IF 1.8

HAND Pub Date : 2025-10-01 DOI: 10.1177/15589447251369035

Holly Cordray, Miguel Fiandeiro, Sarah L Struble, John R Vaile, Manisha Banala, Meagan Pehnke, Apurva S Shah, Shaun D Mendenhall

{"title":"Choosing the Most Appropriate Patient-Reported Outcome Measures for Hand Function: A Guide for Pediatric Hand Surgeons.","authors":"Holly Cordray, Miguel Fiandeiro, Sarah L Struble, John R Vaile, Manisha Banala, Meagan Pehnke, Apurva S Shah, Shaun D Mendenhall","doi":"10.1177/15589447251369035","DOIUrl":"10.1177/15589447251369035","url":null,"abstract":"Consensus is lacking on a patient-reported outcome measure (PROM) for pediatric hand surgery; many studies use unvalidated ad-hoc surveys. To guide selection, this systematic review searched PubMed, Embase, CINAHL, and Scopus for studies evaluating hand-function-focused PROMs among pediatric patients. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, reviewers independently screened studies, extracted data, assessed quality, and rated psychometrics using the COnsensus-based Standards for selection of health Measurement INstruments. Content analyses used the Occupational Therapy Practice Framework, hand therapist expertise, and readability indices. Thirty-three reports on 9 PROMs were included. Existing validation covers few pediatric hand conditions, notably excluding hand trauma and nearly all congenital differences. The Upper-Extremity Cerebral Palsy Profile of Health and Function Computerized Adaptive Test (UE-CP-PRO) and ABILHAND-Kids are the strongest candidates for generating a gold-standard PROM. Both have good evidence of responsiveness to surgical outcomes. With the highest-quality validity evidence for the broadest age range, the UE-CP-PRO covers all hand function categories and relevant occupational domains; ABILHAND-Kids covers nearly all. Both failed the American Medical Association's readability standard. We provisionally recommend the UE-CP-PRO or ABILHAND-Kids for pediatric hand surgery outcomes. We encourage revising these measures and/or developing a more comprehensive PROM, incorporating adaptive condition-specific content and prioritizing readability to support child-reporting.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251369035"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206225","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

Effects of A2 Pulley Venting on Bowstringing and Tendon Slack: A Biomechanical Investigation. A2 滑轮通风对弓弦和肌腱松弛的影响：生物力学研究。

IF 1.8

HAND Pub Date : 2025-10-01 Epub Date: 2024-06-21 DOI: 10.1177/15589447241259804

Tyler Shipley, Stephanie Leah Vanhoof-Villalba, Seokgi Lee, Tara Saxena, William Adcock, Karl Bilderback, R Shane Barton, Giovanni F Solitro

{"title":"Effects of A2 Pulley Venting on Bowstringing and Tendon Slack: A Biomechanical Investigation.","authors":"Tyler Shipley, Stephanie Leah Vanhoof-Villalba, Seokgi Lee, Tara Saxena, William Adcock, Karl Bilderback, R Shane Barton, Giovanni F Solitro","doi":"10.1177/15589447241259804","DOIUrl":"10.1177/15589447241259804","url":null,"abstract":"Background: A2 pulley release is often needed for exposure of the lacerated tendon, retrieval of retracted tendons, placement of core sutures, or to permit full motion and gliding of the repaired and edematous tendon. However, there is no agreement in the literature on the specific quantity of pulley venting that can be performed and recommendations are limited to an undefined \"judicious release\" of the pulleys when necessary.Methods: Following a previously developed testing protocols, finger kinematics, tendon excursion, and bowstringing were evaluated on cadaveric hands for venting in increments of 20% of the pulley length.Results: In our study, we found a statistically significant influence of venting on bowstringing, although no difference was found between fingers, and a significant difference in tendon slack, which was variable depending on the finger. Bowstringing started increasing at 20% of A2 venting and peaked at full release. Tendon slack did not start until 40% of A2 venting on the index finger, but started at 20% on the middle, ring, and small fingers.Conclusions: Venting of the A2 pulley leads to an incremental increase in tendon bowstringing and tendon slack. However, differences in metacarpophalangeal flexion angle were not observed until full A2 pulley release, and only observed in the index finger, and no differences were observed in proximal interphalangeal flexion angles. Therefore, the benefit of releasing the A2 pulley when clinically necessary will likely outweigh the risks of loss of motion or strength.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1090-1095"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431843","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

