HAND最新文献

{"title":"Comparative Analysis of Methods for Obtaining Median Nerve Cross-Sectional Area Using Ultrasound.","authors":"Chukwudi Onyeukwu, Rachit Saggar, Raymond M Toncich, Jenna Dvorksy, John R Fowler","doi":"10.1177/15589447251366672","DOIUrl":"10.1177/15589447251366672","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound measurement of median nerve cross-sectional area (CSA) is widely used in carpal tunnel syndrome (CTS) diagnosis. This study compared 3 common measurement methods: A-B, Ellipse, and Trace to evaluate their reliability and accuracy.</p><p><strong>Methods: </strong>Two observers (experienced hand surgeon and orthopedic surgery resident) measured median nerve CSA in 10 patients with suspected CTS. Each method was applied in standard and zoom-enhanced views: A-B method (measuring major/minor axes), Ellipse method (fitting ellipse to nerve boundaries), and Trace method (manually tracing nerve boundary). Measurements were compared to ImageJ software analysis as reference standard. Reliability and accuracy were assessed using intraclass correlation coefficients (ICCs), Bland-Altman analysis, and standard detectable difference (SDD).</p><p><strong>Results: </strong>All methods showed high reliability (ICC: 0.940-0.994) but consistently underestimated CSA compared to ImageJ (12.15 ± 5.13 mm²). The Trace method showed smallest mean difference from ImageJ (-1.26 mm²), followed by A-B (-1.46 mm²) and Ellipse (-1.96 mm²). The Trace method demonstrated highest accuracy without zoom (85.5%) and lowest SDD (1.57 mm²). Interrater reliability was significantly higher in zoom condition for all methods, with Trace method showing highest interrater reliability in both zoom and nonzoom conditions.</p><p><strong>Conclusion: </strong>All 3 ultrasound methods demonstrated high reliability in measuring median nerve CSA, with Trace method showing modest advantages in accuracy and precision. Zoom enhanced views improved interrater reliability but reduced measurement accuracy. Based on our findings, we recommend nonzoom Trace method for consistent longitudinal measurements, though maintaining proficiency in one selected method is more important. Further validation with larger studies is warranted.</p><p><strong>Level of evidence: </strong>Level 2.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251366672"},"PeriodicalIF":1.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023169","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 Weightbearing Affect Radiographic or Clinical Outcomes in Distal Radius Fractures Treated With Dorsal Bridge Plate Fixation?","authors":"Jessica M Welch, Bradley Lauck, Daniel J Lorenzana, Tyler S Pidgeon, Marc J Richard, Christopher S Klifto, David S Ruch","doi":"10.1177/15589447251366460","DOIUrl":"10.1177/15589447251366460","url":null,"abstract":"<p><strong>Background: </strong>Dorsal wrist spanning plate (DWSP) fixation in distal radius fractures (DRFs) has been proposed to allow earlier mobilization in polytraumatized patients by enabling early weightbearing (WB) through the injured wrist. The purpose of this study is to compare radiographic and clinical outcomes in patients who bore weight through the injured wrist within the early postoperative period with patients who did not bear weight.</p><p><strong>Methods: </strong>Patients who underwent DWSP fixation at a single institution were retrospectively identified. Patients who bore weight through the injured wrist for purposes of assisted ambulation (WB) were identified and compared with patients who did not bear weight through the injured wrist (non-weightbearing [NWB]). Outcomes included complication rates, radiographic measurements, visual analogue scale (VAS) pain scores, and range of motion.</p><p><strong>Results: </strong>In total, 123 patients underwent DWSP fixation for DRF between 2005 and 2018, including 30 in the WB cohort and 93 in the NWB cohort. There was no significant difference in patient age, sex, or injury to dominant extremity. The WB group had longer duration of DWSP before removal (121 ± 26.2 vs 106.3 ± 29.5 days, <i>P</i> = .02). There was no significant difference in complication rates (13.3% vs 16.1%, <i>P</i> = .71), clinical outcomes (VAS, flexion, extension, pronosupination), or radiographic parameters preoperatively, postoperatively, after plate removal, or at final follow-up.</p><p><strong>Conclusions: </strong>Early WB through the injured wrist appears to be safe in patients with DRFs treated with DWSP. There were no significant differences in outcomes or complications between patients treated with DWSP based on WB status postoperatively.</p><p><strong>Level of evidence: </strong>Retrospective cohort, Level III.