The Journal of hand surgery
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Socioeconomic pressures on medicine have redefined traditional relationships between physicians and patients, researchers and regulatory bodies, and consultants and device companies. Physicians are disheartened that the public perception of medicine, reinforced by the media, is often negative. ⋯ Although both groups have clear codes defining the ethical interaction between them, expediency and loose adherence to those guidelines has been problematic. In a climate of skepticism, the house of medicine needs to reverse and not feed that skepticism.
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Randomized Controlled Trial Comparative Study
Work of flexion related to different suture materials after flexor digitorum profundus and flexor digitorum superficialis tendon repair in zone II: a biomechanical study.
Repair of both flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) tendons is commonly performed in zone II flexor tendon injuries; however, the bulk of the repair may impair tendon gliding. We evaluated whether repairing 1 slip of FDS tendon and resecting the other would significantly decrease work of flexion and whether suture material affected this interaction in an in vitro study. ⋯ Resection of 1 slip of FDS tendon significantly reduces work of flexion in zone II flexor tendon repair. Suture material had no effect on this interaction.
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Review Case Reports Comparative Study
Evidence-based management of acute nondisplaced scaphoid waist fractures.
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Comparative Study
Accuracy of fluoroscopy in closed reduction and percutaneous fixation of simulated Bennett's fracture.
Restoration of joint congruity has been shown to be an important factor in the prevention of arthritis in patients with Bennett's fracture. It is for this reason that surgical management is generally recommended for displaced intra-articular fractures of the base of the thumb metacarpal. Adequacy of closed reduction after pinning of Bennett's fracture is usually evaluated by fluoroscopic examination. The purpose of this study is to determine the accuracy of fluoroscopic examination compared to plain radiographs and direct visualization in closed reduction and percutaneous pin fixation of simulated Bennett's fractures. ⋯ After closed reduction and percutaneous pinning of simulated Bennett's fractures in a cadaver model, the assessment of the articular gap, stepoff, and displacement as detected by fluoroscopy is often in error compared to that detected by plain radiographs and direct examination.
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Radial head arthroplasty has developed into a reliable procedure to address fractures of the radial head not amenable to reconstruction, particularly when associated with an unstable elbow or forearm. Good to excellent results can be anticipated when used for the correct indications and when care is taken to understand and address the concomitant injuries. This article will discuss the technique of radial head arthroplasty in the context of the injuries that often accompany radial head fractures.