Ultrasound Measurements of the Ulnar Nerve at the Medial Epicondyle Correlate With Electrodiagnostic Studies. 内上髁处尺神经的超声波测量与电诊断研究的相关性

IF 1.8

HAND Pub Date : 2025-10-01 Epub Date: 2024-06-21 DOI: 10.1177/15589447241259805

Nicholas F Aloi, Rachel Hyzny, John R Fowler

{"title":"Ultrasound Measurements of the Ulnar Nerve at the Medial Epicondyle Correlate With Electrodiagnostic Studies.","authors":"Nicholas F Aloi, Rachel Hyzny, John R Fowler","doi":"10.1177/15589447241259805","DOIUrl":"10.1177/15589447241259805","url":null,"abstract":"Background: Cubital tunnel syndrome is the second most common compressive neuropathy in the upper extremity and is commonly evaluated with electrodiagnostic studies (EDS). Ultrasound (US) has emerged as a potentially more efficient alternative to EDS. The purpose of this study is to evaluate whether measurements of the cross-sectional area (CSA) of the ulnar nerve at the elbow correlate with EDS results.Methods: This study was a prospective analysis of patients who presented with signs and symptoms consistent of cubital tunnel syndrome, who received USs of the ulnar nerve at the elbow and nerve conduction tests. Pearson correlation coefficients were used to evaluate the correlation between ulnar nerve CSA and electrodiagnostic data. t Tests were used to evaluate statistical differences between the mean ulnar nerve CSA of patients with positive or negative nerve conduction study results. Youden Index was used to calculate the optimal cut-off point for US CSA based on maximal sensitivity and specificity. Statistical significance was based on a two-sided P less than .05.Results: The association between increasing US CSA at the medial epicondyle with slowing of the conduction velocity of the ulnar motor nerve across the elbow was statistically significant (r = -0.35, P = .02). Patients with positive EDS tests had significantly larger nerve size than those with negative tests (all Ps < .03). A cut-off point of greater than or equal to 11 mm2 had a sensitivity of 70.83% and specificity of 66.67%.Conclusions: Larger ulnar nerve CSAs correlate with slowing of the conduction velocity on EDSs, and those with positive EDSs have larger nerve sizes than those with negative tests.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1064-1070"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431844","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

Do Social Deprivation and Surgical Volume Influence Outcomes Following Distal Radius Fracture Fixation? 社会贫困和手术量会影响桡骨远端骨折固定术后的疗效吗？

IF 1.8

HAND Pub Date : 2025-10-01 Epub Date: 2024-07-30 DOI: 10.1177/15589447241265518

Avi D Goodman, Peter Brodeur, Lindsay R Kosinski, Aristides I Cruz, Edward Akelman, Joseph A Gil

{"title":"Do Social Deprivation and Surgical Volume Influence Outcomes Following Distal Radius Fracture Fixation?","authors":"Avi D Goodman, Peter Brodeur, Lindsay R Kosinski, Aristides I Cruz, Edward Akelman, Joseph A Gil","doi":"10.1177/15589447241265518","DOIUrl":"10.1177/15589447241265518","url":null,"abstract":"Background: Distal radius fractures account for nearly 25% of fractures in adults, with a trend toward operative fixation. The objective of this study was to assess the relationship between surgeon and hospital volume with complications following distal radius fixation.Methods: A retrospective study was performed using the New York Statewide Planning and Research Cooperative System database from 2009 to 2015. Outpatient claims were identified for distal radius fractures and surgery. The facility and surgeon's identifier were used to calculate annual procedure volume. The risk for infection, carpal tunnel surgery, and revision/hardware removal was analyzed, and Social Deprivation Index (SDI) was linked to each patient. Patient demographics and rate of complications were compared across hospital and physician volume.Results: A total of 14 748 patients were included, finding Federal and self-pay insurance associated with low-volume (LV) facility care and private insurance with high-volume (HV) facilities. The SDI for patients treated by LV surgeons and hospitals was significantly higher compared with HV providers. Low-volume facilities and surgeons had a higher 3-month risk of infection requiring reoperation. High-volume facilities were less likely to treat Hispanic patients, those with comorbidities, higher SDI, and with Federal or self-pay insurance.Conclusions: Patients treated by LV surgeons and facilities had a higher risk of infection requiring surgery within 3 months than those treated by HV providers. Low-volume facilities were more likely to treat patients who were Hispanic, Federally insured, and with comorbidities and higher SDI than HV facilities, increasing their risk for disadvantaged care.Level of evidence: Level III.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1124-1131"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855368","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

