HAND最新文献

{"title":"Metacarpal Stress Fractures in Athletes: A Systematic Review.","authors":"Ariana L Shaari, Adam N Fano, Joseph Ferraro, Irfan Ahmed","doi":"10.1177/15589447241266965","DOIUrl":"10.1177/15589447241266965","url":null,"abstract":"<p><strong>Background: </strong>Stress fractures in general are common injuries; however, there is limited literature on metacarpal stress fractures in athletes. Our objective is to contribute the first systematic review of metacarpal stress fractures in athletes, with a particular focus on epidemiology, presentation, and outcomes.</p><p><strong>Methods: </strong>A systematic review regarding metacarpal stress fractures in athletes was performed via PubMed, EMBASE, MedLine, Cochrane, and Web of Science. Inclusion criteria consisted of case reports and case series of metacarpal stress fractures in athletes. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.</p><p><strong>Results: </strong>A total of 11 studies (29 cases) were included. The mean patient age was 17 years, with 12 men and 15 women. The most common sports were tennis and badminton. The most common presentation was pain in the dorsal aspect of the hand related to activity. All patients underwent successful nonoperative management, with mean return to play of 9 weeks.</p><p><strong>Conclusions: </strong>Metacarpal stress fractures can present with significant pain and impact performance in athletes who perform sports involving repetitive movements of the hand and wrist. Nonoperative treatment, consisting of abstinence from sport until the patient was pain free combined with gradual return to play, was successful for all patients. The addition of proper technique and training load can result in satisfactory return to play. For patients who present with hand pain related to exercise, particularly a young racquet sport player, metacarpal stress fractures are a \"can't miss\" diagnosis associated with significant functional impairment.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1082-1089"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Fusion Rates/Complications Between Different Types of Thumb Metacarpophalangeal Fusion Techniques.","authors":"Logan E Finger, Max C Hamaker, Anya Singh-Varma, Robert J Goitz, Robert A Kaufmann, John R Fowler","doi":"10.1177/15589447241235343","DOIUrl":"10.1177/15589447241235343","url":null,"abstract":"<p><strong>Background: </strong>Thumb metacarpophalangeal (MP) fusion is generally successful; however, complications have been reported to occur in 0% to 30% of cases, whereas nonunion rates vary by method but, overall, are reported to occur in 0% to 15% of cases. Many fixation techniques have been described, but there is no consensus on the optimal fusion technique. Our goal was to compare complication and union rates of different thumb MP arthrodesis techniques.</p><p><strong>Methods: </strong>We performed a retrospective review of patients who underwent primary thumb MP fusion between 2000 and 2022. Patients who underwent revision fusion, fusion for infection, or amputation were excluded. Fusions of MP joints of other fingers were also excluded. Data collection consisted of demographic data, complications, time to fusion, rate of delayed union and rate of nonunion. Five different fusion constructs were evaluated during our study period: staples, Kirschner wires (K-wires), cerclage, K-wires with cerclage, and intramedullary screw.</p><p><strong>Results: </strong>Forty-seven patients underwent fusion with staples, 16 with K-wires, 14 with cerclage, 9 with K-wires and cerclage, and 6 with an intramedullary screw. The individual complication and nonunion rates differed significantly among the groups with the intramedullary screw group having a statistically higher rate of nonunion (<i>P</i> = .004). Furthermore, smoking, diabetes, and being overweight were associated with nonunions.</p><p><strong>Conclusion: </strong>Union rates were significantly lower in patients treated with an intramedullary screw and those who are smokers, diabetics, and/or overweight. Caution should be exercised when using intramedullary screw fixation for MP fusion, especially in patients with these comorbidities.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1022-1028"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140184355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inter-Rater and Intrarater Reliability of Radiographs in the Diagnosis of Pediatric Scaphoid Fractures.","authors":"Stefan Padeanu, Ken Tang, Kerri Highmore, Khaldoun Koujok, Sasha Carsen, Kevin Smit, Kevin Cheung","doi":"10.1177/15589447241257705","DOIUrl":"10.1177/15589447241257705","url":null,"abstract":"<p><strong>Background: </strong>Pediatric scaphoid fractures can be challenging to diagnose on plain radiograph. Rates of missed scaphoid fractures can be as high as 30% to 37% on initial imaging and overall sensitivity ranging from 21% to 97%. Few studies, however, have examined the reliability of radiographs in the diagnosis of scaphoid fractures, and none are specific to the pediatric population. Reliability, both between different specialists and for individual raters, may elucidate some of the diagnostic challenges.