HAND最新文献

{"title":"Assessment of Union Rates in Ballistic Hand Fractures.","authors":"Cedar Slovacek, Kayla Prezelski, Andi Zhang, Alejandro Ruiz, Heidi Israel, Kevin Chen, Brian Mailey","doi":"10.1177/15589447251325819","DOIUrl":"10.1177/15589447251325819","url":null,"abstract":"<p><strong>Background: </strong>Ballistic hand fractures (BHFs) are complex, multistructure injuries, unique from other hand fractures. We sought to determine BHF union rates and assess factors contributing to nonunion.</p><p><strong>Methods: </strong>Metacarpal or phalangeal BHFs sustained from 2016 to 2023 were identified from an institutional database. Charts and radiographs were reviewed for fracture characteristics and union by 90 days. Fractures without union by 90 days or without minimum 90-day follow-up were excluded. Comminuted fractures were categorized by severity: (1) complete bone loss (NC); (2) partial bony contact (PC); or (3) full (>80%) bony contact (FC). Univariate and multivariate analysis was performed to determine factors associated with nonunion.</p><p><strong>Results: </strong>Ninety-seven BHFs were included. Most were comminuted (78.4%, N = 76). Greater fracture severity was associated with larger bony gap (FC: 2.2 vs PC: 10.2 vs NC: 24.0 mm; <i>P</i> < .001). The overall union rate was 48.5% (N = 47); however, less severe BHF (ie, noncomminuted, FC) had higher rates of union than more severe BHF (ie, PC and NC; 93% and 60.5% vs 36% and 7.7%; <i>P</i> = .003). On multivariate regression, bony gap was an independent predictor of nonunion (<i>P</i> = .02). Thirteen BHFs underwent additional surgery with 90% achieving union within 90 days.</p><p><strong>Conclusions: </strong>Ballistic hand fractures treated with a single surgery demonstrate low union rates (48.5%). Two-stage reconstruction should be considered in all BHFs to improve union rates, particularly when severe comminution or large bony gaps are present. Following stabilization and soft tissue coverage, a second stage with conversion to internal fixation, debridement of devitalized bone, and secondary bone grafting should be performed.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251325819"},"PeriodicalIF":1.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772219","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":"Predictive Factors for Patient Recovery Following Triangular Fibrocartilage Foveal Repair Surgery: A Retrospective Case-Series.","authors":"Luke McCarron, Brooke K Coombes, Randy Bindra, Brett Dyer, Steven Watson, Leanne Bisset","doi":"10.1177/15589447251325821","DOIUrl":"10.1177/15589447251325821","url":null,"abstract":"<p><strong>Background: </strong>There are many factors that may influence patient recovery following triangular fibrocartilage complex (TFCC) foveal repair surgery. This study aimed to retrospectively analyze patient records following TFCC foveal repair surgery to identify characteristics that predict patient outcomes.</p><p><strong>Methods: </strong>A multicenter, retrospective case-series was conducted. Informed written consent was obtained from participating hand therapy clinics, who provided deidentified patient records for adult patients following TFCC foveal repair surgery between January 1 2015 and December 31 2020. Predictors of outcomes were identified using Linear Mixed Effects Regression and Logistic Regression models.</p><p><strong>Results: </strong>A total of 210 patients were included. The most notable improvements in range of motion (ROM) and grip strength, and pain reduction, were observed in the first 10 weeks postsurgery. Longer forearm immobilization duration predicted poorer ROM for pronation, flexion, and extension. Workcover (compensable) patients demonstrated poorer ROM progression compared with private patients. Forty-two patients (20%) required further surgery, of which was due to postoperative TFCC rupture for 22 patients (10%). Patients who received a shorter wrist immobilization period were more likely to experience TFCC rupture. The duration of time between injury and operative treatment did not predict ROM, grip strength, or pain progression.</p><p><strong>Conclusions: </strong>Longer forearm immobilization predicted poorer ROM and grip strength progression, whereas shorter wrist immobilization predicted an increased risk of TFCC rupture. These findings support a staggered commencement of wrist and forearm ROM exercises, whereby forearm rotation exercises could commence earlier than wrist exercises. The duration of time between injury and operative treatment did not predict ROM, grip strength, or pain progression.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251325821"},"PeriodicalIF":1.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752375","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":"Long-Term Patient-Reported Outcomes After Release of the Ulnar Nerve in Guyon's Canal.","authors":"Ritsaart F Westenberg, Daphne van Hooven, Niels W L Schep, J Henk Coert, Kyle R Eberlin, Neal C Chen","doi":"10.1177/15589447251325827","DOIUrl":"10.1177/15589447251325827","url":null,"abstract":"<p><strong>Background: </strong>There are no large studies describing patient-reported outcomes after ulnar tunnel release (UTR). The aims of this study are to describe the causes of ulnar tunnel syndrome (UTS), the incidence of UTR, and identify factors associated with long-term patient-reported outcomes after UTR.