HAND最新文献 - Book学术

Reduction and Association of the Scaphoid and Lunate Versus Internal Brace for Scapholunate Ligament Reconstruction. 舟月骨韧带重建中舟月骨复位联合与内支架的比较。

IF 1.3

HAND Pub Date : 2026-11-01 Epub Date: 2026-02-15 DOI: 10.1177/15589447251414125

Michelle Richardson, Adam Margalit, Gerardo Sanchez, Peter Ren, Samara Moll, Liana Tedesco, Jadie De Tolla, Jacques Hacquebord, Omri Ayalon

{"title":"Reduction and Association of the Scaphoid and Lunate Versus Internal Brace for Scapholunate Ligament Reconstruction.","authors":"Michelle Richardson, Adam Margalit, Gerardo Sanchez, Peter Ren, Samara Moll, Liana Tedesco, Jadie De Tolla, Jacques Hacquebord, Omri Ayalon","doi":"10.1177/15589447251414125","DOIUrl":"10.1177/15589447251414125","url":null,"abstract":"Background: The purpose of this study is to compare outcomes in patients with isolated unrepairable scapholunate (SL) injuries treated with the reduction and association of the scaphoid and lunate (RASL) screw technique versus suture anchors with an internal brace (IB).Methods: Patients treated with either the RASL screw or IB technique for a complete, nonrepairable SL injury were identified. Radiographic and clinical data were recorded preoperatively, immediate postoperatively, and at final follow-up. Patients were then contacted via telephone survey, and Quick Disabilities of the Arm, Shoulder, and Hand (qDASH) questionnaire was administered. Patients with less than 6 months of follow-up were excluded.Results: Twenty-five patients (19 men, 6 women) with an average age of 43 (range = 23-66) years were identified (RASL = 14 and IB = 11). There were no differences between groups in radiographic parameters or range of motion at final follow-up, except for a smaller SL gap at final follow-up in RASL patients (1.5 vs 2.4 mm, P = .03). Four patients in the RASL (29%) group required additional procedures for screw removal secondary to screw breakage (n = 1) or screw migration/loosening (n = 3). One patient in the IB group had complete failure/diastasis postoperatively, and 36% (4/11) of patients had osteolysis at final follow-up. At final follow-up, qDASH was 26 versus 31 in the IB versus RASL groups (P = .79).Conclusions: Both RASL and IB have similar postoperative outcomes when treating SL injuries. It is important to note complications of screw breakage/loosening associated with RASL and recurrent diastasis/gapping and high rate of osteolysis with IB, although this has an unknown clinical significance.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1659-1667"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12909137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146201437","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

Digital Nerve Repair With Flexor Tendon Injury: Conduits are Less Effective. 指神经修复屈肌腱损伤：导管不太有效。

IF 1.3

HAND Pub Date : 2026-11-01 Epub Date: 2025-12-30 DOI: 10.1177/15589447251406917

Jonathan Isaacs, Sanju Eswaran, Asif Ilyas, Kenneth R Means, L Scott Levin

{"title":"Digital Nerve Repair With Flexor Tendon Injury: Conduits are Less Effective.","authors":"Jonathan Isaacs, Sanju Eswaran, Asif Ilyas, Kenneth R Means, L Scott Levin","doi":"10.1177/15589447251406917","DOIUrl":"10.1177/15589447251406917","url":null,"abstract":"Background: Digital nerve injuries resulting in gaps not amendable to direct coaptation are frequently reconstructed utilizing conduits or processed nerve allograft (PNA). Concurrent flexor tendon repair necessitates the incorporation of a postoperative rehab protocol. The effects of this early mobilization on digital nerve regeneration following PNA or conduit reconstruction are not known.Methods: Patient data collected during the RECON study included static 2-point discrimination (S2PD) and Semmes-Weinstein Monofilament testing following digital nerve reconstruction for gap defects of 5 to 25 mm with either PNA or conduits. Additional data included concurrent procedures such as flexor tendon repair and participation in rehab protocols. Outcomes were compared with respect to concurrent flexor tendon repair across all reconstruction techniques.Results: A total of 182 enrollees were included in analysis. Of these, 67 patients suffered concomitant flexor tendon and digital nerve injuries. Thirty-five and 32 of these patients received PNA and collagen conduits for their nerve repairs, respectively. For the patients that underwent tendon repair, S2PD was 6.8 mm in the PNA group and 8.1 mm in the conduit group. S3 + or better was achieved following 65.7% of the PNA and 71.9% conduit reconstructions in the flexor tendon repair group. A significantly lower percentage of conduit repairs achieved American Society for Surgery of the Hand classification normal and fair in patients with tendon injuries (50%) versus those without tendon injury (73.3%) (P = .038).Conclusions: Following digital nerve gap reconstruction in a large multi-center prospective, randomized trial, concurrent flexor tendon repair with early mobilization may have compromised conduit efficacy.Clinical trial registry: NCT01809002.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1590-1596"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12756053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145862824","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

