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  1. Article ; Online: Thumb Injuries in Athletes.

    Kadow, Tiffany R / Fowler, John R

    Hand clinics

    2017  Volume 33, Issue 1, Page(s) 161–173

    Abstract: Thumb injuries are common in athletes and present a challenging opportunity for upper extremity physicians. Common injuries include metacarpal base fractures (Bennett and Rolando types), ulnar and radial collateral ligament injuries, dislocation of the ... ...

    Abstract Thumb injuries are common in athletes and present a challenging opportunity for upper extremity physicians. Common injuries include metacarpal base fractures (Bennett and Rolando types), ulnar and radial collateral ligament injuries, dislocation of the carpometacarpal and metacarpophalangeal joints, and phalanx fractures. This review, although not exhaustive, highlights some of the most common thumb injuries in athletes. The treating physician must balance pressure from athletes, parents, coaches, and executives to expedite return to play with the long-term well-being of the athlete. Operative treatment may expedite return to play; however, one must carefully weigh the added risks involved with surgical intervention.
    Language English
    Publishing date 2017-02
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 1315374-2
    ISSN 1558-1969 ; 0749-0712
    ISSN (online) 1558-1969
    ISSN 0749-0712
    DOI 10.1016/j.hcl.2016.08.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Prevalence of Carpal Tunnel Syndrome in a Hand Surgeon's Practice.

    Kadow, Tiffany R / Kaufmann, Robert A / Goitz, Robert J / Fowler, John R

    Journal of hand and microsurgery

    2018  Volume 10, Issue 2, Page(s) 79–81

    Abstract: ... ...

    Abstract Purpose
    Language English
    Publishing date 2018-03-20
    Publishing country United States
    Document type Journal Article
    ISSN 0974-3227
    ISSN 0974-3227
    DOI 10.1055/s-0038-1626688
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Latissimus Dorsi Tendon Transfer and Superior Capsular Reconstruction for Irreparable, Posterosuperior Rotator Cuff Tears.

    Kadow, Tiffany R / Meredith, Sean J / Garcia, Daniel / Minorini, Rebecca / Delaney, Ruth / Baratz, Mark / Lin, Albert

    The archives of bone and joint surgery

    2021  Volume 9, Issue 1, Page(s) 44–49

    Abstract: Background: The purpose of this study was to compare latissimus dorsi tendon transfer (LDTT) and arthroscopic superior capsular reconstruction (SCR) to determine if one is superior to the other regarding improvement in range of motion (ROM) or patient- ... ...

    Abstract Background: The purpose of this study was to compare latissimus dorsi tendon transfer (LDTT) and arthroscopic superior capsular reconstruction (SCR) to determine if one is superior to the other regarding improvement in range of motion (ROM) or patient-reported outcomes (PROs).
    Methods: A multicenter, retrospective cohort study was conducted on 43 patients with an irreparable, posterosuperior rotator cuff tear who underwent either LDTT or SCR. Preoperative and postoperative forward flexion and external rotation, as well as PROs including ASES, VAS, and SSV, were assessed. Student t-test and chi-square statistical analyses were performed.
    Results: 16 LDTT, at mean follow-up of 18 months, and 27 SCR, at mean follow-up 15 months, were studied. Mean active forward flexion significantly improved from 85.2° to 137.6° in the SCR cohort (
    Conclusion: This study demonstrates successful clinical and patient-reported outcomes with both LDTT and SCR for irreparable, posterosuperior rotator cuff tears, with greater improvement in forward flexion with SCR and greater improvement in external rotation with LDTT.
    Language English
    Publishing date 2021-01-18
    Publishing country Iran
    Document type Journal Article
    ZDB-ID 2782053-1
    ISSN 2345-461X ; 2345-4644
    ISSN (online) 2345-461X
    ISSN 2345-4644
    DOI 10.22038/abjs.2020.50854.2527
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: A Prospective Comparison of Diagnostic Tools for the Diagnosis of Carpal Tunnel Syndrome.

    Wang, William L / Buterbaugh, Kristin / Kadow, Tiffany R / Goitz, Robert J / Fowler, John R

    The Journal of hand surgery

    2018  Volume 43, Issue 9, Page(s) 833–836.e2

    Abstract: Purpose: Nerve conduction studies (NCS), CTS-6, Wainner, Kamath, and Lo are diagnostic tests that are used to diagnose carpal tunnel syndrome (CTS). To our knowledge, no study has compared the sensitivity and specificity of these 5 tests with one ... ...

