HAND最新文献

{"title":"Novel Treatment of Post-Traumatic Scaphoid Osteonecrosis in a Pediatric Patient Utilizing Temporary Scaphocapitate Fixation: A Case Report.","authors":"Jacob M Johnson, Joseph Cusano, Joseph A Gil","doi":"10.1177/15589447251325824","DOIUrl":"https://doi.org/10.1177/15589447251325824","url":null,"abstract":"<p><p>Avascular necrosis or osteonecrosis of the scaphoid following fracture is extremely rare in the pediatric population with no concrete treatment protocol established in the literature. In this case report, we present an 11-year-old boy with a scaphoid waist fracture nonunion complicated by proximal pole osteonecrosis. Due to the severe fragmentation of the scaphoid, fixation across the nonunion site was not feasible, and we instead used temporary scaphocapitate fixation. The patient ultimately had radiographically confirmed bony union and full wrist range of motion at 3 months post-op.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251325824"},"PeriodicalIF":1.8,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999358","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":"Ulnar Extrinsic Ligament Tears: Clinical Presentation, Surgical Management, and Outcomes of Surgical Repair Extending Into Long-term Follow-up.","authors":"Monica J Coughlan, Timothy J Irwin, Saral J Patel, Sebastian D Arango, Jacob Zeitlin, Andrew J Miller, A Lee Osterman, Meredith N Osterman","doi":"10.1177/15589447251329563","DOIUrl":"https://doi.org/10.1177/15589447251329563","url":null,"abstract":"<p><strong>Background: </strong>Injury to the ulnar extrinsic ligaments often causes significant pain without obvious instability. This study aims to further investigate the clinical presentations and outcomes following ulnar extrinsic ligament repair.</p><p><strong>Methods: </strong>A retrospective analysis of 113 patients who underwent ulnar extrinsic ligament surgery was conducted. Collected data included demographics, clinical presentation, intraoperative findings, and postoperative outcomes, such as grip strength, Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) scores, complications, and reoperations. Continuous variables were represented by the mean and standard deviation, whereas categorical variables were expressed as counts and percentages. A matched pair <i>T</i>-test was performed for grip strength and Q-DASH changes from pre-op to post-op for patients who had data available at both time points.</p><p><strong>Results: </strong>Preoperative symptoms primarily included wrist pain (100%), difficulties in rotation (16%), and weakness (16%). Intraoperatively, split tears (75%) and avulsions (11%) were common, often accompanied by triangular fibrocartilage complex (TFCC) pathology (83%). Postoperatively, grip strength improved significantly (<i>P</i> < .001), with a mean reduction of 30.3 points in Q-DASH scores (<i>P</i> < .001). Eighty percent of patients returned to work fully, 14% returned in a limited capacity, and 6% were unable to return to work. The overall complication rate was 9%. Reoperation rate was 8.8%. At final follow-up, 83% of patients reported that they would elect to undergo the same surgery again.</p><p><strong>Conclusions: </strong>Ulnar extrinsic ligament injuries frequently present with wrist pain and TFCC pathology. Surgical repair of ulnar extrinsic ligament injuries improves grip strength and functional outcomes with high patient satisfaction.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251329563"},"PeriodicalIF":1.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12006109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019711","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":"Analysis of Trapeziometacarpal Joint Mechanics During Spanning and Nonspanning Fixation for Thumb Metacarpal Distraction Lengthening.","authors":"Winthrop C Lockwood, Francisco Rodriguez-Fontan, Thomas J France, Alexander Lauder, Fraser Leversedge, Kyros Ipaktchi","doi":"10.1177/15589447251322916","DOIUrl":"https://doi.org/10.1177/15589447251322916","url":null,"abstract":"<p><strong>Background: </strong>Thumb trapeziometacarpal joint (TMj) contact area, pressures, and stability were quantified during metacarpal osteotomy and distraction lengthening with and without TMj-spanning fixation in a cadaver model. Spanning fixation was hypothesized to decrease TMj contact pressure, contact area, joint space narrowing, and subluxation compared with metacarpal fixation alone.</p><p><strong>Methods: </strong>Twenty matched-paired cadaver specimens underwent ligament-sparing thumb TMj dissection. A metacarpal external fixator was applied with and without a TMj-spanning component in 2 groups: spanning and nonspanning. A diaphyseal osteotomy was performed. The TMj contact pressure and area were recorded with an intraarticular sensor at baseline and at distraction intervals of 10, 20, 30, and 35 mm. The number of overloaded sensor cells (sensels), (>2000 psi) were recorded. The TMj subluxation and joint space width were assessed at all intervals with lateral thumb radiographs. Statistical analysis used paired 2-tailed <i>t</i> tests to account for inherent specimen characteristics.</p><p><strong>Results: </strong>Group 1 (TMj-spanning) exhibited a nonstatistically significant reduction in contact area and demonstrated fewer overloaded sensels. There was significantly less joint space narrowing and joint subluxation from 10 to 30 mm of distraction compared with group 2 (nonspanning).</p><p><strong>Conclusions: </strong>The TMj spanning fixation during metacarpal distraction decreased joint space narrowing and TMj subluxation. Despite finding reduced contact area and fewer overloaded sensels in group 1, these parameters did not reach statistical significance. Spanning TMj fixation may mitigate TMj instability during metacarpal distraction osteogenesis.