IF 1.3

HAND Pub Date : 2026-11-01 Epub Date: 2026-01-25 DOI: 10.1177/15589447251414126

Sophia Jacobi, Emily Davidovic-Katz, Michelle Richardson, Samara Moll, Janos Barrera, Jacques Hacquebord

{"title":"Patient-Related Factors Associated With Scaphoid Proximal Pole Avascular Necrosis Healing.","authors":"Sophia Jacobi, Emily Davidovic-Katz, Michelle Richardson, Samara Moll, Janos Barrera, Jacques Hacquebord","doi":"10.1177/15589447251414126","DOIUrl":"10.1177/15589447251414126","url":null,"abstract":"Background: Avascular necrosis (AVN) of the proximal pole is a well-known complication of scaphoid fractures. Avascular necrosis is poorly understood, including the transition from ischemia to necrosis, optimal treatment, and why some AVN heals but others do not. The primary purpose of this study is to evaluate patient-related factors that are associated with healing outcomes in individuals with proximal pole AVN following scaphoid fractures.Methods: This is a retrospective review of all patients diagnosed with scaphoid proximal pole AVN secondary to a fracture from 2018 to 2024 in a single center. Patient baseline characteristics and comorbidities at time of diagnosis were collected. If the patient underwent surgical management, procedural factors were collected. The primary outcome was AVN healing after 4 months of follow-up.Results: A total of 62 patients met inclusion criteria. Thirty of 62 (48.4%) went onto proximal pole AVN resolution. Hyperlipidemia (P = .030), advanced age at time of diagnosis (P = .038), and elevated body mass index (BMI) (P = .026) were independent factors associated with lack of AVN healing. For patients who underwent surgical management, there was no significant difference in healing outcomes between use of a nonvascularized, or no graft, and use of a vascularized bone flap (P = .115, P = .886, respectively).Conclusions: Hyperlipidemia, elevated BMI, and advanced age are patient factors negatively associated with scaphoid proximal pole AVN healing-key information for accurately assessing patient prognosis. For surgical management, the choice of a vascularized bone, nonvascularized bone graft, or no graft does not significantly impact AVN healing.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1686-1692"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12834686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046431","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 Adaptive Proximal Scaphoid Implant: Long-Term Follow-Up. 适应性舟状骨近端植入物：长期随访。

IF 1.3

HAND Pub Date : 2026-11-01 Epub Date: 2026-01-18 DOI: 10.1177/15589447251404959

Massimo Corain, Andrea Colombo, Umberto Lavagnolo

{"title":"The Adaptive Proximal Scaphoid Implant: Long-Term Follow-Up.","authors":"Massimo Corain, Andrea Colombo, Umberto Lavagnolo","doi":"10.1177/15589447251404959","DOIUrl":"10.1177/15589447251404959","url":null,"abstract":"Background: Scaphoid proximal pole fracture with avascular necrosis is a surgical challenge, particularly in patients with high functional demand. An option is the pyrocarbon adaptive proximal scaphoid implant (APSI), replacing the necrotic proximal pole.Methods: A long-term follow-up study of the early cases treated in our department was conducted. Thirty-six patients with a median follow-up time of 19 years (range, 11-25) were included in the analysis, performing clinical and radiological evaluations.Results: Clinically, significant improvements were observed in mean pain Numeric Rating Scale (from 6.8 [SD 2.1] to 2 [2]), range of motion, grip strength measured with the Jamar dynamometer (from 18 [8] kg to 24 [9] kg), Disabilities of the Arm, Shoulder, and Hand score (from 66 [6.5] to 13.7 [6.4]), and Patient-Rated Wrist Evaluation score (from 73 [10] to 28 [12]). Radiographs showed good implant stability. No patient required implant removal.Conclusion: The APSI prosthesis proves effective long term in relieving pain, improving function, and preventing carpal collapse through stable biomechanical integration.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1668-1675"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12812508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997890","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 Effect of Scapholunate Interval and Angle on Radiocarpal Joint Loading. 舟月骨间隔和角度对桡腕关节负荷的影响。

