HAND最新文献

{"title":"A Prospective Randomized Comparison of Median and Ulnar Fascicle Transfers to the Biceps Motor Branch in Upper Brachial Plexus Injury.","authors":"Álvaro B Cho, Antonio Isidoro de S Neto, Ricardo Cartolano, Raquel B Iamaguchi, Gustavo B Silva, Marcelo R de Rezende, Teng H Wei, Rames M Júnior","doi":"10.1177/15589447261487493","DOIUrl":"10.1177/15589447261487493","url":null,"abstract":"<p><strong>Background: </strong>Transfer of an ulnar nerve fascicle to the motor branch of the biceps has been widely adopted in patients with upper brachial plexus injuries, with consistently favorable outcomes. Transfer of a median nerve fascicle has also been reported to yield satisfactory results. This study aimed to compare the outcomes of median and ulnar nerve fascicle transfer to the biceps in patients with C5-C6 and C5-C7 brachial plexus injuries.</p><p><strong>Methods: </strong>A total of 50 consecutive patients underwent surgery between June 2013 and December 2018. The donor nerve was randomized before surgery. After excluding 12 patients due to intraoperative nerve stimulation finding (one nerve stronger than the other) and 5 patients with less than 6 months of follow-up, 33 patients were included in the final analysis. These patients were randomized into group 1 (ulnar nerve fascicle transfer, n = 18) and group 2 (median nerve fascicle transfer, n = 15).</p><p><strong>Results: </strong>Elbow flexion against gravity was achieved in 14 of 18 (78%) patients in group 1 versus 13 of 15 (87%) in group 2. There was no statistically significant difference (<i>P</i> = .665) between the comparing groups with respect to the ability to perform elbow flexion against gravity.</p><p><strong>Conclusion: </strong>In this cohort, no statistically significant differences were observed between median and ulnar nerve fascicle transfers regarding elbow flexion recovery. The median nerve appears to be a viable alternative donor.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261487493"},"PeriodicalIF":1.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166847","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":"Hand Geometry in Forensic Application: Estimating Hand Length Derived from Phalangeal Lengths.","authors":"Dibyashree Goswami, Piyali Das, Diptendu Chatterjee, Biswarup Dey","doi":"10.1177/15589447261480182","DOIUrl":"10.1177/15589447261480182","url":null,"abstract":"<p><strong>Background: </strong>The human hand plays a significant role in the identification of sex and identity, especially when partial remains are recovered from crime scenes. This study explores the importance of using digital phalanx lengths to estimate Hand Length (HL), examine sexual dimorphism, and identify the most reliable biometric predictors of sex in the Bengali population. This study collected bilateral palm impressions from 100 university-level students (50 men, 20.18 ± 1.38; 50 women, 19.61 ± 1.48) from North 24 Pargana District. Different phalanx segments were measured and correlated with HL using regression models.</p><p><strong>Results: </strong>The independent <i>t</i> test revealed that all the middle and distal phalangeal lengths were was significantly higher in men (<i>P</i> < .01). Except for the Proximal Phalanges of the Middle (right hand), Ring (right hand), and Little (both left and right hands) fingers, all the proximal phalangeal lengths were found significantly higher (<i>P</i> < .01) in men than in women. Furthermore, sexual dimorphism was observed, with men showing significantly longer palmar lengths than women (<i>P</i> < .05). Regression analysis revealed that Middle Phalanx of Ring Finger/D4 (LM) in men, and Proximal Phalanx of Index Finger/D2 (CD) in women show the highest predictive value in estimating HL, with statistically significant <i>R</i>² values (<i>P</i> < .05). However, the estimated equation remained consistent across both hands, thereby supporting the literature and emphasising the need for a specific hand-geometry-based dataset.</p><p><strong>Conclusion: </strong>This study therefore confirms the reliability of hand geometry for forensic identification, serves as an accurate sex predictor in cases with partial prints, and highlights the need for more population-specific biometric data.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261480182"},"PeriodicalIF":1.