The Journal of hand surgery
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In many academic medical centers, resident physicians typically write initial opioid prescriptions, but little is known about their prescribing practices. We hypothesized that lower resident postgraduate year, residency-training program, and noncompletion of an opioid prescribing training would be factors associated with increased opioid prescribing by orthopedic residents after open reduction and internal fixation of distal radius fractures. ⋯ This study describes the opioid prescribing practices and prior training of orthopedic residents. It highlights an opportunity for increased involvement in educational programs on opioid prescribing that better align with published recommendations/guidelines.
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Treatment of scaphoid nonunion with a segmental defect presents a challenging clinical problem. Various techniques have been proposed, often involving structural grafting with vascularized and nonvascularized bone. The authors hypothesize that satisfactory clinical and radiographic outcomes are possible with a relatively simplified technique of volar plate fixation with autogenous, purely cancellous graft. ⋯ Therapeutic IV.
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Recent studies demonstrated the overprescription of opioids after ambulatory hand surgery in the setting of a national opioid epidemic. Prescriber education has been shown to decrease these practices on a small scale; however, currently no nationally standardized prescriber education or postoperative opioid prescribing guidelines exist. The purpose of this study was to evaluate the effect of prescriber opioid education and postoperative opioid guidelines on prescribing practices after ambulatory hand surgery. ⋯ Therapeutic IV.
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To report the clinical outcomes of elbow flexion reconstruction using a reverse free gracilis muscle flap plus Steindler flexorplasty in patients with previously failed reconstruction of extended upper-type brachial plexus paralysis. ⋯ Therapeutic IV.
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Randomized Controlled Trial
The Effect of the Content of Patient-Reported Outcome Measures on Patient Perceived Empathy and Satisfaction: A Randomized Controlled Trial.
The purpose of this study was to examine whether positively or negatively phrased Patient-Reported Outcome Measures (PROMs) prior to a visit with the hand surgeon affect patient perceived empathy and patient satisfaction (Patient-Reported Experience Measures [PREMs]). ⋯ Given the degree to which PROMs are influenced by psychosocial factors, and prior evidence that PROMs are primed by negatively framed questionnaires, it is reassuring that negatively framed PROMs did not affect PREMs, but more research is merited.