Wednesday, July 16, 2014

Best Scientific Publication on Birth Anomalies of the Upper Extremity

I have been fortunate to learn from a number of wonderful hand surgeons over my career.  One of the most impactful was Paul Manske, a hand surgeon and, more specifically, a congenital hand surgeon.  He spent the majority of his career here at Washington University School of Medicine.  I am not alone in this sentiment of appreciation and 4 of us have established an an annual award recognizing the "best" or most impactful publication in the field of upper extremity congenital/ pediatric anomalies.  Ann Van Heest, Michelle James, Relton McCarroll and I review the literature in our field to determine the winner of the award each year.  


 In 2011, the winner was Ann Nachemson's group for "Children with surgically corrected hand deformities and upper limb deficiencies: self concept and psychological well- being.  JHS 2011; 36E: 795- 801.  This manuscript provides insight into how children with deficiencies of varying severity identify with their anomalies.  The more severe group had a self concept score similar to a group of healthy children.  Children with milder deformities were found to have lower (worse) scores than those children with more severe deformities.  Nachemson Study
 
 In 2012, the winner was PP Kotwal, et al for "Comparison of surgical treatment and nonoperative management for radial longitudinal deficiency.  JHS Eur 2012; 37(2) 161-9.  This study evaluated two groups of children treated for radial deficiency and found superior outcomes in those treated with centralization (or radialization).  This study is important as it was the first to scientifically demonstrate the positive effect of centralization. Kotwal Study
 

Finally, we recently notified the authors Clement and Porter that "Forearm Deformity in Patients with Hereditary Multiple Exostoses: Factors Associated with Range of Motion and Radial Head Dislocation" in the Journal of Bone and Joint Surgery was the 2013 winner.  In a large group of patients, this study showed that distal radius exostoses were most common.  Additionally it confirmed that a shortened ulna was related to decreased forearm motion and radial head dislocations.  It suggested, therefore, that surgery should be considered in such patients. Clement Study

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