IF 16.4

HAND Pub Date : 2024-11-05 DOI: 10.1177/15589447241292654

Hannah C Langdell, Emmanuel O Emovon, Warren C Hammert

{"title":"Management Options and Clinical Outcomes After Flexor Tendon Ruptures Following Volar Plating of Distal Radius Fractures.","authors":"Hannah C Langdell, Emmanuel O Emovon, Warren C Hammert","doi":"10.1177/15589447241292654","DOIUrl":"10.1177/15589447241292654","url":null,"abstract":"Background: The transition to volar locking plates for the treatment of distal radius fractures has improved patients' range of motion, reduced extensor tendon issues, and hastened return to activity compared to older fixation methods or nonoperative treatment. One drawback to volar plating is the potential for flexor tendon ruptures due to aberrant plate or screw placement. This study aims to describe the reconstruction options and patient outcomes after flexor tendon rupture due to volar plating.Methods: This is a single-institution, retrospective review of patients who presented with flexor tendon rupture from 2014 to 2023 after a distal radius fracture previously managed with a volar plate. Patient demographics, operative details, range of motion, complications, and patient-reported outcomes were collected.Results: Ten patients presented with flexor tendon ruptures after volar plating for distal radius fractures from 2014 to 2023. The most common rupture was flexor pollicis longus (FPL) in 7 patients, followed by index finger flexor digitorum profundus (FDP) in 2 patients, and small and ring finger FDP rupture in 1 patient. Flexor pollicis longus (FPL) was reconstructed with a palmaris longus (PL) graft in 4 patients, ring finger flexor digitorum superficialis transfer in 2 patients, and repaired primarily in 1 patient. All patients with FPL ruptures regained functional thumb interphalangeal flexion except for 1 patient who reruptured 4 weeks after surgery.Conclusions: Flexor tendon ruptures can occur following volar plating of distal radius fractures, even years after fixation of the fracture. These are attritional ruptures and generally reconstructed with tendon grafting of transfer, providing functional flexion of the affected digit.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447241292654"},"PeriodicalIF":16.4,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583038","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

Infections and Patient Satisfaction in WALANT Hand Surgery in a Hospital Procedure Room. 医院手术室中 WALANT 手部手术的感染情况和患者满意度。

IF 16.4

HAND Pub Date : 2024-11-05 DOI: 10.1177/15589447241284814

Michaela J Derby, Kelly N McKnight, Robert E Van Demark

{"title":"Infections and Patient Satisfaction in WALANT Hand Surgery in a Hospital Procedure Room.","authors":"Michaela J Derby, Kelly N McKnight, Robert E Van Demark","doi":"10.1177/15589447241284814","DOIUrl":"10.1177/15589447241284814","url":null,"abstract":"Background: Wide-awake hand surgery has allowed many hand procedures to be moved out of the operating room and into minor procedure rooms while increasing efficiency, maintaining safety, and reducing both patient and hospital costs. The goal of this study was to evaluate patient satisfaction and postoperative complications of wide-awake local anesthesia with no tourniquet procedures performed in a community-based hospital procedure room. Methods: A total of 786 patients underwent 948 elective hand procedures in a hospital procedure room. At the conclusion of their surgeries, the patients were surveyed regarding their satisfaction. Following surgery, patients were evaluated for postoperative complications including infections. The trend in postoperative infection rates across 8 age groups was analyzed using a Cochran-Armitage test in R. Results: The overall infection rate was 6.2% (n = 59). All infections were superficial. Carpal tunnel had the highest number of infections (n = 25), followed by trigger finger (n = 8), and the combination trigger finger with carpal tunnel (n = 7). All infections were managed with antibiotics and/or soaks. Three patients did require a return to the operating room for irrigation and debridement. Ninety-nine percent of patients said the procedure room experience was better or the same as going to the dentist, would recommend wide-awake anesthesia to a friend or family member, and would undergo the procedure again. Conclusion: Wide-awake procedures performed in a hospital procedure room have low infection rates with high patient satisfaction.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447241284814"},"PeriodicalIF":16.4,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583018","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

Impact of Time to Fixation on Outcomes of Operative Treatment of Intra-articular Distal Radius Fractures. 固定时间对桡骨远端关节内骨折手术治疗结果的影响