</p><p><strong>Methods: </strong>We reviewed the medical charts of 76 adult patients who had an UTR for UTS at 1 of 5 academic medical centers between January 1, 2003 and January 1, 2017. Of these patients, 30 completed a follow-up questionnaire including the PROMIS Upper Extremity (PROMIS-UE), Numerical Rating Scale for Pain Intensity (NRS Pain), the Global Rating Scale of Change, and a custom questionnaire about satisfaction and current UTS-specific symptoms.</p><p><strong>Results: </strong>Approximately 3% of the patients who underwent a decompression surgery of the ulnar nerve at one of our centers between 2003 and 2017 had a UTR. The most frequent described cause of compression was ganglion cyst (16%). The 30 patients who completed the follow-up survey had a mean ± SD PROMIS-UE score of 46.0 ± 12 and a median (interquartile range) NRS Pain score of 0.5 (0-4). Twenty-five patients (83%) described themselves improved compared to before UTR. Bivariate analysis showed that patients who had a preoperative electromyography and nerve conduction velocity study (EMG/NCV) positive for UTS had a higher mean ± SD PROMIS-UE score compared to patients who had a negative EMG/NCV for UTS, respectively 48 ± 12 versus 37 ± 7.6, <i>P</i> = .04.</p><p><strong>Conclusion: </strong>Diagnosis of UTS is challenging and made with substantial variation among surgeons. We observed that most patients improve after UTR, but patients with a negative EMG/NCV have a lower PROMIS Upper Extremity score at long-term follow-up.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251325827"},"PeriodicalIF":1.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742715","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":"Comparative Outcomes of Surgical and Nonsurgical Treatments for Scapholunate Ligament Injuries With Concomitant Distal Radius Fractures: A Systematic Review.","authors":"Nicole Liddy, Cara Mohammed, Sten H Kajitani, Niyathi Prasad, Sukrit J Suresh, Philip Mathew, Dawn M LaPorte","doi":"10.1177/15589447251324533","DOIUrl":"10.1177/15589447251324533","url":null,"abstract":"<p><p>Distal radius fractures (DRFs) are common, especially in elderly populations, and often occur alongside scapholunate (SL) ligament injuries (SLIs), which can progress to scapholunate advanced collapse if untreated. There is no standardized treatment for SLIs with DRFs, with options ranging from conservative management to surgical interventions. This review aims to evaluate functional, radiographic, and clinical outcomes of surgical and nonsurgical treatments for SLIs associated with DRFs. A systematic search was conducted across PubMed, ScienceDirect, and Embase according to International Prospective Register of Systematic Reviews and Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Studies comparing surgical and nonsurgical management in adults (≥18 years) with SLIs and DRFs were included. Outcomes assessed included Disabilities of the Arm, Shoulder, and Hand (DASH) scores, QuickDASH scores, Mayo Wrist Scores, mean grip strength, SL gap, SL angle, and wrist range of motion (ROM). Thirteen studies involving 4315 DRF patients (423 with SLIs) were analyzed. Surgical treatment showed better functional outcomes, with lower DASH scores (<i>P</i> = .0011) and improved radiographic alignment, indicated by lower SL angles (<i>P</i> = 7.5 × 10^-20). However, wrist ROM was lower in surgically treated patients, particularly in flexion (<i>P</i> = .00031) and extension (<i>P</i> = .0080). Pain was the most commonly reported complication across both groups. Surgical treatment for SLIs with DRFs may lead to functional and radiographic outcomes similar to nonsurgical options, but is associated with reduced wrist mobility. Nonsurgical management remains effective for patients with milder symptoms. Further research is necessary to refine treatment protocols and optimize outcomes for these complex injuries.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251324533"},"PeriodicalIF":1.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742637","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":"Early Amyloid Diagnosis and Treatment: Experience of Single Hand Surgeon With a Series of 182 Carpal Tunnel Biopsies.","authors":"Corinne Vennitti, Miloš Lešević, James D Bergin, Dylan N Deal","doi":"10.1177/15589447251326617","DOIUrl":"10.1177/15589447251326617","url":null,"abstract":"<p><strong>Background: </strong>Amyloidosis is a systemic disease characterized by buildup of abnormal amyloid deposits that may lead to multiple organ failure and is associated with early onset musculoskeletal manifestations. Orthopedic surgeons are positioned to aid with early diagnosis in the form of a biopsy which allows for workup for other areas of disease, specifically cardiac manifestations, and intervention prior to irreversible cardiac damage. In this review, we describe the biopsy results of a series of 182 patients and workup and treatment of the 46 amyloid positive patients biopsied by a single surgeon during a 4-year period.</p><p><strong>Methods: </strong>We retrospectively reviewed biopsy results from 2019 to 2024 for all patients who met criteria for biopsy at time of open carpal tunnel release (CTR). All surgeries were performed by a single surgeon at a single academic institution. Patient selection was based on a previously published algorithm.</p><p><strong>Results: </strong>Forty-six (25.3%) of 182 patients who underwent CTR and met criteria for biopsy were found to test positive on Congo red staining and liquid chromatography tandem mass spectrometry. All 46 patients were referred to cardiology for evaluation. Thirty-three patients completed cardiology evaluation and 32 of those patients were started on treatment as a result of testing.