Jeffrey Yao, MD

Journal Articles

• Minimally Invasive Approaches to Ulnar-Sided Wrist Disorders HAND CLINICS Pirolo, J. M., Yao, J. 2014; 30 (1): 77-?

  Abstract

  Ulnar-sided wrist pain is a common cause of pain and disability, which has long been a diagnostic and therapeutic dilemma for hand surgeons. A thorough understanding of the anatomy, clinical examination, and radiographic evaluation is essential to establish a focused differential diagnosis, with the cause of disability often being multifactorial. Arthroscopy is particularly well suited to both directly visualize and treat multiple causes of ulnar-sided wrist pain, including pathology of the TFCC, UIS, LTIL tears, and hamate arthrosis.

  View details for DOI 10.1016/j.hc1.2013.09.001

  View details for Web of Science ID 000329087000012

  View details for PubMedID 24286746

• Incidence of Failure of Continuous Peripheral Nerve Catheters for Postoperative Analgesia in Upper Extremity Surgery. journal of hand surgery Ahsan, Z. S., Carvalho, B., Yao, J. 2014; 39 (2): 324-329

  Abstract

  To explore the incidence of failure of continuous peripheral nerve blockade (CPNB) after upper extremity operations.Patient data regarding postoperative CPNB were retrospectively obtained from our institution's regional anesthesia database. Documented information on the first postoperative day included pain assessment ratings (numerical verbal pain scale, patient-reported breakthrough pain upon perceived return of sensation, appearance of the catheter site, complications, time of return of sensation, day of return of sensation, residual blockade, patient satisfaction with the block, and whether patient would receive the block again).A total of 207 patients received CPNB for postoperative analgesia. The failure rate on the first postoperative day for infraclavicular (133 patients) and supraclavicular (58 patients) CPNB was 19% and 26%, respectively. Interscalene CPNB (16 patients) yielded 3 incidences of failure. No significant difference was found between supraclavicular and infraclavicular block techniques. In addition, no significant differences were found between the incidences of CPNB failures with potentially more painful surgeries involving bone compared with potentially less painful soft tissue procedures.The CPNB technique used for hand surgery postoperative analgesia was associated with nontrivial failure rates. The potential of CPNB failure and resulting breakthrough pain upon recovery from the primary nerve block is important to help establish patient expectations.Therapeutic IV.

  View details for DOI 10.1016/j.jhsa.2013.11.011

  View details for PubMedID 24480691

• Plating of metacarpal fractures with locked or nonlocked screws, a biomechanical study: how many cortices are really necessary? Hand (New York, N.Y.) Barr, C., Behn, A. W., Yao, J. 2013; 8 (4): 454-459

  Abstract

  Dorsal plate and screw fixation is a popular choice for metacarpal stabilization. The balance between construct stability and soft tissue dissection remains a surgical dilemma. Historically, six cortices of bone fixation on either side of a fracture were deemed necessary. This study aims to elucidate whether four cortices of locked fixation on either side of the fracture is equivalent to the current gold standard of six cortices of nonlocked fixation on either side of the fracture. If so, less dissection to insert shorter plates with fewer screws could be used to stably fix these fractures.With biomechanical testing-grade composite Sawbones, a comminuted metacarpal fracture model was used to test two fixation constructs consisting of a standard dorsal plate and either six bicortical nonlocking screws (three screws per segment) or four bicortical locking screws (two screws per segment). Thirty specimens were tested to failure in cantilever bending and torsion.There was statistical equivalence between the locking and nonlocking constructs in cantilever bending stiffness, torsional stiffness, maximum bending load, and maximum torque.The tested metacarpal fracture model had equivalent biomechanical properties when fixed with a standard dorsal plate and either six bicortical nonlocking screws or four bicortical locking screws. By utilizing fewer cortices of fixation, there will be less dissection and less soft tissue stripping during fixation of metacarpal fractures. This will also be of benefit in very proximal or distal fractures as multiple cortices of fixation are often difficult to obtain during stabilization of these challenging fractures.

  View details for DOI 10.1007/s11552-013-9544-3

  View details for PubMedID 24426966

• The Fragmented Proximal Pole Scaphoid Nonunion Treated With Rib Autograft: Case Series and Review of the Literature JOURNAL OF HAND SURGERY-AMERICAN VOLUME Yao, J., Read, B., Hentz, V. R. 2013; 38A (11): 2188-2192

  View details for DOI 10.1016/j.jhsa.2013.08.093

  View details for Web of Science ID 000326553200015

• Outcomes of Ulnar Shortening Osteotomy Fixed With a Dynamic Compression System JOURNAL OF HAND SURGERY-AMERICAN VOLUME Ahsan, Z. S., Song, Y., Yao, J. 2013; 38A (8): 1520-1523

  View details for DOI 10.1016/j.jhsa.2013.04.040

  View details for Web of Science ID 000322925700009

• Suture-button suspensionplasty for thumb carpometacarpal arthritis: a minimum 2-year follow-up. journal of hand surgery Yao, J., Song, Y. 2013; 38 (6): 1161-1165

  Abstract

  To retrospectively review the results at a minimum of 2 years of suture-button plasty with partial or full trapeziectomy and suture-button suspensionplasty.We evaluated 21 patients who received suture-button suspensionplasty at least 2 years after surgery. We measured postoperative pinch strength, grip strength, range of motion, and metacarpal height. All patients also completed the Quick Disabilities of the Arm, Shoulder, and Hand questionnaire.At an average follow-up of 2.8 ± 0.7 years, the mean Quick Disabilities of the Arm, Shoulder, and Hand score was 10 ± 9. Pinch and grip strengths were 86% and 89% of the contralateral limb, respectively. Average first trapezial height was 74% of the contralateral trapezial height. There were no major complications.The favorable results of the suture-button suspensionplasty procedure confirm its usefulness in treating thumb carpometacarpal arthritis with minimal risk of complications, ineffective fixation, or loss of function. Subjective and objective outcomes measures are similar to previously described techniques. The benefit of this technique results from the implanted nature of the suspensionplasty elements that require no time to heal, so rehabilitation is begun as early as 10 days postoperatively.Therapeutic IV.

