This update reviews material presented at the 2008 annual meetings of the American Society for Surgery of the Hand (ASSH), American Association for Hand Surgery (AAHS), and the American Academy of Orthopaedic Surgeons (AAOS) as well as articles published in the field of hand surgery (other than those published in this journal) between August 2007 and July 2008. Over the years, as with other maturing organizations, the trend at meetings has been for fewer free papers and more symposia and hands-on workshops, including many non-continuing medical education (non-CME)-credit industry-sponsored workshops in facilities adjacent to the accredited scientific meeting. In addition, both hand surgery organizations feature presentations on shoulder and elbow surgery and general microsurgery that are beyond the scope of this review. Meeting abstracts for the annual meetings of the ASSH and the AAOS are maintained online at www.assh.org and www.aaos.org, respectively.
Although internal fixation is increasingly used to treat distal radial fractures, high-quality data on the relative merits of this modality have been lacking. There is now level-I evidence to consider. In a prospective randomized trial that was presented to the ASSH, fifty patients with complex or unstable fractures of the distal part of the radius were randomized to either external fixation or internal fixation with fragment-specific fixation (Trimed system) (Trimed, Valencia, California). At both seven weeks and one year after surgery, the patients in the internal fixation group had significantly better grip strength, wrist motion, and forearm motion. However, Disabilities of the Arm, Shoulder and Hand (DASH) scores (a measure of upper limb function) and radiographic appearance were not different between the two groups. In a second prospective randomized trial presented to the ASSH, patients were randomized to external fixation or to one of two methods of locked plate fixation (either volar or radial). While the locked …
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