Allograft Prosthetic Composites in Complex Primary and Revision Shoulder and Elbow Arthroplasty.

Substantial bone loss at the time of complex primary and revision shoulder or elbow arthroplasty is challenging. Large bone defects compromise component support and important muscle-tendon units. Megaprosthesis, osteoarticular allografts, vascularized bone transfers, fusions, and allograft prosthetic composites (APCs) have all been described for reconstruction in these difficult situations.

Outcomes of Humeral Allograft-Prosthetic Composites with Plate Fixation in Revision Total Elbow Arthroplasty.

Background: Traditionally, the reconstruction of severe distal humeral bone loss at the time of revision total elbow arthroplasty (TEA) has used allograft-prosthetic composites (APCs) stabilized with cerclage wires or cables. We have migrated to plate fixation when revision TEA using a humeral APC is performed. This study shows the outcomes of patients treated with a humeral APC with plate fixation during revision TEA.

Evaluating the utility of inflammatory markers in the diagnosis of soft tissue abscesses of the forearm and hand.

Upper extremity abscesses frequently present to the acute care setting with inconclusive physical examination and imaging findings. We sought to investigate the diagnostic accuracy of inflammatory markers including white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). A retrospective cohort study was performed to identify subjects  years treated with surgical debridement of upper extremity abscesses at our institution between January 2012 and December 2015.

Virtual surgical planning and mirrored, 3-dimensionally printed guides for corrective clavicle osteotomies in clavicle malunions and nonunions.

Background: The objective of this study was to retrospectively review clinical and radiographic outcomes of patients who underwent corrective osteotomies for clavicle malunion and internal fixation for nonunion using a combination of virtual surgical planning, patient-specific 3-dimensional (3D)-printed clavicles, and 3D-printed cutting guides manufactured at the point of care.

Methods: Between 2015 and 2021, 18 patients underwent corrective osteotomy for a clavicle malunion (7 shoulders) or internal fixation for a clavicle nonunion (11 shoulders). There were 11 male and 7 female individuals with an average patient age of 43.

A bone-conserving revision stem for unstable intertrochanteric fractures of the geriatric osteoporotic population.

Purpose: Primary hemiarthroplasty is gaining popularity for the treatment of unstable intertrochanteric fractures in geriatric patients with severe osteoporosis. This study evaluated early clinical and radiographic outcomes by using a bone-conserving revision stem for unstable intertrochanteric fractures in the geriatric osteoporotic population.

Methods: A retrospective study involving 31 patients with unstable intertrochanteric fractures was conducted.

Unexpected high early failure rate of the Nexel total elbow arthroplasty.

Background: Aseptic loosening, polyethylene wear, and mechanical failure have limited the use of total elbow arthroplasty (TEA) in physically demanding patients. Newer implant designs have been introduced to improve mechanical performance. The purpose of this study was to report the results obtained after implantation of the Nexel TEA.

Venothromboembolism following shoulder arthroscopy: a systematic review.

Background: Venous thromboembolic events (VTEs) following orthopedic surgery may lead to serious morbidity and mortality. Fortunately, VTEs following upper extremity procedures are uncommon. However, the true incidence is likely underreported.

Effectiveness of a patient-specific guide for femoral stem implantation in primary total hip arthroplasty: a randomized control trial.

Purpose: The purpose of the present study was to evaluate the efficacy and feasibility of a novel CT-based patient-specific femoral alignment guide (PSG) as compared with conventional pre-operative planning during THA.

Methods: From March 2020 to September 2020, patients receiving unilateral primary THA were enrolled and randomly allocated to the conventional pre-operative planning group and the PSG group. Primary outcomes were radiographic measurements including lower limb length, femoral offset, femoral anteversion and stem varus/valgus angle, and post-operative perception of leg length discrepancy (LLD).

Radiographic evaluation of vascularity in scaphoid nonunions: A review.

Scaphoid fractures, particularly those that occur more proximally, are unreliable in achieving union due to the retrograde blood supply of the scaphoid bone. Vascular compromise is associated with the development of nonunions and avascular necrosis of the proximal pole. Due to the tenuous blood supply of the scaphoid, it is imperative that the vascularity be assessed when creating diagnostic and treatment strategies.

Chronic Nicotine Exposure Minimally Affects Rat Supraspinatus Tendon Properties and Bone Microstructure.

Cigarette smoking is the largest cause of preventable deaths, and a known risk factor for musculoskeletal issues including rotator cuff tendon tears. Tendon degeneration is believed to be due in part to changes in tendon cell health and collagen structure. Several studies have demonstrated that exposure to nicotine negatively impacts tendon healing, but surprisingly, nicotine exposure was shown to increase rat supraspinatus tendon stiffness.

Epidemiology of Pediatric Nonballistic Firearm Injuries to the Upper Extremity in the United States From 2000 to 2017.

This study aimed to describe the epidemiology of pediatric upper extremity injury secondary to nonballistic firearms in the United States. The National Electronic Injury Surveillance Survey (NEISS) database was queried between 2000 and 2017 for injuries to the upper extremity from nonballistic firearms in patients aged ≤18 years. In total, 1502 unique cases were identified.

American Society for Surgery of the Hand (ASSH) Presidential Address Themes, 1964-2018: Revisiting Our History as We Move Forward.

The American Society for Surgery of the Hand (ASSH) was established in 1946. Since then, important advances have been made in the diagnosis and treatment of conditions affecting the upper extremity. However, there has been little documentation regarding how the largest and oldest society dedicated to hand surgery has evolved over time.

Epidemiology of Fireworks-Related Injuries to the Upper Extremity in the United States From 2011 to 2017.

Purpose: Fireworks may result in a wide spectrum of injury to the upper extremity ranging from mild burns to amputation. In this cross-sectional study, we describe the epidemiology of upper-extremity injuries in the United States associated with fireworks using the Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS).

Methods: The NEISS database was queried between 2011 and 2017 for all injuries of the upper extremity (from shoulder to fingertip) associated with fireworks.

The effects of incremental ulnar styloid osteotomies on distal radioulnar joint stability: a biomechanical cadaveric study.

The purpose of this study was to systematically quantify distal radioulnar joint stability with a cadaveric model, using radiographic and joint contact force measurements. Six fresh-frozen cadavers underwent sequential ulnar styloid osteotomies. Posteroanterior and lateral stress radiographs were obtained and joint contact forces and areas were measured.

Nicotine impairs intra-substance tendon healing after full thickness injury in a rat model.

Nicotine is harmful to many bodily systems; however, the effects of nicotine on intra-substance tendon healing remain largely unexplored. The purpose of this study was to examine the functional, structural, and biomechanical effects of nicotine on the healing of Achilles tendons in rats after an acute full-thickness injury. Sixty Sprague-Dawley rats were enrolled in this study.

The Effect of Computed Tomography Scans Oriented Along the Longitudinal Scaphoid Axis on Measurements of Deformity and Displacement in Scaphoid Fractures.

Purpose: Reformatting computed tomography (CT) scans along the scaphoid longitudinal axis improves the ability to detect scaphoid fractures compared with reformats along the wrist axis. However, it remains unclear whether scaphoid axis reformats affect measurements of displacement or deformity, which are factors that drive the clinical decision to perform open reduction internal fixation. Our null hypothesis was that reformatting CT scans along the scaphoid axis does not affect measurements of fracture displacement and deformity.