RESUMEN
Intramedullary fixation has long been popular for fracture fixation in the upper extremity from the shoulder through the carpus. Recently, intramedullary fixation in the hand has gained increasing interest, specifically in the metacarpals and phalanges, corresponding with the development of improved cannulated headless screw technology. Along with the advantages of increased operative speed and less surgical dissection, which can promote rapid healing, many benefits exist, supporting their use despite some drawbacks. This article reviews the background and biomechanics of intramedullary fixation with a specific focus on cannulated headless screws, describes the application and techniques of intramedullary screw fixation in the hand, and details the associated outcomes and costs for metacarpal fractures, phalangeal fractures, and interphalangeal joint arthrodesis.
Asunto(s)
Falanges de los Dedos de la Mano , Fracturas Óseas , Traumatismos de la Mano , Huesos del Metacarpo , Humanos , Fracturas Óseas/cirugía , Fijación Interna de Fracturas/métodos , Mano , Falanges de los Dedos de la Mano/cirugía , Huesos del Metacarpo/cirugía , Huesos del Metacarpo/lesiones , ArtrodesisRESUMEN
BACKGROUND: Orthopaedic interest groups (OIGs) are student-run organizations that can provide medical students with early exposure to orthopaedic surgery. OIGs can serve as venues for musculoskeletal education, clinical experiences, and mentorship to students with otherwise limited access to orthopaedics. The purpose of this study was to evaluate the prevalence and opportunities offered by OIGs. METHODS: The websites of all allopathic medical schools in the United States were evaluated. Each website was examined for an established OIG and any pertinent information regarding shadowing, research opportunities, lectures, workshops, or opportunities to interact with residents. OIGs were categorized based on the number and type of offerings provided to their members. RESULTS: Of the 141 allopathic medical school websites evaluated, 108 (108/141, 76%) had evidence of an orthopaedic interest group. Sixty-nine (69/108, 64%) of these schools described the opportunities provided. The most common opportunities were clinical skills workshops (41/69, 59%), lectures (32/69, 46%), and opportunities to interact with current residents (30/69, 43%). The majority of OIGs (39/69, 57%) offered fewer than half of the possible opportunities and only 6 groups (9%) offered all five opportunities. CONCLUSION: The majority of allopathic medical schools in the United States have an OIG; however, the opportunities provided to orthopaedic interest group members vary widely from institution to institution.
Asunto(s)
Ortopedia/educación , Facultades de Medicina/estadística & datos numéricos , Sociedades/estadística & datos numéricos , Estudiantes de Medicina , Selección de Profesión , Humanos , Estados UnidosRESUMEN
Hoverboards pose a significant risk of musculoskeletal injury to pediatric riders. A prospectively enrolled cohort yielded 9 pediatric patients injured while riding hoverboards in 2016. Eight of the injuries involved the upper extremity, and one involved the lower extremity. No riders wore any safety equipment and injury patterns modeled those seen in skateboard riders.