IF 1.3

HAND Pub Date : 2026-11-01 Epub Date: 2026-02-04 DOI: 10.1177/15589447251414113

Thomas France, Songyuan Gu, Winthrop Lockwood, Todd Baldini, Carson Keeter, Steven Glickel, Louis W Catalano

{"title":"The Effect of Scapholunate Interval and Angle on Radiocarpal Joint Loading.","authors":"Thomas France, Songyuan Gu, Winthrop Lockwood, Todd Baldini, Carson Keeter, Steven Glickel, Louis W Catalano","doi":"10.1177/15589447251414113","DOIUrl":"10.1177/15589447251414113","url":null,"abstract":"Introduction: Carpal instability related to scapholunate ligament injury can manifest as an increased scapholunate (SL) interval and/or angle. Radiocarpal arthrosis is expected with chronic carpal instability due to an imbalance of normal joint loading. This study seeks to quantify the effect of an increased SL interval and angle on joint loading properties.Methods: Radioscaphoid (RS) and radiolunate (RL) contact area and pressure were collected in 13 cadaveric specimens tested under the following conditions (#): normal SL interval and SL angle (1), increased interval only (2), increased angle only (3), and both increased interval and angle (4).Results: Compared with condition 1, RS contact area decreased by 21%, 49%, and 33% in conditions 2, 3, and 4, respectively, and RL contact area increased by 0.3%, 55%, and 36%. Compared with condition 1, RS pressure increased by 167%, 207%, and 185% in conditions 2, 3, and 4, respectively, and RL pressure decreased by 13% in condition 2 and increased by 27% and 76% in conditions 3 and 4, respectively.Conclusions: Radioscaphoid and RL joint loading properties change with an increased SL interval and angle. An increased SL angle alters radiocarpal joint loading to a greater extent than an increased SL interval. As a result, an increased SL angle likely has a more significant impact on the development of carpal arthrosis.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1652-1658"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12872416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113066","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

Not Just for Kids: A Systematic Review of Outcomes of the Thenar Flap. 不只是儿童：大鱼际皮瓣的系统评价结果。

IF 1.3

HAND Pub Date : 2026-11-01 Epub Date: 2026-01-19 DOI: 10.1177/15589447251406716

Camren S Toole, Carlos R Martinez, Joshua M Adkinson

{"title":"Not Just for Kids: A Systematic Review of Outcomes of the Thenar Flap.","authors":"Camren S Toole, Carlos R Martinez, Joshua M Adkinson","doi":"10.1177/15589447251406716","DOIUrl":"10.1177/15589447251406716","url":null,"abstract":"Fingertip injuries are common, and the thenar flap is a well-described technique used to maintain digital length. However, its use in patients aged 30 years and above is generally discouraged due to concerns regarding postoperative joint contracture. The purpose of this review was to evaluate whether these concerns are substantiated. A search of PubMed, Embase, and SCOPUS (1947-2025) identified 15 studies involving 519 flaps. Case reports and studies lacking functional outcome data were excluded. Bias was assessed using the Methodological Items for Non-Randomized Studies instrument, and results were synthesized using Microsoft Excel. Joint contracture occurred in 32.4% of cases, all of which involved only the distal interphalangeal (DIP) joint. Active range of motion (AROM) at the metacarpophalangeal and proximal interphalangeal (PIP) joints remained near normal and comparable with contralateral finger values. Distal interphalangeal joint AROM was reduced by 14.1° compared with contralateral fingers. Patients older than 30 years demonstrated a 3° greater PIP joint AROM than younger patients (P = .02). Our analysis of the literature shows that there is an elevated risk of DIP joint contracture after thenar flap reconstruction of a fingertip injury, but this risk was not significantly different in patients above 30 years. Further investigation with larger studies and standardized outcomes assessment is recommended.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1576-1582"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12815617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997911","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

Upper Limb Wound Profile in Patients Who Inject Heroin and Fentanyl Mixed With Xylazine. 注射海洛因、芬太尼与噻嗪混合剂患者上肢伤口特征分析。