</p><p><strong>Methods: </strong>We conducted a 2-iteration survey of pediatric orthopedic surgeons, plastic surgeons, radiologists, and emergency physicians at a tertiary children's hospital. Participants were asked to assess 10 series of pediatric wrist radiographs for evidence of scaphoid fracture. Inter-rater and intrarater reliability was calculated using the intraclass correlation coefficient of 2.1.</p><p><strong>Results: </strong>Forty-two respondents were included in the first iteration analysis. Inter-rater reliability between surgeons (0.66; 95% confidence interval, 0.43-0.87), radiologists (0.76; 0.55-0.92), and emergency physicians (0.65; 0.46-0.86) was \"good\" to \"excellent.\" Twenty-six respondents participated in the second iteration for intrarater reliability (0.73; 0.67-0.78). Sensitivity (0.75; 0.69-0.81) and specificity (0.78; 0.71-0.83) of wrist radiographs for diagnosing scaphoid fractures were consistent with results in other studies.</p><p><strong>Conclusions: </strong>Both inter-rater and intrarater reliability for diagnosing pediatric scaphoid fractures on radiographs was good to excellent. No significant difference was found between specialists. Plain radiographs, while useful for obvious scaphoid fractures, are unable to reliably rule out subtle fractures routinely. Our study demonstrates that poor sensitivity stems from the test itself, and not rater variability.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1101-1108"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141765843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior Interosseous Nerve Palsy in Rheumatoid Arthritis: A Systematic Review.","authors":"Brooke Kowalski, Nicholas J Zarkadis, Mitchell Harris, John Scanaliato, John Dunn","doi":"10.1177/15589447241260766","DOIUrl":"10.1177/15589447241260766","url":null,"abstract":"<p><p>The purpose of this systematic review is to describe the pathoanatomy, presentation, diagnostic workup, treatment modalities, and outcomes of posterior interosseous nerve (PIN) palsy in patients with rheumatoid arthritis (RA). All reported cases of PIN palsy in patients with RA were reviewed to yield 72 cases of PIN palsy in 70 patients. The male-to-female ratio was 1:2.7. Pain involving the elbow was very common (20/33 cases reporting this information), and paralysis or weakness of digit extension was noted in 27/33 cases and 6/33 cases, respectively. Only 1 of the 54 cases undergoing surgical intervention reported persistent weakness, and this 1 patient had undergone a 3-month trial of conservative management. In conclusion, Appropriate pharmacologic management in conjunction with magnetic resonance imaging (MRI) and ultrasound monitoring may be used for conservative management, but surgical decompression should still be utilized for patients with a compressive disease pathology who fail to improve with 6 weeks of conservative treatment, or for those with advanced disease on initial presentation.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1004-1011"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Direct Versus Peripheral Adjuvant Dexamethasone on Duration and Rebound Pain in Regional Anesthesia for Outpatient Distal Radius Fracture Fixation: A Prospective Randomized Controlled Blinded Study.","authors":"Alexis A Kasper, Kyle Plusch, Armen Voskerijian, David Barnabei, Michael Rivlin, Pedro K Beredjiklian, Mark L Wang","doi":"10.1177/15589447241270678","DOIUrl":"10.1177/15589447241270678","url":null,"abstract":"<p><strong>Background: </strong>Despite increasingly wider use, there remains controversy among anesthesiologists regarding preferred formulations and the role of steroid adjuvants in regional anesthesia. There is also uncertainty in the role of dexamethasone when administered directly versus peripherally. We hypothesize that directly mixing dexamethasone into the regional nerve block rather than peripherally administered intravenous dexamethasone will demonstrate a difference in efficacy concerning duration and rebound pain, decreased postoperative pain scores, or opioid consumption within the short-term postoperative period.</p><p><strong>Methods: </strong>A prospective, randomized controlled blinded study was conducted for patients undergoing open reduction and internal fixation with a volar plate technique for distal radius fractures. Patients were randomized for their preoperative anesthesia. One group had ultrasound-guided supraclavicular block with ropivacaine with a direct mix of dexamethasone 4 mg (Direct group), while the other group had ultrasound-guided supraclavicular block with ropivacaine and peripheral intravenous dexamethasone 4 mg (Indirect group). Data was collected pre, intra, and postoperatively.</p><p><strong>Results: </strong>Fifty patients consented and participated in the study, with 27 participants in the direct group and 23 participants in the indirect group. Compared to intravenous administration, directly administered dexamethasone demonstrated a significant difference in the average time for the block to fade, onset of motor and sensory recovery, and block resolution.</p><p><strong>Conclusion: </strong>Our findings prove that directly mixing dexamethasone compared to peripherally administered intravenous dexamethasone will demonstrate a difference in efficacy with regards to duration and rebound pain, but do not prove that there will be a difference in decreased postoperative pain scores or opioid consumption within the 24-hour postoperative period.