HAND最新文献

{"title":"The Sensitivity of the Scapholunate Interval and Bony Landmarks to Wrist Rotation on Posteroanterior Radiographs.","authors":"Maxwell Campbell, Glenn Schurmans, Nina Suh, Gregory Garvin, Emily Lalone","doi":"10.1177/15589447241255705","DOIUrl":"10.1177/15589447241255705","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to examine the effect of wrist rotation on the scapholunate interval in the posteroanterior radiograph and to identify radiographic landmarks on the posteroanterior projection that can be used to assess position.</p><p><strong>Methods: </strong>Eleven healthy cadaveric wrists were radiographed in the neutral position and subsequently were rotated and imaged from 30° pronation to 30° supination in 10° intervals. At each interval, the scapholunate interval was measured as well as the following landmarks: (1) the visible perimeter of the base of the hook of the hamate; (2) the radial-ulnar distribution of the dorsal nonarticular surface of the distal third metacarpal head; (3) the radial-ulnar distribution of the pisiform about the longitudinal axis of the ulna; and (4) the overlap of the pisiform and triquetrum.</p><p><strong>Results: </strong>The scapholunate interval was largest in the neutral position and linearly decreased by 34% for every 10° of pronation and decreased nonlinearly by 86% after the first 10° of supination. The appearance of the distal third metacarpal head was shown to be sensitive to both pronation and supination. The perimeter of the hook of the hamate and the distribution of the pisiform compared to the ulna were both shown to be sensitive to supination, whereas overlap of the pisiform and triquetrum was not shown to be sensitive to either direction of rotation.</p><p><strong>Conclusions: </strong>Our results highlight the significant effect of rotation on radiographic landmarks at the wrist, indicating that 10° of supination can drastically alter the developed radiograph.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"958-965"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141174643","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":"A Systematic Review of Qualitative Research in Hand Surgery.","authors":"Caroline Hircock, Xue-Wei Lin, Rafael P Lansang, Cameron F Leveille, Lucas Gallo, Achilles Thoma","doi":"10.1177/15589447231225271","DOIUrl":"10.1177/15589447231225271","url":null,"abstract":"<p><p>No formal review of qualitative research in hand surgery has been previously performed. The primary objective of this study was to evaluate the reporting quality of hand surgery qualitative research with the Standards for Reporting Qualitative Research (SRQR), a 21-item checklist. The secondary objectives were to describe qualitative research in hand surgery by domain, determine differences in reporting quality based on use of a reporting guideline, publication of SRQR and journal of publication, and to identify important outcomes in hand surgery conditions. Fifty-five studies were included from MEDLINE, Embase, PsycINFO, and Emcare. The median SRQR score was 16. The lowest reported sections were <i>context, data collection methods</i>, and <i>data analysis.</i> Qualitative research was found in multiple domains of hand surgery. There was a significant difference between papers that used a reporting guideline and studies published after the publication of the SRQR. Clinical/medical/basic science journals had the highest median SRQR score. Outcomes identified were pain for carpal tunnel syndrome and pain, function, unintentional harm, recurrence, and recovery time for Dupuytren disease. To further improve reporting quality in hand surgery qualitative research, we recommend that investigators ensure they provide rationale for their methodology and become familiar with the SRQR guidelines.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"840-848"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139542203","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":"Characterization of Major Complications of Bridge Plating of Distal Radius Fractures at a Level I Trauma Center.","authors":"A Scott Emmert, Alan K Swenson, Robert N Matar, Phillip R Ross, Peter J Stern","doi":"10.1177/15589447241257964","DOIUrl":"10.1177/15589447241257964","url":null,"abstract":"<p><strong>Background: </strong>Comminuted, markedly displaced distal radius fractures can cause instability requiring advanced stabilization with dorsal bridge plating. However, published complication rates of bridge plating widely vary. We hypothesize that complications of bridge plating of distal radius fractures are more prevalent than published rates.