The Journal of hand surgery
-
Although clinical outcomes of peripheral nerve injuries are often suboptimal, an adherence to well-established basic principles of evaluation and repair can optimize results of even the most complex injuries. Proper assessment of injury patterns both preoperatively and intraoperatively can guide treatment, and multiple repair techniques including strategies for overcoming both small and large gaps offer different advantages and disadvantages. New technologies and ideas address some unsolved problems, but more experience and research is necessary to elucidate fully their roles in the treatment algorithm.
-
Kienböck's disease is considered rare and currently affects fewer than 200,000 people in the United States. Given the inherent challenges associated with researching rare diseases, the intense effort in hand surgery to treat this uncommon disorder may be influenced by publication bias in which positive outcomes are preferentially published. The specific aim of this project was to conduct a systematic review of the literature with the hypothesis that publication bias is present for the treatment of Kienböck's disease. ⋯ The acceptance rate for negative outcomes studies regarding Kienböck's disease is higher than for other surgical disorders. This may indicate a relative decrease in positive outcome bias among published Kienböck's disease studies compared with other surgical disorders. However, the increasing positive outcome rate for published Kienböck's disease studies over time may suggest a trend of increasing publication bias among journals toward Kienböck's disease studies.
-
Kienböck's disease is considered rare and currently affects fewer than 200,000 people in the United States. Given the inherent challenges associated with researching rare diseases, the intense effort in hand surgery to treat this uncommon disorder may be influenced by publication bias in which positive outcomes are preferentially published. The specific aim of this project was to conduct a systematic review of the literature with the hypothesis that publication bias is present for the treatment of Kienböck's disease. ⋯ The acceptance rate for negative outcomes studies regarding Kienböck's disease is higher than for other surgical disorders. This may indicate a relative decrease in positive outcome bias among published Kienböck's disease studies compared with other surgical disorders. However, the increasing positive outcome rate for published Kienböck's disease studies over time may suggest a trend of increasing publication bias among journals toward Kienböck's disease studies.
-
The painful neuroma is an often debilitating sequela of nerve injury about the hand. The exact pathophysiology of this condition is poorly understood. After sharp trauma to a peripheral nerve, as nerve ends try to connect with their end organs and "find" the distal nerve stump, fascicular escape and scarring can lead to the development of a painful neuroma. ⋯ In addition, certain nerves such as the superficial radial nerve are more prone to the development of a painful neuroma. Treatment of neuromas of the hand is important because they can be quite debilitating and painful, often preventing patients from continuing with their normal daily activities. There are a number of approaches to the painful neuroma, and the treatment plan must be tailored to the individual patient.