What’s New in Hand Surgery
Peter C. Amadio, MD

Introduction

This update reviews material presented at the 2012 annual meetings of the American Society for Surgery of the Hand (ASSH), American Association for Hand Surgery (AAHS), and 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 2011 and July 2012. In addition to the broad focus of the AAOS, both hand surgery organizations feature presentations on shoulder and elbow surgery and general microsurgery, all of which are beyond the scope of this review. If a work was presented at more than one meeting, only the first presentation is described.

Meeting abstracts for the ASSH, AAHS, and AAOS annual meetings are maintained online at www.assh.org, www.handsurgery.org, and www.aaos.org, respectively.

Skeletal Trauma

The treatment of wrist fractures is increasingly surgical. However, several recent studies called into question the benefits of operative treatment as compared with nonoperative treatment. A report that was presented to ASSH reviewed 258 patients over the age of sixty-five years with distal radial fractures that were treated either operatively or nonoperatively. The patients were matched according to AO type, age, and sex. One year after the fracture, Patient Rated Wrist Evaluation (PRWE) scores, wrist motion, and grip strength were similar in the two treatment groups. The operative treatment group had a higher risk of complications (29% compared with 17%; p = 0.03) and a greater need for subsequent surgery (11% compared with 5%; p = 0.1) but had a lower malunion rate (4% compared with 26%) in comparison with the nonoperative treatment group. The authors concluded that surgery improves radiographic appearance but not function in patients over the age of sixty-five years and that these results come at the cost of higher rates of complications and additional surgery. A recent report …


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