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Predictors of True Scaphoid Fractures in Children. 儿童真性肩胛骨骨折的预测因素

IF 1.8

HAND Pub Date : 2025-07-01 Epub Date: 2024-02-27 DOI: 10.1177/15589447241231311

Daniel Milad, Aneesh Karir, Kevin Smit, Sasha Carsen, Kevin Cheung

{"title":"Predictors of True Scaphoid Fractures in Children.","authors":"Daniel Milad, Aneesh Karir, Kevin Smit, Sasha Carsen, Kevin Cheung","doi":"10.1177/15589447241231311","DOIUrl":"10.1177/15589447241231311","url":null,"abstract":"Background: The scaphoid is the most commonly fractured carpal bone in children. True scaphoid fractures have proven to be difficult to diagnose, as they may not be apparent on initial imaging. Children with clinical suspicion of a scaphoid fracture may be treated with continued immobilization, even in the absence of radiographic evidence of a fracture. The purpose of this study is to identify predictors of true scaphoid fractures in children to help guide management.Methods: This study is a retrospective cohort study of children presenting to a tertiary pediatric hospital with hand or wrist injuries. Patients were grouped based on the presence of a true scaphoid fractures (confirmed on imaging) or those with clinical suspicion of a scaphoid fracture alone (no radiographic evidence of fracture). Demographic and clinical characteristics were compared with univariate and multivariate statistics to identify fracture predictors.Results: One hundred and thirty patients were included in the study: 57 in the true scaphoid fracture group and 73 in the clinical scaphoid fracture group. Patients with a true scaphoid fracture were older than those with a clinical scaphoid fracture (median age [interquartile range], 14.2 [13.0-15.4] vs 12.9 [11.9-14.4], P = .01). Men were more likely to sustain a true scaphoid fracture (65.0% vs 35.0%, P = .01). Older age and male sex were shown to be independent predictors of true scaphoid fractures (odds ratio [95% confidence interval], 1.25 [1.03-1.50] and 2.93 [1.39-6.17], respectively).Conclusions: In the pediatric population, older age and male children may be at increased risk of true scaphoid fractures. This may help guide decisions surrounding further imaging and treatment.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"706-710"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971697","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}

引用次数: 0

Estimating the Minimal Clinically Important Difference on the Visual Analogue Scale for Carpometacarpal Thumb Joint Osteoarthritis. 估算拇指掌关节骨关节炎视觉模拟量表的最小临床意义差异

IF 1.8

HAND Pub Date : 2025-07-01 Epub Date: 2024-03-16 DOI: 10.1177/15589447241235344

Oluwatobi R Olaiya, Beraki Abraha, Lucas Gallo, Caroline Hircock, Minh Huynh, Matthew McRae

{"title":"Estimating the Minimal Clinically Important Difference on the Visual Analogue Scale for Carpometacarpal Thumb Joint Osteoarthritis.","authors":"Oluwatobi R Olaiya, Beraki Abraha, Lucas Gallo, Caroline Hircock, Minh Huynh, Matthew McRae","doi":"10.1177/15589447241235344","DOIUrl":"10.1177/15589447241235344","url":null,"abstract":"Background: The minimal clinically important difference (MCID) is the smallest perceived treatment effect that patients deem clinically significant. There is currently no agreement on an appropriate MCID for the pain visual analogue scale (VAS) in the context of thumb osteoarthritis (OA).Methods: We approximated MCIDs using a distribution-based approach that pooled standard deviations (SDs) associated with baseline mean values of the pain VAS (0-100 mm). We extracted the data from randomized controlled trials (RCTs) included in a systematic review of adults with long-term OA of the thumb. We excluded RCTs that did not report baseline SD values. The MCIDs were derived at 0.4 and 0.5 SDs of the pooled SD and compared with previously published MCIDs for the pain VAS in OA.Results: A total of 403 patients were pooled from 7 RCTs for the analysis. The mean baseline VAS pain score was 5.6 cm. We derived an MCID of 0.72 cm at 0.4 SDs and 0.91 cm at 0.5 SDs using baseline SDs. We found that MCIDs derived from a distribution-based approach approximated published MCIDs for the VAS for pain for OA in the knee and hip.Conclusion: The authors propose that a change of 0.7 to 0.9 cm on the VAS is clinically meaningful in the context of long-term OA of the thumb.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"720-724"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140197","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}

引用次数: 0

A Comparison of Outcomes in Acute Perilunate Injuries: Systematic Review and Meta-Analysis of Treatment Approaches. 急性肛周损伤的疗效比较：治疗方法的系统回顾和元分析。

