What’s New in Hand Surgery: Level I and II Studies

Every month, JBJS publishes a Specialty Update—a review of the most pertinent and impactful studies published in the orthopaedic literature during the previous year in 13 subspecialties. Here is a summary of selected findings from Level I and II studies cited in the March 18, 2015 Specialty Update on hand surgery:

Distal Radial Fractures

–A study that randomized 50 patients with unstable radial fractures and Kirschner-wire fixation to receive demineralized bone-matrix allograft or no graft found no significant differences in bone density or function throughout one year of follow-up.

–Among 130 patients with a displaced distal radial fracture who were randomized for treatment with either a volar plate or percutaneous pins (with or without external fixation), plate-treated patients had a quicker return to function, but functional results were similar between the two groups at three months and one year.

Trapeziometacarpal Arthritis

–A randomized trial of 43 women aged 40 and older with trapeziometacarpal osteoarthritis comparing trapeziectomy with trapeziometacarpal arthrodesis (with plate and screws) was terminated early because of the high complication rate in the arthrodesis group.

Carpal Tunnel Release

–A Cochrane Database systematic review of 28 studies comparing endoscopic and open carpal tunnel release concluded that both techniques provided similar outcomes, but that the current literature on the subject is rife with low-quality studies.

–A meta-analysis of 21 studies comprising 1,859 patients that compared endoscopic and open carpal tunnel release showed that endoscopically treated patients had modestly greater strength at early follow-up but that the difference disappeared after six months.

This Specialty Update also includes many recent findings from papers presented at 2014 meetings of the American Society for Surgery of the Hand and the American Association for Hand Surgery.

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2 responses to “What’s New in Hand Surgery: Level I and II Studies”

  1. Martin Pomphrey,M.D. says :

    I know it’s anecdotal evidence, but I had endoscopic carpal tunnel release on both wrists at different occasions. After the first surgery, I drove to Lake Vermillion in northern Minnesota for a vacation and some work on our cabin there. Five days after the second procedure, I performed endoscopic carpal tunnel release on a patient and several other procedures. I was definitely able to return to normal activity sooner than I would have after an open procedure.

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  2. Deanna R. Jones says :

    My mother was recently diagnosed with distal radial fractures. I want to make sure that she gets the best treatment possible for her condition, so it helps to read up on the latest updated procedures. The study between the fifty patients with unstable radial fractures and Kirschner-wire fixation was really interesting. It’s good to know that there’s little difference between whether patients receive demineralized bone-matrix allografts versus not getting a graft at all. That would answer my mother’s question whether it matters if she gets a graft.

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