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164780","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":"Coronal Alignment and Ulnar Deviation After Radial-Sided Lateral-Approach Silicone Arthroplasty of the Proximal and Distal Interphalangeal Joints: A Prospective Case Series.","authors":"Takuya Tsumura, Taiichi Matsumoto, Toshihide Imanaka, Nana Kishi, Kosuke Yoshioka, Hiromu Ito","doi":"10.1177/15589447261487499","DOIUrl":"10.1177/15589447261487499","url":null,"abstract":"<p><strong>Background: </strong>Following radial-sided lateral exposure for interphalangeal silicone arthroplasty, the repaired radial collateral ligament must maintain coronal stability against postoperative ulnar drift. Prospective direction-specific alignment data are limited.</p><p><strong>Methods: </strong>Consecutive patients undergoing proximal interphalangeal (PIP) or distal interphalangeal (DIP) silicone arthroplasty through a radial-sided lateral approach with structured collateral ligament repair were prospectively enrolled (minimum follow-up, 12 months). The primary outcome was signed coronal-plane deviation on standardized posteroanterior radiographs, with radial deviation recorded as positive and ulnar deviation as negative. Secondary outcomes included pain, motion, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH). Proximal interphalangeal (PIP) joints constituted the primary cohort; DIP joints were analyzed descriptively.</p><p><strong>Results: </strong>Forty PIP arthroplasties in 26 patients and 13 DIP arthroplasties in 8 patients were analyzed (33 unique patients; mean follow-up, 42.2 and 27.0 months). In the PIP cohort, mean signed deviation improved from -10.9° ± 7.9° preoperatively to -4.0° ± 9.8° at final follow-up, and 75.0% of joints were within ±10° of neutral. Final ulnar deviation >5° occurred in 37.5% of PIP and 15.4% of DIP joints, and >10° in 20.0% of PIP and no DIP joints. Pain, active arc, and QuickDASH improved in both cohorts (all <i>P</i> < .01). Three complications occurred; no implant was permanently removed, and no joint required arthrodesis.</p><p><strong>Conclusions: </strong>Radial-sided lateral-approach silicone arthroplasty with structured collateral ligament repair improved pain and motion while maintaining acceptable coronal alignment in most joints. Direction-specific ulnar deviation remained limited. These findings support feasibility, but not superiority over other approaches.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261487499"},"PeriodicalIF":1.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136357","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":"Morpho-histological Analysis of the Ultrastructure of the Dupuytren Cord Subjected to Progressive Distraction Using an External Fixator.","authors":"Umberto Lavagnolo, Anna Andrioli, Paolo Bernardi, Roberta Sartore, Massimo Corain, Andrea Sbarbati","doi":"10.1177/15589447261487485","DOIUrl":"10.1177/15589447261487485","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to provide a detailed morphological and ultrastructural characterization of Dupuytren disease cords in advanced stages, with particular attention to the effects of progressive mechanical distraction on extracellular matrix organization and tissue architecture.</p><p><strong>Methods: </strong>Six patients with stage IV Dupuytren disease affecting the fifth ray were included. Three underwent treatment with a distractible angular external fixator followed by open fasciectomy, while 3 controls received open fasciectomy alone. Excised cords were analyzed by light microscopy and scanning electron microscopy, with additional morphometric assessment of collagen organization.</p><p><strong>Results: </strong>Distracted samples showed increased cellularity, enhanced fascicular definition, and greater peripheral vascularization. At ultrastructural level, a more regular and modular arrangement of collagen was observed, with thicker and more widely spaced low-density regions compared with controls. Quantitative analysis confirmed a significant increase in thickness (9.23 ± 0.91 µm vs 7.33 ± 0.75 µm; <i>P</i> = .041) and spacing (21.3 ± 2.4 µm vs 13.4 ± 1.7 µm; <i>P</i> = .009), alongside a reduced linear fraction of these regions (52.4% ± 2.3% vs 59.5% ± 3.2%; <i>P</i> = .032).</p><p><strong>Conclusions: </strong>Progressive distraction induces substantial remodeling of Dupuytren disease cords, resulting in a more cellular and structurally organized extracellular matrix. These findings suggest that mechanical stimulation contributes not only to contracture correction but also to modification of the underlying fibrotic architecture, potentially improving surgical handling and providing a more favorable structural substrate for subsequent surgical intervention.