Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hand 89 articles


Weaker Functional Pinch Strength Is Associated With Early Thumb Carpometacarpal Osteoarthritis

Thomas J. McQuillan BA, Deborah Kenney MS, OTR, Joseph J. Crisco PhD, Arnold-Peter Weiss MD, Amy L. Ladd MD

The thumb carpometacarpal (CMC) joint orchestrates pinch in its various positions, and thumb CMC osteoarthritis (OA) is a major source of orthopaedic morbidity. Self-reported pain, weakness, and physical examination may not correspond to radiographic findings when diagnosing early thumb CMC OA. Weakness is a prominent feature of the disease, but little evidence exists to quantify self-reported loss of strength with time, or to compare weakness with that of a nonarthritic population during early disease.

Patients With Thumb Carpometacarpal Arthritis Have Quantifiable Characteristic Expectations That Can Be Measured With a Survey

Lana Kang MD, MSc, Sohaib Z. Hashmi BS, Joseph Nguyen MPH, Steve K. Lee MD, Andrew J. Weiland MD, Carol A. Mancuso MD

Although patient expectations associated with major orthopaedic conditions have shown clinically relevant and variable effects on outcomes, expectations associated with thumb carpometacarpal (CMC) arthritis have not been identified, described, or analyzed before, to our knowledge.

What Is the Radiographic Prevalence of Incidental Kienböck Disease?

Wouter F. Leeuwen MD, Stein J. Janssen MD, Dirk P. Meulen MD, David Ring MD, PhD

Kienböck disease is characterized by osteonecrosis of the lunate. Not all patients with radiographic evidence of the disease experience symptoms bothersome enough to consult a doctor. Little research has been performed on the prevalence of Kienböck disease, and the prevalence in the asymptomatic population is unclear. Knowledge of the natural course of the disease and how often patients are not bothered by the symptoms is important, because it might influence the decision as to whether disease-modifying treatment would be beneficial.

What Is the Impact of Comorbidities on Self-rated Hand Function in Patients With Symptomatic Trapeziometacarpal Arthritis?

Ryan Calfee MD, MSc, Jennifer Chu MD, Amelia Sorensen MD, Erin Martens MD, John Elfar MD

The thumb trapeziometacarpal joint is one of the most common sites of arthritic degeneration prompting specialty care. Surgical treatment algorithms are based on radiographic arthritic progression. However, the pain and disability attributable to trapeziometacarpal arthritis do not correlate with arthritic stage, and depression has independently predicted poorer self-rated hand function both at baseline and after treatment in patients’ atraumatic hand conditions.

Do Patient- and Parent-reported Outcomes Measures for Children With Congenital Hand Differences Capture WHO-ICF Domains?

Joshua M. Adkinson MD, Rebecca S. Bickham BS, Kevin C. Chung MD, MS, Jennifer F. Waljee MD, MS

Patient- and parent-reported outcome measures (PROMs) are increasingly used to evaluate the effectiveness of surgery for congenital hand differences (CHDs). Knowledge of an existing outcome measure’s ability to assess self-reported health, including psychosocial aspects, can inform the future development and application of PROMs for CHD. However, the extent to which measures used among children with CHD align with common, accepted metrics of self-reported disability remains unexplored.

Is Arthroscopic Bone Graft and Fixation for Scaphoid Nonunions Effective?

Ho Jung Kang MD, Yong-Min Chun MD, Il Hyun Koh MD, Jae Han Park MD, Yun Rak Choi MD

Arthroscopic management of scaphoid nonunions has been advanced as a less invasive technique that allows evaluation of associated intrinsic and extrinsic ligamentous injuries; however, few studies have documented the effectiveness of arthroscopic treatment of scaphoid nonunions and which intraarticular pathologies coexist with scaphoid nonunions.

Emergency Department Visits After Hand Surgery Are Common and Usually Related to Pain or Wound Issues

Mariano E. Menendez MD, David Ring MD, PhD

As payment models shift toward a focus on value and reimbursement becomes increasingly tied to quality and patient experience, minimizing unexpected acute health needs has become a priority for both policymakers and clinical leaders. Despite recent emphasis on emergency department (ED) visits as a quality measure in surgery, little is known about the role of the ED in the early postoperative period after hand surgery.

What Is the Most Useful Questionnaire for Measurement of Coping Strategies in Response to Nociception?

Joost T. P. Kortlever BSc, Stein J. Janssen MD, Marijn M. G. Berckel BSc, David Ring MD, PhD, Ana Maria Vranceanu PhD

There are several measures of coping strategies in response to nociception. These measures all correlate highly both with each other and with symptom intensity and magnitude of disability in patients with upper limb illness. This study aims to determine if distinct measures of coping strategies in response to nociception address the same underlying aspect of human illness behavior.

What Middle Phalanx Base Fracture Characteristics are Most Reliable and Useful for Surgical Decision-making?

Stein J. Janssen MD, Jeroen Molleman BSc, Thierry G. Guitton MD, PhD, David Ring MD, PhD

Fracture-dislocations of the proximal interphalangeal joint are vexing because subluxation and articular damage can lead to arthrosis and the treatments are imperfect. Ideally, a surgeon could advise a patient, based on radiographs, when the risk of problems merits operative intervention, but it is unclear if middle phalanx base fracture characteristics are sufficiently reliable to be useful for surgical decision making.

Do Upper Extremity Trauma Patients Have Different Preferences for Shared Decision-making Than Patients With Nontraumatic Conditions?

Michiel G. J. S. Hageman MD, Rajesh Reddy BA, Dennis J. S. Makarawung BSc, Jan Paul Briet MD, C. Niek Dijk MD, PhD, David Ring MD, PhD

Shared decision-making is a combination of expertise, available scientific evidence, and the preferences of the patient and surgeon. Some surgeons contend that patients are less capable of participating in decisions about traumatic conditions than nontraumatic conditions.