Background There are scarce data regarding the epidemiology of metacarpal fractures within the US population. The purpose of this study is to report the epidemiology of metacarpal fractures in the USA using the National Electronic Injury Surveillance System Database (NEISS). Methods The NEISS database represents a national probability sample of approximately 100 hospitals in the USA and its territories. The database was queried for metacarpal fractures during the time period [2002][2003][2004][2005][2006]. US census data were used to calculate incidence rate (IR) for various demographic criteria. Results A total of 4,718 metacarpal fractures were identified, representing approximately 160,790 metacarpal fractures. The calculated IR was 13.6 (95 % CI, 13.6-13.67) per 100,000 person-years. The highest IR occurred in the 10-19 age group (IR 38.8; 95 % CI, 38.6-38.9) followed by those 20-29 years of age (IR 28.4; 95 % CI, 28.3-28.5). Metacarpal fractures were found more commonly in males (IR 23; 95 % CI, 22.9-23.1) than females (IR 4.5; 95 % CI, 4.5-4.5), with an incidence rate ratio of 5.08. The most common mechanisms of injury were contact with a wall or door, and falls. The most common setting was in the home, followed by recreational locations. Conclusions The estimated incidence of metacarpal fractures presenting for acute hospital care in the USA is 13.6 per 100,000 person-years. Males in the second and third decades of life sustain this injury most commonly. Metacarpal fractures occur frequently in the home or recreational setting, with contact force as the primary mechanism of injury.

Purpose of Review Compressive neuropathy of the ulnar nerve across the elbow is a common diagnosis encountered frequently within a hand and upper extremity clinical practice. Appropriate and timely evaluation, diagnosis, objective testing, and evidence-based decisions regarding treatment options are paramount in the optimal care of the patient with this pathology. An understanding of current literature is critical in determining and understanding best practices. Recent Findings A thorough review of the recent literature regarding physical examination, diagnostic testing, and nonoperative versus operative results was performed. Regarding physical examination, the glenohumeral internal rotation test and scratch collapse test are more effective and sensitive than traditional maneuvers such as Tinel's testing and the elbow flexion test. Electrodiagnostic testing, magnetic resonance imaging, and ultrasound evaluation have all been shown to be effective in diagnosing cubital tunnel syndrome. However, no single test has proven itself to be superior. Nonoperative treatment can be successful for mild cases of cubital tunnel syndrome. Surgical release techniques comparing open with endoscopic release are equivocal, and in situ release versus transposition techniques show that transposition should not be performed routinely. Summary The diagnosis and treatment of cubital tunnel syndrome do not have a well-defined algorithm based on current literature. The treating physician must therefore utilize the available information to determine a diagnostic and treatment plan individualized to the patient. More rigorous scientific studies are needed to determine the most effective surgical approaches for cubital tunnel syndrome. Keywords Cubital tunnel syndrome . Ulnar neuropathy . Ulnar nerve compression . Ulnar nerve transposition . Cubital tunnel release . In situ decompression This article is part of the Topical Collection on Compressive Neuropathies in the Upper Extremity

The recent coronavirus pandemic has prompted providers to adopt telehealth as a way to maintain contact with their patients on an unprecedented scale. The purpose of this study was to evaluate the perception of care for both patients and physicians using telehealth visits for the management of upper extremity orthopaedic conditions. This study consisted of the analysis of surveys sent to both physicians and patients immediately after the completion of a telehealth visit for an upper extremity condition. Eighty percent of patients responded as “very satisfied” with their encounter. Satisfaction scores were similar for patients seen for a new issue or an existing issue. The use of a video platform was preferable to patients compared with a telephone call. Physicians would have requested a radiograph or offered a steroid injection during a new patient evaluation in 77% of cases. Physicians were less satisfied with the use of telemedicine, particularly when evaluating a new patient. A large majority of patients and physicians alike felt telehealth visits have a role in patient management, acknowledging they would both choose to incorporate “some” of their visits as telehealth evaluations for any particular issue.

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