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Background International volunteering missions are becoming an important focus of plastic surgeons in the United States. The purpose of this paper is to describe the teaching of pediatric hand surgery in Vietnam to share the lessons learned from this project. Methods Two medical education trips were conducted to the no. 1 Children’s Hospital in Ho Chi Minh city (Saigon) to teach pediatric hand and...
Functional hand reconstruction following treatment of soft tissue sarcomas (STS) is a difficult surgical problem. Because survival rates between amputation and limb salvage do not differ, there is a trend toward reconstruction. Unlike amputation, hand salvage usually requires multiple complex operations in combination with adjuvant radiation or chemotherapy, prolonged rehabilitation, and carries a...
Isolated fractures of the trapezoid are rare. Of all of the fractures of the carpus, the most common is the scaphoid, which represents 68.2% of all carpal fractures (Papp, Orthop Clin N Am 38:251–60, 2007). In contrast, trapezoid fractures represent 0.4% of all carpal injuries. Because it is an infrequently fractured carpal bone, there is a wide variety of treatment plans, including rest, immobilization,...
The multitier healthcare system of the USA has several major flaws. High costs and uncertain quality of care indicate that this system is no longer practical. Several improvement initiatives, such as the Oregon Health Plan, Leapfrog, Lean Manufacturing, and Pay-for-Performance have been implemented into the current system. All of these quality improvement models are being experimented in a limited...
The quality of ultrasound imaging to examine anatomical structures in the wrist and hand has improved highly over the last years. The value of ultrasonography (US) performed by hand surgeons on treatment decisions was investigated in this study. One hundred and ninety-five patients with an unclear clinical hand problem were evaluated by high-definition ultrasonography from January 2005 until June...
Hand surgeons rely on referrals from general providers. Appropriate referral is dependent upon referring physicians having an understanding of the problem and available treatments. This study evaluates the referring physicians’ knowledge and perceptions of basic hand problems and their treatment. This study also evaluates the impact of a brief lecture on our referring physicians’ understanding of...
Radiological changes have been described in de Quervain’s disease of the wrist. The author analyzed the clinical data of 114 patients who reported to the orthopedic clinic of a Regional Referral Hospital for a period of 4 years [2003 to 2007]. Radiographs of the wrist were available for 39 cases, of which 14 [35.89%] were found abnormal. Two patients with abnormal radiographs [14.28%] required surgery...
Background There have been few attempts to identify classic papers within the hand surgery literature. This study used citation analysis to identify and characterize the top 50 highly cited hand surgery articles published in six peer-reviewed journals. Methods The 50 most highly cited hand surgery articles were identified in the Journal of Bone and Joint Surgery (JBJS) American, JBJS British, Plastic...
Background Hand trauma is the most frequently treated injury in emergency departments, but presently there is a crisis of insufficient emergency coverage. This study evaluates the discrepancy of emergent and elective hand care trends based on socioeconomic factors in the state of Tennessee. Methods We identified 119 hospitals in Tennessee that contained operating and emergency room facilities. Of...
Background Data are limited regarding the use of peripheral nerve blockade at the level of the forearm, and most studies regard these procedures as rescue techniques for failed or incomplete blocks. The purpose of the study was to investigate patients undergoing hand surgery with distal peripheral nerve (forearm) blocks and compare them with patients having similar procedures under more proximal brachial...
Background Patients who miss scheduled appointments without notifying office staff––“no-shows”––disrupt practice workflow and decrease access for others, resulting in misuse of resources and lost revenue. The primary purpose of this study was to identify factors associated with no-shows in a hospital-based outpatient hand office. Secondarily, we studied factors associated with cancelations. Methods...
Background Patients and surgeons can feel uncomfortable discussing coping strategies, psychological distress, and stressful circumstances. It has been suggested that patient-reported outcome measures (PROMs) facilitate the discussion of factors associated with increased symptoms and disability. This study assessed the effect of providing feedback to patients regarding their coping strategy and illness...
Background The purpose of this study was to evaluate (1) patient preferences regarding iPad and paper-based questionnaires, (2) the efficacy of iPad and paper questionnaires in a hand surgery practice, (3) the influence of questionnaire length on patient preferences and data collection, and (4) patient characteristics associated with a preference for iPad-based questionnaires. Methods Two hundred...
Background In our experience, for all surgeries in the hand, the optimal epinephrine effect from local anesthesia—producing maximal vasoconstriction and visualization—is achieved by waiting significantly longer than the traditionally quoted 7 min from the time of injection. Methods In this prospective comparative study, healthy patients undergoing unilateral carpal tunnel surgery waited either 7 min...
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