Bony Mallet Finger Malunion: Corrective Osteotomy Technique.

Although many mallet finger injuries are effectively managed with nonoperative treatment, failure to address these bony mallet fingers can lead to complications such as soft tissue imbalances or a bony mallet malunion, ultimately resulting in a chronic mallet injury. As these chronic injuries progress, patients often report considerable functional impairment, pain, and stiffness. Various surgical techniques have been described to treat chronic mallet injuries, but many of them fail to restore DIP extension, particularly in severe cases when patients have bony malunions or hyperlaxity.

Correlation Between GDI Improvements in Cerebral Palsy Patients After Orthopaedic Surgical Interventions and COI Scores.

Introduction: Orthopaedic literature suggests that patients with lower socioeconomic status (SES) have worse perioperative outcomes and higher complication rates after surgical interventions compared with patients with higher SES. Pediatric patients with cerebral palsy (CP) from low SES may be particularly vulnerable. This study aims to determine the relationship between SES as measured by the Child Opportunity Index (COI) and improvements in Gait Deviation Index (GDI) following orthopaedic surgical interventions in pediatric patients with CP.

Surgical Site Infection After Posterior Lumbar Instrumented Fusions.

Minimally invasive surgery (MIS) has shown the potential in reducing surgical site infection (SSI); however, its impact on instrumented lumbar fusion procedures remains unclear. We sought to investigate the difference in SSI rates for open, mini-open, and MIS techniques in patients who underwent posterior lumbar instrumented fusions. We conducted a retrospective review of all patients at a single academic institution who underwent instrumented 1- or 2-level posterior lumbar fusion between January 2019 and June 2022.

Patient Perceptions After Elective, Outpatient Lumbar Spine Surgery: Do Patients Prefer Same Day Discharge or an Overnight Stay?

Study Design: Single-center, survey-based study.

Objective: This study aims to assess patient experiences in ambulatory lumbar spine surgery, with a focus on their expectations and preferences regarding discharge disposition, as well as the impact of discharge timing and alignment with patient preferences on satisfaction and early recovery outcomes.

Summary Of Background Data: While the safety and efficacy of ambulatory spine surgery have been well established, patient perceptions and experiences with these accelerated recovery pathways remain underexplored.

Predictors of Patient Migration for Staged Bilateral Carpal Tunnel Release Procedures.

Purpose: Staged bilateral carpal tunnel release (CTR) is a common surgical treatment for patients with bilateral carpal tunnel syndrome refractory to nonsurgical measures. Factors influencing whether a patient undergoes surgery on both hands by the same or different surgeons are not well characterized. This study aimed to identify patient and clinical factors associated with patient migration during staged bilateral CTR within 90 days of the index procedure.

The State of Telemedicine, Telerehabilitation, and Virtual Care in Musculoskeletal Health: A Narrative Review.

Telemedicine has become an increasingly important component of musculoskeletal care, with recent advances in virtual physical examinations, enhanced patient education, and expanded access to treatment and telerehabilitation. Emerging applications of artificial intelligence, including virtual triaging and remote patient monitoring, promise to further augment telemedicine's effectiveness and scope. Despite limitations and a continued preference for in-person visits among some patients, telemedicine can be a valuable tool for musculoskeletal health practitioners, offering new ways to deliver high-quality, timely, and cost-effective care.

Utility of Preoperative Whole-Body Imaging in Candidates for Lumbar Spine Surgery: The Impact of Concomitant Lower Extremity Osteoarthritis.

Study Design: Retrospective cohort study.

Objective: To assess the utility of whole-body imaging in diagnosing lower extremity osteoarthritis (LEOA), evaluate the association of LEOA with radiculopathy, and determine the impact of LEOA on postoperative recovery.

Summary Of Background Data: Whole-body imaging offers rapid, low-radiation assessment of both spinal and lower extremity pathology.

Development and validation of a novel survey measuring lumbar activity levels: the Hospital for Special Surgery Core Health Evaluation-Lumbar Activity Rating Scale (HSS CHEV-LARS).

Background Content: Preoperative activity level provides a key baseline metric to evaluate postoperative recovery. Preoperative physical therapy also may positively impact length of stay and postoperative mobility after spine surgery. While there are surveys measuring activity levels in other areas of orthopedics (eg knee, shoulder, ankle), there are no such validated surveys in spine surgery.

Zero-Profile Stand-Alone Cages Versus Traditional Cage-and-Plate Constructs in Single and Multi-Level Anterior Cervical Discectomy and Fusion: A Propensity-Matched Analysis Using Validated Fusion Assessment Methods.

ObjectivesStand-alone (SA) and anterior cage-and-plate (ACP) have been studied in anterior cervical discectomy and fusion (ACDF). However, fusion assessment methods vary and existing studies are not propensitymatched and often lack patient-reported outcomes (PROMs). We compare fusion rates between propensity-matched single- and multi-level SA versus ACP using a method validated by intraoperative motion testing during revision surgery.

Spine Surgery Outcomes in Patients With Limited English Proficiency.

Study Design: Retrospective cohort study.

Objective: The purpose of this study is to investigate the impact of language-discordant spine care. Specifically, do non-English speakers (NES) experience (1) increased length of stay? (2) increased rates of complications (ie, intra/perioperative complications, revision surgery, reoperation)?

Background: To provide the best care, there exists a growing focus on understanding which patient groups may be at greater risk for poorer outcomes.