</p><p><strong>Methods: </strong>A retrospective review was performed on all patients at an academic level I trauma center treated with a bridge plate for a distal radius fracture from 2014 to 2022.</p><p><strong>Results: </strong>Sixty-five wrists were included in the final analysis: average age 53 years, male 51%, average plate retention 4 months, and average follow-up 6 months. Carpal tunnel release (CTR) was performed at time of primary procedure in 7 (10%) cases. Radial height, radial inclination, dorsal tilt, and ulnar variance were all significantly improved (<i>P</i> < .001). Grip strength, flexion, extension, and supination were significantly limited (<i>P</i> < .03). Twenty-one patients (32%) developed 35 major complications requiring unplanned reoperation, including mechanical hardware-related complication (15%), deep infection (11%), nonunion/delayed union (9%), adhesions (6%), median neuropathy (6%), symptomatic arthritis (5%), and tendon rupture (2%). Plate breakage occurred in 3 patients (5%) and was always localized over the central drill holes of the bridge plate.</p><p><strong>Conclusions: </strong>Major complications for bridge plating of distal radius fractures were higher at our institution than previously published. Plate breakage should prompt reconsideration of plate design to avoid drill holes over the wrist joint. Signs and symptoms of carpal tunnel syndrome should be carefully assessed at initial presentation, and consideration for concomitant CTR should be strongly considered.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"979-988"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310605","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 Impact of Florida Law HB21 on Opioid Prescribing Patterns After Outpatient Hand Surgery.","authors":"Joseph S Geller, Moses I Markowitz, Juan J Lizardi, Sinan K Jabori, Seth D Dodds","doi":"10.1177/15589447231217763","DOIUrl":"10.1177/15589447231217763","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study is to evaluate the effects of Florida lae House Bill 21 (HB21) on opioid prescribing patterns by a single orthopedic hand surgeon after outpatient hand and upper extremity surgery.</p><p><strong>Methods: </strong>The following variables were evaluated with retrospective chart review before and after implementation of HB21: type of opioid, number of pills, morphine milligram equivalents (MMEs), emergency department visits, and readmissions. In addition, the Florida Prescription Drug Monitoring Program (E-FORCSE [Electronic-Florida Online Reporting of Controlled Substance Evaluation]) was queried to determine the number of pills and MMEs prescribed and sold for the latter cohort. Student <i>t</i> tests, Fisher exact tests, and binary logistic regression were used for statistical analysis. <i>P</i> < .05 was considered significant.</p><p><strong>Results: </strong>We reviewed 231 consecutive patients who underwent hand or upper extremity surgery from July 2017 to July 2018 and 207 consecutive patients from January 2020 to January 2021. The average age was significantly different between the cohorts (48.41 vs 44.98 years, <i>P</i> = .025); however, there were no significant differences across other demographic variables. After controlling for age, the average number of pills prescribed per patient decreased significantly after HB21 (25.11 vs 21.6 pills, <i>P</i> < .001). The number of MMEs prescribed per patient decreased as well, but the decrease was not statistically significant (167.8 vs 154.1 MMEs, <i>P</i> = .054). There was an association between preoperative opioid prescriptions filled and prolonged opioid use (odds ratio 6.438, <i>P</i> = .003).</p><p><strong>Conclusion: </strong>Florida law HB21 resulted in significantly fewer pills prescribed per patient, suggesting that legislation likely changed prescriber behavior and/or patient demand regarding postoperative opioid prescriptions after outpatient hand and upper extremity surgery.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"871-876"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073933","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":"Thumb Pronation Angle in Thumb Opposition Evaluated by the Nail Tip Angle of Thumb-Ring Finger Opposition.","authors":"Shinji Taniguchi, Yusuke Matsuura, Tatsuya Takehara, Ayae Yamada, Yuki Shiko, Koichi Nakagawa, Seiji Ohtori","doi":"10.1177/15589447241236249","DOIUrl":"10.1177/15589447241236249","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to devise the method for the evaluation of the thumb pronation angle and calculate its reference value.