Samir K Trehan

Hospital for Special Surgery · Hand & Upper Extremity Surgery

Purpose of review: The purpose of this review is to describe various forms of hand polydactyly and their different treatment approaches. Hand polydactyly is commonly classified as ulnar (small finger) or radial (thumb). Polydactyly can be sporadic, genetic, and/or associated with syndromic conditions. Recent findings: Both ulnar and radial polyd...

Purpose: To investigate whether the location of distal radius osteotomy/shortening relative to the radial insertion of the distal interosseous membrane (DIOM) is correlated with distal radioulnar joint (DRUJ) instability. We hypothesized that distal radius osteotomy and shortening proximal to the DIOM insertion would result in increased DRUJ insta...

We assessed outcomes of 43 paediatric and adolescent patients (44 wrists) undergoing arthroscopic triangular fibrocartilage complex surgery by a single surgeon between 2003 and 2016. Medical records were reviewed for clinical, imaging, and operative data. Preoperatively, 49% of patients had additional diagnoses and mean QuickDASH was 47. Patients w...

Background Carpal tunnel release (CTR) has traditionally been performed through an open approach, although in recent years endoscopic CTR has gained in popularity. Questions/Purposes We sought to assess whether a difference exists between the rates of nerve repair surgery following open versus endoscopic CTR in New York State (NYS). Methods Patie...

Purpose: To determine whether the arthroscopic hook and trampoline tests are accurate and reliable diagnostic tests for foveal triangular fibrocartilage complex (TFCC) detachment. Methods: Wrist arthroscopy was performed on 10 cadaveric upper extremities. Arthroscopic hook and trampoline tests were performed and videos recorded (baseline). The d...

Background: Despite potential concerns regarding their validity, physician-rating websites continue to grow in number and utilization and feature prominently on major search engines, potentially affecting patient decision-making regarding physician selection. Questions/purposes: We sought to determine whether patient ratings on public physician-...

Background Periprosthetic osteolysis (PPO) is a frequent indication for total hip replacement (THR) failure. Currently, PPO diagnosis occurs in advanced stages that often necessitate complex revisions due to bone loss. PPO biomarkers could facilitate earlier diagnosis. Alternative macrophage activation pathway regulators, chitotriosidase (CHIT1) an...

In this chapter, anatomic variations and anomalies of the median nerve in or adjacent to the carpal tunnel are described. Cadaveric and clinical studies are reviewed that delineate the variable patterns, courses, and anastomoses of the median nerve and its branches in this region. Specific attention is given to the palmar cutaneous branch, thenar m...

Buy Article Permissions and Reprints Abstract Purpose To determine the reliability of wrist range of motion (WROM) measurements based on digital photographs taken by patients at home compared with traditional measurements done in the office with a goniometer. Methods Sixty-nine postoperative patients were enrolled in this study at least 3 months p...

Background The advent of modular shoulder arthroplasty systems has allowed the conversion of hemiarthroplasty or total shoulder arthroplasty to reverse total shoulder arthroplasty (RTSA) without removing a well-fixed stem. Questions/PurposesTo determine the feasibility, functional outcome, and complication profile of RTSA modular conversion. Method...

Hypothesis: We hypothesized that at-home photography-based wrist range of motion (WROM) measurements would be as reliable as traditional physician-performed goniometry. Methods: Sixty-nine postoperative patients who had wrist surgery greater than 3 months prior were enrolled in this study according to an approved institutional review board protocol...

Background Consumer-driven healthcare and an increasing emphasis on quality metrics have encouraged patient engagement in the rating of healthcare. As such, online physician rating websites have become mainstream and may play a potential role in future healthcare policy. Questions/PurposesThe purpose of this study was to evaluate online patient rat...

Background: Temporary, implant-mediated hemiepiphysiodesis (ie, guided growth) is an effective and popular treatment method for lower extremity angular deformities. The purpose of this study was to retrospectively evaluate the safety profile of 3 different implants used to correct lower extremity angular deformities in pediatric patients. Methods...

Purpose: To assess the accessibility and content of query Interventional Radiology (IR) fellowship program websites and determine the impact of these websites on applicants. Materials and methods: All IR fellowship programs were individually evaluated, and all IR fellowship applicants to our institution were surveyed. Results: In 2015, 44.3% o...

Background Previous authors have reported pisotriquetral pain and subsequent pisiform excision following partial or total wrist fusion in patients with scapholunate advanced collapse (SLAC). Prior studies have not considered the potential role of SLAC biomechanics on pisotriquetral osteoarthritis (PT OA) development preoperatively. Purpose To deter...

