Introduction: Thumb carpometacarpal joint arthritis can cause significant pain and limitation in activity. Patients who are unable to obtain symptomatic relief from anti-inflammatories, splinting, and cortisone inject...Introduction: Thumb carpometacarpal joint arthritis can cause significant pain and limitation in activity. Patients who are unable to obtain symptomatic relief from anti-inflammatories, splinting, and cortisone injections may be indicated for surgical treatment. The earliest form of surgical intervention was trapeziectomy alone;since, numerous adjunctive procedures have evolved. In this study, we conduct a literature review comparing outcomes of simple trapeziectomy to other interventions for thumb carpometacarpal arthritis. Methods: A literature search using the PubMed/Medline database was conducted. Inclusion criteria were the following: 1) the study was a primary study written in English, 2) treatment options were surgical and compared trapeziectomy with other forms of surgical treatment for thumb carpometacarpal arthritis, 3) the study was a randomized controlled trial, 4) the study included outcomes such as pain, physical function, range of motion, and/or strength. Included studies were then compiled into a table for further review. Results: 11 studies met inclusion criteria. All studies were randomized controlled trials and demonstrated level II evidence. Surgical procedures in these studies included ligament reconstruction and tendon interposition (LRTI), flexor carpi radialis suspension, carpometacarpal joint denervation, and carpometacarpal joint arthroplasty. No significant differences were found between trapeziectomy alone versus adjunctive surgical procedures when comparing patient-reported outcomes, patient satisfaction, range of motion, grip strength, and key/tip pinch strength with follow-up ranging from 1 year to 18 years post-operative. Discussion/Conclusions: In our review of the evidence, we find no significant differences in patient-reported outcomes, patient satisfaction, range of motion, grip strength, and key/tip pinch strength both in the short- and long-term post-operative periods. This raises the question of whether adjunctive procedures are necessary for the treatment of thumb carpometacarpal arthritis, as they may lead to increased operative time, costs, and complications compared to trapeziectomy alone.展开更多
Background: Orthopedic surgeons often refer patients to hand therapy following orthopedic injury or surgery to facilitate recovery and maximize outcomes. Patients should be a key part of the shared decision-making pro...Background: Orthopedic surgeons often refer patients to hand therapy following orthopedic injury or surgery to facilitate recovery and maximize outcomes. Patients should be a key part of the shared decision-making process when it comes to their rehabilitation. While there is existing literature investigating factors considered by patients when choosing other medical providers, there are currently no studies investigating factors considered by patients when choosing a hand therapist. Purpose: The purpose of the study is to investigate public perception of factors which are important when choosing a hand therapist. Methods: A convenience sample (N = 220) of adults over the age of 18 completed an anonymous online survey using an internet crowdsourcing platform. Respondents were asked to quantitatively rank the importance of 10 predetermined factors related to selecting a hand therapist. Results: Respondents ranked insurance coverage and credentialing as a certified hand therapist as highest in terms of importance. Conclusion: We found that the factors people consider important when selecting a hand therapist are similar to the factors described in the medical literature that are important when selecting a physician or other healthcare provider. The results have implications for physicians when ensuring continuity of care for their patients.展开更多
Ultraviolet (UV) lamps are used in nail salons as part of standard gel nail manicures. While UV radiation is a known risk factor for the development of skin cancers, the risk from exposure to UV nail lamps is unclear....Ultraviolet (UV) lamps are used in nail salons as part of standard gel nail manicures. While UV radiation is a known risk factor for the development of skin cancers, the risk from exposure to UV nail lamps is unclear. We present a case of a woman who developed squamous cell carcinoma in one finger after exposure to UV lamps. A discussion of the correlation between UV nail lamps and squamous cell carcinoma (SCC) is provided. Orthopedic surgeons frequently encounter skin cancers of the hand however the role of UV nail lamps has not yet been elucidated in the orthopedic literature. This manuscript aims to address that gap and facilitate patient counseling during such consultations.展开更多
文摘Introduction: Thumb carpometacarpal joint arthritis can cause significant pain and limitation in activity. Patients who are unable to obtain symptomatic relief from anti-inflammatories, splinting, and cortisone injections may be indicated for surgical treatment. The earliest form of surgical intervention was trapeziectomy alone;since, numerous adjunctive procedures have evolved. In this study, we conduct a literature review comparing outcomes of simple trapeziectomy to other interventions for thumb carpometacarpal arthritis. Methods: A literature search using the PubMed/Medline database was conducted. Inclusion criteria were the following: 1) the study was a primary study written in English, 2) treatment options were surgical and compared trapeziectomy with other forms of surgical treatment for thumb carpometacarpal arthritis, 3) the study was a randomized controlled trial, 4) the study included outcomes such as pain, physical function, range of motion, and/or strength. Included studies were then compiled into a table for further review. Results: 11 studies met inclusion criteria. All studies were randomized controlled trials and demonstrated level II evidence. Surgical procedures in these studies included ligament reconstruction and tendon interposition (LRTI), flexor carpi radialis suspension, carpometacarpal joint denervation, and carpometacarpal joint arthroplasty. No significant differences were found between trapeziectomy alone versus adjunctive surgical procedures when comparing patient-reported outcomes, patient satisfaction, range of motion, grip strength, and key/tip pinch strength with follow-up ranging from 1 year to 18 years post-operative. Discussion/Conclusions: In our review of the evidence, we find no significant differences in patient-reported outcomes, patient satisfaction, range of motion, grip strength, and key/tip pinch strength both in the short- and long-term post-operative periods. This raises the question of whether adjunctive procedures are necessary for the treatment of thumb carpometacarpal arthritis, as they may lead to increased operative time, costs, and complications compared to trapeziectomy alone.
文摘Background: Orthopedic surgeons often refer patients to hand therapy following orthopedic injury or surgery to facilitate recovery and maximize outcomes. Patients should be a key part of the shared decision-making process when it comes to their rehabilitation. While there is existing literature investigating factors considered by patients when choosing other medical providers, there are currently no studies investigating factors considered by patients when choosing a hand therapist. Purpose: The purpose of the study is to investigate public perception of factors which are important when choosing a hand therapist. Methods: A convenience sample (N = 220) of adults over the age of 18 completed an anonymous online survey using an internet crowdsourcing platform. Respondents were asked to quantitatively rank the importance of 10 predetermined factors related to selecting a hand therapist. Results: Respondents ranked insurance coverage and credentialing as a certified hand therapist as highest in terms of importance. Conclusion: We found that the factors people consider important when selecting a hand therapist are similar to the factors described in the medical literature that are important when selecting a physician or other healthcare provider. The results have implications for physicians when ensuring continuity of care for their patients.
文摘Ultraviolet (UV) lamps are used in nail salons as part of standard gel nail manicures. While UV radiation is a known risk factor for the development of skin cancers, the risk from exposure to UV nail lamps is unclear. We present a case of a woman who developed squamous cell carcinoma in one finger after exposure to UV lamps. A discussion of the correlation between UV nail lamps and squamous cell carcinoma (SCC) is provided. Orthopedic surgeons frequently encounter skin cancers of the hand however the role of UV nail lamps has not yet been elucidated in the orthopedic literature. This manuscript aims to address that gap and facilitate patient counseling during such consultations.