IF 1.8

HAND Pub Date : 2024-11-01 Epub Date: 2023-05-26 DOI: 10.1177/15589447231174642

A Jordan Grier, Kallie J Chen, Alexandra V Paul, Cynthia L Green, Marc J Richard, David S Ruch, Tyler S Pidgeon

{"title":"Impact of Time to Fixation on Outcomes of Operative Treatment of Intra-articular Distal Radius Fractures.","authors":"A Jordan Grier, Kallie J Chen, Alexandra V Paul, Cynthia L Green, Marc J Richard, David S Ruch, Tyler S Pidgeon","doi":"10.1177/15589447231174642","DOIUrl":"10.1177/15589447231174642","url":null,"abstract":"Background: The incidence of operative treatment of distal radius fractures (DRFs) has increased recently, but the optimal timing for surgical fixation remains unclear. We hypothesized that: (1) an increase in time to fixation of intra-articular DRFs would increase the likelihood of postoperative complications; and (2) increased time from injury to fixation would lead to longer surgical time and worse range of motion (ROM) outcomes.Methods: We retrospectively reviewed 299 fractures in 284 adult patients who underwent open reduction and internal fixation (ORIF) of a closed, intra-articular DRF at our institution over a 10.5-year period. Demographic information, time to surgery (TTS) from injury, surgical time, tourniquet time, complications, and final postoperative ROM were collected for logistic regression modeling to predict the risk of postoperative complication.Results: Twenty-seven (9.0%) patients experienced postoperative complications. The median TTS (Q1-Q3) for all patients was 7.0 (4.0-12.0) days. Patients who experienced an early postoperative complication had significantly longer median TTS (10.0 days) than those who did not (7.0 days). Patients with longer TTS were more likely to experience a complication (odds ratio, 1.11; 95% confidence interval, 1.04-1.19; P = .006). Tourniquet time and final wrist ROM were not related to TTS. A logistic regression analysis found that early complication rate doubles at 7.0 days after injury (from 3.5% to 6.9%).Conclusions: Patients with operative intra-articular distal radius fractures should ideally be fixed within 7 to 10 days of injury to minimize the risk of early postoperative complications. The tourniquet time and final ROM were not associated with time to surgery.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1269-1276"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9525455","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

Response to: Revisiting the Methodology and Implications of the Network Meta-analysis on Dupuytren Disease Treatments: A Letter to the Editor. 回应重新审视杜普伊特伦病治疗方法网络 Meta 分析的方法和意义：致编辑的一封信。

IF 1.8

HAND Pub Date : 2024-11-01 Epub Date: 2023-12-15 DOI: 10.1177/15589447231218397

Silas Nann, Joshua Kovoor, James Fowler, James Kieu, Aashray Gupta, Joseph Hewitt, Christopher Ovenden, Suzanne Edwards, Stephen Bacchi, Jonathan Henry W Jacobsen, Richard Harries, Guy Maddern

引用次数: 0

Revisiting the Methodology and Implications of the Network Meta-Analysis on Dupuytren Disease Treatments: A Letter to the Editor. 重新审视杜普伊特伦氏病治疗网络 Meta 分析的方法和意义：致编辑的一封信

IF 1.8

HAND Pub Date : 2024-11-01 Epub Date: 2023-12-15 DOI: 10.1177/15589447231218398

Ishith Seth, Warren M Rozen

引用次数: 0

Dupuytren Disease Surgical Treatment: A Randomized Clinical Trial Comparing Partial Fasciectomy by Bruner Approach Versus Zetaplasty. 杜普伊特伦病的手术治疗：比较布鲁纳法部分筋膜切除术与Zetaplasty术的随机临床试验。

IF 1.8

HAND Pub Date : 2024-11-01 Epub Date: 2023-07-23 DOI: 10.1177/15589447231185581

Renan G Leão, Vinicius Y de Moraes, Luis R Nakachima, João C Belloti, João B G Santos