    Abstract Purpose: Nerve conduction studies (NCS), CTS-6, Wainner, Kamath, and Lo are diagnostic tests that are used to diagnose carpal tunnel syndrome (CTS). To our knowledge, no study has compared the sensitivity and specificity of these 5 tests with one another. The purpose of this study is to compare NCS, CTS-6, Wainner, Kamath, and Lo using clinical diagnosis by a hand fellowship-trained orthopedic surgeon as reference standard.
    Methods: A hand fellowship-trained surgeon completed the CTS-6, Wainner, Kamath, and Lo diagnostic tools. Cutoff values for a positive test were based on values in the literature, if available. The NCS were performed by a certified electrodiagnostic physician according the standards of the American Association of Neuromuscular and Electrodiagnostic Medicine and were interpreted using absolute latencies, relative latencies, and combined sensory index. Sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio were calculated for the tests using clinical diagnosis as the reference standard.
    Results: A total of 408 wrists from 250 patients were analyzed in the study. The NCS had the highest sensitivity (94%) but also the lowest specificity (50%) of any of the diagnostic tests. Using a cutoff of 18, CTS-6 had the highest specificity (99%). The NCS had the highest area under the curve at 74%, followed closely by the Kamath at 69%.
    Conclusions: The NCS were traditionally felt to be a strong confirmatory test given their high specificity. However, this prospective series demonstrated that NCS had the lowest specificity of any diagnostic test.
    Clinical relevance: Consideration should be given to using alternative diagnostic tests/tools based on the results of this study.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carpal Tunnel Syndrome/diagnosis ; Electrodiagnosis ; Female ; Humans ; Male ; Medical History Taking ; Middle Aged ; Neural Conduction ; Neurologic Examination ; Predictive Value of Tests ; Prospective Studies ; Sensitivity and Specificity ; Surveys and Questionnaires ; Young Adult
    Language English
    Publishing date 2018-06-21
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 605716-0
    ISSN 1531-6564 ; 0363-5023
    ISSN (online) 1531-6564
    ISSN 0363-5023
    DOI 10.1016/j.jhsa.2018.05.022
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Prevalence of Carpal Tunnel Syndrome in a Hand Surgeon's Practice

    Kadow, Tiffany R. / Kaufmann, Robert A. / Goitz, Robert J. / Fowler, John R.

    Journal of Hand and Microsurgery

    2018  Volume 10, Issue 02, Page(s) 79–81

    Abstract: Purpose: Additional methods of diagnosing carpal tunnel syndrome (CTS) are increasingly being investigated, such as ultrasound or diagnostic tools such as carpal tunnel syndrome 6 (CTS-6), and the sensitivity and specificity of these tests are ... ...

    Abstract Purpose: Additional methods of diagnosing carpal tunnel syndrome (CTS) are increasingly being investigated, such as ultrasound or diagnostic tools such as carpal tunnel syndrome 6 (CTS-6), and the sensitivity and specificity of these tests are determined by the pretest probably and thereby the prevalence of a condition. It is critical that the prevalence used in these calculations accurately reflects the population undergoing these tests for a true assessment of their quality. Orthopaedic surgeons and, specifically, upper extremity specialists are most often studying these diagnostic methods, and given referral patterns, these physicians likely have a greater prevalence of CTS in their clinics than previously published for only the general population (5%). The purpose of this study is to define the prevalence of CTS in a hand surgery practice consisting of three fellowship-trained orthopaedic hand surgeons for use in future assessing the accuracy of diagnostic tests for CTS among patients presenting to a hand surgeon for evaluation.
    Methods: All the adult patients (≥ 18 years) who had a face-to-face encounter with an orthopaedic surgeon in this practice between January 1 and December 31, 2014 were identified. The ICD-9 code 354.0 was used to identify all patients diagnosed with CTS. The medical records of all patients with ICD-9 code were reviewed and the results of electrodiagnostic testing (EDX) documented.
    Results: A total 56,641 patients were evaluated by the orthopaedic department from January 1 to December 31, 2014. Of these patients, 812 (1.4%) had EDX-confirmed CTS. The prevalence of EDX-confirmed CTS was 0.2% for nonhand orthopaedic specialists and 10.7% for hand specialists. Of those seen by the hand subspecialists, 66% were female, 34% were male with the right hand affected in 42%, left in 26%, and bilateral upper extremities in 32%.
    Conclusion: Current literature demonstrates a prevalence of CTS among the general population of 5%. The authors have demonstrated a prevalence of CTS in an orthopaedic surgical practice to be 1.4% with a prevalence of only 0.2% noted among nonupper extremity orthopaedic specialists. They have determined the prevalence of EDX confirmed CTS in a tertiary referral hand practice to be 10.7%, much higher than the prevalence in the general population. Accurate identification of the prevalence of CTS within these patient groups is critical for statistical analysis of new diagnostic tools being developed to assess for CTS.
    Level of Evidence: Level IV, cross-sectional, prognostic.
    Keywords carpal tunnel syndrome ; prevalence ; specialty practice
    Language English
    Publishing date 2018-03-20
    Publisher Thieme Medical and Scientific Publishers Private Ltd.
    Publishing place Stuttgart ; New York
    Document type Article
    ISSN 0974-6897 ; 0974-3227
    ISSN (online) 0974-6897
    ISSN 0974-3227
    DOI 10.1055/s-0038-1626688
    Database Thieme publisher's database