  View details for DOI 10.1016/j.jhsa.2013.02.040

  View details for PubMedID 23647637

• Outcomes of ulnar shortening osteotomy fixed with a dynamic compression system. The Journal of hand surgery Ahsan, Z. S., Song, Y., Yao, J. 2013; 38 (8): 1520-3

  Abstract

  To evaluate the outcomes of patients with ulnar impaction syndrome treated with a jig-facilitated, oblique, diaphyseal ulnar shortening osteotomy and fixed with a TriMed (Santa Clarita, CA) ulnar osteotomy compression plate.A retrospective chart review of patients with ulnar impaction syndrome identified 38 patients who had had ulnar shortening osteotomy and fixation with the TriMed dynamic compression system. The following clinical data were obtained: patient age, sex, follow-up range of motion, grip strength, and complications. After a minimum of 2 years after surgery, patients reported complications and completed a Disabilities of the Arm, Shoulder, and Hand questionnaire.Eight patients were lost to follow-up. Compared to the opposite limb at an average of 8 months after surgery, the remaining 30 patients attained 92% to 97% of wrist and forearm motion and 71% of grip strength. The average Disabilities of the Arm, Shoulder, and Hand score was 12 after a minimum of 2 years after surgery. Four patients required plate removal due to irritation. Two patients reported persistent ulnar-sided pain, and 2 other patients developed atrophic nonunions and required autologous bone grafting. There were no infections.Ulnar shortening osteotomy using the TriMed system yielded good clinical outcomes that are comparable to those previously documented using other systems.Therapeutic IV.

  View details for PubMedID 23830678

• The thumb carpometacarpal joint: anatomy, hormones, and biomechanics. Instructional course lectures Ladd, A. L., Weiss, A. C., Crisco, J. J., Hagert, E., Wolf, J. M., Glickel, S. Z., Yao, J. 2013; 62: 165-179

  Abstract

  Although there are many surgical options to treat thumb carpometacarpal (CMC) arthritis, a precise etiology for this common disorder remains obscure. To better understand the physiology of the thumb CMC joint and treat pathology, it is helpful to examine the biomechanics, hormonal influences, and available surgical treatment options, along with the evolutionary roots of the thumb; its form and function, its functional demands; and the role of supporting ligaments based on their location, stability, and ultrastructure. It is important to appreciate the micromotion of a saddle joint and the role that sex, age, and reproductive hormones play in influencing laxity and joint disease. Minimally invasive surgery is now challenging prevailing treatment principles of ligament reconstruction and plays a role in thumb CMC joint procedures.

  View details for PubMedID 23395023

• Suture-Button Suspensionplasty for the Treatment of Thumb Carpometacarpal Joint Arthritis HAND CLINICS Yao, J. 2012; 28 (4): 579-?

  Abstract

  Trapeziectomy has been regaining popularity in treatment of thumb carpometacarpal (CMC). Current approaches to trapeziectomy use Kirschner wire fixation to prevent subsidence of the thumb metacarpal into the newly created trapeziectomy space. This fixation method requires at least 4 weeks of strict immobilization of the thumb. A technique using a suture-button device to suspend the thumb allows for earlier mobilization of the thumb and potentially leads to a faster overall recovery. Preliminary results are promising, but further studies must be conducted to confirm the long-term efficacy of this suture-button suspensionplasty.

  View details for DOI 10.1016/j.hcl.2012.08.013

  View details for Web of Science ID 000311875800014

  View details for PubMedID 23101608

• The Effect of Suture Coated With Mesenchymal Stem Cells and Bioactive Substrate on Tendon Repair Strength in a Rat Model JOURNAL OF HAND SURGERY-AMERICAN VOLUME Yao, J., Woon, C. Y., Behn, A., Korotkova, T., Park, D., Gajendran, V., Smith, R. L. 2012; 37A (8): 1639-1645

  Abstract

  Exogenously administered mesenchymal stem cells and bioactive molecules are known to enhance tendon healing. Biomolecules have been successfully delivered using sutures that elute growth factors over time. We sought to evaluate the histologic and biomechanical effect of delivering both cells and bioactive substrates on a suture delivery vehicle in comparison with sutures coated with bioactive substrates alone.Bone marrow-derived stem cells were harvested from Sprague-Dawley rat femurs. Experimental cell and substrate-coated, coated suture (CS) group sutures were precoated with intercellular cell adhesion molecule 1 and poly-L-lysine and seeded with labeled bone marrow-derived stem cells. Control (substrate-only [SO] coated) group sutures were coated with intercellular cell adhesion molecule 1 and poly-L-lysine only. Using a matched-paired design, bilateral Sprague-Dawley rat Achilles tendons (n = 105 rats) were transected and randomized to CS or SO repairs. Tendons were harvested at 4, 7, 10, 14, and 28 days and subjected to histologic and mechanical assessment.Labeled cells were present at repair sites at all time points. The CS suture repairs displayed statistically greater strength compared to SO repairs at 7 days (12.6 ± 5.0 N vs 8.6 ± 3.7 N, respectively) and 10 days (21.2 ± 4.9 N vs 16.4 ± 4.8 N, respectively). There was no significant difference between the strength of CS suture repairs compared with SO repairs at 4 days (8.1 ± 5.1 N vs 6.6 ± 2.3 N, respectively), 14 days (22.8 ± 7.3 N vs 25.1 ± 9.7 N, respectively), and 28 days (40.9 ± 12.4 N vs 34.6 ± 15.0 N, respectively).Bioactive CS sutures enhanced repair strength at 7 to 10 days. There was no significant effect at later stages.The strength nadir of a tendon repair occurs in the first 2 weeks after surgery. Bioactive suture repair might provide a clinical advantage by jump-starting the repair process during this strength nadir. Improved early strength might, in turn allow earlier unprotected mobilization.

