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Find video protocols related to scientific articles indexed in Pubmed.
Emerging multidrug resistance of methicillin-resistant Staphylococcus aureus in hand infections.
J Bone Joint Surg Am
PUBLISHED: 09-19-2014
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Methicillin-resistant Staphylococcus aureus has been the most commonly identified pathogen in hand infections at urban centers, but the evolving antibiotic sensitivity profiles of methicillin-resistant Staphylococcus aureus are not known. The purposes of this study are to determine if multidrug resistance in methicillin-resistant Staphylococcus aureus is emerging and to provide current recommendations for empiric antibiotic selection for hand infections in endemic regions.
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Does the ulnar nerve enlarge after surgical transposition?
J Ultrasound Med
PUBLISHED: 08-27-2014
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The purpose of this study was to test the hypothesis that symptomatic transposed ulnar nerves have a larger average cross-sectional area (CSA) than symptomatic in situ ulnar nerves.
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Thrower's fracture of the humerus.
Orthop. Clin. North Am.
PUBLISHED: 08-03-2014
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Thrower's fractures are spiral fractures of the humerus caused by forceful throwing of a ball. Although these fractures have been cited in the literature, little research exists regarding the significance of stress fractures and fatigue injuries that may precede these injuries. This article presents 3 cases of middle-aged recreational baseball pitchers who sustained mid to distal third spiral humerus fractures, reviews the biomechanics of a thrower's fracture, and provides a detailed review of the literature to help better understand this condition and guide treatment.
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Interobserver variability in the treatment of little finger metacarpal neck fractures.
J Hand Surg Am
PUBLISHED: 05-15-2014
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To address the null hypothesis that surgeons shown radiographs of little finger metacarpal neck fractures with measured fracture angulation would recommend surgery as often as surgeons shown unmarked radiographs.
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Radiation exposure to hand surgeons' hands: a practical comparison of large and mini C-arm fluoroscopy.
J Hand Surg Am
PUBLISHED: 02-03-2014
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To determine and compare the radiation exposure to surgeons' hands with large and mini C-arm fluoroscopy in a practical, clinically based model.
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Evaluation and medical management of fragility fractures of the upper extremity.
Orthop. Clin. North Am.
PUBLISHED: 01-23-2014
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Osteoporosis continues to be a major health condition plaguing the aging population. The major manifestation of osteoporosis, the development of fragility fractures, is a burden both clinically and economically on patients and the nation's health care system, with up to half of all American women sustaining a fragility fracture in their older years. The high frequency of injuries to the distal radius and proximal humerus should lead upper extremity surgeons to take pause and recognize the magnitude of impact these fractures have on their patient population. Recommended interventions span a spectrum of aggressiveness and have various financial implications.
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Frostbite in an Adolescent Football Player: A Case Report.
J Athl Train
PUBLISHED: 10-23-2013
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Objective :? To present the case of vascular compromise of a finger from a confluent circumferential blister due to an inappropriately applied commercial cold pack in a high school athlete and to describe the mechanism of iatrogenic injury, acute surgical management, rehabilitation, and pathophysiology of frostbite and constriction injuries. Background :? A 17-year-old male football player presented with a frostbite and constriction injury to the index finger secondary to prolonged use of a cooling pack after a mild traumatic injury to the digit. He developed a prolonged sensory deficit from thermal injury, as well as acute vascular compromise requiring urgent operative intervention. Differential Diagnosis :? Frostbite and constriction injury to the index finger. Treatment :? Emergency surgical decompression and occupational therapy. Uniqueness :? Frostbite injuries can occur iatrogenically because of inappropriate use of cooling devices or gel packs. Fingers are commonly injured extremities that are particularly susceptible to frostbite and compression injuries. To our knowledge, no case of vascular compromise from the blister constriction of digits has been reported. Conclusions :? Patients and their caregivers must be educated about how to properly use cooling devices. Clinicians need to fully evaluate patients with iatrogenic frostbite injuries, giving particular attention to neurovascular status, and must recognize and surgically release constriction syndrome to prevent substantial morbidity.
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Intrinsic contracture of the hand: diagnosis and management.
J Am Acad Orthop Surg
PUBLISHED: 10-03-2013
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Intrinsic contracture of the hand may result from trauma, spasticity, ischemia, rheumatologic disorders, or iatrogenic causes. In severe cases, the hand assumes a posture with hyperflexed metacarpophalangeal joints and hyperextended proximal interphalangeal joints as the contracted interossei and lumbrical muscles deform the natural cascade of the fingers. Considerable disability may result because weakness in grip strength, difficulty with grasping larger objects, and troubles with maintenance of hygiene commonly encumber patients. Generally, the diagnosis is made via history and physical examination, but adjunctive imaging, rheumatologic testing, and electromyography may aid in determining the underlying cause or assessing the severity. Nonsurgical management may be appropriate in mild cases and consists of occupational therapy, orthoses, and botulinum toxin injections. The options for surgical management are diverse and dictated by the cause and severity of contracture.