IF 1.3

HAND Pub Date : 2026-11-01 Epub Date: 2026-01-18 DOI: 10.1177/15589447251397009

Attila K Dos Santos, Talia A Sisroe Dos Santos, Bhargav Doddala, David Zabel

{"title":"Upper Limb Wound Profile in Patients Who Inject Heroin and Fentanyl Mixed With Xylazine.","authors":"Attila K Dos Santos, Talia A Sisroe Dos Santos, Bhargav Doddala, David Zabel","doi":"10.1177/15589447251397009","DOIUrl":"10.1177/15589447251397009","url":null,"abstract":"Background: Over the last few decades, hand surgeons have described a variety of wounds resulting from opioid use disorder (OUD). In the Philadelphia region, fentanyl mixed with xylazine has risen as a substance of choice. Our primary focus is to report and compare the upper limb wound morphology in patients using fentanyl/xylazine with patients using heroin.Methods: A retrospective cohort study was performed by reviewing charts of patients seen in consultation in a single plastic surgeon's private practice for upper limb soft tissue infections associated with opioid use from September 1, 2019, to November 30, 2023. Seventy patients were included and stratified based on wound morphology.Results: We identified 70 patients (36% male, 64% female). In the heroin group, the most common wound was abscess (50%). In the fentanyl/xylazine group, it was full-thickness wound (55%). Chi-square analysis revealed a significant relationship between substance used (heroin or fentanyl/xylazine) and wound severity (mild/moderate or severe), χ2 (1, N = 70) = 42.06, P < .0001.Conclusions: There is a paucity of medical literature about the spectrum of wound manifestations in OUD. Our data suggests that heroin use more commonly causes unilateral soft tissue injuries, which is likely a result of site-specific infection with intravenous administration. Patients using fentanyl/xylazine had a higher rate of bilateral upper limb injury and presented with more severe wounds than patients who used heroin. Hand surgeons must be informed on the spectrum of wound morphology with OUD and nuances between substances to best manage them in their practice.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1737-1741"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12815641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997963","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 Impact of Scapholunate Angle Correction on Radiographic Union in Adult Scaphoid Nonunion Surgery: An Institutional Retrospective Cohort Study. 成人舟骨不连手术中舟月骨角度矫正对影像学愈合的影响：一项机构回顾性队列研究。

IF 1.3

HAND Pub Date : 2026-11-01 Epub Date: 2026-01-18 DOI: 10.1177/15589447251397007

Philip P Ratnasamy, Peter Y Joo, Neil Pathak, Claire A Donnelley, Xuan Luo

{"title":"The Impact of Scapholunate Angle Correction on Radiographic Union in Adult Scaphoid Nonunion Surgery: An Institutional Retrospective Cohort Study.","authors":"Philip P Ratnasamy, Peter Y Joo, Neil Pathak, Claire A Donnelley, Xuan Luo","doi":"10.1177/15589447251397007","DOIUrl":"10.1177/15589447251397007","url":null,"abstract":"Background: The objective of the study is to characterize factors associated with radiographic union and pain at final follow-up in surgical repair of scaphoid nonunion.Methods: Patients who underwent scaphoid nonunion repair at our institution between 2005 and 2024 were retrospectively reviewed. Demographic and surgical factors were abstracted. Preoperative, immediate postoperative, and final follow-up scapholunate (SL) angles were measured. Radiographic union (>75% healing) and patient-reported pain at final follow-up were assessed. Associations between SL angle measurements, patient characteristics, and surgical variables with union and pain were evaluated using unpaired t tests and χ2 tests.Results: Fifty-five patients met inclusion criteria with persistent nonunion occurring in 17 patients (30.1%). Patient sex was significantly associated with union (P = .045) but not pain at final follow-up (P = .399). All other demographic factors (smoking status, diabetes, prior surgery) and surgical factors (fracture location, surgical approach, implant type, graft type, and use of adjunct Kirschner-wire) were not significantly associated with union or pain at final follow-up (all P > .05). Among SL angle measurements, only a lower final follow-up SL angle was significantly associated with higher union rates (P = .038). No SL angle measurement was associated with pain at follow-up (all P > .05).Conclusions: Patient sex was associated with union. No other demographic or surgical variables were associated with union or pain at final follow-up. A lower SL angle at final follow-up was independently associated with successful union, suggesting that correction of carpal alignment may contribute to improved healing in scaphoid nonunion repair.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1644-1651"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12815643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997941","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

Flexor Carpi Radialis and Dorsal Intercarpal Complex Elongation After 3 Ligament Tenodesis. 桡侧腕屈肌和腕背间复合体3韧带固定术后的延伸。