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261487485"},"PeriodicalIF":1.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136378","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":"Comparative Analysis of Readability Levels of Hand Surgery Patient Information on the ASSH Website and Artificial Intelligence.","authors":"Neha R Momin, Rosevine A Azap, Zainab Yousaf, Addi Moya, Daniel P Donato","doi":"10.1177/15589447261478323","DOIUrl":"10.1177/15589447261478323","url":null,"abstract":"<p><strong>Background: </strong>The American Medical Association (AMA) recommends patient education materials (PEMs) be written at a sixth-grade level to ensure accessibility. This study aims to compare hand surgery topics from the American Society for Surgery of the Hand (ASSH) website and artificial intelligence (AI)-generated PEMs to evaluate their alignment with the AMA's recommendations.</p><p><strong>Methods: </strong>Ninety-eight hand surgery topics from the ASSH Hand Care \"The Upper Extremity Expert\" website were analyzed. Artificial intelligence (AI) platforms (Google Gemini 2.0 Flash and ChatGPT-4) were asked to: (1) create original PEMs based on ASSH website topics; (2) rewrite the ASSH topics at a sixth-grade reading level; and (3) create original PEMs over the ASSH topics at a sixth-grade reading level. Readability was assessed using the Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL) scores.</p><p><strong>Results: </strong>The ASSH website and AI-generated PEMs initially exceeded the sixth-grade readability level. Original ASSH PEMs ranged from a readability of 10th to 12th-grade (FRE 57.5 [6.6]; FKGL 9.4 [1.2]). Google Gemini and ChatGPT's initial PEMs were at the college level (Google Gemini: FRE 49.7 [7.5]; FKGL 9.6 [1.1] vs ChatGPT: FRE 47.4 [9.1]; FKGL 10.4 [1.4]). Artificial intelligence-rewritten ASSH content had improved readability, and AI-generated PEMs at a sixth-grade readability had lower word counts, higher FRE, and lower FKGL than original ASSH PEMs (all <i>P</i> < .001).</p><p><strong>Conclusions: </strong>Artificial intelligence platforms can be used as a tool to create hand surgery PEMs at the recommended sixth-grade reading level. Future efforts are needed to ensure the accuracy of AI-generated PEMs and accessibility to patients of varying health literacy for informed decision-making.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261478323"},"PeriodicalIF":1.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136406","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":"Entrapment of the Proximal Phalangeal Head by the Flexor Digitorum Superficialis Tendon as a Mechanical Block to Reduction in Open Dorsal Proximal Interphalangeal Joint Dislocations: Two Case Reports.","authors":"Yuzo Honda, Hiroyuki Takita, Kotaro Nishi, Aki Nishi, Koyu Nakao, Akito Nishida","doi":"10.1177/15589447261493182","DOIUrl":"10.1177/15589447261493182","url":null,"abstract":"<p><p>Most dorsal proximal interphalangeal (PIP) joint dislocations can be reduced closed, but soft-tissue entrapment may prevent reduction. We report 2 open dorsal PIP joint dislocations in which the flexor digitorum profundus (FDP) tendon was displaced ulnarly. In both cases, the joint remained irreducible after the FDP tendon was restored to its normal volar position. In case 1, the ulnar condyle of the proximal phalangeal head was entrapped by the flexor digitorum superficialis (FDS) tendon. In case 2, the entire proximal phalangeal head had passed between the 2 FDS slips and become entrapped. Releasing the entrapment allowed reduction in both cases, after which the volar plate was repaired. At final follow-up, active PIP motion was 0° to 100° at 12 months in case 1 and -10° to 100° at 6 months in case 2, without lateral instability. Persistent irreducibility after restoration of the FDP tendon to its normal volar position should prompt direct inspection for entrapment of the proximal phalangeal head by the FDS tendon.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261493182"},"PeriodicalIF":1.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136446","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":"Social Determinants of Health Are Associated With 2-Year Implant Complications Following Total Elbow Arthroplasty.","authors":"Adam M Gordon, Mohamed Said, Patrick P Nian, Murad Ruzzak, Jack Choueka","doi":"10.1177/15589447261489335","DOIUrl":"10.1177/15589447261489335","url":null,"abstract":"<p><strong>Background: </strong>Social determinants of health (SDOH) may influence outcomes after total elbow arthroplasty (TEA), but associations with long-term implant-related complications are unclear. We evaluated the relationship between documented SDOH and: (1) 2-year implant-related complications after primary TEA; and (2) discharge disposition and 90-day health care utilization.