jun 3.

Klinik und Poliklinik für Unfall‑, Hand- und Wiederherstellungschirurgie - Operative Notaufnahme, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen, Rudolf-Buchheim-Str. 7, 35392, Gießen, Deutschland.

Objective: Anatomical reduction of dislocated fractures using an angle-stable hook plate. Surgical revision of symptomatic nonunions with the aim of bone regeneration.

Indications: Dislocated fractures of the ulnar styloid process with involvement of the ulnar fovea. Read More

Orthop Surg 2021 May 25. Epub 2021 May 25.

Department of Orthopaedic, China-Japan Friendship Hospital, Beijing, China.

Objective: To assess whether low grip strength (GS) is associated with clinical outcomes after total hip arthroplasty (THA).

Methods: A prospective case-control study was designed to assess 231 cases of primary THA between January 1, 2015 to May 1, 2018, at an urban tertiary care hospital. Patients were placed into two cohorts based on preoperative GS levels. Read More