IF 1.3

HAND Pub Date : 2026-11-01 Epub Date: 2025-12-29 DOI: 10.1177/15589447251404957

Daniel Bakker, Steven Merkens, Niek Parser, Joost Colaris, Gert-Jan Kleinrensink, Nina Mathijssen, Gerald Kraan

{"title":"Flexor Carpi Radialis and Dorsal Intercarpal Complex Elongation After 3 Ligament Tenodesis.","authors":"Daniel Bakker, Steven Merkens, Niek Parser, Joost Colaris, Gert-Jan Kleinrensink, Nina Mathijssen, Gerald Kraan","doi":"10.1177/15589447251404957","DOIUrl":"10.1177/15589447251404957","url":null,"abstract":"Background: To improve the surgical procedure and rehabilitation after surgery, a better understanding of the biomechanical properties of the 3 ligament tenodesis (3LT) procedure is necessary.Method: This study examined elongation in relation to flexion, and type of failure after 3LT using 10 anatomic specimens, each wrist undergoing 5 tests.Results: At 80° flexion mean elongation of the flexor carpi radialis (FCR) tendon slip was 0.96 ± 0.38 mm. Mean elongation of the dorsal intercarpal complex (DIC) was 3.75 ± 0.91 mm at 80° flexion. Relative elongation at the FCR tendon slip was 4.1% and 33.4% at the DIC. In 2 tests (4%), sutures loosened at the proximal side of the DIC after 30° flexion. Ruptures of the radiotriquetral ligament, pull-outs of the bone anchor or FCR tendon ruptures were not observed.Conclusion: This experiment suggests that following 3LT, the most elongation occurs at the DIC. Since instances of failure were noted at the proximal aspect of the DIC, if early active motion protocols are used, it is recommended to initiate wrist flexion with a limitation to 30° wrist flexion.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1706-1710"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12747861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850094","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

Outcomes of Metacarpal Shaft Fractures Treated by Open Reduction Internal Fixation With Plates and Screws Versus Intramedullary Screws. 切开复位钢板螺钉内固定与髓内螺钉治疗掌骨骨干骨折的疗效比较。

IF 1.3

HAND Pub Date : 2026-11-01 Epub Date: 2025-10-08 DOI: 10.1177/15589447251371087

Stephanie A Kwan, Tiffany N Bridges, Johnlevi S Lazaro, Jeffrey C Lynch, Christopher Jones, Jonas L Matzon, Michael Rivlin

{"title":"Outcomes of Metacarpal Shaft Fractures Treated by Open Reduction Internal Fixation With Plates and Screws Versus Intramedullary Screws.","authors":"Stephanie A Kwan, Tiffany N Bridges, Johnlevi S Lazaro, Jeffrey C Lynch, Christopher Jones, Jonas L Matzon, Michael Rivlin","doi":"10.1177/15589447251371087","DOIUrl":"10.1177/15589447251371087","url":null,"abstract":"Background: Metacarpal fractures are among the most common orthopedic injuries. When metacarpal shaft fractures require surgical fixation, common options include closed reduction percutaneous pinning, open reduction internal fixation (ORIF) using plates and screws (PS), and intramedullary screw fixation (IMS). Certain metacarpal shaft fractures are amenable to ORIF with either PS or IMS. The purpose of this study is to compare the functional outcomes and complication rates between these techniques.Methods: A retrospective review was performed of all patients that underwent ORIF with PS or IMS of metacarpal shaft fractures between the years 2015-2021 at a single, large private-academic institution. Postoperative patient-reported outcome measures were collected and medical records were reviewed for complications and range of motion (ROM). In addition, complications were subdivided into major and minor complications in accordance with previously published data on the subject.Results: A total of 120 patients (60 PS, 60 IMS) were included in this study, and each of the groups were similar in age at the time of procedure, sex, hand dominance, laterality, and mechanism of injury. Postoperative functional scores were similar among both groups. Metacarpophalangeal joint ROM in the acute postoperative period was significantly greater in the IMS group when compared with PS. The overall complication rate was not significantly different between the 2 groups.Conclusion: When treating metacarpal shaft fractures, both ORIF with PS and IMS can achieve acceptable outcomes. Patients treated with either fixation method should be counseled on the risk of developing symptomatic hardware that may require removal.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1720-1727"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12511004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250886","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