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Purpose: Osteoporosis and fragility fractures incur substantial costs to quality of life and global health care systems. The current gold standard for quantifying bone density is dual-energy X-ray absorptiometry. Our hypothesis is that bone density can be accurately predicted with a simpler method using plain radiographs of the hand., Methods: This retrospective cohort study was undertaken in two centers in the United Kingdom, where the second metacarpal cortical percentage (2MCP) scores were calculated from radiographs. This study included patients who had sustained a distal radius fracture between 2020 and 2022 and had received both a posteroanterior radiograph of the hand and a dual-energy X-ray absorptiometry scan within 12 months of their radiograph and fracture. The Pearson correlation coefficient was calculated to determine the correlation between 2MCP scores and t-scores of the femoral neck on dual-energy X-ray absorptiometry scans., Results: Of the 188 patients, the 2MCP score significantly correlated with bone density t-scores of the femoral neck. A 2MCP score <50% demonstrated 100% sensitivity and 100% specificity for differentiating osteoporotic from normal subjects, whereas a 2MCP score <60% demonstrated 94.4% sensitivity and 83.0% specificity in differentiating osteopenic from normal subjects., Conclusions: These data confirm that the likelihood of osteoporosis being present can be determined via the 2MCP score., Type of Study/level of Evidence: Diagnostic I., (Copyright © 2023 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)

Adolescence is a difficult time, both physically and emotionally. Rapid growth coupled with physical changes in the background of high levels of activity can be overwhelming. Meanwhile, unfamiliar life stressors coupled with undeveloped compensatory mechanisms can lead to overwhelming anxiety and emotional distress. Emotional factors can make injuries and overuse syndromes feel more catastrophic. Occasionally, an adolescent's emotional distress can manifest physically, without antecedent injury or physiologic cause. Understanding the psychological milieu is as important as understanding the disease processes that can affect adolescents if one hopes to manage these patients effectively., (Copyright © 2022. Published by Elsevier Inc.)

Purpose: Studies have shown the effects of surgical treatments for trapeziometacarpal osteoarthritis on thumb biomechanics; however, the biomechanical effects on the wrist have not been reported. This study aimed to quantify alterations in wrist muscle forces following trapeziectomy with or without ligament reconstruction and replacement., Methods: A validated physiological wrist simulator replicated cyclic wrist motions in cadaveric specimens by applying tensile loads to 6 muscles. Muscle forces required to move the intact wrist were compared with those required after performing trapeziectomy, suture suspension arthroplasty, prosthetic replacement, and ligament reconstruction with tendon interposition (LRTI)., Results: Trapeziectomy required higher abductor pollicis longus forces in flexion and higher flexor carpi radialis forces coupled with lower extensor carpi ulnaris forces in radial deviation. Of the 3 surgical reconstructions tested post-trapeziectomy, wrist muscle forces following LRTI were closest to those observed in the intact case throughout the range of all simulated motions., Conclusions: This study shows that wrist biomechanics were significantly altered following trapeziectomy, and of the reconstructions tested, LRTI most closely resembled the intact biomechanics in this cadaveric model., Clinical Relevance: Trapeziectomy, as a standalone procedure in the treatment of trapeziometacarpal osteoarthritis, may result in the formation of a potentially unfilled trapezial gap, leading to higher wrist muscle forces. This biomechanical alteration could be associated with clinically important outcomes, such as pain and/or joint instability., (Copyright © 2020 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)