The Effects of Varus or Valgus Malalignment of Proximal Ulnar Fractures on Forearm Rotation

Snow, Brian J.; Javidan, Pooya; Itamura, John M.; Lee, Thay Q.

doi:10.1097/bot.0b013e31829f5ebc

Cited by 4 publications

(2 citation statements)

References 22 publications

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“…Likewise, our simulations cannot quantitatively determine the maximal supination based on the resistance of the IOM but can rather assess qualitatively which of its parts predominantly lengthen during the full ROM and afterwards conjecture if it would produce a rotational deficit. As a comparison, a cadaveric study from Snow et al showed predominantly deficits of supination with isolated ulnar valgus deformities of 5° and which led to a substantial resistance when small rotational torques of 27 or 68 Nxcm were applied (maximal supination reached 65.2° and 78.1° respectively) 21 . Based on our results, we can affirm that this deficit of motion may be caused by a lengthening in the DOB (1.8 mm), DOAC (1.7 mm), and POC (1.3 mm) during a supination of 90°, leading to a mean lengthening of the whole IOM of +1 mm (Figures 6 and 7).…”

Section: Discussionmentioning

confidence: 99%

Malunion deformity of the forearm: Three‐dimensional length variation of interosseous membrane and bone collision

Mania

Zindel

Götschi

et al. 2022

Journal Orthopaedic Research

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It remains unclear to what extent the interosseous membrane (IOM) is affected through the whole range of motion (ROM) in posttraumatic deformities of the forearm. The purpose of this study is to describe the ligament‐ and bone‐related factors involved in rotational deficit of the forearm. Through three‐dimensional (3D) kinematic simulations on one cadaveric forearm, angular deformities of 5° in four directions (flexion, extension, valgus, varus) were produced at two locations of the radius and the ulna (proximal and distal third). The occurrence of bone collision in pronation and the linear length variation of six parts of the IOM through the whole ROM were compared between the 32 types of forearm deformities. Similar patterns could be observed among four groups: 12 types of deformity presented increased bone collision in pronation, 8 presented an improvement of bone collision with an increase of the mean linear lengthening of the IOM in neutral rotation, 6 had an increased linear lengthening of the IOM in supination with nearly unchanged bone collision in pronation and 6 types presented nearly unchanged bone collision in pronation with a shortening of the mean linear length of IOM in supination or neutral rotation. This kinematic analysis provides a better understanding of the ligament‐ and bone‐related factors expected to cause rotational deficit in forearm deformity and may help to refine the surgical indications of patient‐specific corrective osteotomy.

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Section: Discussionmentioning

confidence: 99%

Malunion deformity of the forearm: Three‐dimensional length variation of interosseous membrane and bone collision

Mania

Zindel

Götschi

et al. 2022

Journal Orthopaedic Research

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“…Given the routine use of the elbow for work, recreation, and most activities of daily living, operative repair is a clear and obvious solution to these debilitating consequences. 28 Despite the evidence-based need for open reduction and internal fixation when treating proximal ulnar fractures involving the olecranon, 29 these procedures apparently are still thought to be overvalued by the CMS.…”

Section: Discussionmentioning

confidence: 99%

Medicare Reimbursement in Hand and Upper Extremity Procedures: A 20-Year Analysis

Weiss

Gilbert

Gentile

et al. 2022

Hand (New York, N,Y.)

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Purpose: Concern exists that Medicare physician fees for procedures have decreased over the past 20 years. The Centers for Medicare & Medicaid Services (CMS) is set to re-evaluate these physician fees in the near future for concern that these procedures are overvalued. Our study sought to analyze trends in Medicare reimbursement rates from 2000 to 2019 for the top 20 most billed hand and upper extremity surgical procedures at our institution. Methods: The financial database of a single academic tertiary care center was queried to identify the Current Procedural Terminology codes most frequently utilized in orthopedic hand and upper extremity procedures in 2019. The Physician Fee Schedule Look-Up Tool from the CMS was queried for annual physician fee data. Monetary data were adjusted for inflation using the consumer price index of Urban Research Series (CPI-U-RS) and expressed in 2019 constant US dollars (USD). The average annual and total percent change in reimbursement were calculated via linear regression for all procedures ( P < .05). Results: Accounting for inflation, the total average physician reimbursement decreased by 20.9% from 2000 to 2019, with 12 of 20 codes decreasing by more than 20%. The greatest decrease pertained to arthrodesis of the wrist at 33.9%. Upon linear regression, all procedures were found to decrease annually, with arthrodesis of the wrist decreasing by an average of 2.3% annually over this period. Conclusions: Over the past 2 decades, physician reimbursement for hand and upper extremity procedures has significantly decreased.

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Omar¹,

Graulich

2023

Orthopädie Und Unfallchirurgie

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The Effects of Varus or Valgus Malalignment of Proximal Ulnar Fractures on Forearm Rotation

Abstract: Proximal ulna varus and valgus malunions lead to a significant loss of forearm pronation, supination, and total arc of motion. Valgus deformities lead to a loss of supination, whereas varus deformities lead to a greater loss of pronation.

Cited by 4 publications

References 22 publications

Malunion deformity of the forearm: Three‐dimensional length variation of interosseous membrane and bone collision

Malunion deformity of the forearm: Three‐dimensional length variation of interosseous membrane and bone collision

Medicare Reimbursement in Hand and Upper Extremity Procedures: A 20-Year Analysis

Komplikationen der Frakturbehandlung

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