IF 1.8

HAND Pub Date : 2025-07-01 Epub Date: 2024-02-28 DOI: 10.1177/15589447241231291

Matthew V Abola, Brett A Gerber, Madeline C Rocks, Jeffrey S Chen, Jacques H Hacquebord, Ali Azad

{"title":"A Comparison of Outcomes in Acute Perilunate Injuries: Systematic Review and Meta-Analysis of Treatment Approaches.","authors":"Matthew V Abola, Brett A Gerber, Madeline C Rocks, Jeffrey S Chen, Jacques H Hacquebord, Ali Azad","doi":"10.1177/15589447241231291","DOIUrl":"10.1177/15589447241231291","url":null,"abstract":"Background: Perilunate dislocations (PLD) and fracture-dislocations (PLFD) comprise a spectrum of high-energy wrist injuries. The purpose of this review was to review operative strategies for perilunate injuries based on approach and compare outcomes.Methods: A systematic review of literature on PLD and fracture-dislocations was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). PubMed and EMBASE databases were queried for literature. Inclusion criteria included English studies reporting clinical or functional outcomes of acute PLD and PLFD.Results: Twenty-nine full-text articles (604 PLD and PLFD injuries) were included. The most common method of PLD and PLFD fixation is through an open approach with combined volar and dorsal exposure. There were no differences between approaches with regard to total arc range of motion, grip strength, Mayo Wrist Score, or mean scapholunate angle. Similarly, there was no difference between approaches and postoperative radiographic arthritis or complications. Most patients were able to return to their prior level of function and work. The incidence of postoperative complications ranged from 0% to 22.5%.Conclusion: Current evidence shows no difference in postoperative total wrist arc range of motion, grip strength (as compared to contralateral), or Mayo Wrist Score with regard to surgical approach. The most common method of PLD and PLFD fixation in the literature is through an open approach with combined volar and dorsal exposure. There is a large difference in reported rates of radiographic arthritis, although this finding does not appear to correlate with postoperative pain or disability.Level of evidence: I, Systematic Review.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"725-732"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982813","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}

引用次数: 0

Management of Pediatric Volar Plate Avulsion Fractures of the Proximal Interphalangeal Joint: A Systematic Review. 小儿近端指间关节沃尔钢板撕脱骨折的处理：系统回顾。

IF 1.8

HAND Pub Date : 2025-07-01 Epub Date: 2024-02-21 DOI: 10.1177/15589447241231308

Hongseo Choi, Seong Hui Moon, Hosouk Lee, Sabrina Poppy Barnes, Yangmyung Ma, Andrea Jester, Sami Al-Ani

{"title":"Management of Pediatric Volar Plate Avulsion Fractures of the Proximal Interphalangeal Joint: A Systematic Review.","authors":"Hongseo Choi, Seong Hui Moon, Hosouk Lee, Sabrina Poppy Barnes, Yangmyung Ma, Andrea Jester, Sami Al-Ani","doi":"10.1177/15589447241231308","DOIUrl":"10.1177/15589447241231308","url":null,"abstract":"Background: Sudden, forced hyperextension injuries to the proximal interphalangeal joint leading to volar plate avulsion fractures are common hand injuries in children. Suboptimal management of these fractures can lead to the development of long-term complications such as stiffness and flexion contracture.Methods: MEDLINE (PubMed), Scopus, Embase, Google Scholar, and Cochrane CENTRAL databases were systematically searched, and additional studies were found through reference of articles up to June 15, 2023. Identified articles were assessed using predetermined inclusion/exclusion criteria.Results: Twenty-five articles were included, involving 268 patients with ages from 3 to 17 years. Fractures with less than 30% joint involvement, classified as Eaton type I or II, or designated as \"Stable\" in the Keifhaber-Stern classification, were treated through nonsurgical means. Surgical interventions, encompassing open reduction and internal fixation, were reserved for fractures with more than 30% joint involvement and/or meeting criteria such as Eaton type IIIa or IIIb and Keifhaber-Stern \"Tenuous\" or \"Unstable.\" Positive outcomes were seen in 99.5% of patients receiving nonsurgical treatment, compared with 85.7% in the surgical cohort.Conclusions: The literature demonstrated positive outcomes for fractures presenting with less than 30% joint involvement that were managed nonsurgically. In fractures with more than 30% joint involvement, surgical interventions yielded positive results. To further substantiate these findings, larger prospective studies with uniform measures are needed to validate the results of this study.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"664-674"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139912528","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}

引用次数: 0

Quite a Pickle: A 10-Year Increase in Pickleball-Related Hand Injuries. 相当棘手与乒乓球有关的手部伤害十年来的增长。