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  6. Article ; Online: Correlating Median Nerve Cross-sectional Area With Nerve Conduction Studies.

    Pulikkottil, Benson J / Schub, Micah / Kadow, Tiffany R / Wang, William / Fowler, John R

    The Journal of hand surgery

    2016  Volume 41, Issue 10, Page(s) 958–962

    Abstract: Purpose: To determine whether there is a correlation between the cross-sectional area (CSA) of the median nerve, as measured using ultrasound, and the distal motor and/or sensory latencies as measured on nerve conduction studies.: Methods: Patients ... ...

    Abstract Purpose: To determine whether there is a correlation between the cross-sectional area (CSA) of the median nerve, as measured using ultrasound, and the distal motor and/or sensory latencies as measured on nerve conduction studies.
    Methods: Patients with clinical signs and symptoms of carpal tunnel syndrome were prospectively enrolled in this study. Subjects underwent ultrasound measurement of the CSA of the median nerve at the carpal tunnel inlet by a fellowship-trained hand surgeon, followed by nerve conduction studies (NCS) by a certified electrodiagnostic technician who was blinded to the results of the ultrasound examination. Pearson correlations were performed to compare CSA and NCS.
    Results: Pearson correlation was r = 0.57 between CSA and distal motor latency and r = 0.47 between CSA and distal sensory latency. Correlation was r = 0.81 between distal motor latency and distal sensory latency.
    Conclusions: There is a correlation between CSA of the median nerve and NCS. Further research is necessary to determine which test correlates better with patient symptoms and function.
    Type of study/level of evidence: Diagnostic II.
    Language English
    Publishing date 2016-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605716-0
    ISSN 1531-6564 ; 0363-5023
    ISSN (online) 1531-6564
    ISSN 0363-5023
    DOI 10.1016/j.jhsa.2016.08.018
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Molecular basis of intervertebral disc degeneration and herniations: what are the important translational questions?

    Kadow, Tiffany / Sowa, Gwendolyn / Vo, Nam / Kang, James D

    Clinical orthopaedics and related research

    2014  Volume 473, Issue 6, Page(s) 1903–1912

    Abstract: Background: Intervertebral disc degeneration is a common condition with few inexpensive and effective modes of treatment, but current investigations seek to clarify the underlying process and offer new treatment options. It will be important for ... ...

