Background: Dorsal wrist ganglia are the most common soft tissue tumor type of the upper limb. Surgical resection, open or arthroscopic, is one of the most frequent procedures performed by hand surgeons. This study sought to perform an objective evaluation of the outcomes of arthroscopic resection of dorsal wrist ganglia and their recurrence rates over 4 years. Patients treated with arthroscopic resection were expected to have favorable outcomes and low complication rates after 4 years of follow-up. Methods: We evaluated 34 cases of dorsal wrist ganglia in patients who underwent arthroscopic resection. The patients were evaluated using the Quick-Disabilities of the Arm, Shoulder and Hand (QuickDASH) outcome measure, visual analog scale (VAS) for pain, range of motion of the wrist, palmar grip strength, rates of recurrence, and complications. Results: During the postoperative period, the QuickDASH score averaged 2.3 points, the mean residual pain by VAS was 0.54, full range of wrist movement was recovered by all patients, and the mean palmar grip strength was 29.4 kgf; there was 1 case with recurrence. There were no severe postoperative complications throughout the follow-up period. Conclusions: The outcomes, recurrence, and complications rates after 4 years of follow-up presented in this study support the use of arthroscopy as a treatment for dorsal wrist ganglion.

Background: The assessment of post-surgical outcomes among patients with Workers’ Compensation is challenging as their results are typically worse compared to those who do not receive this compensation. These patients’ time to return to work is a relevant outcome measure as it illustrates the economic and social implications of this phenomenon. In this meta-analysis we aimed to assess the influence of this factor, comparing compensated and non-compensated patients. Findings: Two authors independently searched MEDLINE (Ovid), Embase (Ovid), CINAHL, Google Scholar, LILACS and the Cochrane Library and also searched for references from the retrieved studies. We aimed to find prospective studies that compared carpal tunnel release and elective rotator cuff surgery outcomes for Workers’ Compensation patients versus their non-compensated counterparts. We assessed the studies’ quality using the Guyatt & Busse Risk of Bias Tool. Data collection was performed to depict included studies characteristics and meta-analysis. Three studies were included in the review. Two of these studies assessed the outcomes following carpal tunnel release while the other focused on rotator cuff repair. The results demonstrated that time to return to work was longer for patients that were compensated and that there was a strong association between this outcome and compensation status - Standard Mean Difference, 1.35 (IC 95%; 0.91-1.80, p < 0.001). Conclusions: This study demonstrated that compensated patients have a longer return to work time following carpal tunnel release and elective rotator cuff surgery, compared to patients who did not receive compensation. Surgeons and health providers should be mindful of this phenomenon when evaluating the prognosis of a surgery for a patient receiving compensation for their condition. Type of study/level of evidence: Meta-analysis of prospective Studies/ Level III

Key words: Wounds and Injuries; Hand Injuries; Accident Prevention; Cross-Sectional Study

Objetivos Avaliar a prevalência da ausência de função dos tendões do músculo flexor superficial do quarto e quinto dedos em uma população brasileira. Métodos Estudo prospectivo foi realizado no departamento de ortopedia e traumatologia de um hospital universitário. O estudo foi desenvolvido no período de outubro de 2017 a abril 2018. A amostra foi formada por voluntários sem histórico de trauma, cirurgia ou qualquer afecção dos membros superiores. Foram incluídos neste estudo indivíduos de ambos os gêneros com idade igual ou superior a 18 anos. A avaliação da função do tendão do múculo flexor superficial do quarto e quinto dedos foi realizada por meio de testes clínicos por três examinadores independentes. Para análise dos dados foi utilizado o programa GraphPad Prism 5.0 (GraphPad Software, San Diego, CA, EUA). Resultados Foram analisados 1.008 voluntários totalizando 2.016 mãos. A prevalência da ausência de função do tendão do músculo flexor superficial do quarto dedo foi de 0,56% na mão direita e 0,99% na mão esquerda. Em relação ao gênero, foi verificado na mão direita uma maior prevalência da ausência de função do flexor superficial do quarto dedo no gênero feminino quando comparado ao masculino (p = 0,0328). Na mão esquerda não foi observada diferença entre os gêneros (p = 0,7562). A ausência de função do músculo flexor superficial no quinto dedo foi de 34,53% na mão direita e de 30,06% na mão esquerda. Quando analisamos o quinto dedo em relação aos gêneros, foi verificado que a prevalência da ausência de função do músculo flexor superficial foi mais frequente no gênero feminino que no masculino, tanto na mão direita (p = 0.0001) como na mão esquerda (p = 0.0003). Conclusão Apesar de haver estudos realizados separadamente em diversas etnias, não havia na literatura dados referentes à prevalência da ausência de função do músculo flexor superficial do quarto e quinto dedos da mão em uma população miscigenada como a brasileira. ^∗ Trabalho desenvolvido na disciplina de cirurgia da mão e membro superior do departamento de ortopedia e traumatologia da Universidade Federal de São Paulo, São Paulo, SP, Brasil.

The relationship between viral infection in pregnancy and congenital anomalies is reported in the medical literature. The risks for the SARS-CoV-2 virus interfering with implantation, growth, and fetal development are not yet known. Many drugs with potential teratogenic risk are being used for treatment. The studies with the vaccine excluded pregnant women from clinical trials, currently preventing high-quality evidence. We present a review of the most common anomalies in the upper extremities caused by congenital viral infection and the risks of anti-COVID-19 therapy and vaccine during pregnancy. We aim to alert orthopedic and hand surgeons to the possibility of these conditions in the future. Level of evidence V; Narrative review.