{"title":"Dupuytren Disease Surgical Treatment: A Randomized Clinical Trial Comparing Partial Fasciectomy by Bruner Approach Versus Zetaplasty.","authors":"Renan G Leão, Vinicius Y de Moraes, Luis R Nakachima, João C Belloti, João B G Santos","doi":"10.1177/15589447231185581","DOIUrl":"10.1177/15589447231185581","url":null,"abstract":"Background: Dupuytren is a fibroproliferative pathology leading to contracture of the palmar fascia. Several approaches have been described for the surgical treatment with partial fasciectomy with few comparisons in literature. Our purpose is to compare the functional outcomes between the partial fasciectomy performed by Bruner type incision and zetaplasty incision.Methods: The method used was a randomized clinical trial including adult patients of both sexes with surgical indication for Dupuytren disease presented to a reference center. Patients were randomly and consecutively allocated in the groups 1:1. We recorded the Disabilities of the Arm, Shoulder, and Hand (DASH) score; range of motion for active and passive extension of the metacarpophalangeal (MP) and proximal interphalangeal (PIP) joints; visual analog scale for pain; and complications.Results: In all, 62 patients were included, with 48 patients reaching the minimum follow-up of 6 months with 63 operated fingers. In the Bruner approach group, we obtained a correction of the active and passive extension of the MP of 28° and of the PIP of 23°. In the zetaplasty group, correction of MP was 30° for active and passive, and 18° for active extension and 16° for passive extension of the PIP. The reduction in the DASH score was 10 points in the Bruner group and 22 points in the zetaplasty group. There was no statistically significant effect of the type of treatment on preoperative and postoperative differences in any of the parameters evaluated.Conclusions: There were no statistically significant differences between the 2 techniques for self-reported functional outcomes or objective measures of physical examination.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1300-1307"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9860947","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

Effect of Capitolunate Positioning on Outcomes in Scaphoid Excision and 4-Bone Fusion Patients. Capitolunate定位对肩胛骨切除术和4骨融合术患者疗效的影响

IF 1.8

HAND Pub Date : 2024-11-01 Epub Date: 2023-07-23 DOI: 10.1177/15589447231187074

Cameron L Hallihan, Robert J Goitz, Robert A Kaufmann, John R Fowler

{"title":"Effect of Capitolunate Positioning on Outcomes in Scaphoid Excision and 4-Bone Fusion Patients.","authors":"Cameron L Hallihan, Robert J Goitz, Robert A Kaufmann, John R Fowler","doi":"10.1177/15589447231187074","DOIUrl":"10.1177/15589447231187074","url":null,"abstract":"Background: Scaphoid excision and 4-bone fusion (4BF) is a surgical procedure to treat scapholunate advanced collapse. Some surgeons align the lunate over the capitates, whereas others leave the capitate in its uncovered native position. The capitolunate angle may affect long-term outcomes. This study examined whether postsurgical outcomes differed based on these differences in positioning.Methods: A retrospective analysis was performed for patients that underwent a 4BF between 2006 and 2020. Wrist range of motion; pain (0-10); and Disabilities of the Arm, Shoulder, and Hand (DASH) scores were recorded. The width of the capitate, the width of the lunate contacting the capitate, and the capitolunate angle were measured. Pearson correlations and t tests were performed. For t tests of capitolunate uncovering, patients were divided into 2 groups: patients with 0% capitate uncovering and patients with >0% uncovering. For capitolunate angle, the 2 groups were patients with a capitolunate angle of ≤10° and patients with a capitolunate angle of >10°.Results: There was a significant correlation between capitate coverage and wrist extension, but no correlation for flexion, pain, or DASH scores. Group 1 (0% uncovering) had increased wrist extension and decreased pain compared with group 2 (>0% uncovering). There were no significant correlations or differences in the analyses of capitolunate angle's impact on outcomes.Conclusions: In patients undergoing 4BF, those who had the lunate aligned to completely cover the capitate head had improved wrist extension and pain compared with patients where the capitate head was left partially uncovered. Capitolunate angle was not predictive of postsurgical outcomes.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1252-1259"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9860948","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

Efficacy and Safety of Different Trapezium Implants for Trapeziometacarpal Joint Osteoarthritis: A Systematic Review and Meta-Analysis. 不同梯形假体治疗梯形掌关节骨性关节炎的有效性和安全性：系统回顾与元分析》。

IF 1.8

HAND Pub Date : 2024-11-01 Epub Date: 2023-07-02 DOI: 10.1177/15589447231183172

Ishith Seth, Gabriella Bulloch, Nimish Seth, Quentin Fogg, David J Hunter-Smith, Warren M Rozen

