In  Vivo Mechanical Function of the Distal Radial Ulnar Ligaments During Rotation of the Wrist
The purpose of this study was to investigate changes in length of the volar and dorsal radioulnar ligaments (VRULs and DRULs), and the distal radioulnar joint (DRUJ) space during unweighted and weighted rotation of the wrist using magnetic resonance imaging and biplanar fluoroscopy. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - August 12, 2020 Category: Surgery Authors: Matthew M. Crowe, John T. Martin, A. Jordan Grier, Charles E. Spritzer, Marc J. Richard, David S. Ruch Tags: Editor ’s Choice Source Type: research

Forearm Nonunion: Characterization and Management
Adult forearm nonunion should be investigated prior to developing a treatment strategy: “Why did the fracture not heal?” Optimizing the patient’s biology and the stability at the nonunion site are critical for a successful outcome. This review concisely discusses the initial work-up, including history, physical examination, imaging, and laboratory testing, as well as available su rgical techniques—irrigation and debridement with deep cultures, revision open reduction internal fixation with or without biological adjuvant therapies, cancellous autograft, tricortical iliac crest, reamer/irrigator/aspir...
Source: The Journal of Hand Surgery - August 12, 2020 Category: Surgery Authors: Ramesh C. Srinivasan, Russell L. Hutson, Marc J. Richard Tags: Current Concepts Source Type: research

Volar Tilt of the Lunate After Open Reduction Internal Fixation of a Distal Radius Fracture
We report 5 patients who had normal carpal alignment on injury radiographs that developed marked volar angulation of the lunate during recovery from volar plate fixation of a fracture of the distal radius. There were no signs of alteration of the carpal ligaments. Two patients had similar volar tilt on the contralateral side. The cause and optimal treatment of carpal malalignment after restoration distal radial alignment are unclear. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - August 12, 2020 Category: Surgery Authors: Daniel Bakker, Joost T.P. Kortlever, David Ring, Douglas Patterson, David Napoli, Neil G. Harness, Lee M. Reichel Tags: Case Repository Source Type: research

Epidemiology and Treatment of Radial Head Fractures: A Database Analysis of Over 70,000 Inpatient Cases
We aimed to study the epidemiology of radial head fractures within a single national registry database while analyzing trends in available treatments. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - August 11, 2020 Category: Surgery Authors: Alexander Klug, Yves Gramlich, Dennis Wincheringer, Reinhard Hoffmann, Kay Schmidt-Horloh é Tags: Scientific Article Source Type: research

Are Vascularized Periosteal Flaps Useful for the Treatment of Difficult Scaphoid Nonunion in Adults? A Prospective Cohort Study of 32 Patients
To evaluate clinical and radiological outcomes after surgical treatment of difficult scaphoid nonunion in adults with a vascularized thumb metacarpal periosteal pedicled flap (VTMPF). (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - August 6, 2020 Category: Surgery Authors: Sergi Barrera-Ochoa, Lidia-Ana Martin-Dominguez, David Campillo-Recio, Sergi Alabau-Rodriguez, Xavier Mir-Bullo, Francisco Soldado Tags: Editor ’s Choice Source Type: research

The Effect of Distal Radius Fractures on 3-Dimensional Joint Congruency
The objective of this study was to compare joint contact mechanics bilaterally a minimum of 3 years following a distal radius fracture. Our hypothesis was that 3-dimensional joint space would be reduced in individuals following wrist fracture and that these changes in joint load lead to the development of degenerative arthritis. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - August 4, 2020 Category: Surgery Authors: Emily A. Lalone, Joy MacDermid, Graham King, Ruby Grewal Tags: Scientific Article Source Type: research

Outcomes of Botulinum Toxin Injection for Shoulder Internal Rotation Contractures in Infants with Brachial Plexus Birth Injury
Shoulder internal rotation contractures (IRC) are common sequela of brachial plexus birth injuries (BPBI). Botulinum toxin A (BTX-A) injection into targeted muscles has been described to facilitate functional improvement at the shoulder joint and prevent glenohumeral dysplasia. The purpose of this study was to assess the outcomes of BTX-A injections on shoulder IRC in children with BPBI. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - August 2, 2020 Category: Surgery Authors: Avreeta K. Singh, M. Claire Manske, Michelle A. James Tags: Scientific Article Source Type: research