</p><p><strong>Methods: </strong>The study was conducted from October 2021 to March 2022, and 600 hands of 300 healthy volunteers were included in this study. The participants were divided into 6 age groups with 50 participants each. In study 1, 12 participants from group 1 were randomly selected, which included 6 male and 6 female participants. We measured the thumb pronation angle using FASTRAK system and the nail tip angle of thumb-ring finger opposition (T-R angle) and also evaluated the relation between them. In study 2, we measured the T-R angle of 600 hands of 300 healthy volunteers. The T-R angle mean (SD) and 95% confidence interval (CI) of each age group were calculated as reference values.</p><p><strong>Results: </strong>The thumb pronation angle was correlated with the T-R angle. The T-R angle mean (SD) and 95% CI of the 6 groups were as follows: group 1, 142.5° (12.4) and 117.7 to 167.3; group 2, 139.9° (10.1) and 119.7 to 160.1; group 3, 142.3° (9.7) and 122.9 to 160.5; group 4, 140.2° (12.6) and 115.0 to 165.4; group 5, 138.3° (11.9) and 114.5 to 162.1; and group 6, 135.4° (13.0) and 109.4 to 161.4. The 95% CI tended to decrease with an increasing age.</p><p><strong>Conclusions: </strong>The T-R angle was a suitable evaluation method for the thumb pronation angle, and it should be evaluated by age groups.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"938-943"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140199","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":"A Systematic Review of Anti-Adhesion Agents in Hand Trauma.","authors":"Kirstie E Forbes, Davina Cavallaro, Dominic Power","doi":"10.1177/15589447241238374","DOIUrl":"10.1177/15589447241238374","url":null,"abstract":"<p><p>Adhesions following hand surgery are common, leading to stiffness, which compromises the functional outcomes for the patient. The objective of this study was to conduct a systematic review to analyze the role of antiadhesive barriers in surgery for hand trauma. A comprehensive literature search was conducted using PubMed/MEDLINE, Embase and the Cochrane Central Register of Controlled Trials, in line with the Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines. The inclusion criteria included both randomized and non-randomized control studies in patients aged 18 or over, with the intervention of an anti-adhesive barrier compared against traditional repair without a barrier in patients with hand trauma, including nerve, fracture, and tendon injury. The primary outcome measure of interest was range of movement (ROM) after operative surgery. Secondary outcomes of interest included further surgery, reported stiffness, complications, quality of life, and time to return to work. A total of 8450 records were identified; 7 studies fulfilled the eligibility criteria and were included. Seven anti-adhesive barriers were included in the review. Three agents (amnion, MASTBiosurgery Surgiwrap antiadhesive film, and acellular dermal matrix [ADM]) demonstrated statistically significant improvements in ROM postoperatively; however, all 3 studies demonstrated a risk of bias. This review highlights the paucity of high-quality studies demonstrating any clear advantage of using anti-adhesive barriers in hand surgery; however, there is some evidence to suggest that amnion, the MAST adhesion barrier film and ADM may have favorable results as an antiadhesive barrier in hand surgery, but further high-quality research is required to quantify this effect.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"831-839"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140305411","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":"Upper Extremity Fractures in the Emergency Department: A Database Analysis of National Trends in the United States.","authors":"Anthony L Karzon, Ehab M Nazzal, Hayden L Cooke, Kevin Heo, Onyinye Okonma, Jacob Worden, Zaamin Hussain, Kevin C Chung, Michael B Gottschalk, Eric R Wagner","doi":"10.1177/15589447231219286","DOIUrl":"10.1177/15589447231219286","url":null,"abstract":"<p><strong>Background: </strong>Upper extremity (UE) fractures are a common reason for emergency department (ED) visits, but recent data on their epidemiology are lacking. This study aimed to describe the incidence, demographics, patient characteristics, and associated health care factors of UE fractures, hypothesizing that they would remain prevalent in the ED setting.