</p><p><strong>Level of evidence: </strong>Prognosis Level I.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1132-1137"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What to Expect? Use of Supplemental Fixation With a Concomitant Dorsal Spanning Plate for Complex Intraarticular Distal Radius Fractures.","authors":"Eric Gruenberger, Elizabeth K Carlino, Adam Webb, Mitchell Bowers, Brent Ponce, Todd Rubin","doi":"10.1177/15589447241247335","DOIUrl":"10.1177/15589447241247335","url":null,"abstract":"<p><strong>Background: </strong>The dorsal spanning plate (DSP) is a versatile implant suitable for bridging severely comminuted intraarticular distal radius fractures [AO (Arbeitsgemeinschaft für Osteosynthesefragen) 23-C.1-C.3]. It may be used alone or with supplemental fixation such as a volar locking plate (VLP) or fragment-specific fixation (FSF). Outcomes following DSP fixation with additional implants have not been specifically evaluated.</p><p><strong>Methods: </strong>We retrospectively reviewed consecutive patients who underwent internal fixation of a distal radius fracture by a single surgeon from 2017 to 2021. Patients were grouped according to implants used: DSP only, DSP + FSF, and DSP + VLP. Preoperative variables, treatment times, and wrist range of motion (ROM) were assessed. Functional wrist ROM was defined as minimum 80° combined flexion and extension.</p><p><strong>Results: </strong>One hundred fifty-two patients underwent surgery for wrist fracture, 33 of them were treated with a DSP: 8 DSP only, 6 DSP + VLP, and 19 DSP + FSF. Falls from height greater than 10 ft accounted for 52% of injuries, most of which were treated with a DSP + FSF. Treatment times and ROM were similar between subgroups. Wrist ROM did not improve significantly beyond 4 weeks following DSP removal. Overall, DSP patients recovered a mean wrist ROM of 85° (range 0°-130°) within a median 26 weeks total treatment period (range 12-68 weeks).</p><p><strong>Conclusion: </strong>Regardless of the construct used, if the distal radius articular surface is well reduced and other principles of fracture fixation are applied, most patients treated with a DSP can expect to regain functional wrist ROM.</p><p><strong>Level of evidence: </strong>Level IV-Retrospective review of prospectively collected data.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1116-1123"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic Total Trapeziectomy for Thumb Carpometacarpal Arthrosis.","authors":"Alexander J Adams, Alexis Kasper, Rick Tosti","doi":"10.1177/15589447241262055","DOIUrl":"10.1177/15589447241262055","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this individual cohort study is to demonstrate safety and efficacy in removing the trapezium through minimally invasive arthroscopy.</p><p><strong>Methods: </strong>A prospective case series was performed on all arthroscopic total trapeziectomy procedures for thumb basal joint arthrosis between 2018 and 2022. Patients were followed for up to 1 year. All patients received an examination at each visit to include pain, range of motion, strength, and metacarpal height. Complications, concomitant procedures, and revision procedures were recorded as well.</p><p><strong>Results: </strong>A total of 49 arthroscopic trapeziectomy procedures were recorded for 46 patients. The average preoperative visual analog pain scale score was 8.8 out of 10, and the postoperative score was 1 out of 10. All patients had a resolution of the carpometacarpal grind test postoperatively. The average preoperative key pinch, 3-point chuck, and grip strength were 9.8 lbs/in², 7.8 lbs/in², and 45 lbs/in², respectively. Final 6-month postoperative key pinch, 3-point chuck, and grip strength were 11.0 lbs/in², 9.8 lbs/in², and 49.2 lbs/in², respectively. Metacarpal height subsided on average 50%. We report one revision and no cases of radial sensory neuritis or flexor tendon rupture.</p><p><strong>Conclusions: </strong>Arthroscopic total trapeziectomy appears to be a safe and effective treatment for end-stage arthrosis of the thumb basal joint.</p><p><strong>Level of evidence: </strong>2b Therapeutic; Individual Cohort Study.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1096-1100"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief Ectopic Banking and Immediate Plate Fixation With Free Omental Flap Addresses Multiple Fundamental Problems for Single-Stage Replant of Transhumeral Amputation.","authors":"David Chi, Anna Rose Johnson, Andrea Biaggi-Ondina, John M Felder, Shoichiro Tanaka, Thomas H Tung","doi":"10.1177/15589447251314143","DOIUrl":"10.1177/15589447251314143","url":null,"abstract":"<p><p>High-velocity traumatic amputations of the proximal upper extremity are devastating to the patient and represent an extreme surgical challenge to the treatment team. The hand surgeon must simultaneously battle devascularization with timely microvascular anastomosis, gross contamination with meticulous debridement, and amputation with stable fixation. In restoring a functional extremity, many of these goals are in contention with each other. This case describes a novel management strategy for a left transhumeral amputation sustained by a 23-year-old man in a motorcycle accident. The amputated arm was temporized by ectopic banking via the lateral circumflex femoral artery to allow for thorough debridement and immediate open reduction internal plate fixation with coverage provided by a free omental flap and subsequent split-thickness skin graft. This strategy allows for a single-stage treatment of upper arm amputations with immediate microvascular anastomosis, stable internal fixation, and soft tissue coverage by the omentum providing immunogenic and lymphangiogenic properties to combat infection, lymphedema, and swelling. Functional reconstruction was then performed in a staged fashion with a free functional muscle transfer using the contralateral gracilis.