Hand (New York, N.Y.)
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Background: The purpose of this study was to determine the factors that affect hand surgeon operating room (OR) turnover time. We hypothesized that surgeon presence in the OR, decreased American Society of Anesthesiologists (ASA) class, smaller case type, and earlier case time, as well as other factors, decreased OR turnover time. Methods: A total of 685 hand surgery cases performed by 5 attending hand surgeons between September 2013 and December 2014 were identified. ⋯ Comparison of OR turnover time among the 5 surgeons revealed a statistically significant difference at the OSH but not at the ASC. Conclusion: OR turnover time is significantly affected by surgeon routine, location of surgery, patient ASA class, procedure type, and case order. Interestingly, the effect of hand surgeon routine on OR turnover time may be amplified at an academic OSH versus an ASC.
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Hand (New York, N.Y.) · Mar 2016
Evaluation of Physical Examination Tests for Thumb Basal Joint Osteoarthritis.
We compare the ability of 3 diagnostic tests to reproduce the pain of basilar joint arthritis (BJA): the grind test, the lever test (grasping the first metacarpal just distal to the basal joint and shucking back and forth in radial and ulnar directions), and the metacarpophalangeal extension test. ⋯ The lever test was the diagnostic test that best reproduced the pain caused by thumb basal joint osteoarthritis. We recommend using the lever physical examination test when evaluating the patient with suspected basal joint osteoarthritis. The often-quoted grind test is of limited diagnostic value.
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Hand (New York, N.Y.) · Mar 2016
Assessment of Intra-articular Screw Penetration During Radial Head and Olecranon Locking Plate Fixation: A Cadaveric Study.
The purpose of this study is to evaluate the role of radiographic and clinical exams in predicting screw penetration into the proximal radioulnar joint and ulnohumeral joint during open reduction and internal fixation of the radial head and proximal ulna. ⋯ The study evaluates sensitivity and specificity of clinical and radiographic means when assessing for articular penetration of screws during olecranon and radial head locking plate fixation. Certain screw locations are more difficult to evaluate than others and may go undetected by standard means of assessment used in a surgical setting.
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Hand (New York, N.Y.) · Dec 2015
The use of a single volar locking plate for AO C3-type distal radius fractures.
A single volar locking plate (VLP) is now frequently used for open reduction and internal fixation (ORIF) of many types of distal radius fractures. Comminuted intra-articular distal radius fractures (AO C3-type) are typically the most challenging to surgically treat. No studies directly address the adequacy of a VLP alone for maintaining reduction of AO C-type fractures. We hypothesized that a single VLP provides an effective method for maintaining reduction for these fractures. ⋯ Level IV.
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Hand (New York, N.Y.) · Sep 2015
The role of fracture reduction and plate position in the aetiology of flexor pollicis longus tendon rupture after volar plate fixation of distal radius fractures.
Flexor pollicis longus (FPL) rupture has been described as complication following volar plating for distal radius fractures. It has been hypothesised that this is due to plate prominence. The aim of the study was to investigate the relationship between sub-optimal plate position and fracture reduction on plate prominence. ⋯ The results show a statistically and clinically significant effect of both plate position and fracture reduction on plate prominence and support the theory that both contribute to the aetiology of post-operative FPL rupture.