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Hand Fracture

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1. Is Use of a Psychological Workbook Associated With Improved Disabilities of the Arm, Shoulder and Hand Scores in Patients With Distal Radius Fracture?

Is Use of a Psychological Workbook Associated With Improved Disabilities of the Arm, Shoulder and Hand Scores in Patients With Distal Radius Fracture? Symptom intensity and magnitude of limitations correlate with stress, distress, and less effective coping strategies. It is unclear if interventions to target these factors can be used to improve outcomes after distal radius fracture in either the short- or longer term.(1) Are there any factors (including the use of a workbook aimed at optimizing (...) psychological response to injury, demographic, radiographic, medical, or psychosocial) associated with improved Disabilities of the Arm, Shoulder and Hand (DASH) and Numerical Rating Scale pain (NRS pain) scores at 6 weeks after management of distal radius fracture? (2) Are any of these factors associated with improved DASH and NRS pain scores at 6 months after management of distal radius fracture?We conducted a double-blind randomized controlled trial comparing a workbook designed to optimize

2018 EvidenceUpdates

2. Developing a core outcome set for hand fractures and joint injuries in adults: a systematic review of treatment outcomes

Developing a core outcome set for hand fractures and joint injuries in adults: a systematic review of treatment outcomes Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any

2019 PROSPERO

3. Wide-Awake Surgical Management of Hand Fractures: Technical Pearls and Advanced Rehabilitation. (PubMed)

Wide-Awake Surgical Management of Hand Fractures: Technical Pearls and Advanced Rehabilitation. Most unstable metacarpal and phalangeal fractures for which operative treatment is indicated can be reduced and stabilized with either open or closed techniques using local anesthetic with epinephrine instead of intravenous sedation or general anesthesia. With the patient wide-awake during surgery, the hand can be taken through active range of motion to assess fracture stability. In this article (...) , the authors review the rationale and technique for wide-awake, local anesthesia, no tourniquet surgery in the treatment of phalangeal and metacarpal fractures and impart pearls to optimize the patient experience and illustrate common fixation techniques using percutaneous Kirschner wires. The intraoperative assessment of fracture stability permits an accelerated, protected-range-of-motion protocol that minimizes postoperative stiffness and facilitates expedient recovery.

2019 Plastic and reconstructive surgery

4. The Relationship between Hand Therapy and Long-Term Outcomes after Distal Radius Fracture in Older Adults: Evidence from the Randomized Wrist and Radius Injury Surgical Trial. (PubMed)

The Relationship between Hand Therapy and Long-Term Outcomes after Distal Radius Fracture in Older Adults: Evidence from the Randomized Wrist and Radius Injury Surgical Trial. Older patients are frequently referred to hand therapy after distal radius fracture. Supervised therapy sessions place a transportation burden on patients and are costly on both the individual and systematic levels. Furthermore, there is little evidence that supervised therapy or home exercises improve long-term (...) outcomes.Data were collected for the Wrist and Radius Injury Surgical Trial, a multicenter, international, pragmatic, randomized trial of distal radius fracture treatment in patients aged 60 years and older. Referral to therapy and therapy protocol were at the discretion of the treating surgeon and therapist. The authors examined outcomes between participants who underwent therapy and those who did not and assessed the duration of therapy. The authors also analyzed the effect of therapy on subgroups at risk

2019 Plastic and reconstructive surgery

5. Treatment interventions for hand fractures and joint injuries: a scoping review of randomized controlled trials. (PubMed)

Treatment interventions for hand fractures and joint injuries: a scoping review of randomized controlled trials. The aim of this study was to identify and assess all existing randomized studies on treatment interventions for hand fractures and joint injuries, to inform practice and plan future research. PubMed, Cochrane CENTRAL, MEDLINE and Embase were searched. We identified 78 randomized controlled trials published over 35 years, covering seven anatomical areas of the hand. We report (...) on sources of bias, sample size, follow-up length and retention, outcome measures and reporting. In terms of interventions studied, the trials were extremely heterogeneous, so it is difficult to draw conclusions on individual treatments. The published randomized controlled clinical trial evidence for hand fractures and joint injuries is narrow in scope and of generally low methodological quality. Mapping provides a useful resource and stepping-stone for planning further research. There is a need for high

2019 Journal of Hand Surgery - European

6. Hand function outcome in closed small bone fractures treated by open reduction and internal fixation by mini plate or closed crossed pinning: a randomized controlled trail. (PubMed)