</p><p><strong>Methods: </strong>A retrospective matched cohort study was performed using a national insurance claims database (2010-2021). Primary TEA patients with 2 years or more of continuous follow-up were included. Social determinants of health exposure was defined using International Classification of Diseases, Ninth and Tenth Revision codes. Social determinants of health patients (N = 342) were matched 1:5 to controls (N = 1683) by age, sex, and overall Elixhauser Comorbidity Index. The outcomes evaluated included 2-year implant-related complications, non-home discharges, 90-day emergency department (ED) visits, and readmissions. Multivariable logistic regression computed odds ratios (ORs) of each outcome with 95% CIs. Significance was set at <i>P</i> < .01.</p><p><strong>Results: </strong>Social determinants of health exposure was associated with higher odds of 2-year infection (OR, 2.01; 95% CI, 1.35-2.94; <i>P</i> = .0004) and elbow stiffness (OR, 1.74; 95% CI, 1.22-2.43; <i>P</i> = .001), with no significant differences in revision or other implant-related complications. Social determinants of health exposure was associated with higher odds of non-home discharges (OR, 1.82; 95% CI, 1.15-2.82; <i>P</i> = .008), while 90-day ED visits and readmissions were not significantly different between groups.</p><p><strong>Conclusion: </strong>Documented SDOH were associated with increased 2-year infection and stiffness after TEA and higher odds of non-home discharges, without increased revision risk.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261489335"},"PeriodicalIF":1.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136428","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":"Metacarpophalangeal Arthroplasty: A 14-Year Nationwide Analysis of Trends and Acute Perioperative Outcomes in Rheumatoid Arthritis and Osteoarthritis.","authors":"Adam Schluttenhofer, Marco Rizzo","doi":"10.1177/15589447261485505","DOIUrl":"10.1177/15589447261485505","url":null,"abstract":"<p><strong>Background: </strong>Metacarpophalangeal (MCP) arthroplasty is an established surgical option for end-stage MCP arthritis. We analyzed trends in case volumes and 30-day perioperative outcomes after MCP arthroplasty performed for rheumatoid arthritis (RA) and osteoarthritis (OA).</p><p><strong>Methods: </strong>We used the National Surgical Quality Improvement Program database to identify all MCP arthroplasties performed for RA (n = 216) or OA (n = 452) between 2010 and 2023. Bivariate analysis was used to compare patient demographics, operative characteristics, and 30-day outcomes. We analyzed temporal trends in case volumes using Poisson regression models and trends in patient characteristics using linear regression.</p><p><strong>Results: </strong>Patients with RA were more likely to be female (85% vs 54%) and have a history of smoking (22% vs 10%) and chronic steroid use (58% vs 4%). Patients with OA had more prevalent comorbidities including obesity, diabetes, and hypertension. Patients with RA more frequently required multi-joint replacement, concomitant soft tissue balancing procedures, plastic surgery involvement, and inpatient admission. The annual case volume for OA increased at +5.9% per year (<i>P</i> < .001), whereas the volume for RA remained steady. The outpatient case volume grew at a rate of +4.6% per year (<i>P</i> < .001). Both groups had similarly low rates of 30-day complications (0.9% RA, 1.8% OA), readmission (0.5% RA, 1.5% OA), and reoperation (0% RA, 0.9% OA).</p><p><strong>Conclusions: </strong>Despite distinct patient profiles and operative complexity, both OA and RA patients experience low rates of perioperative adverse events after MCP arthroplasty. Osteoarthritis is a growing indication for this procedure, which is increasingly being performed in the outpatient setting.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261485505"},"PeriodicalIF":1.