</p><p><strong>Conclusions: </strong>The incidence of amyloid positive biopsy results was 25.3% in a single surgeon, single institution study using currently accepted screening criteria. All positive patients were referred for cardiac imaging and evaluation to obtain early diagnosis of amyloid cardiomyopathy and initiate treatment if indicated. A significant portion of patients referred to cardiology (58%) were started on pharmacological management as a result.</p><p><strong>Level of evidence: </strong>Retrospective cohort study, II, prognostic.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251326617"},"PeriodicalIF":1.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742638","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":"Is Immobilization Necessary After Open Reduction and Internal Fixation of Distal Radius Fractures? A Meta-Analysis of Randomized Controlled Trials.","authors":"Mohammad Daher, Jack C Casey, Pierre Helou, Alan H Daniels, Joseph A Gil","doi":"10.1177/15589447251325825","DOIUrl":"10.1177/15589447251325825","url":null,"abstract":"<p><p>Distal radius fractures (DRFs) are the most common fractures in adults. With the increased trend in open reduction and internal fixation (ORIF) using a volar locking plate, the postoperative rehabilitation course remains debated and whether or not a postoperative immobilization is necessary is unknown. PubMed, Cochrane, and Google Scholar (pages 1-20) were queried through August 2024. Inclusion criteria consisted of studies that compared patients undergoing immediate mobilization after ORIF for DRF with patients undergoing postoperative immobilization. Adverse events, patient-reported outcomes measures, and range of motion (ROM) were all compared between the 2 groups at various postoperative time points. Four randomized controlled trials were included in this study. No difference was seen in the risk of complications (odds ratio = 1.17, <i>P</i> = .70) and reoperations (odds ratio = 1.35, <i>P</i> = .53) between the 2 groups. The immediate mobilization group had lower pain scores at 6 months (mean difference = -0.46, <i>P</i> = .005) and lower Disabilities of the Arm, Shoulder, and Hand at 3 months (mean difference = -0.45, <i>P</i> = .002), and 6 months (mean difference = -0.46, <i>P</i> = .005). As for ROM, better forearm rotation was seen in the immediate mobilization group at 6 months (mean difference = 3.43, <i>P</i> = .004).</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251325825"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718792","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":"Decade-Long Examination of Gender Disparities in Session and Speaker Roles at Hand Surgery Conferences.","authors":"Chloe C Krasnoff, Peter C Ferrin, Ellie A Moeller, Brynn A Hathaway","doi":"10.1177/15589447251324664","DOIUrl":"10.1177/15589447251324664","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates women speakership over a 10-year period at a major hand surgery conference, specifically focusing on differences in speaker specialty, speaking roles, and session topics.</p><p><strong>Methods: </strong>Data from the American Association for Hand Surgery annual conference meeting programs between 2014 and 2024 were collected (excluding 2021 due to its virtual nature). Data regarding gender, speaking role, and specialty were extracted and verified via internet search. Each session was additionally categorized by topic. A reference of 14% women composition was used to compare proportional representation of women in various categories.</p><p><strong>Results: </strong>Three thousand and ninety-four speaking opportunities were identified for 1631 presenters, consisting of 27.7% women individual speakers and 28.3% women total speaking opportunities. Women made up the minority of all physician groups and majority of nonphysician groups. Among surgeons, women plastic surgeons were proportionately overrepresented while women orthopedic surgeons were underrepresented. Women constituted 18.8% of leadership and 32.3% of secondary positions. Women composed less than 40% of speakers of all sessions, with proportionately higher leadership rates in nontechnical sessions, panels, abstract sessions, and symposia and similar rates in keynotes and skills courses. Finally, 30.15% of all sessions had men-only speakers.</p><p><strong>Conclusion: </strong>Women represent a minority across all categories analyzed, including overall speaking roles, leadership and secondary roles, and session types. Proportionately, women were overrepresented among plastic surgeons and underrepresented among orthopedic surgeons. Despite existing initiatives encouraging women to pursue careers in hand surgery, the field must prioritize achieving gender parity, particularly in representation at national conferences.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251324664"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718789","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":"Fixation of the Volar Ulnar Corner in Distal Radius Fractures: A Comparative Study.","authors":"Thomas S Soussou, Jason Chan, Dominick Congiusta, Teren Yedikian, Daniella Ogilvie, Michael Vosbikian, Irfan Ahmed","doi":"10.1177/15589447251326201","DOIUrl":"10.1177/15589447251326201","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to compare outcomes of distal radius fractures with a volar ulnar corner (VUC) component treated with standard volar plating or by specific VUC fixation. This study investigated outcomes, radiographic measures, and specialty-based preference associated with surgical treatment of VUC injuries using VUC-specific fixation versus nonspecific VUC fixation.