Hand function outcome in closed small bone fractures treated by open reduction and internal fixation by mini plate or closed crossed pinning: a randomized controlled trail. No study in literature clearly gives advantage of one method of surgical fixation of fracture over the other in metacarpal and phalangeal bones of hand comparing wider outcome measures.A randomized controlled trial between closed reduction and percutaneous Kirschner wire fixation or open reduction and internal fixation (...) with mini fragment plates was conducted. A total of 32 patients with 16 in each group were taken in tertiary-level teaching hospital from 2014 to 2016. Four patients lost to follow-up apart from 32 studied. Inclusion criteria were age group 16-60 years, fresh (3 days) closed shaft fractures of metacarpal and phalanges. Outcome evaluated were time to union of fracture, degree of strength achieved measured with dynamometer, DASH scoring, range of motion of hand and each digit.Both groups were comparable

2018 Musculoskeletal surgery

7. Management of distal radius fractures in the emergency department: A long-term functional outcome measure study with the Disabilities of Arm, Shoulder and Hand (DASH) scores. (PubMed)

Management of distal radius fractures in the emergency department: A long-term functional outcome measure study with the Disabilities of Arm, Shoulder and Hand (DASH) scores. Distal radius fracture (DRF) is a common presentation to the ED. However, little is known about the long-term functional outcome of these patients following their initial management in the ED.In order to evaluate the long-term functional outcome of DRF, we collected the Disabilities of Arm, Shoulder and Hand (DASH) scores

2018 Emergency medicine Australasia

8. The association between decreased hand grip strength and hip fracture in older people: A systematic review. (PubMed)

The association between decreased hand grip strength and hip fracture in older people: A systematic review. Hip fractures are a global concern, resulting in poor outcomes and high health care costs. They mostly affect people >80 years. Hip fractures are influenced by various (modifiable) risk factors. Emerging evidence suggests hand grip strength (HGS) to be one of several useful tools to identify hip fracture risk. This is the first systematic review that aims to assess the evidence underlying (...) the relationship between hip fracture incidence and HGS. Eleven studies were selected for this review (six case-control and five cohort studies), comprising 21,197 participants. Where reported, HGS was significantly decreased in individuals with a hip fracture near the time of injury as compared to controls (p < 0.001); HGS was associated with increased hip fracture risk in all included studies. Meta-analysis was not possible. All studies included in this systematic review confirmed a relationship between

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2018 Experimental Gerontology

9. Crossed Wires Versus 2 Lateral Wires in Management of Supracondylar Fracture of the Humerus in Children in the Hands of Junior Trainees (PubMed)

Crossed Wires Versus 2 Lateral Wires in Management of Supracondylar Fracture of the Humerus in Children in the Hands of Junior Trainees The objective of this study was to evaluate and compare the outcome of the crossed and the lateral pin configurations in the management of supracondylar humeral fractures in children in the hands of junior trainees.Prospective randomized controlled trial.Level I Trauma Center.Sixty children with supracondylar humeral fractures. The mean age was 5.1 years (1.5-9 (...) configuration, especially, in the hands of junior trainees in their first 3 years of training, and the difference was statistically significant.Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

2016 EvidenceUpdates

10. Buried Versus Exposed Kirschner Wires Following Fixation of Hand Fractures: l Clinician and Patient Surveys (PubMed)

Buried Versus Exposed Kirschner Wires Following Fixation of Hand Fractures: l Clinician and Patient Surveys Fractures of the metacarpals and phalanges are common. Placement of Kirschner wires (K-wires) is the most common form of surgical fixation. After placement, a key decision is whether to bury the end of a K-wire or leave it protruding from the skin (exposed). A recent systematic review found no evidence to support either approach. The aim of study was to investigate current clinical (...) surgical trainees preferred to leave K-wires not buried. Ease of removal correlated with a decision to leave wires exposed, whereas perceived risk of infection correlated with burying wires. Cost did not affect the decision. Hand therapists were primarily concerned about infection and patient-related outcomes. Patients were most concerned about wire-related problems and pain.This national survey provides a new understanding of the use of K-wires to manage hand fractures in the United Kingdom. A number

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2018 Plastic and Reconstructive Surgery Global Open

11. Are the patient-rated wrist evaluation (PRWE) and the disabilities of the arm, shoulder and hand (DASH) questionnaire used in distal radial fractures truly valid and reliable? (PubMed)

Are the patient-rated wrist evaluation (PRWE) and the disabilities of the arm, shoulder and hand (DASH) questionnaire used in distal radial fractures truly valid and reliable? The patient-rated wrist evaluation (PRWE) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire are patient-reported outcome measures (PROMs) used for clinical and research purposes. Methodological high-quality clinimetric studies that determine the measurement properties of these PROMs when used (...) . W. Poolman, V. A. B. Scholtes. Are the patient-rated wrist evaluation (PRWE) and the disabilities of the arm, shoulder and hand (DASH) questionnaire used in distal radial fractures truly valid and reliable? Bone Joint Res 2018;7:36-45. DOI: 10.1302/2046-3758.71.BJR-2017-0081.R1.© 2018 Kleinlugtenbelt et al.

