The Journal of hand surgery
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Randomized Controlled Trial
Distal Peripheral Nerve Blocks in the Forearm as an Alternative to Proximal Brachial Plexus Blockade in Patients Undergoing Hand Surgery: A Prospective and Randomized Pilot Study.
Limited data exist regarding the role of perineural blockade of the distal median, ulnar, and radial nerves as a primary anesthetic in patients undergoing hand surgery. We conducted a prospective and randomized pilot study to compare these techniques to brachial plexus blocks as a primary anesthetic in this patient population. ⋯ Therapeutic II.
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To evaluate prolonged opioid use in opioid-naïve patients after common hand surgery procedures in the United States. ⋯ The current national opioid use epidemic requires an assessment of the prevalence of hand surgery patients who receive and fill opioid prescriptions after common hand surgery procedures.
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Comparative Study
Preferences for Shared Decision Making in Older Adult Patients With Orthopedic Hand Conditions.
The practice of medicine is shifting from a paternalistic doctor-patient relationship to a model in which the doctor and patient collaborate to decide optimal treatment. This study aims to determine whether the older orthopedic population desires a shared decision-making approach to care and to identify patient predictors for the preferred type of approach. ⋯ This study quantifies older adults' desire to participate in decision making when choosing among treatments for hand conditions.
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Comparative Study
Regional Ulnar Nerve Strain Following Decompression and Anterior Subcutaneous Transposition in Patients With Cubital Tunnel Syndrome.
Simple decompression and anterior subcutaneous transposition are effective surgical interventions for cubital tunnel syndrome and yield similarly favorable outcomes. However, a substantial proportion of patients demonstrate unsatisfactory outcomes for reasons that remain unclear. We compared effects of decompression and transposition on regional ulnar nerve strain to better understand the biomechanical impacts of each strategy. ⋯ Our data provide insight into how surgery resolves and redistributes traction on the ulnar nerve. These findings may help inform which surgical procedure to perform for a specific patient, guide rehabilitation protocols, and suggest regions of anatomic concern during index and revision surgery.