  View details for DOI 10.1016/j.jhsa.2012.04.038

  View details for Web of Science ID 000307260200018

• Complications of Wrist Arthroscopy ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY Ahsan, Z. S., Yao, J. 2012; 28 (6): 855-859

  Abstract

  The purpose of this systematic review was to address the incidence of complications associated with wrist arthroscopy. Given the paucity of information published on this topic, an all-inclusive review of published wrist arthroscopy complications was sought.Two independent reviewers performed a literature search using PubMed, Google Scholar, EBSCO, and Academic Megasearch using the terms "wrist arthroscopy complications," "complications of wrist arthroscopy," "wrist arthroscopy injury," and "wrist arthroscopy." Inclusion criteria were (1) Levels I to V evidence, (2) "complication" defined as an adverse outcome directly related to the operative procedure, and (3) explicit description of operative complications in the study.Eleven multiple-patient studies addressing complications of wrist arthroscopy from 1994 to 2010 were identified, with 42 complications reported from 895 wrist arthroscopy procedures, a 4.7% complication rate. Four case reports were also found, identifying injury to the dorsal sensory branch of the ulnar nerve, injury to the posterior interosseous nerve, and extensor tendon sheath fistula formation.This systematic review suggests that the previously documented rate of wrist arthroscopy complications may be underestimating the true incidence. The report of various complications provides insight to surgeons for improving future surgical techniques.Level IV, systematic review of Levels I-V studies.

  View details for DOI 10.1016/j.arthro.2012.01.008

  View details for Web of Science ID 000304444200016

  View details for PubMedID 22483733

• All-Arthroscopic Repair of Peripheral Triangular Fibrocartilage Complex Tears Using FasT-Fix HAND CLINICS Yao, J. 2011; 27 (3): 237-?

  Abstract

  Injury to the triangular fibrocartilage complex (TFCC) is a major source of ulnar-sided wrist pain that results in disability with common activities of daily living involving forearm rotation, for which operative management is indicated if conservative management fails. Past results with open repairs have been successful, but recent surgical advances have allowed the development of arthroscopic management. This article describes and reviews an all-arthroscopic technique of repair of Palmer type IB TFCC injuries with FasT-Fix suture technology (Smith and Nephew, Andover, MA, USA), which is advantageous both biomechanically and in terms of decreasing risk of morbidity.

  View details for DOI 10.1016/j.hcl.2011.05.004

  View details for Web of Science ID 000295232400002

  View details for PubMedID 21871346

• Optimization of volar percutaneous screw fixation for scaphoid waist fractures using traction, positioning, imaging, and an angiocatheter guide. journal of hand surgery Zlotolow, D. A., Knutsen, E., Yao, J. 2011; 36 (5): 916-921

  Abstract

  Percutaneous screw fixation of nondisplaced or reducible scaphoid fractures has become more popular as techniques and implants have improved. Many authors have advocated for the dorsal approach, citing difficulties with adequate screw placement from the volar approach. We have developed a straightforward and reproducible technique for volar percutaneous scaphoid screw fixation that mitigates most of the drawbacks of the approach. The wrist is held in extension and ulnar deviation with traction through the thumb. A 14-gauge angiocatheter needle is then used to localize the starting point and as a cannula for the guide wire. Specific fluoroscopic views help to confirm optimal guide wire placement.

  View details for DOI 10.1016/j.jhsa.2011.02.017

  View details for PubMedID 21527146

• All-Arthroscopic Repair of Palmer 1B Triangular Fibrocartilage Complex Tears Using the FasT-Fix Device JOURNAL OF HAND SURGERY-AMERICAN VOLUME Yao, J., Lee, A. T. 2011; 36A (5): 836-842

  Abstract

  The FasT-Fix device (Smith and Nephew Endoscopy, Andover, MA), initially developed for knee meniscal tears, is described for all-arthroscopic triangular fibrocartilage complex (TFCC) repairs. Potential benefits of this technique are ease of use, the lack of prominent suture knots, and strength of repair. This case series evaluates the early clinical outcomes of this technique.We conducted a retrospective review of patients with TFCC Palmer type 1B injuries treated by 1 hand surgeon from 2005 to 2009. The patients' charts were reviewed for postoperative complications, range of motion, grip strength (percentage of contralateral), and return to full activity. In addition, each patient completed Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) and Patient-Rated Wrist Evaluation (PRWE) questionnaires.Twelve patients had all-arthroscopic peripheral (1B) TFCC repairs using the FasT-Fix suture device. The mean follow-up period was 17.5 months (range, 11-27). Mean supination was 78° (± 14°), and mean grip strength was 64% (±16%) of the nonsurgical extremity by 3 months after surgery. All other range of motion was full. The mean QuickDASH score was 11 (±12), and the mean PRWE score was 19 (±14). Average time to full activity was 5 months. There were no surgical complications of the procedure. One patient complained of persistent ulnar-sided wrist pain 12 months after surgery and had an ulnar shortening osteotomy. Arthroscopy at the time of the osteotomy revealed that the TFCC was stable.At mean 1-year follow-up, 11 out of 12 patients achieved excellent subjective outcomes based on QuickDASH and PRWE questionnaires. Although range of motion and grip strength were slightly decreased compared to prior case series reports, the short-term results indicate that the FasT-Fix all-arthroscopic, all-inside technique is a safe and effective technique for repair of Palmer type 1B TFCC tears.

  View details for DOI 10.1016/j.jhsa.2011.01.005

  View details for Web of Science ID 000290185700012

• Color-Aided Visualization of Dorsal Wrist Ganglion Stalks Aids in Complete Arthroscopic Excision ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY Yao, J., Trindade, M. C. 2011; 27 (3): 425-429

  Abstract

  Dorsal wrist ganglia are the most common mass of the upper extremity. Treatment modalities include benign neglect, aspiration, and surgical excision. Arthroscopic excision is a less invasive surgical alternative to open resection with the benefit of visualizing and treating other intra-articular pathology, fewer potential complications, earlier return to activities, and possibly, a more complete resection. This may lead to a lower rate of recurrence, although this has not been proven in the literature. Recurrence depends in part on adequate ganglion stalk visualization and resection. This is often difficult in open and arthroscopic ganglionectomy. This work describes a new technique with improved arthroscopic stalk visualization and ganglion resection using intralesional injection of an inert dye.

