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Bone Jt Open 2022 Jul;3(7):529-535

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science (NDORMS), University of Oxford, Oxford, UK.

Aims: Hand trauma accounts for one in five of emergency department attendances, with a UK incidence of over five million injuries/year and 250,000 operations/year. Surgical site infection (SSI) in hand trauma surgery leads to further interventions, poor outcomes, and prolonged recovery, but has been poorly researched. Antimicrobial sutures have been recognized by both the World Health Organization and the National Institute for Clinical Excellence as potentially effective for reducing SSI. Read More

Orthop Rev (Pavia) 2022 6;14(3):32339. Epub 2022 Mar 6.

Emergency Medicine, Lakeland Regional Health Medical Center.

The authors present a case of a triquetrum fracture and pisiform dislocation diagnosed in the emergency department. The patient described wrist pain with no other complaints. However, after a plain radiograph in the emergency department, a minimally displaced avulsion fracture of the triquetrum and subtle pisiform dislocation was detected. Read More

BMC Musculoskelet Disord 2022 Jun 30;23(1):625. Epub 2022 Jun 30.

Department of Microrepair and Reconstruction, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.

Background: The most commonly used approach for distal radius fractures is the traditional Henry approach. However, it requires an intraoperative incision of the pronator quadratus (PQ) muscle, which results in a series of complications if the repair of the PQ fails.

Aim: The objective of this study was to investigate the efficacy of sparing the pronator quadratus for volar plating of the distal radius fractures. Read More

J Hand Surg Am 2022 Jun 24. Epub 2022 Jun 24.

Department of Orthopaedic Surgery, Rothman Orthopaedic Institute - Hand, Wrist, Elbow, & Microvascular Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, Rothman Institute, Philadelphia, PA. Electronic address:

Purpose: The purpose of the study was to compare the efficacy of 6 different commercially available waterproof cast protectors in their ability to maintain a dry environment and evaluate whether cast protectors perform better than a plastic bag secured with tape in keeping casts dry.

Methods: We enrolled 23 adult participants to test 6 different commercially available cast protectors and a plastic bag. Participants trialed all cast protectors twice, with and without motion, by fully submerging each cast protector in water with a paper towel held between their index and middle fingers. Read More

J Clin Orthop Trauma 2022 Jul 16;30:101921. Epub 2022 Jun 16.

MaineGeneral Orthopedics, Augusta, ME, USA.

Introduction: There is increasing evidence that the prescription opioid crisis is spreading internationally. However, there is scarce literature comparing contemporary prescribing practices between units in different countries, particularly in the context of this evolving international problem. We sought to determine the patterns of postoperative opioid prescribing in three hospitals from geographically distinct regions. Read More

Surgeon 2022 Jun 21. Epub 2022 Jun 21.

Department of Orthopaedic, 920th Hospital of Joint Logistics Support Force, Kunming 650032, China. Electronic address:

Scaphoid fracture is the most common carpal fracture, accounting for 50%-80% of all carpal fractures in the Youngers and manual workers. The nonunion rate of scaphoid fractures was approximately 10-15%. Scaphoid nonunion can lead to wrist deformity, wrist collapse, ischemic necrosis, and traumatic osteoarthritis resulting in the loss of wrist function and seriously influence the patients' lives. Read More

Plast Reconstr Surg Glob Open 2022 Jun 20;10(6):e4414. Epub 2022 Jun 20.

Department of Hand-, Plastic, Reconstructive and Burn Surgery, BG Klinik Tübingen, University of Tübingen, Germany.

We report the case of a 62-year-old female patient with a triple-crush radial nerve injury, diagnosed in subsequent order following a fracture of the left humerus. The patient developed flaccid paralysis of all muscles innervated by the left radial nerve except the triceps brachii and reported a sensory deficit corresponding to the innervation territories of the posterior nerve of the forearm as well as the superficial branch of the radial nerve. Following neurolysis of the radial nerve at the humerus level, wrist extension as well as sensory perception on the dorsal aspect of the forearm recovered, but finger extension and thumb abduction were still impossible. Read More

Medicina (Kaunas) 2022 May 30;58(6). Epub 2022 May 30.

Department of Hand Surgery, Balgrist University Hospital, University of Zurich, 8008 Zurich, Switzerland.

