Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hand 89 articles


Medical Services and Associated Costs Vary Widely Among Surgeons Treating Patients With Hand Osteoarthritis

Stéphanie J. E. Becker MD, Teun Teunis MD, Johann Blauth PhD, Joost T. P. Kortlever BSc, George S. M. Dyer MD, David Ring MD, PhD

There are substantial variations in medical services that are difficult to explain based on differences in pathophysiology alone. The scale of variation and the number of people affected suggest substantial potential to lower healthcare costs with the reduction of practice variation. Our study assessed practice variation across three affiliated urban sites in one city in the United States and related healthcare costs following the diagnosis of hand osteoarthritis (OA) in patients.

The 2014 ABJS Nicolas Andry Award: The Puzzle of the Thumb: Mobility, Stability, and Demands in Opposition

Amy L. Ladd MD, Joseph J. Crisco PhD, Elisabet Hagert MD, PhD, Jessica Rose PhD, Arnold-Peter C. Weiss MD

The paradoxical demands of stability and mobility reflect the purpose and function of the human thumb. Its functional importance is underscored when a thumb is congenitally absent, injured, or afflicted with degenerative arthritis. Prevailing literature and teaching implicate the unique shape of the thumb carpometacarpal (CMC) joint, as well as its ligament support, applied forces, and repetitive motion, as culprits causing osteoarthritis (OA). Sex, ethnicity, and occupation may predispose individuals to OA.

How Does Ulnar Shortening Osteotomy Influence Morphologic Changes in the Triangular Fibrocartilage Complex?

Yoshiaki Yamanaka MD, Toshiyasu Nakamura MD, PhD, Kazuki Sato MD, PhD, Yoshiaki Toyama MD, PhD

Ulnar shortening osteotomy often is indicated for treatment of injuries to the triangular fibrocartilage complex (TFCC). However, the effect of ulnar shortening osteotomy on the changes in shape of the TFCC is unclear. In our study, quantitative evaluations were performed using MRI to clarify the effect of ulnar shortening on triangular fibrocartilage (TFC) thickness attributable to disc regeneration of the TFC and TFC angle attributable to the suspension effect of ulnar shortening on the TFC.

The PROMIS Physical Function Correlates With the QuickDASH in Patients With Upper Extremity Illness

Celeste L. Overbeek BSc, Sjoerd P. F. T. Nota MD, Prakash Jayakumar MD, Michiel G. Hageman MD, David Ring MD, PhD

To assess disability more efficiently with less burden on the patient, the National Institutes of Health has developed the Patient Reported Outcomes Measurement Information System (PROMIS) Physical Function—an instrument based on item response theory and using computer adaptive testing (CAT). Initially, upper and lower extremity disabilities were not separated and we were curious if the PROMIS Physical Function CAT could measure upper extremity disability and the Quick Disability of Arm, Shoulder and Hand (QuickDASH).

Open versus Endoscopic Carpal Tunnel Release: A Meta-analysis of Randomized Controlled Trials

Eli T. Sayegh BS, Robert J. Strauch MD

Carpal tunnel syndrome is a common compressive neuropathy of the median nerve. The efficacy and safety of endoscopic versus open carpal tunnel release remain controversial.

Prevalence of Triangular Fibrocartilage Complex Abnormalities Regardless of Symptoms Rise With Age: Systematic Review and Pooled Analysis

Jimmy J. Chan BSc, Teun Teunis MD, David Ring MD, PhD

Triangular fibrocartilage complex abnormalities seem to be more common with age, but the degree to which this is so, and the degree to which the presence of an abnormality is associated with symptoms, are topics of controversy.

CORR® ORS Richard A. Brand Award for Outstanding Orthopaedic Research: Engineering Flexor Tendon Repair With Lubricant, Cells, and Cytokines in a Canine Model

Chunfeng Zhao MD, Yasuhiro Ozasa MD, PhD, Ramona L. Reisdorf BS, Andrew R. Thoreson MS, Gregory D. Jay MD, PhD, Kai-Nan An PhD, Peter C. Amadio MD

Adhesions and poor healing are complications of flexor tendon repair.

What is the Minimum Clinically Important Difference in Grip Strength?

Jae Kwang Kim MD, PhD, Min Gyue Park MD, Sung Joon Shin MD

Grip strength reflects functional status of the upper extremity and has been used in many of the clinical studies regarding upper extremity disease or fracture. However, the smallest difference in grip strength that a patient would notice as an improvement resulting from treatment (defined as the minimum clinically important difference [MCID]), to our knowledge has not been determined.

Carpal Tunnel Syndrome Impairs Thumb Opposition and Circumduction Motion

Tamara L. Marquardt BS, Raviraj Nataraj PhD, Peter J. Evans MD, PhD, William H. Seitz MD, Zong-Ming Li PhD

Carpal tunnel syndrome is associated with sensory and motor impairments resulting from the compressed and malfunctioning median nerve. The thumb is critical to hand function, yet the pathokinematics of the thumb associated with carpal tunnel syndrome are not well understood.

When Do Patients With Hand Illness Seek Online Health Consultations and What Do They Ask?

Jan Paul Briet MD, Michiel G. Hageman MD, Robin Blok BSc, David Ring MD, PhD

Several websites allow people to post health questions and get answers from doctors. Knowing more about what patients seek from these websites might help in-office educational efforts, but little is known about what occurs on these sites.