    Abstract Background: Intervertebral disc degeneration is a common condition with few inexpensive and effective modes of treatment, but current investigations seek to clarify the underlying process and offer new treatment options. It will be important for physicians to understand the molecular basis for the pathology and how it translates to developing clinical treatments for disc degeneration. In this review, we sought to summarize for clinicians what is known about the molecular processes that causes disc degeneration.
    Results: A healthy disc requires maintenance of a homeostatic environment, and when disrupted, a catabolic cascade of events occurs on a molecular level resulting in upregulation of proinflammatory cytokines, increased degradative enzymes, and a loss of matrix proteins. This promotes degenerative changes and occasional neurovascular ingrowth potentially contributing to the development of pain. Research demonstrates the molecular changes underlying the harmful effects of aging, smoking, and obesity seen clinically while demonstrating the variable influence of exercise. Finally, oral medications, supplements, biologic treatments, gene therapy, and stem cells hold great promise but require cautious application until their safety profiles are better outlined.
    Conclusions: Intervertebral disc degeneration occurs where there is a loss of homeostatic balance with a predominantly catabolic metabolic profile. A basic understanding of the molecular changes occurring in the degenerating disc is important for practicing clinicians because it may help them to inform patients to alter lifestyle choices, identify beneficial or harmful supplements, or offer new biologic, genetic, or stem cell therapies.
    MeSH term(s) Extracellular Matrix Proteins/metabolism ; Humans ; Inflammation Mediators/metabolism ; Intervertebral Disc/metabolism ; Intervertebral Disc/pathology ; Intervertebral Disc/physiopathology ; Intervertebral Disc Degeneration/diagnosis ; Intervertebral Disc Degeneration/metabolism ; Intervertebral Disc Degeneration/physiopathology ; Intervertebral Disc Degeneration/therapy ; Intervertebral Disc Displacement/diagnosis ; Intervertebral Disc Displacement/metabolism ; Intervertebral Disc Displacement/physiopathology ; Intervertebral Disc Displacement/therapy ; Orthopedic Procedures ; Peptide Hydrolases/metabolism ; Predictive Value of Tests ; Risk Factors ; Signal Transduction ; Treatment Outcome
    Chemical Substances Extracellular Matrix Proteins ; Inflammation Mediators ; Peptide Hydrolases (EC 3.4.-)
    Language English
    Publishing date 2014-07-15
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 80301-7
    ISSN 1528-1132 ; 0009-921X
    ISSN (online) 1528-1132
    ISSN 0009-921X
    DOI 10.1007/s11999-014-3774-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Staged treatment of high energy midfoot fracture dislocations.

    Kadow, Tiffany R / Siska, Peter A / Evans, Andrew R / Sands, Steven S / Tarkin, Ivan S

    Foot & ankle international

    2014  Volume 35, Issue 12, Page(s) 1287–1291

    Abstract: Background: Staged care with interval external fixation is a successful established treatment strategy for high energy periarticular fractures with often extensive soft tissue damage such as the tibial plateau and plafond. The aim of the current study ... ...

    Abstract Background: Staged care with interval external fixation is a successful established treatment strategy for high energy periarticular fractures with often extensive soft tissue damage such as the tibial plateau and plafond. The aim of the current study was to determine whether staged care of high energy midfoot fracture/dislocation with interval external fixation prior to definitive open reconstruction in the polytraumatized patient was both safe and efficacious.
    Methods: One hundred twenty-three patients were operated on for high energy midfoot fracture/dislocation during the 8-year study period. Eighteen polytrauma patients were selectively treated with a staged protocol. Radiographic assessment was utilized to determine if the fixator achieved gross skeletal alignment. Further, final alignment after definitive reconstruction and postoperative complications were analyzed.
    Results: The fixator improved both length and alignment of all high energy midfoot fracture/dislocations. Loss of acceptable reduction while in the temporary frame occurred in only 1 case. Final alignment after definitive reconstruction was anatomic in all cases. No cases of wound-related complication and/or deep infection occurred.
    Conclusion: Delayed reconstruction of high energy midfoot fracture/dislocation using interval external fixation should be an accepted care paradigm in selected polytrauma patients.
    Level of evidence: Level III, retrospective comparative study.
    MeSH term(s) Adult ; Aged ; Cohort Studies ; External Fixators ; Female ; Follow-Up Studies ; Foot Injuries/diagnostic imaging ; Foot Injuries/surgery ; Forefoot, Human/diagnostic imaging ; Forefoot, Human/injuries ; Forefoot, Human/surgery ; Fracture Fixation/adverse effects ; Fracture Fixation/methods ; Fracture Healing/physiology ; Fractures, Bone/diagnostic imaging ; Fractures, Bone/surgery ; Humans ; Injury Severity Score ; Joint Dislocations/diagnostic imaging ; Joint Dislocations/surgery ; Male ; Middle Aged ; Multiple Trauma/diagnostic imaging ; Multiple Trauma/surgery ; Radiography ; Recovery of Function/physiology ; Retrospective Studies ; Risk Assessment ; Time Factors ; Treatment Outcome ; Young Adult
    Language English
    Publishing date 2014-12
    Publishing country United States
    Document type Comparative Study ; Evaluation Studies ; Journal Article
    ZDB-ID 1183283-6
    ISSN 1944-7876 ; 1071-1007
    ISSN (online) 1944-7876
    ISSN 1071-1007
    DOI 10.1177/1071100714552077
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: NSAID use in intervertebral disc degeneration: what are the effects on matrix homeostasis in vivo?

