Initially, all surgeons in Australia were generalists and those with an interest in the anatomy of the hand performed
This study aims to determine the incidence of surgical site infection leading to reoperation for sepsis following minor hand procedures performed outside the main operating room using field sterility in the South African setting. The investigators retrospectively reviewed the records of 485 patients who had WALANT-assisted minor
Pediatric
Aims. Hand trauma, consisting of injuries to both the hand and the wrist, are a common injury seen worldwide. The global age-standardized incidence of hand trauma exceeds 179 per 100,000. Hand trauma may require surgical management and therefore result in significant costs to both healthcare systems and society. Surgical site infections (SSIs) are common following all surgical interventions, and within
The use of regional anaesthesia for upper limb surgery has been increasing in popularity recently. It is safe, effective and has financial benefits. We report the activity in a tertiary
Compared with general anaesthesia, brachial plexus (BP) anaesthesia improves patient satisfaction and accelerates hospital discharge after ambulatory
Aims: The aim of this study was to evaluate the haemo-dynamic and blockade effects of 25 μg and of 200 μg adrenaline adding to 1.5% lidocaine under axillary brachial plexus blockade. Methods: Fifty patients presenting for
Wrist fusion, ulna head resection and fusion of the MP or PIP joints are not anymore the only operations that can be offered to patients with RA. The modern medical treatment has changed the course of the disease and we are not anymore in front of patients with major joint destruction, very bad hand function and low demands. Young ladies with well controlled disease expect surgery to result in restitution of function which allows a life close to normal in terms of work and leisure time activities. If pain relief remains the main indication it has to be associated with reconstruction of function, preserving mobility and increasing grip strength. For these reasons it appears necessary to limit fusions and increase the use of joint implants. Accurate evaluation of the patients’ need and expectations will help in the choice of the appropriate surgical procedure to achieve the treatment goal.
Hand trauma accounts for one in five of emergency department attendances, with a UK incidence of over five million injuries/year and 250,000 operations/year. Surgical site infection (SSI) in hand trauma surgery leads to further interventions, poor outcomes, and prolonged recovery, but has been poorly researched. Antimicrobial sutures have been recognized by both the World Health Organization and the National Institute for Clinical Excellence as potentially effective for reducing SSI. They have never been studied in hand trauma surgery: a completely different patient group and clinical pathway to previous randomized clinical trials (RCTs) of these sutures. Antimicrobial sutures are expensive, and further research in hand trauma is warranted before they become standard of care. The aim of this protocol is to conduct a feasibility study of antimicrobial sutures in patients undergoing hand trauma surgery to establish acceptability, compliance, and retention for a definitive trial. A two-arm, multicentre feasibility RCT of 116 adult participants with hand and wrist injuries, randomized to either antimicrobial sutures or standard sutures. Study participants and outcome assessors will be blinded to treatment allocation. Outcome measures will be recorded at baseline (preoperatively), 30 days, 90 days, and six months, and will include SSI, patient-reported outcome measures, and return to work.Aims
Methods
Costings of theatre time and out-patient time were obtained from the hospital management.
Based on a cost of £216 per out-patient clinic session, the cost of the out-patient procedures was calculated at £1872 over 6 months, or £3744 per annum. Based on a theatre cost of £1785 per session, to perform all the clinic procedures as formal operations would have cost £60,690 over 6 months, or £121380 per annum. The cost savings were therefore £117636 per annum.
METHODS AND RESULTS: 1700 cases were reviewed retrospectively. Of the respondents to the questionnaire, 457 (65%) patients had dorsal, 255 patients (35%) volar wrist ganglia. Dorsal ganglia had been treated by observation in 99 (22.4%), aspiration in 57 (12.9%), aspiration plus injection in 37 (8.4%) or surgery in 249 (56.3%) of the cases. The analysis showed that the recurrence rates were 39%, 74.5%, 28.5%, and 35% respectively for each type of treatment. Scar tenderness was present in more than half of surgically treated patients. Repeat surgery was performed in 20 out of 70 (28.5%) recurrent cases. The satisfaction rate did not correlate with the recurrence rate. For volar ganglia, treatment had been observation in 49 (19.2%), aspiration in 13 (5%), aspiration plus injection in 12 (4.7%) or surgery in 153 (60%) of the cases. The analysis showed that the recurrence rates were 28.5%, 92%, 25.5%, and 33.3% respectively. Scar tenderness was present in 67% and sensory loss in 32% of surgically treated patients. Repeat surgery was only performed in 18 out of 52 (34.6%) recurrences. The satisfaction rate was highest in the aspiration and injection group, which had the lowest recurrence rate among all treatment modalities.
Aims. Wrist arthroscopy is a standard procedure in
In the field of
In-office surgeries have the potential to offer high quality medical care in a more efficient, cost-effective setting than outpatient surgical centers for certain procedures. The primary concerns with operating on patients in the office setting are insufficient sterility and lack of appropriate resources in case of excessive bleeding or other surgical complications. This study serves to investigate these concerns and determine whether in-office
Aims. Orthopaedic surgery requires grafts with sufficient mechanical strength. For this purpose, decellularized tissue is an available option that lacks the complications of autologous tissue. However, it is not widely used in orthopaedic surgeries. This study investigated clinical trials of the use of decellularized tissue grafts in orthopaedic surgery. Methods. Using the ClinicalTrials.gov (CTG) and the International Clinical Trials Registry Platform (ICTRP) databases, we comprehensively surveyed clinical trials of decellularized tissue use in orthopaedic surgeries registered before 1 September 2022. We evaluated the clinical results, tissue processing methods, and commercial availability of the identified products using academic literature databases and manufacturers’ websites. Results. We initially identified 4,402 clinical trials, 27 of which were eligible for inclusion and analysis, including nine shoulder surgery trials, eight knee surgery trials, two ankle surgery trials, two
The second wave of COVID-19 infections in 2021 resulting from the delta strain had a significantly larger impact on the state of New South Wales, Australia and with it the government implemented harsher restrictions. This retrospective cohort study aims to explore how the increased restrictions affected hand trauma presentations and their treatment. Retrospective analysis was performed on patients who underwent
The COVID-19 pandemic has disrupted all segments of daily life, with the healthcare sector being at the forefront of this upheaval. Unprecedented efforts have been taken worldwide to curb this ongoing global catastrophe that has already resulted in many fatalities. One of the areas that has received little attention amid this turmoil is the disruption to trainee education, particularly in specialties that involve acquisition of procedural skills.
To compare 24-month patient-reported outcomes after surgical treatment or casting in patients age 60 years of age or older with unstable distal radius fractures (DRF's). The Wrist and Radius Injury Surgical Trial (WRIST), is the largest randomized, multicenter trial in
The aim of this study was to develop a core outcome set of what to measure in all future clinical research on hand fractures and joint injuries in adults. Phase 1 consisted of steps to identify potential outcome domains through systematic review of published studies, and exploration of the patient perspective through qualitative research, consisting of 25 semi-structured interviews and five focus groups. Phase 2 involved key stakeholder groups (patients, hand surgeons, and hand therapists) prioritizing the outcome domains via a three-round international Delphi survey, with a final consensus meeting to agree the final core outcome set.Aims
Methods
It has been shown that extremity injuries form a large proportion of the operative surgical workload in conflict situations. Injuries to the hands are an important subgroup and