In-house 3D-printed custom splints for non-operative treatment of distal radial fractures: a randomized controlled trial.

We compared patient satisfaction and clinical effectiveness of 3D-printed splints made of photopolymer resin to conventional fibre glass casts in treating distal radial fractures. A total of 39 patients with minimally displaced distal radius fractures were included and randomized. Of them, 20 were immobilized in a fibre glass cast and 19 in a 3D-printed forearm splint. The 3D-printed splints were custom-designed based on forearm surface scanning with a handheld device and printed in-house using digital light processing printing technology. Patient satisfaction and clinical effectiveness were assessed with questionnaires 1 and 6 weeks after the initiation of immobilization. Fracture healing, pain, range of motion, grip strength and the DASH and PRWE scores were assessed up to 1-year follow-up. 3D-printed splints proved to be equally well tolerated by the patients and equally clinically effective as conventional fibre glass casts although there was a higher rate of minor complications. 3D-printed splints present a safe alternative, especially in young, active patients, for non-operative treatment of distal radial fractures.Level of evidence: I.

Artificial intelligence in patient-specific hand surgery: a scoping review of literature.

PURPOSE: The implementation of artificial intelligence in hand surgery and rehabilitation is gaining popularity. The purpose of this scoping review was to give an overview of implementations of artificial intelligence in hand surgery and rehabilitation and their current significance in clinical practice. METHODS: A systematic literature search of the MEDLINE/PubMed and Cochrane Collaboration libraries was conducted. The review was conducted according to the framework outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews. A narrative summary of the papers is presented to give an orienting overview of this rapidly evolving topic. RESULTS: Primary search yielded 435 articles. After application of the inclusion/exclusion criteria and addition of supplementary search, 235 articles were included in the final review. In order to facilitate navigation through this heterogenous field, the articles were clustered into four groups of thematically related publications. The most common applications of artificial intelligence in hand surgery and rehabilitation target automated image analysis of anatomic structures, fracture detection and localization and automated screening for other hand and wrist pathologies such as carpal tunnel syndrome, rheumatoid arthritis or osteoporosis. Compared to other medical subspecialties the number of applications in hand surgery is still small. CONCLUSION: Although various promising applications of artificial intelligence in hand surgery and rehabilitation show strong performances, their implementation mostly takes place within the context of experimental studies. Therefore, their use in daily clinical routine is still limited.

Overview of In-Hospital 3D Printing and Practical Applications in Hand Surgery.

Three-dimensional (3D) printing is spreading in hand surgery. There is an increasing number of practical applications like the training of junior hand surgeons, patient education, preoperative planning, and 3D printing of customized casts, customized surgical guides, implants, and prostheses. Some high-quality studies highlight the value for surgeons, but there is still a lack of high-level evidence for improved clinical endpoints and hence actual impact on the patient's outcome. This article provides an overview over the latest applications of 3D printing in hand surgery and practical experience of implementing them into daily clinical routine.

A Rare Case of Cutaneous Trichophyton verrucosum of the Forearm in a 51-Year-Old Cattle Farmer.

Trichophyton verrucosum is a pathogen causing superficial mycoses in cattle worldwide and is one of the few zoophilic dermatophytes. Farmers and veterinarians are at a higher risk for infection owing to frequent direct animal contact. An increase in cases among humans has been observed in the past few years. We report a rare case of T verrucosum of the forearm in a 51-year-old cattle farmer, who after initial treatment with antibiotics and surgery, and in whom diagnosis was delayed, was finally successfully treated with terbinafine and itraconazole.

Relationship of sex steroid hormones with bone mineral density of the lumbar spine in adult men.

AIMS: To examine the relationship of sex steroid hormones with osteopenia in a nationally representative sample of men in the USA. METHODS: Data on bone mineral density (BMD), serum sex hormones, dairy consumption, smoking status, and body composition were available for 806 adult male participants of the cross-sectional National Health and Nutrition Examination Survey (NHANES, 1999-2004). We estimated associations between quartiles of total and estimated free oestradiol (E2) and testosterone (T) and osteopenia (defined as 1 to 2.5 SD below the mean BMD for healthy 20- to 29-year-old men) by applying sampling weights and using multivariate-adjusted logistic regression. We then estimated the association between serum hormone concentrations and osteopenia by percentage of body fat, frequency of dairy intake, cigarette smoking status, age, and race/ethnicity. RESULTS: Men in the lowest quartile of total E2 concentrations (< 21.52 pg/ml) had greater odds of osteopenia compared with men in the highest quartile (odds ratio (OR) 2.29, 95% confidence interval (CI) 1.11 to 4.73; p-trend = 0.030). Total and free T were not associated with osteopenia. Low total E2 concentrations were associated with greater odds of osteopenia among non-daily dairy consumers (p-trend = 0.046), current or former smokers (p-trend = 0.032), and younger men (p-trend = 0.031). No differences were observed by race/ethnicity and obesity. CONCLUSION: In this nationally representative study of the USA, men with lower total E2 were more likely to have osteopenia, which was particularly evident among younger men, men with less-than-daily dairy consumption, and current or former smokers.Cite this article: Bone Joint Res. 2020;9(3):139-145.