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"NP1-NP7"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Effects of Volar-Assisted and Elastic Wrist Splints on Edema, Pain, Grip Strength, and Functionality in Pregnant Women With Carpal Tunnel Syndrome.","authors":"Funda Mete Cavus, Cagtay Maden, Begumhan Turhan","doi":"10.1177/15589447241257647","DOIUrl":"10.1177/15589447241257647","url":null,"abstract":"<p><strong>Background: </strong>Carpal tunnel syndrome (CTS) is a common musculoskeletal problem in pregnancy. The aim of this study is to compare the effects of rigid and elastic wrist splints on edema, pain levels, grip strength, and upper-extremity functionality in pregnant women with CTS.</p><p><strong>Methods: </strong>Forty-one pregnant women in the last trimester of pregnancy who were diagnosed with CTS were included in the study. The grip strength was evaluated with the Jamar hand dynamometer, functionality with the Quick Disabilities of the Arm, Shoulder, and Hand and Boston Carpal Tunnel Syndrome Questionnaire, pain with the Visual Analog Scale (VAS), and edema with the water overflow method.</p><p><strong>Results: </strong>The mean age of the participants was 31.71 ± 5.78 years, body mass index was 28.85 ± 3.63 kg/m², duration of pain was 2.24 ± 0.79 months, and their pain intensity was 6.63 ± 1.69 according to the VAS. As a result of the study, reductions in pain (<i>P</i> = .001), increases in functionality values (<i>P</i> = .001), increases in grip strength (<i>P</i> = .001), and decreases in edema (<i>P</i> = .001) were observed in both groups after the treatment. However, there was no significant difference in pain, functionality, or grip strength values between the groups after the treatment (<i>P</i> > .05).</p><p><strong>Conclusion: </strong>In this study comparing the effects of a wrist splint to those of an elastic splint, both treatment methods for pregnant women with CTS decreased pain and edema, increased grip strength, and improved upper-extremity functionality. Considering individual needs, characteristics, and living conditions, both splints can be recommended for pregnant women with CTS.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1048-1056"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding Radiology Reports: Artificial Intelligence-Large Language Models Can Improve the Readability of Hand and Wrist Orthopedic Radiology Reports.","authors":"James J Butler, Ernesto Acosta, Michael C Kuna, Michael C Harrington, Andrew J Rosenbaum, Michael T Mulligan, John G Kennedy","doi":"10.1177/15589447241267766","DOIUrl":"10.1177/15589447241267766","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to assess the effectiveness of an Artificial Intelligence-Large Language Model (AI-LLM) at improving the readability of hand and wrist radiology reports.</p><p><strong>Methods: </strong>The radiology reports of 100 hand and/or wrist radiographs, 100 hand and/or wrist computed tomography (CT) scans, and 100 hand and/or wrist magnetic resonance imaging (MRI) scans were extracted. The following prompt command was inserted into the AI-LLM: \"Explain this radiology report to a patient in layman's terms in the second person: [Report Text].\" The report length, Flesch reading ease score (FRES), and Flesch-Kincaid reading level (FKRL) were calculated for the original radiology report and the AI-LLM-generated report. The accuracy of the AI-LLM report was assessed via a 5-point Likert scale. Any \"hallucination\" produced by the AI-LLM-generated report was recorded.</p><p><strong>Results: </strong>There was a statistically significant improvement in mean FRES scores and FKRL scores in the AI-LLM-generated radiograph report, CT report, and MRI report. For all AI-LLM-generated reports, the mean reading level improved to below an eighth-grade reading level. The mean Likert score for the AI-LLM-generated radiograph report, CT report, and MRI report was 4.1 ± 0.6, 3.9 ± 0.6, and 3.9 ± 0.7, respectively. The hallucination rate in the AI-LLM-generated radiograph report, CT report, and MRI report was 3%, 6%, and 6%, respectively.</p><p><strong>Conclusions: </strong>This study demonstrates that AI-LLM effectively improves the readability of hand and wrist radiology reports, underscoring the potential application of AI-LLM as a promising and innovative patient-centric strategy to improve patient comprehension of their imaging reports.<b>Level of Evidence:</b> IV.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1144-1152"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}