HAND最新文献

{"title":"Reevaluating the Need for Antibiotic Prophylaxis in Adult Upper Extremity Surgery With Hardware.","authors":"Yufan Yan, Nathan Khabyeh-Hasbani, Rami Z Abuqubo, Joshua M Cohen, Victoria P Robbins, Aravind Pothula, Steven M Koehler","doi":"10.1177/15589447241307051","DOIUrl":"10.1177/15589447241307051","url":null,"abstract":"<p><strong>Background: </strong>Although it is well established that antibiotic prophylaxis is not needed in soft tissue upper extremity cases, there is still no definitive consensus when hardware implantation is involved. We hypothesize that antibiotic prophylaxis is not necessary and there is no difference in postoperative surgical site infection rates regardless of preoperative antibiotic administration.</p><p><strong>Methods: </strong>A retrospective cohort analysis was performed on upper extremity surgical cases with hardware implantation performed at a single institution amongst 5 hand surgeons between November 2021 and November 2023. Implants included plates, screws, Kirschner wires, and suture anchors. Primary outcome measures were diagnosis of surgical site infection by 14 and 30 days postoperatively. Secondary outcomes included the type of management used to treat infection. Categorical variables were compared using Fisher exact test, and continuous variables were compared using Wilcoxon rank-sum test.</p><p><strong>Results: </strong>A total of 232 patients were included for analysis-152 received antibiotic prophylaxis and 80 did not. There were no differences between the 2 groups in terms of demographic factors, comorbidities, or smoking status. There was no difference in infection rates between the group who received antibiotic prophylaxis and the group who did not. Infection rate in the antibiotic prophylaxis group was 4.6% and in the sans antibiotics group was 2.5%. All infections were treated with antibiotics, and there were no differences in the rates of operative washout and hardware removal between the 2 groups.</p><p><strong>Conclusions: </strong>Antibiotic prophylaxis is not necessary in upper extremity surgical cases even when implantation of hardware is involved.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447241307051"},"PeriodicalIF":1.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864071","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":"Predictors of Functional Outcomes of Nonoperatively Treated Extra-articular Distal End Radius Fractures in Older Individuals: A Prospective Clinical Study.","authors":"Neel Aggarwal, Siddhartha Sinha, Arvind Kumar, Sandeep Kumar, Owais A Qureshi, Javed Jameel","doi":"10.1177/15589447241305421","DOIUrl":"10.1177/15589447241305421","url":null,"abstract":"<p><strong>Background: </strong>Distal radius fractures (DRFs) are some of the most common injuries suffered by the elderly; however, there are varied opinions on management. As there is limited research on patient factors affecting functional outcomes in conservatively managed patients with DRFs, this study aimed to find predictive factors for functional outcomes in such patients.</p><p><strong>Methods: </strong>Patients with DRFs satisfying the inclusion criteria were managed with closed reduction and slab followed by cast application. Radiological parameters (radioulnar angulation, dorsal tilt, radial height, and ulnar variance) and functional scores (patient-rated wrist evaluation [PRWE] score, Short Form 8 questionnaire [SF-8], and QuickDASH [Disabilities of the Arm, Shoulder, and Hand]-9) were recorded prereduction, postreduction, at the time of cast removal, and in follow-up visits. Patient factors such as underlying diseases were also recorded, and correlations were analyzed using appropriate software.</p><p><strong>Results: </strong>Patients with diabetes (43.33% of patients) and those with loss in radial height through the course of treatment were found to have poorer functional outcomes (<i>P</i>-values less than .05 for all functional scores-PRWE, QuickDASH-9, SF-8-except SF-8 at 12 weeks). Patients younger than 60 years were also found to have better functional outcomes at 24 weeks (for PRWE: <i>P</i>-value = .048, for QuickDASH-9: <i>P</i>-value = .032, and for SF-8: <i>P</i>-value = .026).</p><p><strong>Conclusion: </strong>Conservative management plays a major role in the treatment of DRFs, despite the increasing trend of operative management. Diabetes was found to be a predictor of poorer functional outcomes; however, further research is needed to determine the role of these and other factors in detail.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447241305421"},"PeriodicalIF":1.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864069","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":"Anatomical Characterization and Topographic Mapping of the Distal Ulnar Nerve and Its Peripheral Branches: A Cadaveric Analysis.","authors":"Benjamin Pautler, Charles Marchese, Makayla Swancutt, Bryan G Beutel","doi":"10.1177/15589447241306151","DOIUrl":"10.1177/15589447241306151","url":null,"abstract":"<p><strong>Background: </strong>Understanding peripheral ulnar nerve anatomy is necessary to refine surgical treatment of ulnar nerve injuries. This study topographically mapped the ulnar nerve and its distal branch points from a well-defined surgical landmark and assessed for variations in interfascicular motor arrangement and branch size.