Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hand 89 articles


Percutaneous Release, Open Surgery, or Corticosteroid Injection, Which Is the Best Treatment Method for Trigger Digits?

Jia Wang MD, PhD, Jia-Guo Zhao MD, Cong-Cong Liang MD

Percutaneous A1 pulley release surgery for trigger digit (finger or thumb) has gained popularity in recent decades. Although many studies have reported the failure rate and complications of percutaneous release for trigger digit, the best treatment for trigger digit remains unclear.

The Role of Arthroscopy in Trapeziometacarpal Arthritis

David Joseph Slutsky MD

Trapeziometacarpal (TM) arthroscopy should be viewed as a useful minimally invasive adjunctive technique rather than the operation itself since it allows one to visualize the joint surface under high-power magnification with minimal disruption of the important ligamentous complex. Relatively few articles describe the arthroscopic treatment of TM osteoarthritis (OA) and the arthroscopic anatomy of the TM joint. There is lingering confusion as to whether soft tissue interposition and K-wire fixation of the joint are needed and whether the outcomes of arthroscopic procedures compare to the more standard open techniques for TM arthroplasty.

Endoscopic Carpal Tunnel Release Is Preferred Over Mini-open Despite Similar Outcome: A Randomized Trial

Ho Jung Kang MD, PhD, Il Hyun Koh MD, Tae Jin Lee MD, Yun Rak Choi MD, PhD

The decision to perform endoscopic versus the mini-open carpal tunnel release technique is most likely left to surgeons rather than patients with idiopathic carpal tunnel syndrome.

Ultrasound as a First-line Test in the Diagnosis of Carpal Tunnel Syndrome: A Cost-effectiveness Analysis

John R. Fowler MD, Mitchell G. Maltenfort PhD, Asif M. Ilyas MD

The American Academy of Orthopaedic Surgeons (AAOS) recommends that surgeons obtain a confirmatory test in patients for whom carpal tunnel surgery is being considered. The AAOS, however, does not specify a preferred test. Ultrasound reportedly causes less patient discomfort and takes less time to perform, while maintaining comparable sensitivity and specificity to electrodiagnostic testing (EDX).

Radiographic Features Associated With Differing Impinging Hip Morphologies With Special Attention to Coxa Profunda

Gregory Boone BS, Michael R. Pagnotto MD, Justin A. Walker MD, Robert T. Trousdale MD, Rafael J. Sierra MD

Combined with clinical examination and MRI, radiographs have been mainstays in the management femoroacetabular impingement (FAI). Because hip morphology often portends intraoperative damage, radiographic features should inform surgical management.

Surface Treatment of Flexor Tendon Autograft and Allograft Decreases Adhesion Without an Effect of Graft Cellularity: A Pilot Study

Furkan E. Karabekmez MD, Chunfeng Zhao MD

Flexor tendon grafting is often required to reconstruct a failed tendon repair. Previous reports have demonstrated flexor grafts coated with lubricants such as carbodiimide derivatized hyaluronic acid (cd-HA) decrease adhesion formation and improve digit function. However, whether this surface modification would affect graft adhesion and cellularity is unknown.

Correspondence of Patient Word Choice with Psychologic Factors in Patients With Upper Extremity Illness

Arjan G. J. Bot MD, Ana-Maria Vranceanu PhD, James H. Herndon MD, MBA, David C. Ring MD, PhD

Studies of patients with back pain, cancer, and in a general medical practice note that the use of certain phrases by a patient when communicating with their health provider can indicate greater disability and distress than expected for patients with a given disorder. However, it is unclear whether such phrases apply to patients with hand and arm disorders.

Clinical and Radiographic Factors Associated With Distal Radioulnar Joint Instability in Distal Radius Fractures

Bong Cheol Kwon MD, PhD, Bo Kyung Seo MD, Hyoung-June Im MD, Goo Hyun Baek MD, PhD

Distal radioulnar joint (DRUJ) instability is an important cause of ulnar-sided wrist pain in distal radius fractures. However, instability is frequently undiagnosed and the clinical and radiographic factors associated with instability are not well understood.

Peripheral Triangular Fibrocartilage Complex Tears Cause Ulnocarpal Instability: A Biomechanical Pilot Study

Christopher J. Dy MD, MSPH, E. Anne Ouellette MD, MBA, Anna-Lena H. Makowski HTL, Edward Milne BSc, Loren L. Latta PE, PhD

Instability at the ulnocarpal joint has many causes, but the common thread among these causes is the presence of abnormalities in the triangular fibrocartilage complex (TFCC). However, the biomechanical consequences at the ulnocarpal joint after detachment of the TFCC from the ulnar styloid are not clearly defined. Better delineation of whether peripheral TFCC detachments cause ulnocarpal instability will help to design surgical treatments.

Quantitative 3D-CT Anatomy of Hamate Osteoarticular Autograft for Reconstruction of the Middle Phalanx Base

Paul Berg MSc, David Ring MD, PhD

Hamate osteoarticular autografts are difficult to obtain and it is unclear to what degree the graft matches the joint surface to be replaced and whether a direct ulnar approach might provide a more reliable graft than the standard proximal to distal approach.