: Three-dimensional planning and guided osteotomy utilizing patient-specific instrumentation (PSI) with the contralateral side used as a reference have been proven as effective in the treatment of malunions following complex fractures of the distal radius. However, this approach has not yet been described in relation to fracture reduction of the distal radius. The aim of this study was to assess the technical and logistical feasibility of computer-assisted surgery in a clinical setting using PSI for fracture reduction and fixation. Read More

Adv Orthop 2022 13;2022:5863813. Epub 2022 Jun 13.

Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-San Marco, University of Catania, Catania, Italy.

Background: Proximal humerus fractures (PHFs) are one of the most frequent fractures in the elderly and are the third most fractures after those of the hip and wrist. PHFs are assessed clinically through conventionally standard imaging (X-ray and computed tomography (CT) scans). The present study aims to conduct the diagnostic evaluation and therapeutic efficacy of the 3D-printed models (3DPMs) for the PHFs, compared with the standard imaging. Read More

AIDS 2022 Jun 23. Epub 2022 Jun 23.

Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.

Background: Fracture rates have been reported to be higher among older women living with HIV (WLWH) than HIV- women. Hormone therapy with estrogen can reduce vasomotor symptoms (VMS) associated with menopause and prevent fractures. As data are limited on the benefits of hormone therapy use in WLWH, we examined associations of hormone therapy, use and fractures. Read More

Zhongguo Gu Shang 2022 Jun;35(6):566-71

Sichuan Province Orthopaedics Hospital, Chengdu 610041, Sichuan, China.

Objective: To explore clinical effect of treatment for distal radius Fernandez type Ⅳ fractures by wrist arthroscopy assisted open reduction and volar ligament reconstruction through osseous, internal fixation.

Methods: From January 2018 to December 2019, 11 patients distal radius Fernandez type Ⅳ fractures treated with wrist arthroscopy assisted open reduction and volar ligament reconstruction through osseous, internal fixation, including 8 males and 3 females, aged from 23 to 42 years old. The fracture were all calssified to type Ⅳ according to Fernandez classification. Read More

BMC Musculoskelet Disord 2022 Jun 20;23(1):591. Epub 2022 Jun 20.

Central Laboratory, Second Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei, China.

Background: This retrospective study included an alternative treatment for types A2, A3, and B1 distal radius fractures using percutaneous fixation with a cemented K-wire frame.

Methods: From January 2017 to January 2020, 78 patients with distal radius fractures were treated with percutaneous internal fixation using a cemented K-wire frame. There were 47 male patients and 31 female patients. Read More

Cureus 2022 May 14;14(5):e25001. Epub 2022 May 14.

Internal Medicine/Gastroenterology, Valleywise Health Medical Center, Phoenix, USA.

Introduction Primary biliary cholangitis (PBC) is associated with an increased risk of developing fractures. Current guidelines recommend measures that can help prevent the development of fractures in these patients. The purpose of this study was to trend the rates of hospitalizations related to fractures and their burden on healthcare. Read More

J Bone Metab 2022 May 31;29(2):83-92. Epub 2022 May 31.

Amgen Korea Ltd., Seoul, Korea.

Background: Osteoporosis is a progressive skeletal disease associated with an increased risk of bone fracture. This study aimed to estimate the cost-effectiveness of denosumab for osteoporotic fracture prevention compared to bisphosphonates (alendronate, ibandronate, risedronate, and zoledronate) and selective estrogen receptor modulators (raloxifene) in a cohort of postmenopausal women with osteoporosis.

Methods: A Markov model was used to evaluate the cost and effectiveness of denosumab versus comparators. Read More

Medicine (Baltimore) 2022 Jun 17;101(24):e29479. Epub 2022 Jun 17.

Department of Orthopaedic Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Rationale: Pan-carpal dissociation is very rare injury and there is little information as to diagnosis, treatment, and prognosis of this injury.

Patient Concerns: A 35-year-man presented to our hospital with severe pain and swelling of the left wrist and forearm after slipping and falling while riding a motorcycle.

Diagnosis: The wrist simple radiographs demonstrated unrecognizable severe fracture-dislocation of the carpal bones concomitant with fractures of the radioulnar shaft. Read More

BMC Musculoskelet Disord 2022 Jun 15;23(1):580. Epub 2022 Jun 15.

Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, No. 201, Sec 2, Shi-Pai Road, Taipei, 112, Taiwan, ROC.

Introduction: Fixed-angle plate fixation can be an effective treatment for distal radius fractures (DRFs). However, patients with existing ulnar positive variance might be at risk of developing symptoms of ulnar-sided wrist pain (USWP). Ulnar shortening osteotomy (USO) is one of the main treatment options for USWP. Read More

Acta Orthop Traumatol Turc 2022 May;56(3):199-204

Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Objective: The aims of the study were (1) to compare outcomes in terms of malunited distal radius bone union in open-wedge corrective osteotomy using autogenous or allogenic bone and (2) to introduce a new parameter that quantifies the rate of the bone union.

Methods: This retrospective study included 22 patients (14 males, 8 females) who underwent open-wedge corrective osteotomy with bone grafting for a malunited distal radius fracture between January 2006 and December 2018 were enrolled. The mean follow-up duration was 57. Read More

Osteoporos Int 2022 Jun 15. Epub 2022 Jun 15.

Department of Medicine-Western Health, The University of Melbourne, Melbourne, VIC, Australia.

This study identified the costs and health-related quality of life impacts of several post-fracture multidisciplinary care pathways specific to individual skeletal site (hip, distal forearm, vertebrae, humerus). These care pathways may assist healthcare providers in allocating resources for osteoporotic fractures in more effective and cost-efficient ways.

Introduction: This micro-costing study was undertaken to provide the estimated healthcare costs of several fracture site-specific health service use pathways associated with different trajectories of health-related quality of life (HRQoL) 12-months post-fracture. Read More

Tech Hand Up Extrem Surg 2022 Apr 13. Epub 2022 Apr 13.

Santa Casa de Misericórdia Hospital, Porto Alegre, Brazil.

Nonunion is a rare complication of metacarpal fractures and is usually associated with compound, open fractures with tissue loss and infection, or after failed surgical treatment. Repair by rigid osteosynthesis with plate and screws combined with autologous bone grafting has always been the treatment of choice for most patients. Such method allows early motion, although it has been proven that the presence of hardware may cause local soft tissue irritation. Read More

Acta Ortop Bras 2022 23;30(3):e245185. Epub 2022 May 23.

Universidade Federal do Ceará, Faculty of Medicine, Department of Orthopedics, Fortaleza, CE, Brazil.

Objective: To study epidemiology, fracture pattern, associated injuries, and treatment of individuals with bilateral distal radius fracture, in a tertiary hospital.

Methods: Retrospective cross-sectional study developed based on patients with bilateral distal radius fracture from January 2012 to November 2017. Demographic data, trauma mechanism, radiological patterns, degree of deviation, associated injuries, classification of fractures according to the Association of Osteosynthesis (AO), the Salter-Harris (SH) and Frykman scales, and type of treatment used in each case. Read More

Sci Rep 2022 Jun 10;12(1):9648. Epub 2022 Jun 10.

Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Postoperative immobilization protocols after volar fixed-angle plate fixation of distal radius fractures (DRF) vary among surgeons. This study aimed to compare functional outcomes, radiographic parameters, and complications between early and delayed mobilization after volar fixed-angle plate fixation of DRF. This study is a randomized controlled trial. Read More

Int J Clin Pract 2022 31;2022:6414247. Epub 2022 Jan 31.

Department of Orthopedic Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Background: This study aimed to evaluate the injury mechanism of medial epicondylar fractures in children and adolescents and its association with increased carrying angle (CA) as a predisposing factor.

Materials And Methods: We evaluated 37 patients with medial epicondylar fractures who were surgically treated at our institution. Medical records and plain radiographs were reviewed to determine the mechanism of injury and the humerus-elbow-wrist angle (HEWA) and CA of the uninjured arm. Read More

J Hand Surg Asian Pac Vol 2022 May 27:1-7. Epub 2022 May 27.

Department of Orthopaedic Surgery, Chung-Ang University Hospital, Seoul, South Korea.

Few studies have reported the outcomes of primary volar locking plate fixation in Gustilo and Anderson type II and IIIA open distal radius fractures. We report the outcomes of treatment of Gustilo and Anderson type II and IIIA open distal radius fractures using primary volar locking plate fixation. We retrospectively reviewed 24 patients with open distal radius fractures who were treated using primary volar locking plate fixation. Read More

Sports Health 2022 Jun 7:19417381221099005. Epub 2022 Jun 7.