Anatomy of the Lumbrical Muscles: Implications for Mechanical Advantage. 睫状肌解剖：对机械优势的影响。

IF 1.8

HAND Pub Date : 2025-10-01 Epub Date: 2024-03-29 DOI: 10.1177/15589447241235340

Kevin Kooi, Ingmar W F Legerstee, Eva van Vliet, Liliane A Freundt, Kristen Reikersdorfer, Neal C Chen, Kyle R Eberlin

{"title":"Anatomy of the Lumbrical Muscles: Implications for Mechanical Advantage.","authors":"Kevin Kooi, Ingmar W F Legerstee, Eva van Vliet, Liliane A Freundt, Kristen Reikersdorfer, Neal C Chen, Kyle R Eberlin","doi":"10.1177/15589447241235340","DOIUrl":"10.1177/15589447241235340","url":null,"abstract":"Background: The lumbrical muscles comprise 4 intrinsic muscles of the hand and are involved in flexion of the metacarpophalangeal joint (MCPJ) and extension of the proximal interphalangeal and distal interphalangeal joints. The purpose of this study was to investigate the anatomical mechanics of the lumbrical muscles of the index, middle, ring, and small fingers.Methods: We evaluated 25 cadaver arms and measured the distance between the MCPJ and fingertip, the distance between the MCPJ and lumbrical muscle insertion, and the distance between the MCPJ and the most proximal lumbrical muscle origin. With these measurements we calculated the needed force, insertion ratio (length of the proximal, middle, and distal phalanx divided by the MCPJ to insertion distance), and lumbrical muscle length.Results: We found that the force was significantly different between all fingers, except for the comparison of the index and ring finger (P = .34). In addition, we found that muscle length was significantly different between most the fingers, except for the comparison between the index and middle fingers (P = .24), and index and ring fingers (P = .20). There was no significant difference in insertion ratio.Conclusions: Our study suggests that the anatomical mechanics for the motor function of the lumbrical muscles are similar in all fingers. This could further imply that movements are equally precise in all fingers resulting in coordination with one another and, therefore, adequate hand function.Level of evidence: IV.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1029-1034"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Modification to the Brand Transfer for Claw Hand: The Four-Tailed Extensor Carpi Radialis Brevis to Lateral Band Transfer. 爪手品牌转移术的改良版：四尾伸拇肌向外侧带转移。

IF 1.8

HAND Pub Date : 2025-10-01 Epub Date: 2024-06-10 DOI: 10.1177/15589447241257558

Lauren E Wessel, Nirbhay S Jain, Ambika E Paulson, Carrie Bettlach, Mitchell A Pet, Amy M Moore

{"title":"A Modification to the Brand Transfer for Claw Hand: The Four-Tailed Extensor Carpi Radialis Brevis to Lateral Band Transfer.","authors":"Lauren E Wessel, Nirbhay S Jain, Ambika E Paulson, Carrie Bettlach, Mitchell A Pet, Amy M Moore","doi":"10.1177/15589447241257558","DOIUrl":"10.1177/15589447241257558","url":null,"abstract":"Background: Claw deformity is a devastating consequence of low ulnar nerve palsy, resulting in loss of finger function. Traditionally, the Brand transfer is a favored intervention but requires lengthy grafts and bulky tenorrhaphies, risking adhesions in the lumbrical canal. We present a modified Brand tendon transfer, which extends the extensor carpi radialis brevis (ECRB) into 4 tails for individual grafting into the lateral band, decreasing adhesion risk and graft length need.Methods: Nine consecutive patients with claw hand were examined in detail to confirm the diagnosis and appropriateness for claw-correction surgery by the senior author. All patients underwent our modified Brand transfer. Follow-up for a minimum of 6 months was pursued for each patient, with range of motion, grip strength, and pinch strength recorded at that time.Results: Treated patients demonstrate maintained grip and pinch strength, coordinated grasp, and improvement in metacarpophalangeal posture. One patient required reoperation for extensive scarring and underwent tenolysis of the tendon grafts and revision grafting for the small finger.Conclusion: We concluded that our modified weave of a 4-tailed tendon graft through the ECRB is a synergistic transfer that maintains acceptable hand strength in the setting of a chronic low ulnar nerve palsy with a lower risk of tendon adhesion and length of grafting, offering an additional tool in the armamentarium of the hand surgeon approaching the ulnar nerve-injured hand.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1057-1063"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141295936","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