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Evolving incidence of MRSA in urban hand infections.
Orthopedics
PUBLISHED: 06-11-2013
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Methicillin-resistant Staphylococcus aureus (MRSA) is the most commonly cultured bacteria in hand infections. Understanding the most common bacteria involved in hand infections allows appropriate and efficient administration of antibiotics. Delay in treatment may lead to increased morbidity, including stiffness, contracture, and amputation. The purposes of this study are to determine whether the incidence of MRSA in culture-positive hand infections continues to increase and whether MRSA is a risk factor for increased length of stay. Electronic medical records were queried to identify patients admitted to a large, academic urban medical center with the diagnosis of a hand infection between January 1, 2005, and December 31, 2009. Methicillin-resistant S aureus accounted for 220 of the positive cultures over the 5-year study period. Polymicrobial infection represented 81 positive cultures, and MRSA was only present in 10 of these cases. Patients with MRSA were found to have a mean length of hospital stay of 4.1 days compared with 4.5 days in non-MRSA infections. Understanding the most common bacteria involved in hand infections allows appropriate and efficient administration of antibiotics. Methicillin-resistant S aureus is the most commonly cultured bacteria in the hand. However, polymicrobial infections have become increasingly more common. Although incidences of polymicrobial infections increased over the study period in this series, clinical judgment should be exercised before initiating broad-spectrum antibiotic coverage.
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Management of radial nerve palsy following fractures of the humerus.
Orthop. Clin. North Am.
PUBLISHED: 04-24-2013
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Radial nerve palsy is the most common peripheral nerve injury following a humerus fracture, occurring in 2% to 17% of cases. Radial nerve palsies associated with closed humerus fractures have traditionally been treated with observation, with late exploration restricted to cases without spontaneous nerve recovery at 3 to 6 months. Advocates for early exploration believe that late exploration can result in increased muscular atrophy, motor endplate loss, compromised nerve recovery upon delayed repair, and significant interval loss of patient function and livelihood. In contrast, early exploration can hasten nerve injury characterization and repair, and facilitate early fracture stabilization and rehabilitation.
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Prospective evaluation of distal radius fractures treated with variable-angle volar locking plates.
J Hand Surg Am
PUBLISHED: 03-19-2013
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To evaluate the radiographic, objective (range of motion and grip strength), and subjective outcomes of variable-angle volar locking plate (VAVLP) fixation for unstable distal radius fractures.
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Prospective evaluation of pronator quadratus repair following volar plate fixation of distal radius fractures.
J Hand Surg Am
PUBLISHED: 03-07-2013
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To evaluate the efficacy of pronator quadratus (PQ) repair after volar plating of distal radius fractures.
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Epidemiology of adult acute hand infections at an urban medical center.
J Hand Surg Am
PUBLISHED: 02-28-2013
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To define the current epidemiology of adult acute hand infections in an urban setting, with the aim of helping to improve empiric treatment, as hand infections represent a major source of morbidity and can result in stiffness and, possibly, amputation.
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Silicone arthroplasty for chronic proximal interphalangeal joint dislocations.
Tech Hand Up Extrem Surg
PUBLISHED: 11-23-2011
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Chronic dislocations of the proximal interphalangeal (PIP) joint pose a significant treatment challenge. Chronically dislocated PIP joints can experience several changes to the articular cartilage including pressure necrosis, degeneration, and the development of secondary incongruence. Moreover, chronic dislocation allows the edema and hemorrhage from soft tissue trauma to develop into collateral ligament fibrosis and inelastic scar formation. Similarly, chronic dislocations associated with a fracture at the base of the middle phalanx can also experience changes in the form of joint incongruency, bony resorption, or malunion formation. Subsequently, these cumulative joint changes prohibit standard open reduction of the PIP joint and can cause significant loss of motion thereby demanding a different approach to restore motion and minimize pain. We propose the use of silicone arthroplasty in the management of chronic dislocations of the PIP joint.
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Prospective study of distal radial fractures treated with an intramedullary nail.
J Bone Joint Surg Am
PUBLISHED: 09-15-2011
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Intramedullary nailing for the treatment of unstable distal radial fractures is reported to provide stable fixation with minimal soft-tissue complications, but there is a paucity of data documenting the results of this technique. The purpose of this study was to prospectively determine the functional outcomes of treatment of unstable distal radial fractures with an intramedullary nail.