Management of Periprosthetic Joint Infection in Total Elbow Arthroplasty
Periprosthetic joint infection (PJI) is a potentially devastating complication after total elbow arthroplasty (TEA) that can lead to significant morbidity for the patient as well as increased health care –related costs. Despite the potential morbidity associated with TEA PJI, evidence is limited regarding an optimal treatment algorithm. Initial management typically consists of either irrigation and debridement or 2-stage revision. A stable implant, a functioning triceps, and an intact soft tissue envelope are necessary to perform irrigation and debridement. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - August 1, 2020 Category: Surgery Authors: Nitin Goyal, Timothy J. Luchetti, Robert W. Wysocki, Mark S. Cohen Tags: Current Concepts Source Type: research

Hedgehog-Transmitted Trichophyton erinaceid Causing Painful Bullous Tinea Manuum
We describe a case of a 27-year-old healthy man who developed tinea manuum after handling a pet hedgehog. Presenting symptoms included a worsening bullous eruption and severe pain. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - August 1, 2020 Category: Surgery Authors: Amanda L. Walsh, Nelson Merchan, Carl M. Harper Tags: Case Repository Source Type: research

Safety of Releasing the Volar Capsule During Open Treatment of Distal Radius Fractures: An Analysis of the Extrinsic Radiocarpal Ligaments ’ Contribution to Radiocarpal Stability
The contribution of the extrinsic radiocarpal ligaments to carpal stability continues to be studied. Clinically, there is a concern for carpal instability from release of the volar extrinsic ligaments during volar plating of distal radius fractures in which the integrity of the dorsal ligaments may be unknown. The primary hypothesis of this study was that serial sectioning of radiocarpal ligaments would lead to progressive ulnar translation of the carpus. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 31, 2020 Category: Surgery Authors: Lucas A. Suazo Gladwin, Nathan Douglass, Anthony W. Behn, Timothy Thio, David S. Ruch, Robin N. Kamal Tags: Scientific Article Source Type: research

Trapeziometacarpal Joint Arthritis: Is Duration of Symptoms a Predictor of Surgical Outcomes?
Great effort has been placed on determining the optimal surgical treatment for trapeziometacarpal joint arthritis (TMA). However, a paucity of literature exists concerning the optimal timing of surgical intervention. We hypothesized that an increased duration of TMA symptoms before operative intervention would negatively affect surgical outcomes. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 31, 2020 Category: Surgery Authors: Marissa E. Baca, Tamara D. Rozental, Kelly McFarlane, Matthew J. Hall, Peter J. Ostergaard, Carl M. Harper Tags: Scientific Article Source Type: research

A Variant of Madelung Deformity:Management of the Distal Ulna Within the Carpal Canal
Madelung deformity is a rare disease that affects the normal growth of the distal radius and occurs in 1.7% of all pediatric congenital hand deformities. It is characterized by progressive deformity and shortening of the radius at the distal radial physis owing to anomalous tethering of the ulnar-volar growth plate. The distal ulna overgrows the radius and usually displaces dorsally. As growth continues, the carpals assume a wedge shape. Deformity, pain, and functional limitations are the usual presenting problems. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 31, 2020 Category: Surgery Authors: Luisa Burgos, Matthew Walker, Roger A. Daley Tags: Case Repository Source Type: research

The Vascular Anatomy of the Scaphoid: Vascular Illustration and Classification
It was with great interest that I read the recent paper on the vascular anatomy of the scaphoid by Morsy et  al.1 What interested me most was the classification of the intrascaphoid vascular network based on micro-computed tomography imaging. We have done similar studies using the same technique, but with a different contrast agent, and found a more abundant intrascaphoid vascular network.2 (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 30, 2020 Category: Surgery Authors: Ge Xiong Tags: Letter to the Editor Source Type: research