Characterizing the Timing of Surgical Repair of Congenital Hand Differences in the United States. 美国先天性手部差异手术修复时机的特点。

IF 1.8

HAND Pub Date : 2025-10-01 Epub Date: 2024-06-12 DOI: 10.1177/15589447241257646

Olivia W Cummings, Daniel J Koh, Jungho Gong, Navya Baranwal, Nikhil Sobti, Loree Kalliainen

{"title":"Characterizing the Timing of Surgical Repair of Congenital Hand Differences in the United States.","authors":"Olivia W Cummings, Daniel J Koh, Jungho Gong, Navya Baranwal, Nikhil Sobti, Loree Kalliainen","doi":"10.1177/15589447241257646","DOIUrl":"10.1177/15589447241257646","url":null,"abstract":"Background: Suggested timing of reconstruction of congenital hand differences varies widely. The goal of timely intervention is to achieve near-normal appearance and function. We evaluated national trends in surgical timing of congenital hand differences to determine whether interventions align with the literature. Methods: Recommended ages for surgical reconstruction were identified. The Pediatric National Surgical Quality Improvement Project database was queried from 2012 to 2020 for children who underwent surgery for simple syndactyly (SS), complex syndactyly (CS), polydactyly, or congenital trigger finger. Subgroup analysis was conducted to assess whether the surgeon's subspecialty (plastic surgery vs orthopedic surgery, pediatric vs generalist) influenced the timing of repair. Results: Congenital trigger finger and CS reconstructions occurred largely within the recommended age range (73.8% and 52.2%, respectively). Polydactyly repairs primarily occurred earlier than the recommendations (54.0%). Timing of SS reconstruction was split, either occurring before (44.3%) or after (41.4%) the recommendations. For children with polydactyly, plastic surgeons were more likely to perform polydactyly reconstruction at a younger age compared with orthopedic surgeons (P = .0001). Conclusions: Established expert recommendations for the treatment of congenital hand differences are largely not followed in practice in the United States. This suggests that practice patterns may not be determined by the surgical literature.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1041-1047"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Nationwide Analysis on Major Upper Extremity Amputations and Replantations. 关于主要上肢截肢和再植的全国性分析。

IF 1.8

HAND Pub Date : 2025-10-01 Epub Date: 2024-06-22 DOI: 10.1177/15589447241259189

Viola A Stögner, Sacha C Hauc, Helia Hosseini, Mica C G Williams, Sam Boroumand, Lioba Huelsboemer, Martin Kauke-Navarro, Bohdan Pomahac, David Colen

{"title":"A Nationwide Analysis on Major Upper Extremity Amputations and Replantations.","authors":"Viola A Stögner, Sacha C Hauc, Helia Hosseini, Mica C G Williams, Sam Boroumand, Lioba Huelsboemer, Martin Kauke-Navarro, Bohdan Pomahac, David Colen","doi":"10.1177/15589447241259189","DOIUrl":"10.1177/15589447241259189","url":null,"abstract":"Background: The loss of an upper extremity is a severely disabling condition made medically challenging by the limited window for replantation. This study aims to investigate the burden of traumatic major upper extremity amputations in the United States and uncover possibilities for improvements in treatment.Methods: The Healthcare Cost and Utilization Project's National Inpatient Sample was screened for International Classification of Diseases-9/10 diagnosis/procedure codes for traumatic and nontraumatic major upper extremity amputations and replantations within the years 2008 to 2017. The resulting pool of cases was analyzed for multiple variables, including level of injury, patient demographics, hospital type and location, length of stay, costs, comorbidities, and complications.Results: A total of 15 155 major upper extremity amputations were recorded, of which 15.20% (n = 2305) were traumatic amputations-almost half of them related to the upper arm (49.6%; P = .0002). The great majority of replantations, however, was conducted at the lower arm level (87.4%; P < .0001), with an overall replantation rate of 22.3%. Nontraumatic amputations were overall associated with significantly higher burden of comorbidities relative to traumatic amputations except for long-term alcohol use (P < .0001). Both, amputations and replantations, were predominantly treated in large urban teaching hospitals, and were significantly more likely to occur in white men. The Southern region of the United States was handling the highest proportion of amputations in the United States, but had the lowest likelihood of replantation.Conclusion: This study provides an overview of the national trends in major traumatic upper extremity amputations and replantations, revealing potential health care shortcomings.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1071-1081"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440426","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 Pedicled Groin Flaps for Upper Extremity Injuries. 足底腹股沟瓣治疗上肢损伤的效果。