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251322916"},"PeriodicalIF":1.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11996813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005677","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":"Assessing the Usability of ChatGPT Responses Compared to Other Online Information in Hand Surgery.","authors":"Ophelie Z Lavoie-Gagne, Oscar Y Shen, Neal C Chen, Abhiram R Bhashyam","doi":"10.1177/15589447251329584","DOIUrl":"https://doi.org/10.1177/15589447251329584","url":null,"abstract":"<p><strong>Background: </strong>ChatGPT is a natural language processing tool with potential to increase accessibility of health information. This study aimed to: (1) assess usability of online medical information for hand surgery topics; and (2) evaluate the influence of medical consensus.</p><p><strong>Methods: </strong>Three phrases were posed 20 times each to Google, ChatGPT-3.5, and ChatGPT-4.0: \"What is the cause of carpal tunnel syndrome?\" (high consensus), \"What is the cause of tennis elbow?\" (moderate consensus), and \"Platelet-rich plasma for thumb arthritis?\" (low consensus). Readability was assessed by grade level while reliability and accuracy were scored based on predetermined rubrics. Scores were compared via Mann-Whitney <i>U</i> tests with alpha set to .05.</p><p><strong>Results: </strong>Google responses had superior readability for moderate-high consensus topics (<i>P</i> < .0001) with an average eighth-grade reading level compared to college sophomore level for ChatGPT. Low consensus topics had poor readability throughout. ChatGPT-4 responses had similar reliability but significantly inferior readability to ChatGPT-3.5 for low medical consensus topics (<i>P</i> < .01). There was no significant difference in accuracy between sources. ChatGPT-4 and Google had differing coverage of cause of disease (<i>P</i> < .05) and procedure details/efficacy/alternatives (<i>P</i> < .05) with similar coverage of anatomy and pathophysiology.</p><p><strong>Conclusions: </strong>Compared to Google, ChatGPT does not provide readable responses when providing reliable medical information. While patients can modulate ChatGPT readability with prompt engineering, this requires insight into their health literacy and is an additional barrier to accessing medical information. Medical consensus influences usability of online medical information for both Google and ChatGPT. Providers should remain aware of ChatGPT limitations in distributing medical information.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251329584"},"PeriodicalIF":1.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019769","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":"Distal Brachial Artery Perforator: An Anatomic Study.","authors":"Hieu Trung Nguyen, Bao Van Thai Dinh, Tho Phuoc Pham, Duong Binh Tran, Khoi Manh Trang","doi":"10.1177/15589447251329589","DOIUrl":"https://doi.org/10.1177/15589447251329589","url":null,"abstract":"<p><strong>Background: </strong>The medial upper arm is a potential donor site for the perforator flaps because of its ideal thickness, pliability, excellent color, and well-hidden donor site scar. Its main vascular supply originates from the cutaneous perforators of the superior ulnar collateral artery and brachial artery. The purpose of this cadaveric study was to localize and describe the characteristics of the distal brachial artery perforator (DBAp), which supplies the distal medial upper arm, thereby providing databases for flap elevation.</p><p><strong>Methods: </strong>A cross-sectional study was carried out in 24 intact upper limbs from 12 fresh cadavers (6 men, 6 women). The surgical procedure was performed through 3 stages to locate the DBAp and then gather anatomical characteristics.</p><p><strong>Results: </strong>We always identify at least 1 DBAp in each arm. There were 30 perforators (mean number 1.25 ± 0.53). The average external diameter and length of perforator arteries were 0.95 ± 0.22 mm and 3.52 ± 1.29 cm, respectively. The majority of the points where the perforators pierce the deep fascia were spotted within a circle of 3.45 cm diameter, the center of which was 2.82 cm proximal (y value) and 1.40 cm lateral (x value) to the medial epicondyle. A consistent branch of the medial antebrachial cutaneous nerve (MACN) was found supplying sensory innervation to the DBAp flap.</p><p><strong>Conclusion: </strong>The DBAp flap is a viable option for reconstructing soft tissue defects in the elbow and regions such as the face, head, and neck.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251329589"},"PeriodicalIF":1.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980628","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":"Outcomes of Corticosteroid Injection for Lacertus Syndrome.","authors":"Michelle Frees, Christina M Ward","doi":"10.1177/15589447251331103","DOIUrl":"https://doi.org/10.1177/15589447251331103","url":null,"abstract":"<p><strong>Background: </strong>Lacertus syndrome is a proximal median nerve compression neuropathy characterized by weakness of flexor pollicis longus (FPL), index finger flexor digitorum profundus (FDP), and flexor carpi radialis (FCR) and pain with compression of the median nerve at the lacertus fibrosus. The purpose of this study was to investigate the efficacy of corticosteroid injection (CSI) for symptom management in lacertus syndrome.</p><p><strong>Methods: </strong>A retrospective review of patients with lacertus syndrome who underwent lacertus CSI between 2016 and 2021 was performed. Patient demographics, history, and physical examination were extracted from the electronic medical record. Outcomes included subjective improvement in symptoms, physical examination findings, incidence of repeat lacertus CSI, and/or subsequent surgical lacertus fibrosus release.