The Journal of hand surgery
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To retrospectively review the surgical technique, postoperative therapy/splinting protocols, and clinical and radiographic outcomes of patients who had pyrolytic carbon proximal interphalangeal (PIP) joint arthroplasty. ⋯ Therapeutic, Level IV.
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Computed tomography (CT) can be used to triage suspected scaphoid fractures. This study assessed intraobserver and interobserver reliability and positive and negative predictive values of CT for the diagnosis of a nondisplaced scaphoid fracture. ⋯ Computed tomography should be used with caution for triage of nondisplaced scaphoid fractures because false-positive results occur, perhaps from misinterpretation of vascular foraminae or other normal lines in the scaphoid. Given the relative infrequency of true fractures among patients with suspected scaphoid fractures, CT is better for ruling out a fracture than for ruling one in.
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Outcomes study of distal radius fracture (DRF) treatment has been hampered by an uncertainty regarding the most appropriate outcomes assessment tool to evaluate the effectiveness of treatment. This study aimed to measure the responsiveness of the Michigan Hand Outcomes Questionnaire (MHQ) and physical measurements to assess the value of these outcomes tools for DRF studies. ⋯ Unlike other conditions such as carpal tunnel syndrome, for which the outcomes questionnaire is the most responsive measure, in DRF treatment both the MHQ and physical tests are responsive in measuring outcomes and should be reported for outcomes studies of DRFs. The MHQ and physical tests can be used for outcomes research related to DRF with the advantage of also being useful for assessing and comparing outcomes for other hand disorders.
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Surgical treatment of osteoarthritis of the first carpometacarpal joint aims to achieve complete pain relief with restoration of thumb strength and stability. The aim of this study was to introduce a variation of the abductor pollicis longus (APL) sling arthroplasty and to determine its efficacy in comparison with other tendon sling arthroplasty procedures. ⋯ Therapeutic, Level IV.
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The wealth of medical research published on a yearly basis demands methods to summarize the literature. Narrative or expert reviews were the traditional method to provide this summary; however, biases associated with narrative reviews raise questions regarding whether this process provides sufficient evidence to guide practice. ⋯ Although meta-analysis has its limitations, a thoughtful and well-planned analysis is a valuable tool in providing a high level of evidence. We discuss the steps needed to perform a meta-analysis as a guideline for those interested in pursuing this type of research.