Search

Introduction Patients are increasingly relying on the internet for information about their medical diagnoses, but there is little regulation on the content of these websites. The purpose of this study was to investigate the quality of the informational content available on the internet regarding DeQuervain's tenosynovitis.  Methods The search phrasing "'DeQuervain' OR 'DeQuervain's' OR 'Radial styloid tenosynovitis' OR 'DeQuervain's synovitis' OR 'Wrist tendonitis'" was entered into the five most commonly used search engines, and the first 50 universal resource locators (URLs) were recorded, including sponsored sites. Duplicate sites and URLs linking to other search engines were removed, yielding a roster of 109 websites that form the basis for this study. Each site was graded by two authors and scored based on a previously published information evaluation protocol regarding informational content. A third individual resolved any conflict before analysis. The sum of these scores resulted in an "Informational Score" on a scale from 0 to 100. Results Sixty-six (60.6%) of the websites evaluated were authored by an academic institution or a physician, and these all provided conventional information. Thirty-two (29.4%) of the sites were commercial sites or sold commercial products. The remaining 11 websites (10.1%) had nonphysician, unidentified, or lay authorship. The mean informational score for all sites was 46.7 out of a maximum of 100 points. The mean score of the academic or physician-authored websites was 53.3 out of 100 points, compared to 36.7 out of 100 for the remainder of the sites, which was significantly different. The mean score for the 14 sponsored websites was 11.6 out of 100. Discussion/conclusion We concluded that internet information on DeQuervain's tenosynovitis is of poor quality and incomplete. Patients looking for information about DeQuervain's tenosynovitis on the internet should be advised to focus on academic- and physician-authored sites in order to avoid commercial bias and misleading information., Competing Interests: Human subjects: All authors have confirmed that this study did not involve human participants or tissue. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Plusch et al.)

Background: Despite increasingly wider use, there remains controversy among anesthesiologists regarding preferred formulations and the role of steroid adjuvants in regional anesthesia. There is also uncertainty in the role of dexamethasone when administered directly versus peripherally. We hypothesize that directly mixing dexamethasone into the regional nerve block rather than peripherally administered intravenous dexamethasone will demonstrate a difference in efficacy concerning duration and rebound pain, decreased postoperative pain scores, or opioid consumption within the short-term postoperative period., Methods: A prospective, randomized controlled blinded study was conducted for patients undergoing open reduction and internal fixation with a volar plate technique for distal radius fractures. Patients were randomized for their preoperative anesthesia. One group had ultrasound-guided supraclavicular block with ropivacaine with a direct mix of dexamethasone 4 mg (Direct group), while the other group had ultrasound-guided supraclavicular block with ropivacaine and peripheral intravenous dexamethasone 4 mg (Indirect group). Data was collected pre, intra, and postoperatively., Results: Fifty patients consented and participated in the study, with 27 participants in the direct group and 23 participants in the indirect group. Compared to intravenous administration, directly administered dexamethasone demonstrated a significant difference in the average time for the block to fade, onset of motor and sensory recovery, and block resolution., Conclusion: Our findings prove that directly mixing dexamethasone compared to peripherally administered intravenous dexamethasone will demonstrate a difference in efficacy with regards to duration and rebound pain, but do not prove that there will be a difference in decreased postoperative pain scores or opioid consumption within the 24-hour postoperative period., Level of Evidence: Prognosis Level I., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: Injury to the scapholunate (SL) interosseous ligament (SLIL) is a common cause of carpal instability. Internal brace augmentation has been used in various ligament repair procedures; however, further investigation of its outcomes in hand surgery is needed. This study aimed to examine outcomes for patients who underwent SLIL repair with internal brace augmentation., Methods: Patients who underwent SLIL repair with the internal brace technique and had at least 1 year of follow-up were contacted. Available patients returned for an in-person evaluation with new radiographs and physical examination. If patients could not be contacted but had x-rays and physical examinations performed at greater than 1 year after surgery, these data were collected from their medical records. Participating patients completed the Quick DASH and Patient-Rated Wrist Evaluation surveys and rated their satisfaction with the surgery. Outcomes assessed included wrist range of motion, grip strength, scaphoid shift test, SL gap, SL angle, and radiographic evidence of radiocarpal arthritis., Results: We collected outcomes for 14 SLIL repairs among 13 patients (12 male). Mean length of the follow-up was 41 months ( n  = 14, 17-64). Mean Quick DASH and Patient-Rated Wrist Evaluation scores were 6.1 (0-43.2) and 9.6 (0-65), respectively. Radiographic measurements remained stable from immediate to latest follow-up, and no radiocarpal arthritic changes were noted. However, SL gap decreased from a mean of 5.33 mm (3.4-6.7) before surgery to 3.34 mm (2-4.6) at the latest follow-up, and SL angle decreased from a mean of 79.5° (67°-97°) before surgery to 67.3° (51°-85°) at the latest follow-up. All scaphoid shift tests were stable., Conclusions: Therefore, SL internal brace augmentation has favorable short-term results with improvements in pain, function, satisfaction, and carpal alignment at greater than 1 year postoperatively. This technique can be an effective option for the management of SL instability in the short term., Type of Study/level of Evidence: Therapeutic IV., (© 2023 The Authors.)