IF 1.8

HAND Pub Date : 2025-07-01 Epub Date: 2024-03-17 DOI: 10.1177/15589447241238371

Peter K Firouzbakht, Kazimir Bagdady, Rohun Gupta, Stephen M Lu, Kevin Chen

{"title":"Quite a Pickle: A 10-Year Increase in Pickleball-Related Hand Injuries.","authors":"Peter K Firouzbakht, Kazimir Bagdady, Rohun Gupta, Stephen M Lu, Kevin Chen","doi":"10.1177/15589447241238371","DOIUrl":"10.1177/15589447241238371","url":null,"abstract":"Background: Pickleball popularity has significantly increased in the United States. Wrist, hand, and finger injuries are commonly seen among pickleball players and are on the rise.Methods: The National Electronic Injury Surveillance System database was queried from 2013 to 2022 tennis- and pickleball-related injuries in the United States. Data were filtered to include wrist, hand, and finger injuries only.Results: There were a total of 12 021 estimated pickleball injuries between 2013 and 2022, most commonly in white women greater than 55 years old. The most common mechanism of injury (90.5%) was a fall. The number of injuries increased by 765.6% between 2013 and 2022. The growth in the number of pickleball-related injuries was found to be statistically significant (P < .05), whereas the growth for tennis-related injuries was found to be not statistically different from 0. There was a statistical difference between the growth of the number of pickleball injuries per year and the number of tennis injuries. The wrist was the most common location of injury (70.0%) compared with the hand (10.5%) and fingers (19.5%). The most common injury diagnosis was fracture (60.3%). Overall, the most common injury was wrist fracture (50.0%).Conclusions: Hand surgeons should be aware of the increasing prevalence of pickleball-related injuries as an alternative mechanism of injury, particularly among the elderly.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"790-794"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140143247","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}

引用次数: 0

The Limited Utility of Routine Pathologic Examination of Ganglion Cyst Excision From the Hand and Digits. 手部和拇指神经节囊肿切除术的常规病理学检查作用有限。

IF 1.8

HAND Pub Date : 2025-07-01 Epub Date: 2024-02-20 DOI: 10.1177/15589447241231292

Carlton J Fernandes, Heather K Yee, Felicity G Fishman

{"title":"The Limited Utility of Routine Pathologic Examination of Ganglion Cyst Excision From the Hand and Digits.","authors":"Carlton J Fernandes, Heather K Yee, Felicity G Fishman","doi":"10.1177/15589447241231292","DOIUrl":"10.1177/15589447241231292","url":null,"abstract":"Background: It is routine practice at many institutions to send surgically excised ganglion cysts for pathologic analysis. This adds significant cost to the procedure with questionable benefit. The purpose of this study was to determine the necessity of routine pathologic examination of ganglion cysts excised from the hand.Methods: We conducted a retrospective review of 443 patients who underwent ganglion excision from the hand with routine pathologic examination between 2012 and 2022. The final pathologic diagnosis was compared with the treating surgeon's clinical diagnosis, and the rates of concordant, discrepant, and discordant diagnoses were identified. Discrepant diagnoses were defined as differing clinical and pathologic diagnoses that did not change clinical management. Discordant diagnoses were defined as differing clinical and pathologic diagnoses that altered the treatment plan.Results: The prevalence of a concordant diagnosis was 96.2% (426 of 443; 95% confidence interval, 94.4%-98.0%). The prevalence of a discrepant diagnosis was 3.8% (17 of 443; 95% confidence interval, 2.1%-5.6%), and the prevalence of a discordant diagnosis was 0. The odds ratio was 0.04 for a discrepant diagnosis and 0 for a discordant diagnosis.Conclusions: Our study suggests abandoning routine pathologic analysis in patients undergoing ganglion cyst excision from the hand will not compromise quality of care when the surgeon is able to make a confident diagnosis. Discrepant diagnoses were rare and discordant diagnoses that did not occur. We recommend pathologic evaluation only when there is uncertainty in the clinical diagnosis.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"660-663"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139912529","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}

引用次数: 0

Comparison of Intramedullary Screw Fixation, Plating, and K-Wires for Metacarpal Fracture Fixation: A Meta-Analysis. 髓内螺钉固定、钢板固定和 K 型钢丝用于掌骨骨折固定的比较：元分析。

IF 1.8

HAND Pub Date : 2025-07-01 Epub Date: 2024-02-27 DOI: 10.1177/15589447241232094

Cristina R DelPrete, John Chao, Bobby B Varghese, Patricia Greenberg, Hari Iyer, Ajul Shah