Erratum
In the article by Goldfarb et  al in the June 2020 issue of The Journal of Hand Surgery (“The Oberg-Manske-Tonkin (OMT) Classification of Congenital Upper Extremities: Update for 2020”, Vol. 45, No. 6, p. 542-547), there were formatting issues with section levels in Table 1. In the “III. Dysplasias” section, “C. Cong enital contracture” subsection, the first subcategory should have read “1. Arthrogryposis multiplex congenita”. The three values directly below it should have read “i. Amyoplasia”, “ii. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 30, 2020 Category: Surgery Tags: Erratum Source Type: research

Journal CME Questions
(Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 30, 2020 Category: Surgery Tags: Current Concepts Source Type: research

Masthead
(Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 30, 2020 Category: Surgery Source Type: research

Editorial Board
(Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 30, 2020 Category: Surgery Source Type: research

Table of Contents
(Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 30, 2020 Category: Surgery Source Type: research

Journal CME Instructions
(Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 30, 2020 Category: Surgery Source Type: research

Emergency hand & reconstructive microsurgery in the covid-19 positive patient
The case spectrum in hand surgery is one of extremes – purely elective day surgery cases under local anesthesia to mangling limb injuries that require immediate, and frequently, lengthy, surgery. Despite the cancellation of most elective orthopedic and plastic surgical procedures, hand surgeons around the world continue to see a steady stream of lim b-threatening cases such as severe trauma and infections that require emergent surgical care. With the increase in community-spread, an increasing number of COVID-19 infected patients may be asymptomatic or have mild, non-specific or atypical symptoms. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 29, 2020 Category: Surgery Authors: Soumen Das De, Zhen Chang Liang, Andre Eu-Jin Cheah, Mark Edward Puhaindran, Ellen Yutan Lee, Aymeric Yu Tang Lim, Alphonsus Khin Sze Chong Tags: The Hand Surgery Landscape Source Type: research

Targeted Muscle Reinnervation in the Hand: An Anatomical Feasibility Study for Neuroma Treatment and Prevention
Targeted muscle reinnervation (TMR) has emerged as a treatment for, and prevention of, symptomatic neuromas and has been reported to be of benefit in the hand. Anatomical studies establishing landmarks for consistent identification of the motor entry points (MEPs) to the intrinsic muscles have not been performed. The purpose of this study was to provide details regarding the MEPs to the intrinsic muscles, determine which MEPs are identifiable dorsally, and develop recommended sensory to MEP nerve coaptations for prophylactic TMR at the time of ray amputation or for management of symptomatic neuromas. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 27, 2020 Category: Surgery Authors: Timothy H.F. Daugherty, Brian A. Mailey, Reuben A. Bueno, Michael W. Neumeister Tags: Editor's Choice Source Type: research

Feasibility of Quality Measures for the Diagnosis and Treatment of Carpal Tunnel Syndrome
The American Academy of Orthopaedic Surgeons and the American Society for Surgery of the Hand developed candidate quality measures for potential inclusion in the Merit-Based Incentive Program and National Quality Forum in the hope that hand surgeons could report specialty-specific data. The following measures regarding the management of carpal tunnel syndrome (CTS) were developed using a Delphi consensus process: (1) use of magnetic resonance imaging (MRI) for diagnosis of CTS, (2) use of adjunctive surgical procedures during carpal tunnel release (CTR), and (3) use of formal occupational and/or physical therapy after CTR....
Source: The Journal of Hand Surgery - July 25, 2020 Category: Surgery Authors: Tom J. Crijns, David Ring, Nina Leung, Robin N. Kamal, AAOS and ASSH Carpal Tunnel Quality Measures Workgroup Tags: Editor's Choice Source Type: research

The Influence of Cost Information on Treatment Choice: A Mixed-Methods Study
To test the null hypothesis that exposure to societal cost information does not affect choice of treatment for carpal tunnel syndrome (CTS). (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 25, 2020 Category: Surgery Authors: Thompson Zhuang, Joost T.P. Kortlever, Lauren M. Shapiro, Laurence Baker, Alex H.S. Harris, Robin N. Kamal Tags: Editor ’s Choice Source Type: research