  View details for DOI 10.1016/j.arthro.2010.10.017

  View details for Web of Science ID 000287693200019

  View details for PubMedID 21353171

• Viability and Proliferation of Pluripotential Cells Delivered to Tendon Repair Sites Using Bioactive Sutures-An In Vitro Study JOURNAL OF HAND SURGERY-AMERICAN VOLUME Yao, J., Korotkova, T., Smith, R. L. 2011; 36A (2): 252-258

  Abstract

  We evaluated the fate of pluripotential stem cells adherent to a suture carrier after being passed through tendon tissue in vitro.FiberWire suture segments were coated with poly-L-lysine (PLL) and a 2 × 10(6) C3H10T1/2 (a mouse embryo pluripotential cell line) cell suspension. The sutures were incubated for 7 days, passed through two 1-cm segments of acellularized rabbit Achilles tendons and tied (horizontal mattress). The repairs were frozen and sectioned (6 μm). The sections were stained with 4',6-diamidino-2-phenylindole and a live/dead viability/cytotoxicity (calcein/ethidium homodimer) kit and examined with fluorescent microscopy to evaluate cell presence and viability. Alamar Blue was used in parallel to assess metabolic activity.PLL-coated sutures showed a 3-fold increase in fluorescence when compared with the phosphate-buffered saline-coated controls. At day 3, fluorescence was 2.2 times greater. At day 5, a 2-fold increase was found, and at day 8 there was no significant difference in values. Furthermore, after delivery of the cells into tendon, fluorescence readings for the samples (n = 19) showed 9450 compared with the positive control at 21,218. At 96 hours the mean was 27,609 compared with 34,850 for the positive control. The difference in fluorescence means at 48 hours and 96 hours were significant (p < .001). Live-dead and DAPI staining confirmed the presence of live cells at the tendon repair site.Sutures seeded with pluripotential embryonic cells deliver cells to a tendon repair site. The cells deposited at the repair site survive the trauma of passage and remain metabolically active, as seen in staining and metabolic assay studies. Use of bioactive sutures leads to repopulation of the acellular zone surrounding sutures within the tendon.

  View details for DOI 10.1016/j.jhsa.2010.10.004

  View details for Web of Science ID 000286951900008

• Arthroscopic repair of the scapholunate interosseous ligament. Techniques in hand & upper extremity surgery Stuffmann, E. S., McAdams, T. R., Shah, R. P., Yao, J. 2010; 14 (4): 204-208

  Abstract

  Scapholunate injuries are the most frequent of the intercarpal ligament injuries in the wrist. Current repair methods generally involve an open approach the dorsal capsule of the wrist. Arthroscopic repair of the dorsal portion of the scapholunate interosseus ligament would carry the advantages of less stiffness and would preserve the important dorsal capsular stabilizers. In the development of this technique, we first sought to determine the anatomic location and accessibility of the dorsal scapholunate ligament and the site in which a suture anchor would be placed. Ten fresh-frozen cadaver limbs were used. With the arthroscope in the 4 to 5 portal, the most dorsal portion of the SLIL was visualized in each specimen. K-wires were inserted through the 3 to 4 portal into the scaphoid adjacent to most distal portion of the dSLIL visualized. All limbs were dissected and the location of the wires relative to the prominence on the scaphoid directly adjacent to the central portion of the dSLIL was measured. The location of the prominence relative to the dSLIL was studied through magnified photography of a stained section of a cadaveric scaphoid. The mean distance of these wires distal to the center of the dSLIL is presented. Then the technique of arthroscopic repair of the dSLIL was developed using additional cadaveric wrist specimens. The technique is described.

  View details for DOI 10.1097/BTH.0b013e3181df0a93

  View details for PubMedID 21107214

• Suture Button Compared With K-Wire Fixation for Maintenance of Posttrapeziectomy Space Height in a Cadaver Model of Lateral Pinch JOURNAL OF HAND SURGERY-AMERICAN VOLUME Yao, J., Zlotolow, D. A., Murdock, R., Christian, M. 2010; 35A (12): 2061-2065

  Abstract

  Hematoma distraction arthroplasty has regained popularity as a treatment for thumb carpometacarpal arthritis with reports of satisfactory results. Our goal was to investigate the use of a suture button device to maintain the posttrapeziectomy space height of the thumb metacarpal. Our hypothesis is that a suture button that suspends the thumb metacarpal from the second metacarpal, when applied to the hematoma distraction arthroplasty technique, would provide subsidence resistance comparable to traditional K-wire fixation.Ten fresh frozen matched pairs of human cadaveric arms were used. After open trapeziectomy, suspension of the thumb metacarpal was performed with either a 1.4-mm (0.045-inch) K-wire advanced through the base of the thumb metacarpal into the second metacarpal shaft or a suture button device that suspended the thumb metacarpal from the second metacarpal shaft. Cyclic pinch was simulated by using a lateral pinch model previously described and validated. Lateral pinch is simulated by loading the extensor pollicis longus, adductor pollicis, abductor pollicis brevis, and flexor pollicis longus in a 1:5:6:10 ratio. Dynamic pinch is achieved with cyclic unloading of the abductor pollicis brevis, adductor pollicis, and flexor pollicis longus tendons. Measurements were made of the height of excised trapeziums, the distance from the metacarpal base to the scaphoid after trapeziectomy (trapeziectomy space height) at time zero, both loaded and unloaded, and at sequential loading cycles of 1,000, 2,000, 3,000, 4,000, 5,000, and 10,000 cycles.Student t-test evaluation showed no significant differences between the groups in initial trapeziectomy space height (p = .10), postfixation trapeziectomy space height (p = .10), or loss of trapeziectomy space height between precycling and after 10,000 cycles (p = .80).Suture button fixation maintains similar posttrapeziectomy space height and prevents subsidence of the thumb metacarpal when compared with K-wire fixation in this model. This technique may allow for earlier range of motion after the hematoma distraction arthroplasty.

  View details for DOI 10.1016/j.jhsa.2010.09.007

  View details for Web of Science ID 000285371300023

• Suture Button Suspensionplasty After Arthroscopic Hemitrapeziectomy for Treatment of Thumb Carpometacarpal Arthritis ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY Cox, C. A., Zlotolow, D. A., Yao, J. 2010; 26 (10): 1395-1403

  Abstract

  A myriad of techniques for reconstruction of the arthritic thumb carpometacarpal joint have been described. In the modern era, there has been a push, driven by both clinicians and patients, for more rapid rehabilitation after these procedures. A majority of the historically described techniques require pinning of the thumb ray for 4 weeks. Suture button placement between the thumb and index ray metacarpals has been shown in biomechanical studies to effectively resist subsidence of the thumb ray. We describe a novel technique of using a suture button for suspensionplasty of the thumb ray after arthroscopic partial trapeziectomy. This technique allows for early mobilization and may offer a potential improvement on current techniques. Early results of use of this technique are encouraging, but well-conducted follow-up studies are necessary.

