The Journal of hand surgery
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In growing numbers, patients are using social media platforms as resources to obtain health information and report their experiences in the health care setting. More physicians are making use of these platforms as a means to reach prospective and existing patients, to share information with each other, and to educate the public. In this ever-expanding online dialogue, questions have arisen regarding appropriate conduct of the physician during these interactions. The purpose of this article is to review the laws that govern online communication as they pertain to physician presence in this forum and to discuss appropriate ethical and professional behavior in this setting.
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To assess long-term functional outcome after ulnar head excision for distal radioulnar joint dysfunction with prior or concomitant wrist trauma. We hypothesized that long-term outcomes would reflect good functional results with satisfactory pain relief. ⋯ The Darrach procedure provides reliably good long-term subjective and objective results for the treatment of a symptomatic DRUJ after a distal radius fracture. Patients can expect to have excellent forearm range of motion at long-term follow-up. Nearly one-half of patients had dynamic convergence of the DRUJ when stressed radiographically; however, the presence of radiographic dynamic convergence did not influence clinical outcomes.
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To investigate the dynamic stabilizing effect of the extensor carpi ulnaris (ECU) on the distal radioulnar joint (DRUJ) and the ulnocarpal joint in a simulated model of triangular fibrocartilage complex (TFCC) injury. ⋯ Maintaining the ECU and its subsheath may reduce DRUJ instability in patients with TFCC injuries.
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Variable-angle volar locked constructs for distal radius fractures are a recent treatment addition. This study sought to biomechanically evaluate a variable-angle volar locking plate as compared with a fixed-angle construct. ⋯ Variable-angle constructs could be expected to hold up to standard loads in the postoperative period as well as traditional fixed-angle devices. The additional cost associated with variable-angle constructs may be warranted when treating distal radius fractures with radial styloid fragments, owing to the fragment-specific fixation allowed by customized screw placement.
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Comparative Study
Results after radioscapholunate arthrodesis with or without resection of the distal scaphoid pole.
To evaluate the differences between radioscapholunate (RSL) arthrodesis alone versus RSL arthrodesis with additional distal scaphoidectomy. ⋯ Additional distal scaphoidectomy with RSL arthrodesis seems to improve postoperative radial deviation of the wrist. The radioscaphoid nonunion rate is high with RSL arthrodesis alone. Distal scaphoidectomy appeared to increase the successful fusion rate of RSL arthrodeses. No significant effect on wrist extension, flexion, ulnar deviation, pain level, restriction in activities of daily living, or grip strength was noted.