</p><p><strong>Methods: </strong>Fifty-four cadaveric upper extremities were dissected to expose the distal ulnar nerve and its branches (dorsal cutaneous (DCB), volar sensory (VSB), and motor branches). The motor branch underwent internal neurolysis to record the topographic orientation of abductor digiti minimi (ADM) and flexor pollicis brevis (FPB) fascicles and the combined intrinsic fascicle identified by its terminal branch (first dorsal interosseus (FDI)). Using a standardized grid system, the branch point location of each terminal branch was measured relative to the hook of the hamate. Diameters of VSB, DCB, and motor fascicles were also measured.</p><p><strong>Results: </strong>Mean branch point coordinates relative to the hook of the hamate for the FDI were 22.8 mm radial/32.1 mm distal, 13.6 mm radial/25.1 mm distal for FPB, 7.7 mm ulnar/5.2 mm proximal for ADM, and 15.7 mm ulnar/95.3 mm proximal for DCB. The diameters of the VSB, motor branch, and DCB had a mean of 2.3, 1.9, and 1.6 mm, respectively. Proximal to the hook of the hamate, the fascicular arrangement from radial-to-ulnar was VSB, FPB, FDI/intrinsics, ADM, and DCB.</p><p><strong>Conclusions: </strong>This study provides a complete characterization and mapping of the distal ulnar nerve and its branches to assist surgeons with treatment of ulnar nerve injuries, including nerve transfer.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447241306151"},"PeriodicalIF":1.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864067","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":"Time to Amputation After Traumatic Digital Injury Does Not Affect Complication Rates: A Retrospective Multi-Institutional Analysis.","authors":"Makenna Ash, Jennifer Wang, Ambika Menon, Ciara Brown, Paul Ghareeb","doi":"10.1177/15589447241302360","DOIUrl":"10.1177/15589447241302360","url":null,"abstract":"<p><strong>Background: </strong>Revisionary digital amputations are often performed after partial or full traumatic digital amputation to minimize complications while preserving as much length and functionality as possible. Many surgeons attempt revisionary procedures swiftly after initial injury. The aim of this study was to investigate the effects of time from injury to surgery on rate of complications and reoperation in revisionary traumatic digital amputations.</p><p><strong>Methods: </strong>This was a retrospective chart review of all patients undergoing revisionary digital amputation for initial traumatic amputation at a single hospital from January 1, 2007 to December 31, 2021. Demographics, comorbidities, surgical details, complications, and time from injury to surgery were collected. Five-factor modified fragility index scores were also computed for each patient. Primary outcomes of interest included complications and need for additional procedures. Secondary outcomes of interest included development of neuroma, phantom limb, and referral to a long-term pain specialist.</p><p><strong>Results: </strong>A total of 97 patients were identified as meeting all inclusion criteria. The average time to surgery was 14.4 days. Body mass index, comorbidities, and time to surgery were not associated with increased risk of complication. Increasing time to surgery was not significantly associated with increased risk of complications, development of neuroma, phantom limb, or a referral to long-term pain service. The only factors which were significantly associated with reoperation were absence of diabetes and hypertension.</p><p><strong>Conclusion: </strong>Increasing time to surgery after initial injury was not significantly associated with increased risk of complications or reoperation. Surgeons should consider this when assessing urgency of surgery in patients after traumatic digital amputation.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447241302360"},"PeriodicalIF":1.8,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846251","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 Induced Membrane Technique for Bone Defects in the Hand and Upper Extremity: A Case Series.","authors":"Rosa Park, Mohammed Muneer, Rodrigo Moreno","doi":"10.1177/15589447241300699","DOIUrl":"10.1177/15589447241300699","url":null,"abstract":"<p><strong>Background: </strong>We present a series of cases in which the induced membrane technique (IMT) was used to treat segmental bone defects from trauma and chronic infection nonunion in the hand and upper extremity. The aims of the study were to present the rates of union and complications using this technique.</p><p><strong>Methods: </strong>Our institutional database was queried between 2012 and 2018. Patients who met the inclusion criteria with segmental defects either from acute trauma or chronic infection nonunion were included in the study. A retrospective review of their charts was performed documenting patient demographics, size of bone defect, time to union, mechanism of injury, and postoperative complications.</p><p><strong>Results: </strong>A total of 13 patients met the inclusion criteria, and their individual charts and operative notes were reviewed. Eleven patients had acute traumatic bone loss, and the remaining 2 patients were treated for postoperative chronic infection nonunion as confirmed with positive cultures taken at the nonunion site. Rate of union after the index procedure was 84.6%, and average time to union was 14 weeks. The mean bone defect length was 2.73 cm. 46.1% of patients had soft tissue defects and complications requiring additional procedures for soft tissue coverage.