Department of Orthopaedic Surgery, Brown University Warren Alpert Medical School, Providence, Rhode Island.

Background: Many studies have analyzed gymnastics-related injuries in collegiate and elite athletes, but there is minimal literature analyzing the epidemiological characteristics of injuries in the greater gymnastics community.

Hypothesis: A higher incidence of injuries in younger gymnasts between the ages of 6 and 15 years compared with those 16 years and older and a difference in the distribution of injuries between male and female gymnasts.

Study Design: Retrospective cross-sectional study. Read More

BMC Emerg Med 2022 Jun 7;22(1):101. Epub 2022 Jun 7.

Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea.

Background: We evaluated the accuracy of the prehospital Field Triage Decision Scheme, which has recently been applied in the Korean trauma system, and the factors associated with severe injury and prognosis at a regional trauma center in Korea.

Methods: From 2016 to 2018, prehospital data of injured patients were obtained from the emergency medical services of the national fire agency and matched with trauma outcomes at our institution. Severe injury (Injury Severity Score > 15), overtriage/undertriage rate, positive predictive value, negative predictive value, and accuracy were reviewed according to the triage protocol steps. Read More

J Hand Surg Am 2022 Jun 3. Epub 2022 Jun 3.

Department of Orthopaedic Surgery, Amsterdam University Medical Centre (UMC), Amsterdam, the Netherlands; Department of Orthopaedic and Trauma Surgery, Flinders Medical Centre, Flinders University, Bedford Park, South Australia, Australia. Electronic address:

Purpose: To identify predictors of a true scaphoid fracture among patients with radial wrist pain following acute trauma, train 5 machine learning (ML) algorithms in predicting scaphoid fracture probability, and design a decision rule to initiate advanced imaging in high-risk patients.

Methods: Two prospective cohorts including 422 patients with radial wrist pain following wrist trauma were combined. There were 117 scaphoid fractures (28%) confirmed on computed tomography, magnetic resonance imaging, or radiographs. Read More

Semin Musculoskelet Radiol 2022 Jun 2;26(3):295-313. Epub 2022 Jun 2.

Department of Orthopaedic Surgery, University of Arizona, Tucson, Arizona.

Common indications for surgical procedures of the wrist and hand include acute fractures or fracture-dislocations; nonunited fractures; posttraumatic, degenerative, and inflammatory arthritides and tendinopathies; injuries to tendons, ligaments, and the triangular fibrocartilage complex; and entrapment neuropathies. Soft tissue or osseous infections or masses may also need surgical treatment. Several of these procedures require surgical hardware placement, and most entail clinical follow-up with periodic imaging. Read More

Adv Clin Exp Med 2022 Jun;31(6):701-706

Department of Orthopaedic and Trauma Surgery, Institute of Medical Sciences, University of Opole, Poland.

Background: The optimal duration of cast immobilization following distal radius fractures (DRFs) in elderly patients has not been established.

Objectives: To assess the functional and radiological parameters following DRF treatment in elderly patients using 2 different periods of cast immobilization.

Material And Methods: We assessed 50 patients (33 women and 17 men). Read More

J Hand Surg Am 2022 May 28. Epub 2022 May 28.

Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA. Electronic address:

Purpose: The reduction of distal radius fractures using volar locking plate fixation can be performed by securing the plate to the distal fragments and then levering the plate to the radial shaft. Oblique placement of the plate on the radial shaft may lead to malreduction. The aim of this study was to evaluate parameters that can be used for the assessment of intraoperative distal radius fracture reduction using "distal-first" volar plate fixation, especially the geometry of the ulnar corner. Read More

Bone Joint J 2022 Jun;104-B(6):709-714

Queen Margaret Hospital, Dunfermline, UK.

Aims: The aim of this study was to describe the introduction of a virtual pathway for the management of patients with a suspected fracture of the scaphoid, and to report patient-reported outcome measures (PROMs) and satisfaction following treatment using this service.

Methods: All adult patients who presented with a clinically suspected scaphoid fracture that was not visible on radiographs at the time of presentation during a one-year period were eligible for inclusion in the pathway. Demographic details, findings on examination, and routine four-view radiographs at the time of presentation were collected. Read More