Orthopaedic Consultation is Associated With Fewer Patient-Perceived Barriers to Total Joint Arthroplasty.

Background: Orthopaedic consultations' influence on perceived barriers to total joint arthroplasty (TJA) remains unclear. This study explores how orthopedic consultations are associated with patient perceptions of barriers to TJA.

Methods: We performed a post-hoc analysis of questionnaire responses based on data from a previous study that used semi-structured interviews with patients with advanced osteoarthritis.

High Modified 5 Factor Frailty Index is Associated With Worse PROMs and Decreased Return to Activities After 1 or 2 Level MI-TLIF.

Study DesignRetrospective cohort study.ObjectiveFrailty is defined as a state of minimal "physiologic reserve." The modified 5 factor frailty index (mFI-5) is a recently proposed metric for assessing frailty and has been previously studied as a predictor of morbidity and mortality.

Impact of pedicle screw accuracy on clinical outcomes after 1- or 2-level minimally invasive transforaminal lumbar interbody fusion.

Objective: When creating minimally invasive spine fusion constructs, accurate pedicle screw fixation is essential for biomechanical strength and avoiding complications arising from delicate surrounding structures. As research continues to analyze how to improve accuracy, long-term patient outcomes based on screw accuracy remain understudied. The objective of this study was to analyze long-term patient outcomes based on screw accuracy.

Barriers to Total Joint Arthroplasty: A Comparison of High-Poverty and Low-Poverty Communities.

Objective: Our aim was to determine the most significant barriers to total joint arthroplasty (TJA) for people living in high-poverty communities relative to low-poverty communities.

Methods: We created a 21-question survey based on interviews with underrepresented minority patients with osteoarthritis targeting five barriers to TJA: trust in surgeon, recovery concerns, cost and/or insurance issues, fear of poor surgical outcomes, and timing considerations. Participants rated the importance of each barrier on a 5-point Likert scale, dichotomized into "very or extremely important" and "not as important.

Racial and Ethnic Disparities in Hip Fracture Surgery: A Systematic Review and Meta-Analysis.

Background: Hip fractures are common injuries that result in substantial loss of quality of life to elderly patients. To date, no meta-analyses have been performed to consolidate findings related to racial and ethnic disparities in hip fracture care.

Purpose: We sought to examine associations between racial or ethnic identity and several metrics of hip fracture care.

Racial disparities in prostate cancer in the UK and the USA: similarities, differences and steps forwards.

In the USA, Black men are approximately twice as likely to be diagnosed with and to die of prostate cancer than white men. In the UK, despite Black men having vastly different ancestral contexts and health-care systems from Black men in the USA, the lifetime risk of being diagnosed with prostate cancer is two-to-three times higher among Black British men than among white British men and Black British men are twice as likely to die of prostate cancer as white British men. Examination of racial disparities in prostate cancer in the USA and UK highlights systemic, socio-economic and sociocultural factors that might contribute to these differences.

Impact of preoperative age-adjusted sagittal imbalance on radiographic and clinical outcomes following 1-level minimally invasive transforaminal lumbar interbody fusion for degenerative spondylolisthesis.

Objective: Prior studies investigating the use of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) for treatment of degenerative lumbar conditions and concomitant sagittal deformity have not stratified patients by preoperative pelvic incidence (PI)-lumbar lordosis (LL) mismatch, which is the earliest parameter to deteriorate in mild sagittal deformity. Thus, the aim of the present study was to determine the impact of preoperative PI-LL mismatch on clinical outcomes and sagittal balance restoration among patients undergoing MI-TLIF for degenerative spondylolisthesis (DS).

Methods: Consecutive adult patients undergoing primary 1-level MI-TLIF between April 2017 and April 2022 for DS with ≥ 6 months radiographic follow-up were included.

Contemporary Patterns of Financial Toxicity Among Patients With Rheumatologic Disease in the United States.

Background/objective: Rheumatologic diseases encompass a group of disabling conditions that often require expensive clinical treatments and limit an individual's ability to work and maintain a steady income. The purpose of this study was to evaluate contemporary patterns of financial toxicity among patients with rheumatologic disease and assess for any associated demographic factors.

Methods: The cross-sectional National Health Interview Survey was queried from 2013 to 2018 for patients with rheumatologic disease.

Quality of ChatGPT Responses to Frequently Asked Questions in Carpal Tunnel Release Surgery.

Background: Although demonstrating remarkable promise in other fields, the impact of artificial intelligence (including ChatGPT in hand surgery and medical practice) remains largely undetermined. In this study, we asked ChatGPT frequently asked patient-focused questions surgeons may receive in clinic from patients who have carpel tunnel syndrome (CTS) and evaluated the quality of its output.

Methods: Using ChatGPT, we asked 10 frequently asked questions that hand surgeons may receive in the clinic before carpel tunnel release (CTR) surgery.

Practical Answers to Frequently Asked Questions in Anterior Cervical Spine Surgery for Degenerative Conditions.

Introduction: Surgical counseling enables shared decision making and optimal outcomes by improving patients' understanding about their pathologies, surgical options, and expected outcomes. Here, we aimed to provide practical answers to frequently asked questions (FAQs) from patients undergoing an anterior cervical diskectomy and fusion (ACDF) or cervical disk replacement (CDR) for the treatment of degenerative conditions.

Methods: Patients who underwent primary one-level or two-level ACDF or CDR for the treatment of degenerative conditions with a minimum of 1-year follow-up were included.