The Journal of hand surgery
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Motivation, job satisfaction, burnout, and secondary gain are factors that can influence return to work and disability after orthopedic injuries. The current study evaluated the separate effects of job satisfaction, burnout, and secondary gain on arm-specific disability after a finger injury. ⋯ Worker's compensation and pain were more important than job satisfaction and burnout in explaining variations in arm-specific disability in patients with finger injuries.
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Ulnar-sided carpometacarpal injuries can be difficult to diagnose radiographically. We hypothesized that the resting position of the normal hand during lateral radiography provides a consistent relationship between the rays and that dorsal subluxation of the metacarpal base in fracture-dislocations increases the angle between the uninjured index and long metacarpals and the injured small metacarpal. ⋯ Both the I-S IMA and the L-S IMA were useful screening measurements on lateral hand radiographs for detection of ulnar-sided carpometacarpal fracture-dislocations. When evaluating posttraumatic ulnar-sided hand pain, advanced imaging should be considered if the I-S IMA or the L-S IMA is greater than 10°.
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Perilunate injuries are complex and occasionally go unrecognized acutely. Open reduction and internal fixation is a valid treatment option for these injuries. The purpose of this study was to evaluate the functional outcome of treating chronic perilunate injuries with open reduction and internal fixation. ⋯ Despite late presentation, patients with chronic perilunate injuries can be treated with open reduction internal fixation, with satisfactory results. Patients with lesser arc injuries have less successful outcome. Patients with irreducible dislocations or major articular damage may require wrist salvage procedures.
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Recent emphasis on shared decision making and patient-centered research has increased the importance of patient education and health literacy. The internet is rapidly growing as a source of self-education for patients. However, concern exists over the quality, accuracy, and readability of the information. Our objective was to determine whether the quality, accuracy, and readability of information online about distal radius fractures vary with the search term. ⋯ Physicians, professional societies, and search engines should consider efforts to improve internet access to high-quality information at an understandable level.