</p><p><strong>Methods: </strong>We retrospectively analyzed outcomes for 39 patients with a distal radius fracture with VUC component at a level-1 trauma center over 10 years, 2011-2021. Patients underwent either VUC-specific fixation with implants such as a volar rim plate, or with a standard volar plate. The primary outcome of this study was fixation failure and need for revision. Secondary outcomes included complication rate, radiographic alignment, and differences in fixation based on fellowship training.</p><p><strong>Results: </strong>Sixteen of the 39 patients studied had undergone VUC-specific fixation, with a significantly higher rate of use of VUC-specific fixation in fellowship trained hand surgeons compared with fellowship-trained trauma surgeons. There was no significant difference in loss of reduction, revision surgery, or complications. Radiographic measures were statistically similar between both groups postoperatively. Trauma trained surgeons had a significantly increased postoperative radial inclination versus hand-trained surgeons.</p><p><strong>Conclusions: </strong>This study suggests that not all VUC injuries require specific VUC fixation, and we may be overtreating distal radius fractures that have a VUC component. Fellowship-trained hand surgeons are more likely to employ VUC-specific fixation methods. Additional studies are warranted to determine whether other considerations such as dynamic testing intraoperatively are worthwhile.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251326201"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718791","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":"Factors Associated With 30-Day Readmission in Hand Surgery Patients.","authors":"Gabriela Sendek, Paige Benyamein, Rachel Segal, Meera Reghunathan, Reid Abrams","doi":"10.1177/15589447251325820","DOIUrl":"10.1177/15589447251325820","url":null,"abstract":"<p><strong>Background: </strong>Surgical patient hospital readmissions are costly to the health care system. The Affordable Care Act Hospital Readmissions Reduction Program introduced penalties for high hospital readmission rates. We performed a retrospective study evaluating factors associated with readmission in hand surgical inpatients.</p><p><strong>Methods: </strong>We performed a retrospective chart review on 566 patients admitted to a level 1 trauma center for hand trauma or infection from January 1, 2016, to December 31, 2019. Data included demographics, social history, medical problems, comorbidities, procedure details, and admission and readmission details. A multivariable regression analysis was performed to identify factors associated with hospital readmission within 30 days.</p><p><strong>Results: </strong>Cigarette smoking (<i>P</i> = .048), bite wound (<i>P</i> = .038), laceration wound (<i>P</i> = .028), laceration repair (<i>P</i> < .01), open reduction internal fixation (<i>P</i> = .041), and disposition to a skilled nursing facility (<i>P</i> = .017) were significantly associated with readmission to the hospital within 30 days. For patients who underwent emergency department interventions, alcohol use (<i>P</i> = .034), houselessness (<i>P</i> = .046), and malnutrition (<i>P</i> = .036) were additional factors associated with readmission.</p><p><strong>Conclusions: </strong>Immediately irremediable factors such as tobacco and alcohol abuse, malnutrition, and houselessness should be considered as exemptions for penalties levied on health care systems for readmissions. Initiating targeted interventions, such as detoxification, smoking cessation, housing assistance, and improved nutrition, may reduce readmission risk and could improve patient outcomes.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251325820"},"PeriodicalIF":1.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692074","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":"The Use of Digital Hand Sympathectomies for the Treatment of Ischemia and Pain Following Inadvertent Corticosteroid Injection of the Radial Artery: Two Case Reports.","authors":"Luke Anderson, Victoria Masear, Ashley Bentley, Grady Maddox","doi":"10.1177/15589447251322915","DOIUrl":"10.1177/15589447251322915","url":null,"abstract":"<p><p>Osteoarthritis of the carpometacarpal (CMC) joint of the thumb is commonly treated with intraarticular corticosteroid injections in clinic. In this case report, we present 2 patients who experienced immediate pain, pallor, and discoloration of their fingers distal to the site of attempted injection of the CMC joint of the thumb. It is believed that this occurred due to inadvertent injection of the dorsal branch of the radial artery as it branches to join both the superficial and deep palmar arches. This caused vasospasm and vasoocclusion leading to subsequent ischemia. To relieve symptomatic pain and prevent ischemic necrosis, both patients underwent sympathectomies of the radial and ulnar arteries and of the common palmar digital arteries. Both patients experienced relief of their pain and reperfusion of their hand and digits.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251322915"},"PeriodicalIF":1.8,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692075","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}