</p><p><strong>Conclusion: </strong>The IMT is an alternative means of treating segmental bone defects in the upper extremity but can present with challenges resulting in persistent nonunion and complications with soft tissue reconstruction.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447241300699"},"PeriodicalIF":1.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817830","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":"Characteristics of Intravenous Fluid Infiltration and Factors Associated With Adverse Events: A Multicenter Retrospective Study.","authors":"Jessica L Duggan, Aron Lechtig, Ian T Watkins, Jonathan Lans, Arvind von Keudell, Dafang Zhang","doi":"10.1177/15589447241302359","DOIUrl":"10.1177/15589447241302359","url":null,"abstract":"<p><strong>Background: </strong>Peripheral intravenous (PIV) infiltration and extravasation are common complications of intravenous fluid administration. Here, we aim to investigate risk factors associated with major adverse events following PIV infiltration, which may help risk stratify those who require early surgical consultation.</p><p><strong>Methods: </strong>Retrospectively, patients were identified who had a documented PIV infiltration or extravasation event at 3 academic hospitals between 2015 and 2022. A major adverse advent was defined as a full-thickness injury requiring operative management (deep infection, compartment syndrome). A minor adverse event was defined as superficial injury (cellulitis, superficial thrombosis).</p><p><strong>Results: </strong>In total, 160 patients with PIV infiltration events were included (37.5% men), with an average age of 64.1 years. A surgical consult for a hand specialist was placed 35% of the time: orthopedic surgery in 46.4% of cases and plastic surgery in 42.9%. Among these consults, 87.5% recommended supportive treatment (elevation, warm/cold compresses, serial examinations). Major adverse events occurred in 4.4% (n = 7) of patients, and minor adverse events occurred in 11.3% (n = 18). Both intensive care unit (ICU) admission and current intubation status (ie, intubated, sedated, and nonexaminable) at the time of infiltration were significantly associated with adverse events (<i>P</i> = .02 and <i>P</i> = .03, respectively). Current intubation status was significantly associated with operative management (<i>P</i> = .001).</p><p><strong>Conclusion: </strong>Robust characterization of PIV infiltration events may facilitate early identification of patients at risk of serious complications. We found ICU admission and current intubation both to be associated with adverse events following PIV infiltration. Further work should be done to evaluate the risk of infiltration with different fluid types (vesicant, nonvesicant).</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447241302359"},"PeriodicalIF":1.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817609","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":"Guidance on Preoperative Management of Hand Surgery Patients Taking GLP-1 Receptor Agonists.","authors":"Sara C Kisiel, Annika Hiredesai, Pooja Dhupati, Shelley Noland","doi":"10.1177/15589447241300712","DOIUrl":"10.1177/15589447241300712","url":null,"abstract":"<p><p>Glucagon-like peptide-1 (GLP-1) receptor agonists are medications used to treat type 2 diabetes and may aid in weight loss efforts. The surgical management of patients taking GLP-1 agonists differs from others due to the slowed gastric emptying effects of GLP-1 medications. Patients taking these medications may have a higher risk of pulmonary aspiration during hand surgery than other patients, which affects their presurgical management. This article reviews GLP-1 agonists and their role in diabetes and weight loss, as well as current recommendations for surgical management of patients taking GLP-1 agonists.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447241300712"},"PeriodicalIF":1.8,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812919","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 Psychological Impact of Adult Traumatic Brachial Plexus Injury.","authors":"Sivaram Emani, Rohit Garg, Bassem Elhassan, Jonathan Winograd, Dafang Zhang","doi":"10.1177/15589447241302357","DOIUrl":"10.1177/15589447241302357","url":null,"abstract":"<p><strong>Background: </strong>Adult traumatic brachial plexus injuries (BPIs) present a significant medical challenge, potentially leading to life-altering consequences for patients' upper extremity pain and function. However, the psychological impact on patients has not been extensively studied.</p><p><strong>Methods: </strong>Adult patients with traumatic BPIs treated at 2 tertiary referral centers in the United States from 2015 to 2019 were retrospectively identified. This cohort of 84 patients was targeted for prospective interviews, and 44 patients (52%) responded. Validated measures including the posttrumatic stress disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition (PCL-5), Decision Regret Scale, Patient-Reported Outcome Measurement Information System (PROMIS) Pain Intensity, PROMIS Pain Interference, PROMIS Upper Extremity, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) were obtained through telephone-based interviews. Additional data were collected through electronic medical record review.