  View details for DOI 10.1016/j.arthro.2010.07.006

  View details for Web of Science ID 000282366300022

  View details for PubMedID 20887938

• All-Arthroscopic Repair of Peripheral Triangular Fibrocartilage Complex Tears OPERATIVE TECHNIQUES IN SPORTS MEDICINE Yao, J. 2010; 18 (3): 168-172

  View details for DOI 10.1053/j.otsm.2010.03.006

  View details for Web of Science ID 000281653900008

• Tourniquet usage in upper extremity surgery. journal of hand surgery Cox, C., Yao, J. 2010; 35 (8): 1360-1361

  View details for DOI 10.1016/j.jhsa.2010.03.016

  View details for PubMedID 20537807

• Electrocautery Use in Hand Surgery: History, Physics, and Appropriate Usage JOURNAL OF HAND SURGERY-AMERICAN VOLUME Cox, C., Yao, J. 2010; 35A (3): 489-490

  View details for DOI 10.1016/j.jhsa.2009.09.016

  View details for Web of Science ID 000277092800023

  View details for PubMedID 19942358

• Perioperative steroid dosing in patients receiving chronic oral steroids, undergoing outpatient hand surgery. journal of hand surgery Fleager, K., Yao, J. 2010; 35 (2): 316-318

  View details for DOI 10.1016/j.jhsa.2009.10.001

  View details for PubMedID 19942359

• Referring Physicians' Knowledge of Hand Surgery Hand (NY) Curtin C, Yao J 2010; 5 (3): 278-285
• Clinical Assessment of the Wrist The Wrist: Diagnosis and Operative Treatment Yao J, Skirven T, Osterman AL, Culp RW 2010
• Monteggia Fracture-Dislocation Associated with Proximal and Distal Radioulnar Joint Instability A Case Report JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME Cheung, E. V., Yao, J. 2009; 91A (4): 950-954

  View details for DOI 10.2106/JBJS.H.00269

  View details for Web of Science ID 000264829700025

• All-Arthroscopic Triangular Fibrocartilage Complex Repair: Safety and Biomechanical Comparison With a Traditional Outside-in Technique in Cadavers JOURNAL OF HAND SURGERY-AMERICAN VOLUME Yao, J. 2009; 34A (4): 671-676

  Abstract

  To compare the biomechanical strength and safety of an all-arthroscopic triangular fibrocartilage (TFCC) repair technique with an outside-in technique in cadavers.Ten matched pairs of fresh-frozen cadaveric wrists were used for this study. The control group TFCC tears were treated with an outside-in technique using 2-0 polydioxane (PDS) sutures. The experimental group was treated with two FasT-Fix suture devices. I measured the location of the implants in relation to the neurovascular structures using a digital caliper. The strength of the repairs was then determined using a tensile testing machine with the load placed across the repair site. I compared results using the Student's t-test.The most volar FasT-Fix block averaged 1.8 cm from the ulnar neurovascular bundle, whereas the PDS knots averaged 1.9 cm from it. The most dorsal FasT-Fix averaged 17.1 mm from the dorsal branch of the ulnar nerve, whereas the PDS knot was 4.6 mm. The average load to failure for the FasT-Fix repairs was 3.7 N, compared with 2.4 N for the PDS repairs (p < .05). The mode of failure for the FasT-Fix implants was the suture cutting through the TFCC tissue. The mode of failure for the PDS controls varied between the suture cutting through the tissue and the knots untying. One extensor carpi ulnaris tendon was injured by the PDS technique. No tendons were injured with the FasT-Fix technique.This all-arthroscopic technique of TFCC repair is faster and stronger than the inside-out technique and is equally safe. Benefits of this repair are decreased operative time, reduced postoperative immobilization, and decreased irritation from prominent suture knots below the skin. For these reasons, it may be desirable to perform this technique to improve patient satisfaction.

  View details for DOI 10.1016/j.jhsa.2009.01.014

  View details for Web of Science ID 000264998800010

• Arthroscopic Treatment of Triangular Fibrocartilage Wrist Injuries in the Athlete AMERICAN JOURNAL OF SPORTS MEDICINE McAdams, T. R., Swan, J., Yao, J. 2009; 37 (2): 291-297

  Abstract

  Triangular fibrocartilage (TFC) injuries are an increasingly recognized cause of ulnar-sided wrist pain and can be particularly disabling in the competitive athlete. Previous studies show that arthroscopic debridement or repair can improve symptoms, but the results of arthroscopic treatment of TFC injuries in high-level athletes have not yet been reported.Arthroscopic debridement or repair of wrist TFC injury will allow a high rate of return to full function in the elite athlete.Case series; Level of evidence, 4.Between 2001 and 2005, 16 competitive athletes (mean age, 23.4 years) with wrist TFC injuries underwent arthroscopic surgery. Repair was performed in unstable tears, and all others underwent debridement alone. Presurgery and post-surgery mini-DASH (Disabilities of the Arm, Shoulder, and Hand) scores were recorded for each athlete through medical record review and clinical evaluation. The mean duration of follow-up was 32.8 months (range, 24-51 months).The TFC was repaired in 11 (68.8%) and debrided in 5 (31.3%) patients. The tear was ulnar-sided in 12 (75%), radial-sided in 2 (12.5%), combined radial-ulnar in 1, and central-sided in 1 patient. Mean mini-DASH scores improved from 47.3 (range, 25-65.9) to 0 (all patients) (P = .002), and the mean mini-DASH sports module improved from 79.7 (range, 68.8-100) to 1.95 (range, 0-18.8) (P = .002). Return to play averaged 3.3 months (range, 3-7 months). Associated conditions in the 2 patients unable to return to play at 3 months were distal radioulnar joint (DRUJ) instability with ulnar-carpal abutment (n = 1) and extensor carpi ulnaris (ECU) tendinosis (n = 1).Arthroscopic debridement or repair of wrist TFC injury provides predictable pain relief and return to play in competitive athletes. Return to play may be delayed in athletes with concomitant ulnar-sided wrist injuries.