    Vaudreuil, Nicholas / Kadow, Tiffany / Yurube, Takashi / Hartman, Robert / Ngo, Kevin / Dong, Qing / Pohl, Pedro / Coelho, J Paulo / Kang, James / Vo, Nam / Sowa, Gwendolyn

    The spine journal : official journal of the North American Spine Society

    2017  Volume 17, Issue 8, Page(s) 1163–1170

    Abstract: Background context: Non-steroidal anti-inflammatory drugs (NSAIDs) are a widely used treatment for low back pain (LBP). Literature on NSAID use in articular cartilage has shown detrimental effects; however, minimal data exist to detail the effects of ... ...

    Abstract Background context: Non-steroidal anti-inflammatory drugs (NSAIDs) are a widely used treatment for low back pain (LBP). Literature on NSAID use in articular cartilage has shown detrimental effects; however, minimal data exist to detail the effects of NSAIDs in intervertebral disc degeneration (IDD). As IDD is a major cause of LBP, we explored the effects of indomethacin, a commonly used NSAID, on disc matrix homeostasis in an animal model of IDD.
    Purpose: This study aimed to determine the effects of oral indomethacin administration on IDD in an in vivo rabbit model. This study hypothesized that indomethacin use would accelerate the progression of IDD based upon serial imaging and tissue outcomes.
    Study design/setting: This was a laboratory-based, controlled, in vivo evaluation of the effects of oral indomethacin administration on rabbit intervertebral discs.
    Methods: Six skeletally mature New Zealand white rabbits were divided into two groups: disc puncture alone to induce IDD (Puncture group) and disc puncture plus indomethacin (Punc+Ind group). The Punc+Ind group received daily administration of 6mg/kg oral indomethacin. Serial magnetic resonance imaging (MRI) was obtained at 0, 4, 8, and 12 weeks. The MRI index and the nucleus pulposus (NP) area were calculated. Discs were harvested at 12 weeks for determination of disc glycosaminoglycan (GAG) content, relative gene expression measured by real-time polymerase chain reaction, and histologic analyses.
    Results: The MRI index and the NP area of punctured discs in the Punc+Ind group demonstrated no worsening of degeneration compared with the Puncture group. Histologic analysis was consistent with less severe disc degeneration in the Punc+Ind group. Minimal differences in gene expression of matrix genes were observed between Puncture and Punc+Ind groups. The GAG content was higher in animals receiving indomethacin in both annulus fibrosus and NP at adjacent uninjured discs.
    Conclusions: Oral indomethacin administration did not result in acceleration of IDD in an in vivo rabbit model. Future research is needed to ascertain long-term effects of indomethacin and other NSAIDs on disc matrix homeostasis.
    MeSH term(s) Animals ; Anti-Inflammatory Agents, Non-Steroidal/administration & dosage ; Anti-Inflammatory Agents, Non-Steroidal/adverse effects ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Female ; Glycosaminoglycans/metabolism ; Homeostasis ; Indomethacin/administration & dosage ; Indomethacin/adverse effects ; Indomethacin/therapeutic use ; Intervertebral Disc Degeneration/drug therapy ; Nucleus Pulposus/drug effects ; Nucleus Pulposus/metabolism ; Rabbits
    Chemical Substances Anti-Inflammatory Agents, Non-Steroidal ; Glycosaminoglycans ; Indomethacin (XXE1CET956)
    Language English
    Publishing date 2017
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2037072-6
    ISSN 1878-1632 ; 1529-9430
    ISSN (online) 1878-1632
    ISSN 1529-9430
    DOI 10.1016/j.spinee.2017.04.012
    Database MEDical Literature Analysis and Retrieval System OnLINE

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