{"title":"Comparison of Intramedullary Screw Fixation, Plating, and K-Wires for Metacarpal Fracture Fixation: A Meta-Analysis.","authors":"Cristina R DelPrete, John Chao, Bobby B Varghese, Patricia Greenberg, Hari Iyer, Ajul Shah","doi":"10.1177/15589447241232094","DOIUrl":"10.1177/15589447241232094","url":null,"abstract":"Background: Metacarpal fractures are common injuries with multiple options for fixation. Our purpose was to compare outcomes in metacarpal fractures treated with intramedullary screw fixation (IMF), Kirschner wires (K-wires), or plating.Methods: A systematic literature review using the MEDLINE database was performed for studies investigating metacarpal fractures treated with IMF, plating, or K-wires. We identified 34 studies (9 IMF, 8 plating, 17 K-wires). A meta-analysis using both mixed and fixed effects models was performed. Outcome measures included mean Disabilities of the Arm, Shoulder, and Hand (DASH) scores, total active motion (TAM), grip strength, time to radiographic healing, and rates of infection and reoperation.Results: Patients with IMF had significantly lower DASH scores (0.6 [95% confidence interval [CI], 0.2-1.0]) compared with K-wires (7.4 [4.8-9.9]) and plating (9.8 [5.3-14.3]). Intramedullary screw fixation also had significantly lower rates of reoperation (4%, [2%-7%]), compared with K-wires (11% [7%-16%]) and plating (11% [0.07-0.17]). Grip strength was significantly higher in IMF (104.4% [97.0-111.8]) compared with K-wires (88.5%, [88.3-88.7]) and plating (90.3%, [85.4-95.2]). Mean odds ratio time was similar between IMF (21.0 minutes [10.4-31.6]) and K-wires (20.8 minutes [14.0-27.6]), but both were shorter compared with plating (52.6 minutes [33.1-72.1]). There were no statistically significant differences in time to radiographic healing, TAM, or rates of reoperation or infection.Conclusions: This meta-analysis compared the outcomes of metacarpal fixation with IMF, K-wires, or plating. Intramedullary screw fixation provided statistically significant lower DASH scores, higher grip strength, and lower rates of reoperation, suggesting that it is a comparable method of fixation to K-wires and plating for metacarpal fractures.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"691-700"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971696","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}

引用次数: 0

Early Results in Total Replacement of the Distal Radioulnar Joint. 桡骨远端关节全置换术的早期效果。

IF 1.8

HAND Pub Date : 2025-07-01 Epub Date: 2024-03-04 DOI: 10.1177/15589447241233362

Mark P Smith, William B Kleinman, Nicholas E Crosby

{"title":"Early Results in Total Replacement of the Distal Radioulnar Joint.","authors":"Mark P Smith, William B Kleinman, Nicholas E Crosby","doi":"10.1177/15589447241233362","DOIUrl":"10.1177/15589447241233362","url":null,"abstract":"Background: Pathology of the distal radioulnar joint (DRUJ) including instability and arthritis presents a challenge for hand and upper extremity surgeons. Surgical options include a Darrach procedure and similar resections, soft tissue interposition arthroplasty, and a one-bone forearm. In 2005, a prosthesis for DRUJ arthroplasty was approved for use in the United States. The authors hypothesize that DRUJ arthroplasty will lead to improved pain and range of motion (ROM) with a moderate, but manageable, complication rate.Methods: A retrospective review of 46 patients who underwent DRUJ arthroplasty by a single private group of hand surgeons was performed. Demographics, complications, postoperative visual analog scale (VAS), and postoperative ROM were obtained and analyzed.Results: The patients were followed up for a mean of 60 weeks. The implant was used both as primary surgical treatment for DRUJ pathology and as salvage for previous failed procedures. Twenty-two percent of patients experienced complications: 15% required revision surgery. No patients were converted to another type of implant, including those who underwent revision surgery. Prominent hardware was the most common indication requiring revision. Patients achieved an improvement in supination of 17° and extension of 5°. They additionally achieved a decrease in average VAS score from 7.1 to 2.3.Conclusions: Distal radioulnar joint arthroplasty reduces pain and improves ROM in patients with DRUJ pathology with a 22% complication rate. This cohort demonstrates improved pain, modest improvement in ROM, but a 22% complication rate for this implant. Further long-term studies are encouraged.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"733-739"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140027930","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}

引用次数: 0

Intramedullary Screw Fixation of Proximal Phalangeal Fractures: Short- to Medium-Term Outcomes. 髓内螺钉固定近端指骨骨折：短期至中期疗效