  View details for DOI 10.1177/0363546508325921

  View details for Web of Science ID 000262954200008

  View details for PubMedID 19059892

• Surgical treatment of thumb carpometacarpal joint arthritis: a single institution experience from 1995-2005. Hand (New York, N.Y.) Park, M. J., Lichtman, G., Christian, J. B., Weintraub, J., Chang, J., Hentz, V. R., Ladd, A. L., Yao, J. 2008; 3 (4): 304-310

  Abstract

  There are numerous techniques for the surgical management of thumb carpometacarpal (CMC) joint arthritis. The four senior authors of this study employ three such techniques: trapeziectomy with hematoma distraction arthroplasty, hemitrapeziectomy with osteochondral allograft, and ligament reconstruction tendon interposition (LRTI). This study examines the three commonly utilized procedures at a single institution. This study examines the 10-year experience from 1995-2005 with a minimum 3-month follow-up. Disabilities of the arm, shoulder, and hand (DASH) scores, pre-and postoperative pinch strength, and operative time were examined. After approval from the institutional review board of our institution was obtained, all patients treated surgically by three of the senior authors were contacted via mail and phone. Each patient was asked to complete and return a DASH questionnaire. Of the 115 patients treated during that period, 60 participated in this study. Each patient's final postoperative pinch measurement was obtained from occupational therapy and clinic records. This pinch strength was compared to the preoperative pinch and contralateral pinch strength. Lastly, the total operative time for each procedure was obtained from the operative record. The only significant finding in this study was a shorter mean operative time with the trapeziectomy group (76.90 min) and osteochondral allograft group (90.45 min) when compared to the LRTI group (139.00 min; p = 0.001 and p = 0.001, respectively). We found no significant difference between groups in terms of DASH score and pinch strength. There was no difference between the techniques in terms of postoperative pinch strength and patient satisfaction measured by DASH scores. The operative times for trapeziectomy and hematoma interposition as well as the osteochondral allograft were significantly shorter than that of the LRTI. This presents further evidence that potentially, "less is more" in the treatment of thumb CMC arthritis. We used a retrospective study design to evaluate potential differences between the three surgical techniques described above, therapeutic, levels III-IV.

  View details for DOI 10.1007/s11552-008-9109-z

  View details for PubMedID 18780018

• Bioactive Sutures for Tendon Repair: Assessment of a Method of Delivering Pluripotential Embryonic Cells JOURNAL OF HAND SURGERY-AMERICAN VOLUME Yao, J., Korotkova, T., Riboh, J., Chong, A., Chang, J., Smith, R. L. 2008; 33A (9): 1558-1564

  Abstract

  Pluripotential embryonic cells may be seeded onto sutures intended for tendon repair. These cells may be influenced to adhere to suture material using adhesion substrates, and furthermore, these cells may remain in culture attached to those sutures. These cell-impregnated sutures may be useful for promoting healing of tendon repairs.Ten-centimeter segments of 4-0 sutures (FiberWire) were coated overnight with 10 microg/mL fibronectin, 10 microg/mL poly-l-lysine, or phosphate-buffered saline. The sutures were placed in dishes and covered with a suspension of C3H10T1/2 cells at concentrations of 1 x 10(6), 2 x 10(6), or 4 x 10(6) cells for 24 hours. The sutures were then placed into low adhesion polypropylene tubes with Dulbecco's modified Eagle's medium and 10% fetal bovine serum for 7 days. The presence of viable cells on these sutures was assessed by the colorimetric Alamar blue cell proliferation assay. Spectrophotometry was used to quantify the relative amount of cell proliferation across the experimental groups. The sutures were also visually inspected using phase-contrast light microscopy.Our results show that at all seeding densities (1 x 10(6), 2 x 10(6), and 4 x 10(6) cells), the suture segments coated with poly-l-lysine and fibronectin showed a significant increase in C3H10T1/2 cell adhesion. Coating the suture with poly-l-lysine increased the adherent cell number to 17% of the initial seeding concentration compared with 2% for the control. Fibronectin coating increased the number of adherent viable cells present to 6.6%.Pluripotential embryonic cells may be seeded onto sutures, adhere, and survive in culture. Coating sutures with poly-l-lysine and fibronectin offers significant improvement in retention of viable cells. This technique may be a useful adjunct for future tendon healing studies.

  View details for DOI 10.1016/j.jhsa.2008.06.010

  View details for Web of Science ID 000260725900015

• Early treatment of degenerative arthritis of the thumb carpometacarpal joint HAND CLINICS Yao, J., Park, M. J. 2008; 24 (3): 251-?

  Abstract

  Degenerative arthritis of the thumb carpometacarpal (CMC) joint is a common disorder that may affect anyone but most frequently affects the postmenopausal female population. Because of its high prevalence, the management of the condition has been a popular topic among hand surgeons and therapists worldwide. There are many decisions to consider when devising the appropriate treatment plan for each patient. In particular, early stages of thumb CMC joint arthritis may be treated nonoperatively or with less invasive surgical techniques to relieve symptoms, restore function and strength, stop the progression of the disease, and even potentially reverse the process. This article explores treatment options at the disposal of primary care physicians and hand surgeons for early thumb CMC arthritis.

  View details for DOI 10.1016/j.hcl.2008.03.001

  View details for Web of Science ID 000258826800005

  View details for PubMedID 18675716

• Update on the Triangular Fibrocartilage Complex Current Orthopaedic Practice, Zlotolow D (Ed) Lee AT, Yao J 2008; 19 (5): 509-514
• A novel technique of all-inside arthroscopic triangular fibrocartilage complex repair ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY Yao, J., Dantuluri, P., Osterman, A. L. 2007; 23 (12)

  Abstract

  Peripheral triangular fibrocartilage complex (TFCC) tears are amenable to repair. Limitations of current repair techniques include prolonged recovery and button or knot intolerance. We present a novel technique of an all-inside repair using existing technology (FasT-Fix; Smith & Nephew Endoscopy, Andover, MA) to circumvent these complications. This technique is faster, easily performed, safe, and potentially stronger than current repairs. Earlier motion and rehabilitation are instituted after this repair. The tear is debrided to stimulate angiogenesis. The FasT-Fix is inserted through the 3-4 portal with the arthroscope in the 6R portal. The first poly-L-lactic acid block is deposited peripheral to the tear. Upon penetration of the wrist capsule, a distinct decrease in resistance is felt. The introducer is withdrawn, depositing the block outside the capsule. The trigger on the introducer advances the second block into the deployment position. It is advanced and deposited central to the tear, forming a vertical mattress configuration. The introducer is removed, leaving the pre-tied suture. The knot is tightened and cut by use of the knot pusher/cutter. Multiple implants may be inserted to complete the repair. Postoperative care involves a sugartong splint for 2 weeks followed by a short arm cast for 4 weeks. Range of motion is begun thereafter with strengthening started at 10 weeks.