Complications Following Transosseous Repair of Zone I Flexor Tendon Injuries
This study evaluated the clinical complications after a transosseous repair technique. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 25, 2020 Category: Surgery Authors: Michael B. Geary, Katherine K. Li, R. Christopher Chadderdon, R. Glenn Gaston Tags: Scientific Article Source Type: research

Measurement of Scaphoid Bone Microarchitecture: A Computed Tomography Imaging Study and Implications for Screw Placement
The objective of this study was to assess bone density and quality in the proximal and distal scaphoid to determine optimum sites for placement of 2 screws in scaphoid fracture fixation. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 25, 2020 Category: Surgery Authors: Lachlan S. Huntington, Avanthi Mandaleson, Freya Hik, Eugene T.H. Ek, David C. Ackland, Stephen K.Y. Tham Tags: Scientific Article Source Type: research

Single-Bone Forearm as a Salvage Procedure in Recalcitrant Pediatric Forearm Pathologies
To report on the outcome of single-bone forearm reconstruction (SBFR) as a salvage procedure in pediatric forearm pathologies. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 25, 2020 Category: Surgery Authors: Kemble K. Wang, Carley B. Vuillermin, Peter M. Waters Tags: Scientific Article Source Type: research

A Prospective Randomized Trial Comparing the Functional Results of Buddy Taping Versus Closed Reduction and Cast Immobilization in Patients With Fifth Metacarpal Neck Fractures
Although fifth metacarpal neck fractures are typically treated nonsurgically, most often with closed reduction and orthosis immobilization, cast immobilization may not improve outcomes compared with buddy taping without reduction. The aim of this study was to compare functional outcomes of buddy  taping versus reduction and cast immobilization in patients with fifth metacarpal neck fractures. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 25, 2020 Category: Surgery Authors: Natalia Mart ínez-Catalán, Samuel Pajares, Lucia Llanos, Ignacio Mahillo, Emilio Calvo Tags: Scientific article Source Type: research

Use of a Reverse Metacarpal Bone Flap for the Treatment of Segmental Bone Defects of the Proximal Phalanges
The purpose of this retrospective study was to report the results of reconstruction of segmental bone defects of the proximal phalanges using a reverse metacarpal vascularized bone flap harvested from the third metacarpal bone. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 23, 2020 Category: Surgery Authors: Yali Xu, Li Lyu, Xinzhong Shao, Li Wang, Zhemin Zhang, Xu Zhang Tags: Scientific Article Source Type: research

Accuracy and Early Clinical Outcome After 3-Dimensional Correction of Distal Radius Intra-Articular Malunions Using Patient-Specific Instruments
To investigate the residual articular incongruity on computed tomography image data and the early clinical outcome of 3-dimensional planned and navigated intra-articular osteotomies of the distal radius. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 23, 2020 Category: Surgery Authors: Simon Roner, Andreas Schweizer, Yannik Da Silva, Fabio Carrillo, Ladislav Nagy, Philipp F ürnstahl Tags: Editor ’s Choice Source Type: research

Clinical, Radiological, and Electrodiagnostic Diagnosis of Pronator Syndrome Concurrent With Carpal Tunnel Syndrome
This is a retrospective observational study that assessed the prevalence of positive diagnostic imaging and electrodiagnostic (EDX) findings in patients diagnosed with pronator syndrome (PS), who previously had a carpal tunnel syndrome (CTS) surgery. The other purpose of our study was to determine how often PS occurred and was missed in patients treated surgically for CTS. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 22, 2020 Category: Surgery Authors: Ali Özdemir, Mehmet Ali Acar, Ali Güleç, Fatih Durgut, Hakan Cebeci Tags: Scientific Article Source Type: research

