Hand (New York, N.Y.)
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Hand (New York, N.Y.) · Jul 2019
Performance and Return to Sport After Thumb Ulnar Collateral Ligament Surgery in National Football League Players.
Background: Acute ruptures of the ulnar collateral ligament (UCL) of the thumb are common injuries in sports. Surgical repair of complete tears has yielded excellent results in elite athletes. Methods: National Football League (NFL) players who underwent thumb UCL surgery and matched controls were identified. ⋯ Conclusions: There is a high rate of RTS in the NFL following thumb UCL surgery. Players who underwent thumb UCL surgery played in a similar number of games per season and had similar career lengths in the NFL as controls. No position group had any significant postoperative performance score differences when compared with postindex matched controls.
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Hand (New York, N.Y.) · May 2019
Trends in Upper Extremity Injuries Presenting to US Emergency Departments.
The purpose of this study was to identify the incidence of upper extremity injuries presenting to emergency departments (EDs) nationally. ⋯ Soft tissue contusion was the most frequent diagnosis. More than half of the patients were male, while the majority of patients were under the age of 44. Ninety-three percent of patients did not require hospital admission. Half had private insurance and the two-thirds of these patients were seen at nonteaching facilities.
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Hand (New York, N.Y.) · Mar 2019
Bone Grafting for Scaphoid Nonunions: Is Free Vascularized Bone Grafting Superior for Scaphoid Nonunion?
Nonvascularized bone grafting (NVBG) and vascularized bone grafts (VBGs) have been used to treat scaphoid nonunions. A comparison of a single institution' s experience using structural iliac crest bone graft (ICBG), 1,2-intercompartmental supraretinacular artery (1,2-ICSRA), and medial femoral condyle (MFC) grafts to treat scaphoid nonunions was undertaken. ⋯ These findings demonstrate the need for careful patient selection. In patients with the most complicated scaphoid nonunions (avascular necrosis, carpal collapse, and previous surgeries), the MFC group had the highest union rate and fastest time to union. Patients with risk factors for failure should be counseled on the outcomes and possible need for salvage fusion surgery.
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Hand (New York, N.Y.) · Mar 2019
Regional Variations of Medicare Physician Payments for Hand Surgery Procedures in the United States.
Medicare reimbursement is known to exhibit geographic variation for inpatient orthopedic procedures. This study determined whether US geographic variations also exist for commonly performed hand surgeries. ⋯ In conclusion, further research is warranted to determine why regional or geographic variations in physician payments exist in the United States for commonly performed hand surgeries.
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Hand (New York, N.Y.) · Jan 2019
Thirty-Day Outcomes Following Surgical Decompression of Thoracic Outlet Syndrome.
Surgical thoracic outlet syndrome (TOS) management involves decompression of the neurovascular structures by releasing the anterior and/or middle scalene muscles, resection of the first and/or cervical ribs, or a combination. Various surgical approaches (transaxillary, supraclavicular, infraclavicular, and transthoracic) have been used with varying rates of complications. The purpose of this study was to evaluate early postoperative outcomes following surgical decompression for TOS. We hypothesized that first and/or cervical rib resection would be associated with increased 30-day complications and health care utilization. ⋯ Early postoperative complications are infrequent after TOS decompression. Rib resection is associated with longer surgical times and hospital stays. Future studies are needed to assess the association between early and long-term outcomes, surgical procedure, and health care utilization to determine the cost-effectiveness of the various surgical interventions for TOS.