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2018 Bone & joint research

12. Three-dimensional Printed Surgical Simulator for Kirschner Wire Placement in Hand Fractures (PubMed)

Three-dimensional Printed Surgical Simulator for Kirschner Wire Placement in Hand Fractures Closed reduction and percutaneous pinning (CRPP) of hand fractures can be a deceptively challenging procedure that requires significant hands-on time to teach and learn. We created a realistic three-dimensional simulator that can be used for teaching junior residents the CRPP. Computer-aided design and computer-aided manufacturing (CAD/CAM) software was used to create a three-dimensional hand model (...) incorporating several common hand fractures: Bennett's fracture, transverse fifth metacarpal neck, and transverse second proximal phalanx. Three-dimensional printing was used to create molds in which the bones and soft tissue were poured. A polyurethane foam was utilized for the bones with iron incorporated to render them radiopaque, whereas silicone of varying viscosities was used for the soft tissues. Five plastic surgery residents and 5 consultants evaluated the model. Individuals then completed

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2018 Plastic and Reconstructive Surgery Global Open

13. Physeal fracture in the wrist and hand due to stress injury in a child climber: A case report. (PubMed)

Physeal fracture in the wrist and hand due to stress injury in a child climber: A case report. In competitive athletes, the upper extremity is subject to tremendous torsional forces with axial loading due to repetitive weight bearing. Approximately 25% of injuries in sports are related to the hand or wrist. Skeletal deformity on the wrist physis is common in athletes due to repetitive loading and presents at early ages between 6 and 13 years. Additionally, it is more common in female than (...) in male athletes.An 11-year-old girl who was a climber complained of pain on her left wrist without direct trauma. She had participated in climbing exercise for several years and had no medical history. Thorough radiological evaluation, we diagnosed physeal injury of the left radius. After healing of the physeal injury of the radius, she complained of pain on fourth finger of right hand and radiographs revealed physeal injury of the right fourth finger.Radiographs revealed physeal injury of the left

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2018 Medicine

14. Comparison of Open and Closed Hand Fractures and the Effect of Urgent Operative Intervention. (PubMed)

Comparison of Open and Closed Hand Fractures and the Effect of Urgent Operative Intervention. To establish and compare the incidence of 30-day postoperative infection in surgically managed open and closed metacarpal and phalangeal fractures, and to determine whether open fractures treated urgently had a lower incidence of postoperative infection.We conducted a retrospective analysis of patient demographics, comorbidities, and 30-day infection rates of patients undergoing operative fixation (...) for postoperative infection.Although 34.2% of open hand fractures were taken urgently to the operating room, the diagnosis of open fractures along with nonurgent surgical treatment for open fractures was associated with a low incidence of postoperative infection. In addition, smoking was a risk factor for postoperative infection although anatomic location (phalanx vs metacarpal) was not.Patients undergoing surgery for metacarpal or proximal/middle phalangeal fractures are not at greater risk for infection based

2018 Journal of Hand Surgery - American

15. Is Use of a Psychological Workbook Associated With Improved Disabilities of the Arm, Shoulder and Hand Scores in Patients With Distal Radius Fracture? (PubMed)

Is Use of a Psychological Workbook Associated With Improved Disabilities of the Arm, Shoulder and Hand Scores in Patients With Distal Radius Fracture? Symptom intensity and magnitude of limitations correlate with stress, distress, and less effective coping strategies. It is unclear if interventions to target these factors can be used to improve outcomes after distal radius fracture in either the short- or longer term.(1) Are there any factors (including the use of a workbook aimed at optimizing (...) psychological response to injury, demographic, radiographic, medical, or psychosocial) associated with improved Disabilities of the Arm, Shoulder and Hand (DASH) and Numerical Rating Scale pain (NRS pain) scores at 6 weeks after management of distal radius fracture? (2) Are any of these factors associated with improved DASH and NRS pain scores at 6 months after management of distal radius fracture?We conducted a double-blind randomized controlled trial comparing a workbook designed to optimize