Trends in the Management of Traumatic Upper Extremity Amputations
Treatment for upper extremity amputations includes revision amputation or attempted replantation. The rate of digital replantation has been declining in the United States. Prior studies discovered the presence of socioeconomic disparities associated with these injuries. The goals of this study were to investigate yearly trends of traumatic upper extremity amputations and evaluate the presence of disparities with access to care in these injuries. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 19, 2020 Category: Surgery Authors: Etka Kurucan, Caroline Thirukumaran, Warren C. Hammert Tags: Scientific Article Source Type: research

Wrist Fractures in Skiers and Snowboarders: Incidence, Severity, and Risk Factors Over 40 Seasons
To determine and compare the incidence and severity of wrist fractures in skiers and snowboarders. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 19, 2020 Category: Surgery Authors: Noah J. Quinlan, Chad M. Patton, Robert J. Johnson, Bruce D. Beynnon, Adam B. Shafritz Tags: Scientific Article Source Type: research

Development and Testing of a Question Prompt List for Common Hand Conditions: An Exploratory Sequential Mixed-Methods Study
A question prompt list (QPL) is a tool that lists possible questions a patient may want to ask their surgeon. Its purpose is to improve patient-physician communication and increase patient engagement. Although QPLs have been developed in other specialties, one does not exist for hand conditions. We sought to develop a QPL for use in the hand surgery clinic using a mixed-methods design. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 19, 2020 Category: Surgery Authors: Ellen S. Satteson, Allison K. Roe, Sara L. Eppler, Jeffrey Yao, Lauren M. Shapiro, Robin N. Kamal Tags: Scientific Article Source Type: research

Ultrasound-Guided Percutaneous Peripheral Nerve Stimulation for the Treatment of Chronic Intractable Pain Originating From a Lipofibromatous Hamartoma of the Median Nerve
This case report presents an application of peripheral nerve stimulation to the median nerve to treat a patient with intractable pain due to a lipofibromatous hamartoma of the left upper extremity. Ultrahigh-frequency ultrasound was used to determine the boundaries of the hamartoma. The patient then underwent an ultrasound-guided implantation of 2 stimulator electrodes distal to the elbow along the median nerve with stimulation coverage achieved at 1.2 and 1.4 mA, respectively. After an uneventful procedure, the pain score immediately decreased from 9 out of 10 to less than 6 on a numeric rating scale. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 19, 2020 Category: Surgery Authors: Guilherme Ferreira-Dos-Santos, Mark Friedrich B. Hurdle, Sahil Gupta, Salim M. Ghazi, Stephen D. Trigg, Steven R. Clendenen Tags: Case Repository Source Type: research

Biomechanical Evaluation of Distal Radioulnar Joint Instability and Adams Procedure
Distal radioulnar joint (DRUJ) instability may occur after an injury, resulting in pain and reduced strength. When primary repair is not possible or initial fixation has failed, chronic instability may result, requiring a reconstructive procedure such as the Adams procedure. The first purpose of this study was to evaluate the role of the triangular fibrocartilage complex and various components of the interosseous membrane as they were sectioned. The second purpose was to evaluate the Adams procedure in stabilizing the forearm. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 18, 2020 Category: Surgery Authors: Holden D. Heitner, Frederick W. Werner, Salvatore M. Cavallaro, Sarah R. Willsey, Brian J. Harley Tags: Scientific Article Source Type: research

The Reliability of Determining the Presence of Surgical Site Infection Based on Retrospective Chart Review
Surgical site infection (SSI) can be a challenging complication after hand surgery. Retrospective studies often rely on chart review to determine presence of an SSI. The purpose of this study was to assess reliability of Centers for Disease Control and Prevention (CDC) criteria for determining an SSI as applied to a chart review. We hypothesized that interobserver and intraobserver reliability for determining an SSI using these criteria while reviewing medical record documentation would be none to minimal ( κ (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 18, 2020 Category: Surgery Authors: Daniel Seigerman, Kevin Lutsky, Lauren Banner, Daniel Fletcher, Charles Leinberry, Ludovico Lucenti, Pedro Beredjiklian Tags: Scientific Article Source Type: research

