Clinical news alert from the American Academy of Orthopaedic Surgeons

Below are highlights of orthopaedic research studies appearing in the May 2, 2012 issue of the Journal of Bone and Joint Surgery (JBJS), as well as the issue's full Table of Contents.

Study Quantifies the High Cost of Hand and Wrist Injuries (Patients Available for Interviews)

Injuries to the hand and wrist account for a significant number of annual emergency department visits each year in the U.S. and throughout the world. In fact, more than 2 million people visited U.S. emergency rooms for symptoms related to the hand and wrist in 2009. Investigators in the Netherlands recently quantified the frequency of these injuries in that country, as well as the cost of treatment and lost productivity (as measured in absenteeism), and compared them with other emergency department injuries. The study, "Economic Impact of Hand and Wrist Injuries: Health-Care Costs and Productivity Costs in a Population Study," appears in the May 2, 2012 issue of JBJS.

• Investigators reviewed data from the Dutch Injury Surveillance System, the National Hospital Discharge Registry, and a patient follow-up survey from 2007 and 2008. Injury incidence, health care costs, and productivity costs were calculated by age group, sex, and different subgroups of injuries.

• Hand and wrist injuries cost approximately $740 million (in U.S. dollars) each year, and are the most expensive injury type in the Netherlands, followed by knee and lower limb fractures ($562 million), hip fractures ($532 million), and skull-brain injuries ($355 million). Productivity costs contributed more to the total costs of hand and wrist injuries (56 percent) than did costs for treatment and care. Among the subtypes of hand and wrist injuries, hand and finger fractures were the most expensive, costing approximately $278 million each year, largely due to loss of productivity in patients 20 to 64 years of age.

• The study authors conclude that hand and wrist injuries are more common compared to injuries in other areas of the body. Further research is needed on potential risk factors to prevent hand and wrist injuries and on rehabilitation interventions to lower the time off work.

Patients with orthopaedic hand and wrist injuries and conditions have had great outcomes, and their inspiring stories of recovery are available at http://anationinmotion.org/condition/hand/.

• Amy Fortin can maintain her business as a personal gardener because of her wrist fracture repair.
• Linda Wortman can move her hands and hold her grandson again after wrist surgery.
• Becky Neuses can open a jar and type without pain because of her hand surgery.
• Matt McCrary is able to play sports again after his hand treatment.

**Interviews with patients can be arranged by AAOS Media Relations

Effectiveness of Anterior Cruciate Ligament Injury Prevention Training Programs: A Meta-Analysis of Controlled Trials
Functional limitations associated with end-stage ankle arthritis as measured through gait analysis, daily step count and survey
Precocious Appearance of the capital femoral ossific nucleus in Larsen Syndrome
The effect of Platelet-Rich Plasma (PRP) on Normal Soft Tissue in the Rabbit
Patient-related risk factors for periprosthetic joint infection and postoperative mortality following total hip arthroplasty in Medicare patients
Evolution of nonoperated symptomatic isolated full-thickness supraspinatus tears
Mean BMI in overweight and obese patients does not decrease after successful ankle reconstruction
The effect of NSAID administration on acute phase fracture healing: a review
The diagnostic accuracy of magnetic resonance imaging and magnetic resonance arthrography for triangular fibrocartiliaginous complex injury
Increased used of intramedullary nails for intertrochanteric proximal femur fractures in Veterans Affairs hospitals: A comparative effectiveness study
Spontaneous dissociation of offset, face-changing polyethylene liners from the acetabular shell: report of four cases
Asymmetric motion distribution between components of a mobile-core lumbar disc prosthesis: an explanation of unequal wear distribution in explanted charite polyethylene cores

The Journal of Bone & Joint Surgery has been the most valued source of information for orthopaedic surgeons and researchers for over 100 years and is the gold standard in peer-reviewed scientific information in the field. JBJS is published twice a month online and in print. Abstracts are available online at (http://www.jbjs.org). Contact Michelle Hache for general information on JBJS at mhache@jbjs.org

More than one in four Americans have bone or joint health problems, making them the greatest cause of lost work days in the U.S. When orthopaedic surgeons restore mobility and reduce pain, they help people get back to work and to independent, productive lives. Orthopaedic surgeons provide the best value in American medicine in both human and economic terms and access to high-quality orthopaedic care keeps this "Nation in Motion." To learn more, to read hundreds of patient stories or to submit your own story, visit anationinmotion.org.

For more AAOS News, visit the News Bureau, or for more information on bone and joint health, visit orthoinfo.org

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