</p><p><strong>Methods: </strong>Using the Nationwide ED Sample database, patients presenting to the ED with UE fractures in 2016 were identified, and population estimates were used to calculate incidence rates. Data on insurance status, trauma designation, cost, and teaching status were analyzed.</p><p><strong>Results: </strong>The study identified 2 118 568 patients with UE fractures, representing 1.5% of all ED visits in 2016. Men accounted for 54.2% of UE fractures, with phalangeal fractures being most common. Distal radius and/or ulna fractures were most common in women (30.4%). The greatest proportion of UE fractures (23.2%) occurred in patients aged 5 to 14 years (1195.5 per 100 000). Nontrauma centers were the most common treating institutions (50.4%), followed by level I (19.5%), II (15.3%), and III (12.8%) centers. The greatest proportion of fractures (38.3%) occurred in the southern United States. Emergency department cost of treatment was almost 2-fold in patients with open UE fractures compared with closed.</p><p><strong>Conclusion: </strong>This study provides important epidemiological information on UE fractures in 2016. The incidence rate of UE fractures in the ED has remained high, with most occurring in the distal radius, phalanges, and clavicle. In addition, UE fractures were most common in younger patients, men, and those in the southern United States during the summer. These findings can be useful for health care providers and policymakers when evaluating and treating patients with UE fractures.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"861-870"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139542212","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":"Trends in Thumb Carpometacarpal Arthroplasty: A Decade in Review.","authors":"Michelle A Richardson, Lawrence J Lin, Andrew S Bi, Eric Mai, Benjamin W Padon, Sophia Jacobi, Samara Moll, Jadie De Tolla","doi":"10.1177/15589447251360266","DOIUrl":"https://doi.org/10.1177/15589447251360266","url":null,"abstract":"<p><strong>Background: </strong>Carpometacarpal (CMC) arthroplasty can provide symptomatic relief and improvement in function in patients with CMC osteoarthritis. The study purpose was to identify demographic, 30-day outcome, and reimbursement trends in CMC arthroplasty between 2012 and 2021.</p><p><strong>Methods: </strong>This was a retrospective cohort study of adult patients undergoing CMC arthroplasty from January 1, 2012, to December 31, 2021, using the National Surgical Quality Improvement Program database. Patients were stratified based on year of index surgery: 2012-2015, 2016-2018, and 2019-2021. Baseline characteristics were collected and compared using the appropriate statistical test. Multivariable logistic regressions controlling for age and sex were performed to identify independent risk factors for 30-day morbidity, readmissions, and reoperations. Economic analyses assessed changes in reimbursement rates over the span of 10 years.</p><p><strong>Results: </strong>A total of 9046 patients were included in the analysis with mean age of 62.7 ± 9.2 and women comprising 74.9% of the total population. Between 2012 and 2021, the annual volume increased from 433 to 1043. The average body mass index (BMI) and proportion of patients with congestive heart failure (CHF) increased in 2019-2021. Increasing age, BMI, smoking, and length of stay ≥ 1 day were independent risk factors for 30-day readmissions. The Medicare reimbursement fee decreased by an average of 1.15% annually, for a total of 9.90% across 10 years.</p><p><strong>Conclusions: </strong>The volume of CMC arthroplasty has risen from 2012 to 2021. However, conditions such as obesity and CHF have become more prevalent. Despite the growing patient complexity, Medicare reimbursement fees have markedly decreased.