Telemedicine After Upper Extremity Surgery: A Prospective Study of Program Implementation
Our purpose was to evaluate the implementation of a postoperative hand and upper extremity telemedicine program. We aimed to compare travel burden, visit time, and patient satisfaction between an initial postoperative telemedicine visit and a second conventional in-clinic visit. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 18, 2020 Category: Surgery Authors: Louis C. Grandizio, Alexander W. Mettler, Morgan E. Caselli, Elizabeth J. Pavis Tags: Editor's Choice Source Type: research

Ultrasonographic Classification of Scapholunate Interosseous Ligament Injury Associated With Distal Radius Fracture
Although scapholunate interosseous ligament (SLIL) injury is often associated with distal radius fracture, it is frequently missed in x-rays. The purpose of this study was to develop a diagnostic classification based on ultrasonography for SLIL injury and evaluate its diagnostic accuracy. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 17, 2020 Category: Surgery Authors: Takahiro Kashiyama, Toshiki Miura, Runa Sugawara, Kosuke Uehara Tags: Scientific Article Source Type: research

Atraumatic, Progressive, and Painful Elbow Contracture From a Ganglion Cyst
We report a case of an elbow joint ganglion cyst in a patient who presented with a painful, progressive elbow contracture. The patient was successfully treated with resection of the subbrachialis ganglion cyst combined with an anterior capsular release and an ulnar nerve decompression to recover elbow motion. This case highlights the value of advanced imaging in patients presenting with an atraumatic, painful, and progressive elbow contracture. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 17, 2020 Category: Surgery Authors: Nitin Goyal, Timothy J. Luchetti, Alan T. Blank, Mark S. Cohen Tags: Case Repository Source Type: research

Measuring Functional Outcomes After Bilateral Vascularized Composite Hand Allotransplantation: A  Report of 3 Cases
Currently, numerous assessment tools are available to measure functional outcomes after bilateral hand transplantation. The purpose of this article is to present our experience utilizing quantitative assessment tools for functional evaluation and to describe our results after bilateral hand transplantation. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 16, 2020 Category: Surgery Authors: Rikesh A. Gandhi, Shaun D. Mendenhall, Gayle Severance, Todd J. Levy, Oded Ben-Amotz, L. Scott Levin Tags: Scientific Article Source Type: research

Enigmatic and Unusual Cases of Upper Extremity Pain: Mislabeling As Malingerers
With the intricate anatomy of the hand and upper extremity, there are many possible etiologies of pain. In addition, one must be alert to conditions typically affecting other areas of the body presenting in the hand and upper extremity. To add to the complexity of diagnosis, one must also be aware of potential secondary gains. With this in mind, a thorough history, physical examination, and broad differential can help avoid mislabeling patients with uncommon ailments. In this article, we present 4 cases of unusual causes of hand and upper extremity pain. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 14, 2020 Category: Surgery Authors: Kayla Nicole Bradburn, Casey Michelle Beleckas, Kathryn Mary Peck, F. Thomas Kaplan, Gregory Alan Merrell Tags: The Hand Surgery Landscape Source Type: research

Measuring and Improving the Quality of Care During Global Outreach Trips: A Primer for Safe and Sustainable Surgery
Trauma is the leading cause of mortality in patients aged 5 years and older. Globally, trauma kills more people than malaria, tuberculosis, and HIV/AIDs combined. As the number of surgical outreach trips to low- and middle-income countries and resources provided for such trips increase, hand surgeons are uniquely positioned to address this global burden. However, the delivery of surgical care alone is insufficient without effectively evaluating the quality of care delivered. It is critical that the care provided on outreach trips improves patient and population health, does not harm patients, and develops the local health ...
Source: The Journal of Hand Surgery - July 14, 2020 Category: Surgery Authors: Lauren M. Shapiro, Global-Quest Investigators Tags: Current Concepts Source Type: research

Rotational stability of scaphoid waist non-union bone graft and fixation techniques
Rotational instability of scaphoid fracture nonunions can lead to persistent nonunion. We hypothesized that a hybrid Russe technique would provide improved rotational stability compared with an instrumented corticocancellous wedge graft in a cadaver model of scaphoid nonunion. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 9, 2020 Category: Surgery Authors: Jacob D. Gire, Timothy Thio, Anthony W. Behn, Robin N. Kamal, Amy L. Ladd Tags: Editor's Choice Source Type: research

