Patrick W. Owens

Functional Outcomes of Replantation Following Radiocarpal Amputation

PURPOSE To assess the long-term functional and clinical outcomes of patients who have undergone replantation after radiocarpal amputation. METHODS We performed a retrospective review of radiocarpal joint amputations at a level 1 trauma center over a 13-year period. Medical records of patients treated with replantation were queried for injury data, operative reports, complications, and clinical progress. Patients who met inclusion criteria were contacted for long-term follow-up. We measured total active motion of each digit, strength (grip and pinch), and 2-point discrimination. Functional outcomes were assessed with Disabilities of Arm, Shoulder, and Hand score, Mayo Wrist Score, Patient-Rated Wrist Evaluation, and Michigan Hand Questionnaire. Descriptive statistics were calculated, including frequencies for categorical variables and means and ranges for continuous variables. RESULTS Six patients met the inclusion criteria. The mean age was 36 years (range, 26-50 y). Five patients were available at a mean follow-up of 3.9 years (range, 1.0-6.9 y). Compared with the contralateral uninjured extremity, total active motion of the hand was 38% (range, 26% to 59%) and grip strength was 9% (range, 0% to 18%). Neither tip nor key pinch was present. Mean 2-point discrimination was 10.6 mm (range, 8-12 mm). All mean outcome scores indicated moderate disability, including Disabilities of Arm, Shoulder, and Hand (76; range, 45-82), Mayo Wrist Score (23; range, 5-50), Patient-Rated Wrist Evaluation (86; range, 56-98), and Michigan Hand Questionnaire (27; range, 15-55). Two patients were able to return to work and 3 were permanently disabled. All patients were satisfied with the hand function. CONCLUSIONS Successful replantation for a radiocarpal joint amputation is associated with major restriction of motion, decreased strength, and moderate disability on functional outcome assessments. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic IV.

Technique for a composite femoral intramedullary plug in cemented hip arthroplasty

A brief technique to place a cement plug on top of a polyethylene is presented. This technique has helped the authors obtain better cement mantles when they are plugging the canal in total hip replacement.

Endoscopic carpal tunnel release

This chapter details essential steps of endoscopic carpal tunnel release. The space between the synovium and the transverse carpal ligament is entered with dilators; the endoscope is inserted into the carpal canal, and the ligament and the antebrachial fascia are transected completely to the level of the skin incision. Indications, essential steps, postoperative care, possible complications, operative dictation, and references are included.

Erratum to: 6-week radiographs unsuitable for diagnosis of suspected scaphoid fractures (Arch Orthop Trauma Surg, (2016), 136, (771-778), 10.1007/s00402-016-2438-4)

Wint, John M. Erickson, John McAuliffe, John T. Capo, John Taras, Jose A. Ortiz, Julie Adams, Karl-Josef Prommersberger, Kevin M. Rumball, Kyle D. Bickel, Lior Paz, Lisa Lattanza, Louis Catalano III, M. Jason Palmer, Marc J. Richard, Marco Rizzo, Maurizio Calcagni, Maximillian Soong, Megan M. Wood, Michael Baskies, Michael Behrman, Michael Darowish, Michael Nancollas, Michael W. Grafe, Michael W. Kessler, Miguel A. Pirela-Cruz, M. P. Bekerom, Naquira Escobar Luis Felipe, Nathan Hoekzema, Oleg M. Semenkin, Patrick W. Owens, Philip Blazar, Ralph M Costanzo, Ramon de Bedout, Renato M. Fricker, Richard L. Hutchison, Richard S. Gilbert, Rick Papandrea, Robert R. Slater, Robert R. L. Gray, Ryan Klinefelter, Ryan P. Calfee, Sander Spruijt, Sanjeev Kakar, Saul Kaplan, Seth Dodds, Stephen A. Kennedy, Steven Beldner, T. Apard, Taizoon Baxamusa, Thomas G. Stackhouse, Todd Siff, W. Arnnold Batson, Warren C. Hammert. Erratum to: Arch Orthop Trauma Surg (2016) 136:771–778 DOI 10.1007/s00402-016-2438-4

The Miami breakout cast: a method for applying a removable cast

from an incomplete resolution of the supratrochlear septum. However, it is now believed that it develops from a separate ossification centre in the olecranon fossa (Gudmundsen and Ostensen, 1987; Obermann and Loose, 1983). The differential diagnosis of the os supratrochleare dorsale includes synovial osteochondromatosis, osteochondritis dissecans and a post-traumatic loose body. However, it should be also distinguished from a sesamoid bone in the triceps tendon and an ununited ossification centre in the olecranon process (Gudmundsen and Ostensen, 1987; Obermann and Loose, 1983; Wood and Campbell, 1994). The pain experienced might be explained because of traumatization of the ossicle by the olecranon when the elbow extends and/or it may be due to rubbing of the triceps tendon against the ossicle (Wood and Campbell, 1994). The os supratrochleare dorsale is a rare benign anatomical variation which is of interest to anatomists, radiologists and surgeons. It might be misdiagnosed if a surgeon is unaware of its existence. It may sometimes produce symptoms and require treatment. However, it must be distinguished from an underlying pathological process. Conflict of interests