2018 Clinical Orthopaedics and Related Research

16. Is Use of a Psychological Workbook Associated With Improved Disabilities of the Arm, Shoulder and Hand Scores in Patients With Distal Radius Fracture? (PubMed)

Is Use of a Psychological Workbook Associated With Improved Disabilities of the Arm, Shoulder and Hand Scores in Patients With Distal Radius Fracture? Symptom intensity and magnitude of limitations correlate with stress, distress, and less effective coping strategies. It is unclear if interventions to target these factors can be used to improve outcomes after distal radius fracture in either the short- or longer term.(1) Are there any factors (including the use of a workbook aimed at optimizing (...) psychological response to injury, demographic, radiographic, medical, or psychosocial) associated with improved Disabilities of the Arm, Shoulder and Hand (DASH) and Numerical Rating Scale pain (NRS pain) scores at 6 weeks after management of distal radius fracture? (2) Are any of these factors associated with improved DASH and NRS pain scores at 6 months after management of distal radius fracture?We conducted a double-blind randomized controlled trial comparing a workbook designed to optimize

2018 Clinical Orthopaedics and Related Research

17. Intramedullary headless screw fixation for fractures of the proximal and middle phalanges in the digits of the hand: a review of 31 consecutive fractures. (PubMed)

Intramedullary headless screw fixation for fractures of the proximal and middle phalanges in the digits of the hand: a review of 31 consecutive fractures. We present the results of 26 patients with 31 consecutive displaced or unstable extra-articular fractures of the base and shaft of the proximal and middle phalanges of the digits of the hand, treated over a period of 12 months with an intramedullary headless compression screw and early mobilization with no splinting. All fractures healed (...) with no major complications. Only one patient, who had a pathological fracture through an enchondroma, required a tenolysis to improve the mobility of the finger. This technique seems to be technically simple, effective and with few drawbacks.IV.© The Author(s) 2016.

2016 Journal of Hand Surgery - European

18. Perihamate-Peripisiform-Transtriquetrum Axial Ulnar Fracture Dislocation of the Hand With an Associated Perilunate Injury. (PubMed)

Perihamate-Peripisiform-Transtriquetrum Axial Ulnar Fracture Dislocation of the Hand With an Associated Perilunate Injury. Axial fracture-dislocations are rare, high-energy injuries. Although cases of axial fracture-dislocations are reported in the literature, there are few reports of a patient who suffered a combined perilunate injury with an ulnar axial dislocation of the hand. This case report describes the anatomical injury and operative treatment of a patient who suffered this injury (...) and discusses the importance of associated soft tissue management.Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

2017 Journal of Hand Surgery - American

19. Antibiotic Management and Operative Debridement in Open Fractures of the Hand and Upper Extremity: A Systematic Review. (PubMed)

Antibiotic Management and Operative Debridement in Open Fractures of the Hand and Upper Extremity: A Systematic Review. Open fractures of the hand are thought to be less susceptible to infection than other open fractures because of the increased blood supply to the area. Current evidence for all open fractures shows that antibiotic use and the extent of contamination are predictive of infection risk, but time to debridement is not. We reviewed in a systematic review the available literature (...) on open fractures of the hand and upper extremity to determine infection rates based on the timing of debridement and antibiotic administration. We continue to recommend prompt debridement and treatment of most open fractures of the upper extremity.Copyright © 2017 Elsevier Inc. All rights reserved.

2017 Hand clinics

20. Smith's fracture generally occurs after falling on the palm of the hand. (PubMed)

Smith's fracture generally occurs after falling on the palm of the hand. Orthopedic trauma surgeons often encounter Smith's fracture in patients who report that they have fallen on the palms of their hands. The aim of this study was to clarify the pathogenesis of Smith's fracture in basic clinical aspects. First, a survey was conducted for investigating the mechanism of injury and arm position at the time of injury among patients with Smith's fractures who consulted at our outpatient clinic (...) . Second, we created three-dimensional finite element models (FEMs) to predict the influence of arm position on the type of injury resulting from a fall. These predictions were then used in ten freshly frozen cadavers to provide experimental proof of Smith's fractures resulting from the impact on the palmar side. Twenty-six patients (5 males and 21 females) with Smith's fractures were enrolled in this study. Injury resulting from a fall on the palm of the hand, the dorsum, or ulno-dorsum of the hand

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2017 Journal of Orthopaedic Research

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