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Classification and treatment of proximal humerus fractures: inter-observer reliability and agreement across imaging modalities and experience.
J Orthop Surg Res
PUBLISHED: 07-29-2011
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Proximal humerus fractures (PHF) are common injuries, but previous studies have documented poor inter-observer reliability in fracture classification. This disparity has been attributed to multiple variables including poor imaging studies and inadequate surgeon experience. The purpose of this study is to evaluate whether inter-observer agreement can be improved with the application of multiple imaging modalities including X-ray, CT, and 3D CT reconstructions, stratified by physician experience, for both classification and treatment of PHFs.
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Proximal row carpectomy with a dorsal capsule interposition flap.
Tech Hand Up Extrem Surg
PUBLISHED: 09-07-2010
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Arthritis of the wrist can be a debilitating condition that presents with progressive pain and loss of motion. A proximal row carpectomy (PRC) is indicated for the management of wrist arthritis and is designed to improve pain while maintaining motion. It involves excision of the scaphoid, lunate, and triquetrum with the formation of a new articulation between the base of the capitate and the lunate fossa of the distal radius. The PRC is a technically straightforward procedure that can produce reliable results. It is contraindicated in cases with midcarpal arthritis and degeneration of the base of the capitate. In addition, there is a question of durability of the new articulation between the capitate and the lunate fossa of the distal radius. The use of interposition tissue can potentially decrease joint contact pressures and improve long-term durability. A PRC technique with the use of an interposition flap based on the dorsal capsule of the distal radius is presented.
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Surgical approaches to the distal radius.
Hand (N Y)
PUBLISHED: 06-22-2010
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Fractures of the distal radius are among the most common fractures seen. They encompass a myriad of presentations and fracture patterns that often benefit from various open reduction and internal fixation techniques-including volar plating, dorsal plating, radial plating, intramedullary nailing, and fragment-specific fixation. In order to obtain optimal reduction of these fractures, surgeons require a thorough understanding of the anatomy and various surgical exposures.
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Variable-angle locking screw volar plating of distal radius fractures.
Hand Clin
PUBLISHED: 06-18-2010
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Surgical treatment options for distal radius fractures are many and commonly involve volar locked plating. More recently, newer volar locking plates have been introduced to the market that allow the placement of independent distal subchondral variable-angle locking screws to better achieve targeted fracture fixation. This article reviews this new technology and presents the authors experience with the Aptus (Medartis, Kennett Square, Pennsylvania) variable-angle volar locking plates.
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Headless compression screw fixation of scaphoid fractures.
Hand Clin
PUBLISHED: 06-18-2010
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Scaphoid fractures carry significant long-term morbidity and short-term socioeconomic difficulty in the young and active patient population in which they most commonly occur. While cast immobilization results in high rates of radiographic union in nondisplaced scaphoid fractures, internal fixation with headless compression screws has been recommended in cases of displaced fractures. Internal fixation has led to high rates of union in both nondisplaced and displaced fractures with the added benefits of earlier mobilization and return to work and sports. Multiple manufacturers are now offering "second generation" headless compression screws for the internal fixation of scaphoid fractures. The few biomechanical studies that exist demonstrate improved compression forces and load to failure for the newer generation of headless compression screws when compared with the first generation headless compression screw, although it is unclear if these differences are clinically significant.
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The accuracy of digital radiography in orthopaedic applications.
Clin. Orthop. Relat. Res.
PUBLISHED: 05-09-2010
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Recent advances in technology and the use of image archiving and communication systems (PACS) has led some institutions to abandon conventional plain film radiography and rely solely on digital computed radiography. The level of accuracy of digital radiography in measuring distances for orthopaedic applications is unclear.
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The sensitivity and specificity of ultrasound for the diagnosis of carpal tunnel syndrome: a meta-analysis.
Clin. Orthop. Relat. Res.
PUBLISHED: 03-24-2010
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Carpal tunnel syndrome (CTS) is the most commonly diagnosed compression neuropathy of the upper extremity. Current AAOS recommendations are to obtain a confirmatory electrodiagnostic test in patients for whom surgery is being considered. Ultrasound has emerged as an alternative confirmatory test for CTS; however, its potential role is limited by lack of adequate data for sensitivity and specificity relative to electrodiagnostic testing.
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The role of locking technology in the upper extremity.