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136399","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":"Efficacy of Pull-In Suture for Tendon Avulsion Injury Associated With Severe Forearm Open Fracture, Forearm Amputation, and Hand Amputation.","authors":"Yuta Izawa, Kentaro Futamura, Masahiro Nishida, Yoshihiko Tsuchida","doi":"10.1177/15589447261490133","DOIUrl":"10.1177/15589447261490133","url":null,"abstract":"<p><strong>Background: </strong>The pull-in suture technique is a method of primary tendon repair that involves pulling the distal stump of the ruptured tendon into the proximal muscle belly and suturing it to the intact muscle fascia for avulsion injuries at the musculotendinous junctions associated with severe open forearm trauma. The aim of this study is to report the clinical outcomes of the pull-in suture technique for musculotendinous avulsion injuries associated with severe open forearm trauma and to evaluate its effectiveness.</p><p><strong>Methods: </strong>This study included patients who underwent pull-in suture repair for musculotendinous avulsion injuries associated with severe open forearm fractures, traumatic forearm amputation, or traumatic hand amputation. Patient demographics, characteristics of injury, functional outcomes at the final follow-up were investigated. Functional outcomes included total active motion (TAM) of the thumb and fingers, Disabilities of the Arm, Shoulder, and Hand (DASH) score, and HAND20 score.</p><p><strong>Results: </strong>Ten patients (mean age, 52 years; 1 female) were included 4 severe open fractures, 4 incomplete amputations, and 2 complete amputations. All injuries resulted from industrial machinery. All patients underwent free flap reconstruction (anterolateral thigh, latissimus dorsi, or radial forearm flap). Mean TAM at the final follow-up was 52.4° for the thumb, and the mean summed TAM of the 4 fingers was 637.2°. Mean DASH and HAND20 scores were 28.7 and 39.8, respectively.</p><p><strong>Conclusion: </strong>Pull-in suture offers a viable option for preserving tendon function in severe forearm trauma with multiple musculotendinous avulsions, including amputations, when other primary repair methods are not feasible.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261490133"},"PeriodicalIF":1.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127278","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":"Does Body Mass Index Influence Time to Surgery After Diagnosis of Carpal Tunnel Syndrome?","authors":"Andrew Ni, Tyler Williamson, Ryan Rose, Brian Sager, Jason Coffman, Abhi Rashiwala, Christina Brady","doi":"10.1177/15589447261489856","DOIUrl":"10.1177/15589447261489856","url":null,"abstract":"<p><strong>Background: </strong>Symptom severity, failure of conservative treatment, and health care access may influence surgical timing of carpal tunnel release (CTR) after diagnosis of carpal tunnel syndrome (CTS). However, the relationship between body mass index (BMI) and the time to surgery (TTS) after diagnosis of CTS remains unclear. The purpose of this study was to assess whether BMI is associated with TTS after CTS diagnosis.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using a multicenter registry to identify patients with a diagnosis of CTS. Patients were stratified into 6 BMI categories (20.0-24.9, 25.0-29.9, 30.0-34.9, 35.0-39.9, 40.0-44.9, and 45.0-49.9) The primary outcome was TTS with either open CTR or endoscopic CTR. Time to surgery was compared across groups using descriptive analysis and Kruskal-Wallis tests with post hoc Dunn test for pairwise comparisons.</p><p><strong>Results: </strong>We identified 272 713 patients with CTS. A total of 52 467 patients (19.2%) had surgical interventions including 40 297 (76.8%) with open CTR and 12 170 (23.2%) with endoscopic CTR. Body mass index was associated with a statistically significant difference in TTS in both open and endoscopic CTR (<i>P</i> < .001). Patients with a BMI of 45.0 to 49.9 had the greatest median length of time between diagnosis of CTS and CTR in open (94 days) and endoscopic (117 days) groups. Compared with patients with a BMI of 20.0 to 24.9, this corresponded to an increase in median time to surgery of 25 and 34 days for open and endoscopic CTR, respectively.</p><p><strong>Conclusion: </strong>Body mass index was associated with significant differences in TTS following diagnosis of CTS. On average, patients with greater BMI faced longer waits from time to diagnosis of CTS to CTR with delays of approximately 3 to 5 weeks compared with patients with normal BMI.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261489856"},"PeriodicalIF":1.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136370","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}