Direct repair and nerve autografting are primary options in the treatment of upper extremity peripheral nerve injuries. Deciding between these surgical options depends on the mechanism of injury, time since injury, and length of repair defect. Principles of direct repair and nerve autografting are reviewed. Finally, a literature-based review of the...

The increasing focus on patient satisfaction and consumer-driven health care, combined with the recent rise in online social media, have resulted in the growing trend of patients rating physicians on publicly accessible Web sites. The number and use of such Web sites continue to grow despite potential concerns about the validity of these ratings an...

Purpose: To evaluate factors associated with positive online patient ratings and written comments regarding hand surgeons. Methods: We randomly selected 250 hand surgeons from the American Society for Surgery of the Hand member directory. Surgeon demographic and rating data were collected from 3 physician review Web sites (www.HealthGrades.com,...

Obesity is a well-known risk factor for postoperative complications following total joint arthroplasty. However, because the operation is often successful, orthopedic surgeons continue to operate on obese individuals, and many surgeons do so under the assumption that patients will lose weight after they are able to walk and exercise without pain. I...

Purpose To evaluate factors associated with positive online patient ratings and written comments regarding hand surgeons. Methods We randomly selected 250 hand surgeons from the American Society for Surgery of the Hand member directory. Surgeon demographic and rating data were collected from 3 physician review Web sites (www.HealthGrades.com, www....

To assess the accessibility and content of accredited hand surgery fellowship Web sites. A list of all accredited hand surgery fellowships was obtained from the online database of the American Society for Surgery of the Hand (ASSH). Fellowship program information on the ASSH Web site was recorded. All fellowship program Web sites were located via G...

Glomus tumors are painful, benign neoplasms that frequently are associated with delayed diagnosis. Commonly in the hand, they rarely present in the foot. The purpose of this case series is to characterize the clinical presentation, radiology, pathology, and surgical outcomes associated with foot glomus tumors. We reviewed our pathology database for...

To determine whether the diagnosis of hand glomus tumors by magnetic resonance imaging (MRI) is associated with tumor size, tumor pathology, tumor location, and/or clinical suspicion. We reviewed our pathology database for patients with hand glomus tumors diagnosed between 2006 and 2013 and included those patients who had preoperative MRI at our in...

Purpose: Fractures of the proximal ulna are common injuries in the elderly population. These fractures can be managed nonsurgically or with open reduction internal fixation (ORIF). Whereas nonsurgical management may lead to a relative loss of elbow extension and to nonunion, ORIF carries a risk of complications. Although complications specific to...

Background: Triple arthrodesis in the appropriately indicated cerebral palsy patient with a painful and/or rigid foot deformity can significantly alleviate pain and improve function. Limited data on long-term outcomes of triple arthrodesis in this patient population exist. In addition, there have been concerns about the long-term consequences of a...

Background: Osteogenesis imperfect (OI) is a genetic disorder characterized by increased bone fragility, frequent fractures, and extremity deformities among other clinical findings. A frequent radiographic finding in OI patients is acetabular protrusio (AP). We hypothesized that AP incidence would be significant in OI patients and highest among ty...

Increased chondrocyte hypertrophy is often associated with cartilage joint degeneration in human osteoarthritis patients. Matrilin-3 knock-out (Matn3 KO) mice exhibit these features. However, the underlying mechanism is unknown. In this study, we sought a molecular explanation for increased chondrocyte hypertrophy in the mice prone to cartilage deg...

ISTAL RADIUS FRACTURES ARE frequently associated with distal radioulnar joint (DRUJ) injury and a substantial proportion of patients develop symptomatic instability after fracture union. Distal radioulnar joint instability can lead to ulnarsided wrist pain, painful or limited forearm rotation, grip strength weakness, and/or degenerative arthritis....

The Ottawa Knee Rule is a validated clinical decision rule for determining whether knee radiographs should be obtained in the setting of acute knee trauma. The objectives of this study were to assess physician knowledge of, barriers to implementation of, and compliance with the Ottawa Knee Rule in academic emergency departments (EDs), and evaluate...

Carotid endarterectomy (CEA) is supported by level 1 evidence as the standard treatment of severe carotid stenosis in both symptomatic and asymptomatic patients. As interventional techniques are emerging for treatment of this disease, this study was undertaken to provide a contemporary surgical standard for comparison to carotid stenting. During th...