Canadian Plastic Surgery Resident Operative Experience in Hand Surgery
This study aimed to determine whether Canadian plastic surgery residents are receiving adequate exposure to CPCs in hand surgery during residency training. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 8, 2020 Category: Surgery Authors: Celine Yeung, Jessica G. Shih, Aaron D.C. Knox, Nick Zhygan, Douglas J. Courtemanche, Joel S. Fish, Mitchell H. Brown, Dimitri Anastakis Tags: Editor's Choice Source Type: research

Outcomes Measurement in Global Hand Surgery
The global burden of musculoskeletal trauma is high. There is a need to improve access to safe, high-quality surgery in many low- and middle-income countries (LMICs). Numerous initiatives have taken aim at solving this underlying shortage in surgical care, including mission trips, academic programs, and international collaborations. However, much work remains to be done in LMICs compared with high-income countries (HICs). In HICs, the field of hand surgery has grown partially owing to the rigorous application of clinical research to examine outcomes and determine best practices. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 7, 2020 Category: Surgery Authors: David N. Bernstein, Kiran J. Agarwal-Harding, George S.M. Dyer, Tamara D. Rozental Tags: The Hand Surgery Landscape Source Type: research

Peripheral Nerve Compression Syndromes in Children
Nontraumatic neuropathies of the upper limb are rare in children. In this paper, we present the latest updates in this field and also critically review the diagnosis and treatment of nerve compression syndromes in children. This review describes the most common manifestations including idiopathic carpal tunnel syndrome (CTS), CTS occurring as a component of lysosomal storage diseases (mucopolysaccharidosis) and hereditary neuropathies, ulnar nerve neuropathy, and atraumatic radial nerve neuropathies. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 6, 2020 Category: Surgery Authors: Giovanni Gallone, Giovanni Luigi Di Gennaro, Sebastian Farr Tags: Current Concepts Source Type: research

Early Mobilization After Volar Locking Plate Osteosynthesis of Distal Radial Fractures in Older Patients —A Randomized Controlled Trial
To investigate if early mobilization after open reduction internal fixation of distal radius fractures improved the functional outcome. We hypothesized that early mobilization would lead to improved patient-reported outcome. Second, we aimed to assess whether early mobilization increased the risk of postoperative implant loosening or breakage. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 5, 2020 Category: Surgery Authors: Thomas Juul S ørensen, Søren Ohrt-Nissen, Kecia V. Ardensø, Gunnar H. Laier, Susanne K. Mallet Tags: Scientific Article Source Type: research

Upper Extremity Function, Peer Relationships, and Pain Interference: Evaluating the Biopsychosocial Model in a Pediatric Hand Surgery Population Using PROMIS
The relationship between biopsychosocial factors and patient-reported function is less clear in pediatric than in adult hand surgery patients. Our primary hypothesis was that pain interference (PI) and peer relationships (PR) would demonstrate association with upper extremity function. Secondarily, we hypothesized that the magnitude of this effect would increase with age. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 5, 2020 Category: Surgery Authors: Nikolas H. Kazmers, Angela P. Presson, Ziji Yu, Wyatt Walsh, Douglas T. Hutchinson, Andrew R. Tyser Tags: Editor's Choice Source Type: research

Harvey Chim replies to Drs Li and Pereira
This study examined the effect of various drugs on synaptosomes or membranes prepared from rat cerebral cortex. These findings, based on calcium channels isolated from the brain, may not correlate exactly with the peripheral nerve model for epineurial lidocaine injection examined in our study.3 L-Type Ca2+ channel agonists and antagonists have been shown to reduce and potentiate the effects of local anesthetics4 and calcium channels are abundantly found in peripheral nerve. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - July 1, 2020 Category: Surgery Authors: Harvey Chim Tags: Letter to the Editor Source Type: research