IF 1.8

HAND Pub Date : 2025-07-01 Epub Date: 2024-03-15 DOI: 10.1177/15589447241235339

Hagen Abbot, Adam R George, Luke McCarron, David J Graham, Brahman Sivakumar

{"title":"Intramedullary Screw Fixation of Proximal Phalangeal Fractures: Short- to Medium-Term Outcomes.","authors":"Hagen Abbot, Adam R George, Luke McCarron, David J Graham, Brahman Sivakumar","doi":"10.1177/15589447241235339","DOIUrl":"10.1177/15589447241235339","url":null,"abstract":"Background: Intramedullary screw fixation of phalangeal and metacarpal fractures has gained popularity as a method of providing rigid internal fixation with minimum tendon disturbance, allowing early mobilization and rehabilitation. Despite this, the literature on outcomes using this technique is limited. Thus, the aim of this study was to assess the short-term to medium-term outcomes of intramedullary screw fixation for proximal phalangeal fracture fixation in an Australian setting.Methods: A retrospective analysis of consecutive patients with a fracture(s) of the proximal phalanx fixated using intramedullary screws between January 2020 and March 2023 was conducted via telehealth.Results: Forty-six phalangeal fractures from 37 patients were included in this study. Mean Quick Disabilities of the Arm, Shoulder, and Hand score of 6.2 (range: 0-61.4, median: 0), mean pain visual analogue scale score of 1.8 (range: 1-7, median: 1), and mean total active motion of 231° (range: 132-282) were noted. A total of 4.4% of fractures sustained a major complication, and 94.6% of patients reported willingness to undergo intramedullary screw fixation again.Conclusion: This study concurs with the prior literature that intramedullary screw fixation is a safe and effective method of stabilizing extra-articular proximal phalangeal fractures in the short to medium term. Superior clinical outcomes, as well as cost-effectiveness and time-effectiveness, render it a viable alternative to plate fixation in this setting.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"684-690"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140198","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}

引用次数: 0

Comparison of Low-Dose Computed Tomography Versus Conventional-Dose Computed Tomography in the Evaluation of Distal Radius Fractures. 低剂量计算机断层扫描与传统剂量计算机断层扫描在评估桡骨远端骨折中的比较。

IF 1.8

HAND Pub Date : 2025-07-01 Epub Date: 2024-03-07 DOI: 10.1177/15589447241232016

Steven L Zeng, A Jordan Grier, Hannah C Langdell, Kier M Blevins, William M Tian, Robert J French, Suhail K Mithani, Warren C Hammert, Christopher S Klifto

{"title":"Comparison of Low-Dose Computed Tomography Versus Conventional-Dose Computed Tomography in the Evaluation of Distal Radius Fractures.","authors":"Steven L Zeng, A Jordan Grier, Hannah C Langdell, Kier M Blevins, William M Tian, Robert J French, Suhail K Mithani, Warren C Hammert, Christopher S Klifto","doi":"10.1177/15589447241232016","DOIUrl":"10.1177/15589447241232016","url":null,"abstract":"Background: Distal radius fractures (DRFs) are common upper extremity fractures and often require surgical fixation when they are intraarticular. Preoperative computed tomography (CT) has emerged as a surgical planning tool to evaluate intraarticular DRFs. Although CT affords additional details, patients receive higher radiation doses than standard radiographs. We aim to develop a low-dose CT (LDCT) protocol, relative to the institutional standard-dose CT wrist for intraarticular DRFs although providing adequate detail for surgical decision-making.Methods: A single-institution prospective study was conducted on patients with intraarticular DRFs who underwent closed reduction and below-elbow splinting who otherwise would undergo wrist CT. Observations were defined as total measurements taken, with each view undergoing 44 measurements. Patients underwent 2 scans with a standard dose and a 10× dose reduction. Articular step and gap measurements were recorded in the sagittal and coronal images.Results: A total of 11 patients were enrolled (7 women and 4 men). The mean age was 55 years (SD = 20.1). There were a total of 4 reviewers: 1 attending surgeon, 2 resident physicians, and 1 student. When comparing LDCT and conventional-dose CT (CDCT), there were no significant differences in step and gap measurements across all reviewers.Conclusion: This study demonstrated that LDCT provides comparable imaging quality for surgical planning as a CDCT without significant diagnostic decay in the setting of DRFs. This comes with the added benefit of a 10-fold reduction in radiation exposure. These results suggest that LDCT is an opportunity to reduce effective radiation in patients although providing beneficial preoperative imaging.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"755-761"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140049284","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}

引用次数: 0