{"title":"Efficacy and Safety of Different Trapezium Implants for Trapeziometacarpal Joint Osteoarthritis: A Systematic Review and Meta-Analysis.","authors":"Ishith Seth, Gabriella Bulloch, Nimish Seth, Quentin Fogg, David J Hunter-Smith, Warren M Rozen","doi":"10.1177/15589447231183172","DOIUrl":"10.1177/15589447231183172","url":null,"abstract":"Background: The trapeziometacarpal joint (TMCJ) is the most common hand joint affected by osteoarthritis (OA), and trapezium implant arthroplasty is a potential treatment for recalcitrant OA. This meta-analysis aimed to investigate the efficacy and safety of various trapezium implants as an interventional option for TMCJ OA. Methods: Web of Science, PubMed, Scopus, Google Scholar, and Cochrane library databases were searched for relevant studies up to May 28, 2022. Preferred Reported Items for Systematic Review and Meta-Analysis guidelines were adhered to, and the protocol was registered in PROSPERO. The methodological quality was assessed by National Heart, Lung, and Blood Institute tools for observational studies and the Cochrane risk of bias tool. Subgroup analyses were performed on different replacement implants; the analysis was done using Open Meta-Analyst software and P values <.05 were considered statistically significant. Results: A total of 123 studies comprising 5752 patients were included. Total joint replacement (TJR) implants demonstrate greater significant improvements in visual analogue scale pain scores postoperatively. Interposition with partial trapezial resection implants were associated with highest grip strength and highest reduction in the Disabilities of the Arm, Shoulder, and Hand (DASH) score. Revision rates were highest in TJR (12.3%) and lowest in interposition with partial trapezial resection (6.2%). Conclusion: Total joint replacement and interposition with partial trapezial resection implants improve pain score, grip strength, and DASH scores more than other implant options. Future studies should focus on high-quality randomized clinical trials comparing different implants to accumulate higher quality evidence and more reliable conclusions.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1242-1251"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9742992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Role of Surgery in the Management of Radiation-Induced Brachial Plexopathy. 手术在治疗辐射引起的臂丛神经病中的作用。

IF 1.8

HAND Pub Date : 2024-11-01 Epub Date: 2023-09-16 DOI: 10.1177/15589447231196902

Mira Shoukry, Shelley S Noland

引用次数: 0

A Comparative Study of 2-Corner, 3-Corner, and 4-Corner Arthrodesis for Midcarpal Arthritis. 两角、三角和四角关节成形术治疗中腕关节炎的比较研究

IF 1.8

HAND Pub Date : 2024-11-01 Epub Date: 2023-06-02 DOI: 10.1177/15589447231174046

Justine Ring, Tod A Clark, Jennifer L Giuffre

{"title":"A Comparative Study of 2-Corner, 3-Corner, and 4-Corner Arthrodesis for Midcarpal Arthritis.","authors":"Justine Ring, Tod A Clark, Jennifer L Giuffre","doi":"10.1177/15589447231174046","DOIUrl":"10.1177/15589447231174046","url":null,"abstract":"Background: Four-corner fusion (4CF) is a common treatment for midcarpal arthritis; however, alternatives including 2-corner fusion (2CF) and 3-corner fusion (3CF) have been described. Limited literature suggests 2CF and 3CF may improve range of motion but have higher complication rates. Our objective is to compare function and patient-reported outcomes following 4CF, 3CF, and 2CF at our institution.Methods: Adult patients undergoing 4CF, 3CF, and 2CF from 2011 to 2021 who attended at least one follow-up were included. Four-corner fusion patients were compared with those who underwent either 3CF or 2CF using staple fixation. Outcomes include nonunion rate, reoperation rate, progression to wrist fusion, range of motion, and patient-reported pain, satisfaction, and Disabilities of the Arm, Shoulder, and Hand (DASH) scores.Results: A total of 58 patients met inclusion criteria. There were 49 4CF and 9 2CF or 3CF patients. Nonunion rates, progression to wrist fusion, and repeat surgery for any indication were not significantly different among groups. Range of motion (flexion-extension, radial-ulnar deviation) and grip strength at postoperative visits were not significantly different. Significantly more 4CF patients required bone grafting. Pain, overall satisfaction, and DASH scores were similar.Conclusions: Although prior studies suggest increased risk of nonunion and hardware migration after 2CF/3CF, we did not observe higher complication rates compared with 4CF. Range of motion, strength, and patient-reported outcomes were similar. While 4CF is traditionally the procedure of choice for midcarpal fusion, we found that when using a staple fixation technique, 2CF and 3CF have comparable clinical and patient-reported outcomes yet decrease the need for autologous bone grafting.","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1235-1241"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9568813","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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