IF 1.8

HAND Pub Date : 2025-10-01 Epub Date: 2024-07-25 DOI: 10.1177/15589447241265520

V V N Manohar Devarasetty, Justin W Vickery, Jed I Maslow

{"title":"Outcomes of Pedicled Groin Flaps for Upper Extremity Injuries.","authors":"V V N Manohar Devarasetty, Justin W Vickery, Jed I Maslow","doi":"10.1177/15589447241265520","DOIUrl":"10.1177/15589447241265520","url":null,"abstract":"Background: Free flap reconstruction has become the more common treatment over pedicled groin flaps for reconstruction of upper extremity injuries in recent years. Groin flaps are still used for a variety of reasons, though limited literature is available to guide surgeons and patients regarding outcomes. This study aimed to investigate the epidemiology and outcomes of pedicled groin flaps for upper extremity pathology.Methods: The study was a single-institution retrospective case series at a level one trauma center including patients who underwent pedicled groin flaps for upper extremity soft tissue coverage between 1992 and 2022. The data collected included patient and injury characteristics, surgical management, and complication data. Ordinal logistic regression, univariate analysis, and bivariate analysis were performed to assess the relationship between the total number of groin flap surgeries and complications with patient and injury characteristics.Results: The analysis included 88 pedicled groin flaps performed for upper extremity injuries, with a median follow-up of 1.14 years after injury. Patients had a median age of 35 (interquartile range [IQR]: 22-49) years and underwent a median of 4 (IQR: 3-5.25) surgeries with stiffness (90.6%), partial flap loss (38%), and infection (32%) as the most common complications. High-energy injuries increased the risk of requiring more surgeries based on ordinal logistic regression. Univariate and bivariate analysis revealed no significant difference in wound complications based on patient or injury characteristics.Conclusions: Patients undergoing pedicled groin flaps for upper extremity injuries can expect to undergo an average of 4 surgeries, and high-energy injuries predict the need for more surgeries.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1138-1143"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758376","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 Utility of Ulnar Nerve Cross-Sectional Area in Predicting Patient Outcomes in the Early Postoperative Period. 尺神经横截面积在预测术后早期患者预后中的应用。

IF 1.8

HAND Pub Date : 2025-10-01 DOI: 10.1177/15589447251374230

Gabrielle K Marushack, Christopher J Dy, Ryan Calfee, Ling Chen, David M Brogan

{"title":"The Utility of Ulnar Nerve Cross-Sectional Area in Predicting Patient Outcomes in the Early Postoperative Period.","authors":"Gabrielle K Marushack, Christopher J Dy, Ryan Calfee, Ling Chen, David M Brogan","doi":"10.1177/15589447251374230","DOIUrl":"10.1177/15589447251374230","url":null,"abstract":"Background: Although ulnar nerve cross-sectional area (CSA) can be used to diagnose cubital tunnel syndrome, the predictive value of preoperative CSA for postoperative outcomes remains uncertain. This study's primary aim was to assess the relationship between preoperative ulnar nerve CSA and postoperative changes in Patient-Reported Outcomes Measurement Information System (PROMIS) scores in the early postoperative period.Methods: A retrospective review was conducted of all cubital tunnel surgeries performed by the senior authors from January 2015 to May 2023. Demographics, preoperative study results, and PROMIS scores were obtained from patient charts. Bivariate and multivariable statistical testing was used to determine statistical significance. After a threshold effect of CSA was observed at 12 weeks post-operation, a Youden analysis was performed to determine the threshold value.Results: At 12 weeks post-operation, patients with preoperative CSA > 16 mm2 had an average change in PROMIS physical function (PF) score of -0.95, which was significantly lower than the 3.41-point improvement experienced by patients with a CSA ≤ 16 mm2. Preoperative CSA and postoperative PROMIS scores did not demonstrate a significant linear relationship, either before or after accounting for advanced patient age and type II diabetes mellitus diagnosis.Conclusions: A preoperative ulnar nerve CSA > 16 mm2 was predictive of significantly less improvement in PF at 12 weeks post-operation compared to the progress experienced by patients with smaller ulnar nerve CSA. These findings may aid in preoperative counseling regarding expectations for improvement in hand function during the early postoperative period.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251374230"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206271","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

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