The Journal of hand surgery
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To describe surgical outcomes of a series of patients with bony mallet fingers treated by a modified extension blocking technique with external fixation. ⋯ Therapeutic IV.
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Ulnar impaction syndrome generally occurs with positive ulnar variance. The solution to the problem is to unload the ulnocarpal joint. Effective surgical options include diaphyseal ulnar shortening osteotomy, open wafer osteotomy, and arthroscopic wafer osteotomy. ⋯ The procedure minimizes the risk of hemarthrosis and does not require hardware removal, which are problems with other surgical options. This article introduces a new arthroscopic technique of distal metaphyseal ulnar shortening osteotomy for ulnar impaction syndrome. This technique offers the advantages of minimizing surgical injury to the dorsal capsule of the distal radoulnar joint and so protects its stability.
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The impact of Massachusetts health care reform on the burden of uninsured orthopedic care is unclear. We examined the patient population at an academic orthopedic hand surgery practice based in an inner city, level 1 trauma center as a model. We hypothesized that the percentage of overall encounters with uninsured patients would decrease and that the percentages of overall encounters with privately insured and MassHealth (Medicaid) patients would increase. ⋯ Economic/Decision Analysis IV.