J Hand Microsurg
PUBLISHED: 04-26-2009
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The technique of locked plating has been a major advance in Orthopaedic fracture surgery and has had an equal impact on the management of upper extremity fractures. The recognition of the role of vascularity and soft tissues in fracture healing was central to the research and development of newer plate designs that left minimal footprints on the surface of the bone. Subsequently, innovative locking technology has improved our ability to manage cases with extensive communition, inadequate bone stock, and peri-articular fractures. This paper will review the role of locking technology in the management of fractures of the upper extremity.
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Treatment of distal radius malunions with an intramedullary nail.
Tech Hand Up Extrem Surg
PUBLISHED: 03-12-2009
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Malunion of the distal radius are the most common complications of distal radius fractures. Increased angulation of the distal radius can result in altered load concentrations on the wrist, decreased range of motion, decreased grip strength, and residual incongruence of the radiocarpal and distal radioulnar joints. Multiple options exist for fixation of corrective osteotomies of the distal radius, including intramedullary nails. The use of an intramedullary nail provides the benefits of a percutaneous insertion technique, low-profile implant, load-sharing design, and fixed-angle locking screws in the distal fragment. We describe an innovative technique for intramedullary fixation for corrective osteotomies of extraarticular distal radius malunions.
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Community-acquired methicillin-resistant Staphylococcus aureus infections of the hand: prevalence and timeliness of treatment.
J Hand Surg Am
PUBLISHED: 03-05-2009
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The prevalence of community-acquired methicillin-resistant Staphylococcus aureus (ca-MRSA) appears to be increasing, but the timeliness of appropriate antibiotic delivery is often delayed. We retrospectively reviewed the prevalence of ca-MRSA infections in an urban setting, time from presentation to the hospital to appropriate antibiotic delivery, and differences in length of stay between the ca-MRSA and non-MRSA hand infections.
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Intramedullary fixation of distal radius fractures.
J Hand Surg Am
PUBLISHED: 02-03-2009
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Intramedullary fixation has recently received increased enthusiasm as an option for distal radius fracture fixation. Indications for this fracture fixation technique should be limited to predominately displaced extra-articular or simple intra-articular distal radius fractures. Intramedullary fixation permits limited soft tissue dissection and insertion of a low-profile implant that acts as an internal splint. Purported benefits include a familiar fracture fixation technique, less soft tissue irritation, and locked fixed-angle technology. Thorough understanding of the radial and dorsal approaches to the distal radius is a prerequisite. Important aspects of intramedullary fixation of distal radius fractures include proper fracture selection, good fracture reduction, protection of sensory nerves, and avoidance of inadvertent intra-articular screw placement. Relevant surgical anatomy, technique, postoperative care, and a review of complications are presented.
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Ultrasound as a first-line test in the diagnosis of carpal tunnel syndrome: a cost-effectiveness analysis.
Clin. Orthop. Relat. Res.
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The American Academy of Orthopaedic Surgeons (AAOS) recommends that surgeons obtain a confirmatory test in patients for whom carpal tunnel surgery is being considered. The AAOS, however, does not specify a preferred test. Ultrasound reportedly causes less patient discomfort and takes less time to perform, while maintaining comparable sensitivity and specificity to electrodiagnostic testing (EDX).
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Carpal tunnel syndrome after distal radius fracture.
Orthop. Clin. North Am.
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Carpal tunnel syndrome is a common condition and is a well-recognized phenomenon following a distal radius fracture. The treating surgeon should be vigilant in noticing the signs and symptoms. If acute carpal tunnel syndrome is noted, then surgical release of the carpal tunnel and fracture fixation should be performed urgently. If early carpal tunnel syndrome findings are noted during distal radius fracture management, all potential causes should be evaluated. Delayed carpal tunnel syndrome presenting after a distal radius fracture has healed is best managed in standard fashion. There is no role for prophylactic carpal tunnel release at the time of distal radius fixation in a patient who is asymptomatic.
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Carpal tunnel syndrome in pregnancy.
Orthop. Clin. North Am.
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During pregnancy, hormonal fluctuations, fluid shifts, and musculoskeletal changes predispose women to carpal tunnel syndrome. While the clinical presentation is similar to other patients, the history obtained must include information regarding the pregnancy itself. Currently, the indication for electrodiagnostic testing is not clearly defined. Given that symptoms often improve with conservative treatment and abate after delivery, EMG/NCV testing can often be avoided. However, if symptoms are severe or persist, carpal tunnel release is indicated and is considered a safe procedure for both mother and fetus.
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Ulnar neuropathy following distal humerus fracture fixation.
Orthop. Clin. North Am.