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251360266"},"PeriodicalIF":1.8,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951857","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":"Increased Surgical Costs Do Not Result in Improved Patient-Reported Outcomes: A Study of 173 Patients Who Underwent Thumb Carpometacarpal Joint Arthroplasty.","authors":"Grace E Guerin, Stephen A Doxey, Rebekah M Kleinsmith, Lily J Qian, Haley D Puckett, Jeffrey B Husband, Brian P Cunningham","doi":"10.1177/15589447251366453","DOIUrl":"https://doi.org/10.1177/15589447251366453","url":null,"abstract":"<p><p><b>Background:</b> The purpose of this study is to evaluate the relationship of surgical cost and patient-reported outcomes (PROs) in thumb carpometacarpal (CMC) arthroplasty. We hypothesize that increasing costs are not positively correlated with PROs. <b>Methods:</b> A prospectively collected PRO registry was retrospectively reviewed for patients who underwent surgery for CMC arthritis treatment. A total of 288 patients in a single health care system were identified with a completed Patient-Rated Wrist and Hand Evaluation (PRWHE) survey at all timepoints. Patients were excluded based on nonoperative treatment, revision, concomitant procedures, and if they lacked PRWHE scores at any timepoint. A total of 173 patients met criteria. Time-driven activity-based costing was used to calculate day-of-surgery (DOS) costs. <b>Results:</b> The most common CMC arthroplasty technique used suture suspensionplasty (n = 142, 82.1%). The average surgical cost was $2830.36 ± $619.41. The average PRWHE scores preoperatively, at 6 weeks, 3 months, and 6 months were 62.1 ± 18.4, 44.9 ± 19.2, 31.5 ± 18.4, and 18.0 ± 17.1, respectively. There were no statistically significant correlations between cost and PROs at 6 weeks, 3 months, or 6 months (<i>r</i> = -0.02, <i>r</i> = -0.03, <i>r</i> = 0.04, respectively). There were no statistically significant correlations between total cost and the change in PRWHE scores from baseline to 6 weeks, baseline to 3 months, or baseline to 6 months (<i>r</i> = 0.09, <i>r</i> = 0.10, <i>r</i> = 0.15, respectively). <b>Conclusions:</b> This study demonstrates that when surgical management is pursued in CMC arthritis, patients do not receive additional benefit with higher DOS costs. Surgeons should implement strategies to minimize variability and drive the value of care within their institution.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251366453"},"PeriodicalIF":1.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951775","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":"Functional Outcomes of Zancolli Lasso Versus Modified Stiles-Bunnell Techniques for Post-Leprosy Ulnar Claw Hand Correction: A Prospective Randomized Comparative Study.","authors":"Gaurab Ranjan Chaudhuri, Sourabh Shankar Chakraborty, Abhishek Kumar Rai, Prasenjit Chattopadhyay, Akhilesh Humnekar","doi":"10.1177/15589447251364568","DOIUrl":"https://doi.org/10.1177/15589447251364568","url":null,"abstract":"<p><strong>Background: </strong>Leprosy, caused by <i>Mycobacterium leprae</i>, leads to peripheral neuropathy, commonly affecting the ulnar nerve, resulting in claw hand deformity. Various tendon transfer techniques, such as the Modified Stiles-Bunnell (flexor digitorum superficialis 4-tail [FDS-4T]) transfer and Zancolli lasso procedure (ZLP), are used for surgical correction. However, comparative studies assessing their functional outcomes are scarce. This prospective, randomized comparative study aimed to evaluate improvements in hand function, grip strength, and range of motion (ROM) between the 2 techniques.</p><p><strong>Methods: </strong>Fifty patients with post-leprosy ulnar claw hand were randomly assigned to undergo either FDS-4T (n = 25) or ZLP (n = 25). Preoperative and postoperative assessments included active metacarpophalangeal (MCP) joint ROM, grip strength, patient-reported outcome measures, and photographic grading of claw correction. Statistical analyses were performed using paired <i>t</i> tests and Pearson correlation, with significance set at <i>P</i> < .05.</p><p><strong>Results: </strong>Both groups showed significant postoperative improvement in MCP joint ROM (<i>P</i> = .0001) and grip strength (<i>P</i> = .0001). Grip strength recovery was higher in ZLP (129%) than in FDS-4T (117%; <i>P</i> = .013). Claw correction was rated excellent in 12 patients (FDS-4T) versus 7 patients (ZLP), although not statistically significant. Zancolli lasso procedure had shorter operating time and faster return to daily activities (<i>P</i> = .02).</p><p><strong>Conclusion: </strong>Both procedures significantly improved hand function without a clear superiority of one over the other. While ZLP offered faster recovery and grip strength, FDS-4T showed slightly better claw correction. The choice of procedure should be tailored to patient needs.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251364568"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951722","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}