Treating Recurrent Dupuytren Disease

Maureen Leahy

Treatment options for Dupuytren disease have increased in recent years. One newer method involves injecting collagenase clostridium histolyticum (CCH) into the cord of the affected joint; the following day the finger is manipulated to rupture the cord, thereby reducing the contracture. Regardless of the initial intervention, however, recurrences of Dupuytren disease are common and often require additional treatment.

Improper Placement of Upper Extremity Splints Common in Children

Maureen Leahy

Initial evaluation and treatment of upper extremity injuries in children frequently occur in an emergency department (ED) or urgent care center. As a result, a variety of healthcare professionals—ED physicians, residents, nurse practitioners, and physician assistants—are involved in applying the splints necessary to immobilize the extremity and stabilize a potential fracture.

AAOS is Moving

The AAOS is moving into its new building! The move is scheduled to begin at 5:00 p.m. (CT) on Thursday, Dec. 4. The AAOS will be closed for business on Friday, Dec. 5, and will reopen at 10:00 a.m. (CT) on Monday, Dec. 8. As of Dec. 4, 2015, please use the following information when writing to the AAOS: American Academy of Orthopaedic Surgeons 9400 West Higgins Road Rosemont, IL 60018-4976 Phone numbers will remain the same.

Local Corticosteroid Injections Have Systemic Effects in Patients with Diabetes

Maureen Leahy

Study data presented at the annual meeting of the American Society for Surgery of the Hand indicate that patients with diabetes who have hemoglobin A1c (HbA1c) levels of 7 percent or greater experience higher and longer-lasting elevations of blood glucose after corticosteroid injections in the hand than those whose HbA1c levels are better controlled.

Scoping Out New Sites in Foot and Ankle Surgery

Terry Stanton

Orthopaedic applications for the arthroscope continue to expand and, in the foot and ankle, to permit exploration in and around small joints. Arthroscopy of the first metatarsophalangeal (MTP) joint, peroneal tendoscopy, and endoscopic calcaneoplasty are among these new arthroscopic applications. At the annual meeting of the American Orthopaedic Foot & Ankle Society, Eric Giza, MD, chief of the foot and ankle service at University of California–Davis, provided an overview of these techniques.

Taking a Closer Look at Osteolysis in TAA Patients

Jennie McKee

“Osteolysis is a frustrating condition: it’s what leads to total ankle arthroplasty (TAA) failure even when the surgeon has done everything right,” said Murray J. Penner, MD, FRCSC, of the University of British Columbia, Vancouver Coastal Health Authority, and Providence Health Care in Vancouver, British Columbia. According to Dr. Penner, polyethylene wear may be a causative factor for osteolysis in these patients.

Syndesmotic Injury: Managing Fractures and Failed Repairs

Terry Stanton

Addressing management of syndesmotic injuries at a symposium at the annual meeting of the American Orthopaedic Foot & Ankle Society, Robert B. Anderson, MD, sounded a theme to work by: Respect the joint. “This is a functional, synovial-lined joint,” he elaborated. “It has cartilage on both sides. It pistons. It rotates. It widens.” The joint “gets its stability from the ligaments that surround it,” Dr. Anderson, of OrthoCarolina in Charlotte, N.C., explained.

Surgical vs. Nonsurgical Treatment for Atraumatic Rotator Cuff Tears

Xavier A. Duralde, MD

Shoulder pain due to rotator cuff disease is a common reason for patients to see an orthopaedic surgeon. However, making clinical recommendations based on high-level evidence is difficult. Controversy continues over the benefits of conservative or surgical options in the management of known atraumatic rotator cuff tears (RCTs). The goal of treatment is to resolve pain, restore function, and provide lasting durable relief that will not deteriorate with time.

Nonoperative Pediatric Orthopaedics

Ken Noonan, MD

How the University of Wisconsin expanded access to pediatric care Ken Noonan, MD A decade or so ago, I often wondered about the division of labor in treating pediatric musculoskeletal conditions. As a pediatric orthopaedic surgeon, I often saw children in clinic who had simple problems that could be treated nonsurgically or who were normal, despite their parents’ concerns.