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Ulnar nerve dysfunction is a well-recognized phenomenon following distal humerus fractures. Its fixed anatomic position predisposes the nerve to injury. Injury can occur at the time of injury, during closed-fracture manipulation, intraoperatively during fracture fixation (when it is routinely identified), or during fracture healing. Intraoperative management varies widely and can include in situ decompression or anterior transposition. This article reviews the literature and presents 24 patient cases. A 38% incidence of late ulnar neuropathy following open reduction and internal fixation is identified. There is no statistical difference between an in situ release and all anterior transpositions, except for submuscular.
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Acute carpal tunnel syndrome.
Orthop. Clin. North Am.
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Acute carpal tunnel syndrome is characterized by rapid onset of median neuropathy caused by sudden increases in carpal tunnel pressures, which leads to ischemia of the median nerve. The most common cause is traumatic injury, although atraumatic sources should also be recognized. Patients generally complain of pain, lose two-point discrimination, and may demonstrate elevated compartment pressure on measurement. Prompt recognition and surgical decompression are imperative to spare median nerve viability.
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Treatment of carpal tunnel syndrome by members of the American Society for Surgery of the Hand: a 25-year perspective.
J Hand Surg Am
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In 1987, Duncan et al.(1) reported on a survey of the members of the American Society for the Surgery of the Hand (ASSH) about their practices in treating carpal tunnel syndrome (CTS). To better understand changes in the treatment of CTS over the past 25 years, we repeated the survey while incorporating present-day controversies.
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Is antibiotic prophylaxis necessary in elective soft tissue hand surgery?
Orthopedics
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Antibiotic prophylaxis for clean soft tissue hand surgery is not yet defined. Current literature focuses on overall orthopedic procedures, traumatic hand surgery, and carpal tunnel release. However, a paucity of data exists regarding the role of antibiotic prophylaxis in a broader variety of soft tissue hand procedures. The goal of the current study was to evaluate the rates of surgical site infection following elective soft tissue hand surgery with respect to administration of prophylactic antibiotics.A multicenter, retrospective review was performed on 600 consecutive elective soft tissue hand procedures. Procedures with concomitant implant or incomplete records were excluded. Antibiotic delivery was given at the discretion of the attending surgeon. Patient comorbidities were recorded. Outcomes were measured by the presence of deep or superficial infections within 30 days postoperatively. The 4 most common procedures were carpal tunnel release, trigger finger release, mass excision, and first dorsal compartment release. The overall infection rate was 0.66%. All infections were considered superficial, and none required surgical management. In patients who received antibiotic prophylaxis (n=212), the infection rate was 0.47%. In those who did not receive prophylaxis (n=388), the infection rate was 0.77%. These differences were not statistically significant (P=1.00).
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Ultrasound-guided injections for de Quervains tenosynovitis.
Clin. Orthop. Relat. Res.
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Nonsurgical management of de Quervains tenosynovitis often includes corticosteroid injections. If the injection does not enter the compartment, or all subcompartments, response to the injection is variable. To ensure proper location of injections we evaluated the role of ultrasound.
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Biomechanical analysis of second-generation headless compression screws.
Injury
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Headless Compression Screws (HCS) are commonly utilized for the fixation of small bone and articular fractures. Recently several new second generation HCS (SG-HCS) have been introduced with the purported benefits of improved biomechanical characteristics. We sought to determine and compare the biomechanical efficiencies of these screws.
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Peripheral nerve injuries following gunshot fracture of the humerus.
Orthopedics
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Current best evidence supports observation for peripheral nerve palsies following a fracture of the humerus unless associated with an open fracture. However, the indications for nerve exploration with humerus gunshot fractures are unclear. All patients aged 18 to 89 years who were treated for a gunshot fracture of the humerus at an academic trauma center between 2004 and 2008 were retrospectively reviewed. Patient demographics, fracture characteristics, fracture healing, nerve injury, and intraoperative findings were examined. Twelve patients were identified, of which 6 had nerve palsies at presentation. Three patients had an isolated single nerve palsy, and all recovered spontaneously within 90 days with observation. The other 3 patients had a concomitant brachial artery laceration, and all required a secondary nerve procedure, including 1 primary nerve repair for a near complete transection and 2 re-explorations with neurolysis due to lack of spontaneous recovery by 90 days. Nerve palsies are common after gunshot fractures of the humerus, but nerve transections are uncommon. We observed 1 nerve transection in 12 cases. However, in all 3 cases with a brachial artery injury, a nerve injury required surgical intervention. Subsequently, we recommend continued observation of isolated nerve palsies associated with gunshot fractures of the humerus. However, consider early nerve exploration of palsies when associated with a concomitant vascular injury.
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What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

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We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.