</p><p><strong>Results: </strong>On average, patients experience low post-traumatic stress (median score 6, interquartile range [IQR] 3-20) and decision regret (median score 5, IQR 0-22.5). However, a notable fraction (18%) of patients met the clinical threshold for PTSD. Significant correlations were observed between PCL-5 scores and worse PROMIS Pain Intensity, PROMIS Pain Interference, PROMIS Upper Extremity, and QuickDASH. Decision regret scores correlated with worse PROMIS Upper Extremity and QuickDASH.</p><p><strong>Conclusions: </strong>While the overall incidence of PTSD and treatment decision regret after adult traumatic BPI is low, clinical PTSD was found in a significant percentage of patients associated with pain and functional impairment. This study highlights the importance of understanding and addressing the psychological burden of traumatic BPI.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447241302357"},"PeriodicalIF":1.8,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806775","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":"Back to the Anatomy Lab to Redefine the Pulley System of the Thumb: Is There an A0 Pulley?","authors":"John M Sullivan, Shelley Edwards, Eric Waetjen, Shireen Dogar, Marc E Walker","doi":"10.1177/15589447241302356","DOIUrl":"10.1177/15589447241302356","url":null,"abstract":"<p><strong>Background: </strong>There are various anatomical descriptions of the pulley system of the fingers and thumb. The A0 pulley, often referred to as palmar aponeurosis of the fingers, is of keen interest, especially regarding surgical release of the A1 pulley for trigger finger; however, there has been no anatomical description of the A0 pulley in the thumb.</p><p><strong>Methods: </strong>Twenty-four cadaveric thumbs were dissected to expose the entire pulley system. Each structure, including the A2, Aob, Av, A1 pulleys, and any proximal transverse elements, were cataloged.</p><p><strong>Results: </strong>Three distinct transverse elements were identified proximal to the A1 pulley including: (1) the named ligament of Grapow; (2) the proximal commissural ligament and associated transverse fascial tissues; and (3) a definable A0, identified in 10/12 (83.3%) cadavers and 15/24 (62.5%) thumbs. Ten A0 pulleys occurred bilaterally, while 5 occurred unilaterally.</p><p><strong>Conclusions: </strong>The presence of an A0 pulley in greater than 80% of the studied thumbs serves as an important anatomic finding that should be considered in surgical treatment. An additional finding of importance is that the pulley system anatomy demonstrated variability in laterality. Based on these anatomic findings, not only can the A0 pulley be defined as a unique anatomic structure of the thumb, but its repair also has implications for successful surgical treatment of thumb pulley system pathologies.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447241302356"},"PeriodicalIF":1.8,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806766","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 Artificial Intelligence the Future of Radiology? Accuracy of ChatGPT in Radiologic Diagnosis of Upper Extremity Bony Pathology.","authors":"Annika N Hiredesai, Casey J Martinez, Megan L Anderson, Carina P Howlett, Krishna D Unadkat, Shelley S Noland","doi":"10.1177/15589447241298982","DOIUrl":"10.1177/15589447241298982","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) is a promising tool to aid in diagnostic accuracy and patient communication. Prior literature has shown that ChatGPT answers medical questions and can accurately diagnose surgical conditions. The purpose of this study was to determine the accuracy of ChatGPT 4.0 in evaluating radiologic imaging of common orthopedic upper extremity bony pathologies, including identifying the imaging modality and diagnostic accuracy.</p><p><strong>Methods: </strong>Diagnostic imaging was sourced from an open-source radiology database for 6 common upper extremity bony pathologies: distal radius fracture (DRF), metacarpal fracture (MFX), carpometacarpal osteoarthritis (CMC), humerus fracture (HFX), scaphoid fracture (SFX), and scaphoid nonunion (SN). X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) modalities were included. Fifty images were randomly selected from each pathology where possible. Images were uploaded to ChatGPT 4.0 and queried for imaging modality, laterality, and diagnosis. Each image query was completed in a new ChatGPT search tab. Multinomial linear regression was used to identify variations in ChatGPT's diagnostic accuracy across imaging modalities and medical conditions.</p><p><strong>Results: </strong>Overall, ChatGPT provided a diagnosis for 52% of images, with accuracy ranging from 0% to 55%. Diagnostic accuracy was significantly lower for SFX and MFX relative to HFX. ChatGPT was significantly less likely to provide a diagnosis for MRI relative to CT. Diagnostic accuracy ranged from 0% to 40% with regard to imaging modality (x-ray, CT, MRI) though this difference was not statistically significant.</p><p><strong>Conclusions: </strong>ChatGPT's accuracy varied significantly between conditions and imaging modalities, though its iterative learning capabilities suggest potential for future diagnostic utility within hand surgery.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447241298982"},"PeriodicalIF":1.8,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784988","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}