Internal bracing (IB) is an augmentation method using high-strength nonabsorbable tape. However, there is no detailed information about the direction, location, or number of IBs required for scapholunate interosseous ligament (SLIL) injury repair. Thus, this study compared the biomechanical characteristics of short-transverse IB, long-oblique IB, and the combination of short-transverse and long-oblique (Combo) IB for SLIL injury in a biomechanical cadaveric model. We prepared nine fresh-frozen full upper extremity cadaveric specimens for this study. The scapholunate distance, scapholunate angle, and radioscaphoid angle were measured using the MicroScribe digitizing system with the SLIL intact, after scapholunate dissociation and the three different reconstructions. Three-dimensional digital records were obtained in six wrist positions in each experimental condition. Short-transverse IB had a similar effect compared with long-oblique IB in addressing the widening of the scapholunate distance. However, both were less effective than Combo IB. For scaphoid flexion deformity, short-transverse IB had minimal effect, while long-oblique IB had a similar effect compared to Combo IB. Combo IB was the most effective for improving distraction intensity and rotational strength. This study provides important information about the biomechanical characteristics of three different IB methods for SLIL injury and may be useful to clinicians in treating scapholunate dissociation.

Chae S, et al. Clin Orthop Surg. 2022 Sep;14:e78. https://doi.org/10.4055/cios22070

Case control study. To determine how the Neck Disability Index (NDI), a cervical spine-specific outcome, reflects health-related quality-of-life, and if NDI is correlated to the 36-item Short-Form Health Survey (SF-36) scores. NDI is a useful tool for assessing health-related quality of life in patients with neck pain. We used the Pearson product-moment correlation coefficient to assess the validity of all items under NDI and SF-36, and the Pearson's correlation coefficient to assess the correlation between NDI and total SF-36 scores. The primary outcome measures were spine-specific health status- and general health status-measures after spine surgery, and these were evaluated every year for 2 years, using both NDI and SF-36 scores. NDI had a strong linear correlation with SF-36 and its two scales, the Physical Component Score (PCS) and the Mental Component Score (MCS), attesting to the validity of these two instruments. Among the eight subscales of SF-36, there was a strong linear correlation between NDI and PCS-physical functioning, PCS-bodily pain, and MCS-role emotional. Further, a moderate linear correlation was observed between NDI and subscales of PCS-role physical, PCS-general health, and MCS-social functioning, and between NDI and MCS-vitality and MCS-mental health. Our findings suggest that the NDI adequately reflects the patient's physical and mental quality of life, implying that the use of NDI to assess functional outcomes can also be ultimately used to evaluate the patient's quality of life.

Rationale: Intraoperative neurophysiological monitoring (IONM) has been utilized not only for the rapid detection of neural insults during surgeries, but also to verify the neurophysiological integrity of nerve lesions in the surgical field. Patient concerns: A 32-year-old woman presented with a wrist and finger drop that had lasted about 3 months. Diagnoses: The result of the initial electrodiagnostic test was consistent with posterior interosseous nerve (PIN) syndrome. Ultrasonography and magnetic resonance imaging of the proximal forearm showed a cystic mass at the anterolateral aspect of the radial head, which was diagnosed as a ganglion cyst. Interventions: Surgical release of the ganglion cyst with IONM was performed. During the surgery, we induced nerve action potentials and compound motor action potentials across the ganglion cyst, which demonstrated neural continuity. Outcomes: Three months after the surgery, the patient showed partial recovery of wrist and finger extensor muscle power. An electrodiagnostic test conducted 3 months after the surgery showed reinnervation potentials in PIN-innervated muscles. Lessons: IONM during peripheral nerve surgeries can support surgical decisions and confirm the location and degree of nerve damage.

Park HY, et al. Clin Orthop Surg. 2024 Oct;16(5):790-799. https://doi.org/10.4055/cios24032

Republic of Korea’s suicide rate is the highest among Organization for Economic Co-operation and Development countries. In Republic of Korea, suicide is the leading cause of death among young people aged 10–19 years. This study aimed to identify changes in patients aged 10–19 years who visited the emergency department in Republic of Korea after inflicting self-harm over the past five years and to compare the situations before and after the outbreak of the COVID-19 pandemic. Analysis of government data revealed that the average daily visits per 100,000 were 6.25, 8.18, 13.26, 15.31, and 15.71 from 2016 to 2020, respectively. The study formed four groups for further analysis, with the population divided by sex and age (10–14 and 15–19 years old). The late-teenage female group showed the sharpest increase and was the only group that continued to increase. A comparison of the figures 10 months before and after the outbreak of the pandemic revealed a statistically significant increase in self-harm attempts by only the late-teenage female group. Meanwhile, visits (per day) in the male group did not increase, but the rates of death and ICU admission increased. Additional studies and preparations that account for age and sex are warranted.