</p><p><strong>Results: </strong>A total of 64 patients met the inclusion criteria. Chief complaint included hand/forearm pain in 44 patients (69%), median nerve paresthesias in 49 patients (77%), and hand weakness in 9 patients (14%). On examination, 63 (98%) had tenderness at the lacertus fibrosus. Manual motor testing identified weakness of the index FDP in 50 patients, FPL weakness in 42 patients, and FCR weakness in 23 patients. Forty-eight (75%) patients had subjective improvement in symptoms following CSI. Seventeen patients who had an initial response to CSI subsequently underwent surgical lacertus release, with 16 of 17 surgical patients reporting postoperative symptom relief.</p><p><strong>Discussion: </strong>Seventy-five percent of patients with lacertus syndrome who underwent CSI at the lacertus fibrosus experienced at least temporary subjective symptomatic relief. Of the 35% of patients who had recurrent symptoms after CSI and underwent surgery, the vast majority experienced symptom relief.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251331103"},"PeriodicalIF":1.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008507","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":"Utility of Patient-Reported Outcomes in Prognosis of Corticosteroid Injection Treatment Success for Trigger Finger and de Quervain's Stenosing Tenosynovitis.","authors":"Walter D Sobba, Sophia Jacobi, Gerardo Sánchez-Navarro, Liana Tedesco, Omri Ayalon, Ali Azad, Jacques H Hacquebord","doi":"10.1177/15589447251329577","DOIUrl":"https://doi.org/10.1177/15589447251329577","url":null,"abstract":"<p><strong>Background: </strong>Corticosteroid injections are a first-line treatment of trigger finger and de Quervain's tenosynovitis. Little research has evaluated preinjection patient-reported outcomes as a predictive factor for treatment success following corticosteroid injection. We hypothesized that patients with less pretreatment impairment would demonstrate greater post-treatment improvement than patients whose function was more severely impaired.</p><p><strong>Methods: </strong>We retrospectively reviewed prospectively collected Patient-Reported Outcomes Measurement Information System (PROMIS) upper extremity (UE) scores in patients undergoing corticosteroid injection for trigger finger or de Quervain's tenosynovitis from 2017 to 2023. Independent variables were patient baseline characteristics, comorbidities, and baseline PROMIS UE. The primary outcome was treatment success between 30 days and 12 weeks, defined as achieving the minimal clinically important difference for PROMIS UE without undergoing surgery.</p><p><strong>Results: </strong>In total, 240 trigger finger and 74 de Quervain's tenosynovitis patients (N = 314) were analyzed. Following injection, 63 (20.1%) patients achieved treatment success, 86 (27.4%) underwent surgical release, and 165 (52.5%) did not significantly improve function or undergo surgery. Each 1-point increase in baseline PROMIS UE was associated with 10% lower odds of treatment success (<i>P</i> < .001). Among nonoperative patients, each 1-point increase in baseline PROMIS UE was associated with a 0.51-point decrease in PROMIS UE score (<i>P</i> < .001) and diabetes was associated with a 2.74-point decrease in PROMIS UE after injection (<i>P</i> = .44).</p><p><strong>Conclusion: </strong>Corticosteroid injection provides meaningful improvement for a subset of trigger finger and de Quervain's tenosynovitis patients. Corticosteroid injection remains a first-line treatment for trigger finger and de Quervain's tenosynovitis patients, especially for those with more severe functional impairment.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251329577"},"PeriodicalIF":1.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011430","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":"Intramedullary Compression Screw Fixation of Proximal Phalanx Fractures: An Updated Systematic Review.","authors":"Dane C Peckston, Harrison Faulkner, David J Graham, Brahman S Sivakumar","doi":"10.1177/15589447251329597","DOIUrl":"https://doi.org/10.1177/15589447251329597","url":null,"abstract":"<p><p>Proximal phalangeal fractures occur at a higher frequency than other phalanges, but the optimal management of these injuries remains subject to debate. The use of intramedullary screw (IMS) fixation has gained popularity over the last decade and aims to minimize extensor apparatus violation whilst providing adequate construct stability to allow early motion and rehabilitation. This systematic review aims to provide an updated analysis of patient- and clinician-reported outcome measures following fracture fixation using IMS in the proximal phalanx. A literature search was conducted using PubMed, Ovid Medline, Embase, and the Cochrane Controlled Register of Trials, yielding 16 studies with 204 fractures for inclusion. A mean total active motion of 237°, Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) score of 3.58, and DASH score of 2.65 was revealed by pooled analysis of the included studies. A total complication rate of 6.4% was reported, including screw prominence, fracture displacement, infection, and flexion contracture. This updated systematic review finds good functional outcomes and a low complication rate following the use of IMS fixation for proximal phalangeal fractures.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251329597"},"PeriodicalIF":1.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011965","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":"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}