  View details for DOI 10.1016/j.arthro.2007.02.010

  View details for Web of Science ID 000252189700019

  View details for PubMedID 18063183

• Tumours of the hand LANCET ONCOLOGY Hsu, C. S., Hentz, V. R., Yao, J. 2007; 8 (2): 157-166

  Abstract

  Hand tumours of soft-tissue and bony origin are frequently encountered, and clinicians must be able to distinguish typical benign entities from life-threatening or limb-threatening malignant diseases. In this Review, we present a diagnostic approach to hand tumours and describe selected cancers and their treatments. Soft-tissue tumours include ganglion cysts, giant-cell cancers and fibromas of the tendon sheath, epidermal inclusion cysts, lipomas, vascular lesions, peripheral-nerve tumours, skin cancers, and soft-tissue sarcomas. Bony tumours encompass enchondromas, aneurysmal bone cysts, osteoid osteomas, giant-cell lesions of bone, bone sarcomas, and metastases. We look at rates of recurrence and 5-year survival, and recommendations for adjunct chemotherapy and radiotherapy for malignant lesions.

  View details for Web of Science ID 000244103100028

  View details for PubMedID 17267330

• Arthroscopic Treatment of Thumb Carpometacarpal Joint Arthritis Master Skills in Wrist and Elbow Arthroscopy and Reconstruction. Trumble TE, Budoff JE, eds. American Society for Surgery of the Hand. Yao J, Culp RW 2007: 315-322
• Late Reconstruction for Ulnar Nerve Palsy Hand Clinics Tse, R., Hentz VR, Yao J 2007; 23 (3): 373-392
• Arthroscopic Techniques for Wrist Arthritis (Radial Styloidectomy and Proximal Pole Hamate Excisions Hand Clinics Yao J, Osterman AL 2005; 21 (4): 519-526
• Fracture Fixation Plastic Surgery: Hand Volume Cox C, Yao J ; Chang, ed: Pub Pending
• Proximal Pole Scaphoid Nonunions Treated with Rib Autograft The Scaphoid Yao J, Read B ; Slutsky ed: Pub Pending
• Elbow Instability Musculoskeletal Examination of the Elbow Wrist and Hand Park MJ, Yao J ; Culp, ed.: Pub Pending
• Diagnosis and Treatment of DRUJ/TFCC Injuries Musculoskeletal Examination of the Elbow, Wrist and Hand Park MJ, Yao J ; Culp, ed.: Pub Pending
• Synthesis and characterization of novel elastomeric poly(D,L-lactide urethane) maleate composites for bone tissue engineering EUROPEAN POLYMER JOURNAL Mercado-Pagan, A. E., Kang, Y., Ker, D. F., Park, S., Yao, J., Bishop, J., Yang, Y. P. 2013; 49 (10): 3337-3349

  View details for DOI 10.1016/j.eurpolymj.2013.07.004

  View details for Web of Science ID 000325233800049

• Suture button suspension following trapeziectomy in a cadaver model. Hand (New York, N.Y.) Song, Y., Cox, C. A., Yao, J. 2013; 8 (2): 195-200

  Abstract

  The safety and the effects of different trajectories on thumb motion of suture-button suspensionplasty post-trapeziectomy are not known.In a cadaveric model, thumb range of motion, trapeziectomy space height, and distance between the device and nerve to the first dorsal interosseous muscle (first DI) were measured for proximal and distal trajectory groups. Proximal trajectory was defined as a suture button angle directed from the thumb metacarpal to the second metacarpal at a trajectory less than 60° from the horizontal; distal trajectory was defined as a suture button angle directed from the thumb metacarpal to the second metacarpal at a trajectory of greater than 60° from the horizontal (Fig. 1).There were no significant differences in range of motion and trapeziectomy space height between both groups. The device was significantly further away from the nerve to the first DI in the proximal trajectory group compared to the distal trajectory group, but was still safely away from the nerve in both groups (greater than 1 cm).These results suggest that the device placement in either a proximal or distal location on the second metacarpal will yield similar results regarding safety and thumb range of motion.

  View details for DOI 10.1007/s11552-012-9473-6

  View details for PubMedID 24426918

• Preface HAND CLINICS Yao, J. 2012; 28 (4): XIII-XIV

  View details for DOI 10.1016/j.hcl.2012.09.001

  View details for Web of Science ID 000311875800001

  View details for PubMedID 23101612

• Titanium integration with bone, welding, and screw head destruction complicating hardware removal of the distal radius: report of 2 cases. journal of hand surgery Van Nortwick, S. S., Yao, J., Ladd, A. L. 2012; 37 (7): 1388-1392

  Abstract

  Increasingly, surgeons treat distal radius fractures with locking plate systems. Recent case reports have focused on technical insertion errors resulting in removal difficulties: poor drilling orientation or cross-threading, destruction of the screw head, and filling of the screw recess with tissue. We report 2 complications of titanium locked plate removal secondary to in vivo reactions including titanium integration with bone and mechanical binding between the titanium screw and plate. We clarify and discuss terminology relevant to implant removal, including cold-welding, galling, fretting, and anodization. Even with optimal technique, in situ reactions can complicate titanium implant removal.

  View details for DOI 10.1016/j.jhsa.2012.04.027

  View details for PubMedID 22652178

• Trapezial Metastasis as the First Indication of Primary Non-small Cell Carcinoma of the Lung JOURNAL OF HAND SURGERY-AMERICAN VOLUME Song, Y., Yao, J. 2012; 37A (6): 1242-1244

  Abstract

  Metastasis to the bones of the hand and wrist is not common, and its discovery may reveal an advanced primary tumor located centrally. Clinically, hand metastasis is hard to differentiate from other more common hand pathologies. Its rarity, coupled with a lack of unique clinical manifestations, makes hand and wrist metastasis difficult to diagnose. However, its diagnosis is critical to initiate an appropriate course of treatment. We present a patient in whom lung carcinoma metastasis to the trapezium was definitively diagnosed upon surgical management of symptoms that were consistent with thumb carpometacarpal arthritis.

  View details for DOI 10.1016/j.jhsa.2012.03.006

  View details for Web of Science ID 000304977600023

• Lunate Fractures in the Face of a Perilunate Injury: An Uncommon and Easily Missed Injury Pattern JOURNAL OF HAND SURGERY-AMERICAN VOLUME Briseno, M. R., Yao, J. 2012; 37A (1): 63-67

  Abstract

  Lunate fractures are rare and are usually associated with high-energy trauma. Typically, they are described in isolation or with associated carpal injuries such as scaphoid, capitate, or radial styloid fractures. We report a case of a complex lunate fracture in combination with a perilunate dissociation injury.

  View details for DOI 10.1016/j.jhsa.2011.09.009

  View details for Web of Science ID 000298967500011

• The use of smartphones in hand surgery. journal of hand surgery Barr, C., Yao, J. 2012; 37 (1): 168-170

  View details for DOI 10.1016/j.jhsa.2011.10.036

  View details for PubMedID 22196296

• Soft Tissue Tumors of the Wrist The Principles and Practice of Wrist Surgery Lee A, Yao J 2010; Slutsky ed: 649-658
• Soft Tissue Coverage of Fingertip Amputations Operative Techniques in Orthopaedic Surgery Ford C, Yao J 2010; Hunt, ed.: 2932-2940
• Perilunate and Lunate Dislocations and Greater Arc Injuries The Prinicples and Practice of Wrist Surgery Jagadish A, Yao J 2010; Slutsky ed: 473-486
• Surgical Treatment of Acute and Chronic Paronychia and Felons Operative Techniques in Orthopaedic Surgery Stuffmann E, Yao J 2010; Hunt, ed.: 2906-2911
• Surgical Treatment of Deep Space Infections of the Hand Operative Techniques in Orthopaedic Surgery Stuffmann E, Yao J 2010; Hunt, ed: 2912-2916
• The History of Distal Radius Fractures Fractures and Injuries of the Distal Radius and Carpus: The Cutting Edge. Imrie M, Yao J 2009; Slutsky ed (Elsevier): 3-10
• Distal Radius Fracture Fixation Systems The Fractured Wrist Mudgal C, Yao J 2008; Ring ed. (May)
• Late reconstruction for ulnar nerve palsy HAND CLINICS Tse, R., Hentz, V. R., Yao, J. 2007; 23 (3): 373-?

  Abstract

  Long term paralysis of the ulnar nerve is associated with an array of specific deficits and deformities. The numerous options for reconstruction are reviewed, as well as the specific patient considerations in selecting a strategy. An approach to late reconstruction for late ulnar nerve palsy is presented based upon the authors' experience and the available literature.

  View details for DOI 10.1016/j.hcl.2007.05.003

  View details for Web of Science ID 000249886700011

  View details for PubMedID 17765589

• Reduction of high-grade isthmic and dysplastic spondylolisthesis in 5 adolescents. American journal of orthopedics (Belle Mead, N.J.) Lonner, B. S., Song, E. W., Scharf, C. L., Yao, J. 2007; 36 (7): 367-373

  Abstract

  Treatment of high-grade isthmic and dysplastic spondylolisthesis in children and adolescents remains a challenge. Surgical treatment of spondylolisthesis has been recommended in adolescents with pain refractory to nonoperative modalities, slippage progression, or > 50% slippage on presentation. Controversy exists as to the optimal surgical approach for high-grade spondylolisthesis. In this report, we describe 5 cases of high-grade isthmic and dysplastic spondylolisthesis in adolescents and review the literature on surgical treatment for this entity. Operative records, charts, x-rays, and Scoliosis Research Society outcome questionnaires (SRS-22) were retrospectively evaluated for 5 consecutive patients diagnosed with and treated for high-grade spondylolisthesis. Each patient received treatment consisting of decompression, reduction, and circumferential fusion with transpedicular and segmental fixation from a posterior approach. Two patients had transient L5 nerve root deficit, which resolved within 3 months. Reduction benefits include a decrease in shear stresses (and resulting decreased rates of postoperative pseudarthrosis and slip progression), restoration of sagittal alignment and lumbosacral spine balance, and improvement in clinical deformity.

  View details for PubMedID 17694184

• Arthroscopic Treatment of Radial-Sided TFCC Lesions Wrist and Hand Arthroscopy - A Practical Approach, Slutsky DJ, ed. Weintraub JL, Osterman AL, Yao J 2007: 32-41
• Bone Grafts and Bone Graft Substitutes in Distal Radius Fractures Hand Surgery Update 4 Ladd AL, Pliam N, Yao J 2007: 165-186
• The use of bone grafts and bone graft substitutes in distal radius fractures. Atlas of Hand Clinics Yao J, Ladd AL 2006; 11 (2): 243-249
• Thumb Carpometacarpal Joint Arthroscopy and Hemitrapeziectomy Online protocols, International Federation of Societies for Surgery of the Hand (IFSSH) Yao J, Culp RW 2006
• Double Crush Syndrome Peripheral Nerve Surgery: Practical Applications in the Upper Extremity. Slutsky DJ & Hentz VR, eds. Elsevier. Yao J, Osterman AL 2006: 277-283
• Surgical Arthroplasty Options for Rotator Cuff Tear Arthropathy Techniques in Shoulder and Elbow Surgery Yao J, Dines D, Warren R 2003; 4 (1): 26-34
• Diagnosis of Acute Cholecystitis: Sensitivity of Sonography, Cholescintigraphy and Combined Sonography-Cholescintigraphy Journal of the American College of Surgeons Kalimi R, Gecelter GR, Caplin D, Yao J, Simms HH, Marini, CP 2001; 193 (6): 609-613
• Seroswitch : Adenovirus-mediated in vivo Gene Transfer : Circumvention of Anti-Adenovirus Humoral Immune Defenses Against Repeat Adenovirus Vector Administration by Changing the Adenovirus Serotype Human Gene Therapy Mastrangeli A, Harvey BG, Yao J, Crystal RG 1996; 7: 79-87