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251366460"},"PeriodicalIF":1.8,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008302","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 Volar Central Approach for Distal Radius Fracture: A Prospective Nerve Conduction Study of 38 Patients.","authors":"Hugo Jakobsson, Eva Lundqvist, Sara Nordkvist, Kathe Dahlbom, Marcus Sagerfors","doi":"10.1177/15589447251366459","DOIUrl":"10.1177/15589447251366459","url":null,"abstract":"<p><strong>Background: </strong>In distal radius fracture (DRF) surgery with volar locking plates, the flexor carpi radialis approach is commonly used. However, the volar central approach (VCA), between the median nerve and the finger flexors, may improve visualization of the volar ulnar corner. A similar approach has been linked with a higher risk of iatrogenic median neuropathy. This study evaluated the risk of median neuropathy after operative treatment using the VCA.</p><p><strong>Methods: </strong>Thirty-eight patients with Arbeitsgemeinschaft für Osteosynthesefragen (AO) type C DRF were assessed prospectively with sensory nerve conduction studies preoperatively and at 6 weeks, 3 months, and 12 months postoperatively.</p><p><strong>Results: </strong>At 6 weeks, 30 of the 38 patients exhibited median neuropathy, decreasing to 12 of the 35 at 12 months. Subjective sensory deficit was reported by 12 of the 38 patients at 6 weeks and 8 of the 37 at 12 months. Patients with median neuropathy (MN) had significantly higher frequency of subjective sensory deficit of the median nerve 12 months postoperatively, but did not have significantly worse patient-reported outcome.</p><p><strong>Conclusions: </strong>Our results suggest that the VCA should be reserved for cases needing optimal exposure of the volar ulnar corner.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251366459"},"PeriodicalIF":1.8,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008231","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":"Evaluating the Educational Quality and Accuracy of Carpal Tunnel-and Cubital Tunnel-Related Videos on TikTok.","authors":"Levi M Travis, Jacob Jahn, Kristen K Dean, Seth D Dodds","doi":"10.1177/15589447251366458","DOIUrl":"10.1177/15589447251366458","url":null,"abstract":"<p><strong>Background: </strong>The increased utilization of social media platforms, including TikTok, has revolutionized the way that medical information is disseminated and consumed globally. Despite the benefits of rapidly accessible health information, the unregulated nature of TikTok raises significant concerns for the validity and reliability of medical advice. The purpose of this study is to evaluate the educational quality and accuracy of information presented on TikTok relating to carpal tunnel syndrome (CTS) and cubital tunnel syndrome (CubTS), 2 common upper extremity conditions.</p><p><strong>Methods: </strong>A sample of CTS- and CubTS-related TikToks (n = 225) was identified on August 25, 2024, through specific search criteria, defined through hashtags, and filtered by the most liked videos, to select those with the greatest reach. Information extracted from each TikTok totaled 22 objective and subjective variables, in addition to 16 metrics from the DISCERN questionnaire, a proven tool for assessing consumer health information.</p><p><strong>Results: </strong>Videos by physicians made up the minority of content while having greater overall DISCERN score, but lower engagement compared with nonphysicians. Alternative-medicine videos included medical recommendations more often than traditional-medicine videos. These videos also were less balanced and unbiased than traditional-medicine videos. Harmful videos had greater engagement than nonharmful videos.</p><p><strong>Conclusions: </strong>This investigation revealed marked variability in both the quality and reliability of TikTok videos related to CTS and CubTS, demonstrating the need for critical assessment of health information disseminated on social media platforms. Although TikTok is a highly engaging platform, it presents considerable misinformation risks for users seeking health information.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251366458"},"PeriodicalIF":1.8,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008287","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":"Glucagon-Like Peptide-1 Receptor Agonist Therapy Associated With Fewer Diagnoses of Carpal Tunnel Syndrome Within 2 Years of Treatment.","authors":"Annika N Hiredesai, Alejandro M Holle, Joyce Zhuang, Carina P Howlett, Cara H Lai, Kevin J Renfree, Shelley S Noland","doi":"10.1177/15589447251366676","DOIUrl":"10.1177/15589447251366676","url":null,"abstract":"<p><strong>Background: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1) are approved for type 2 diabetes treatment. Given the link between diabetes-associated metabolic inflammation and increased carpal tunnel syndrome (CTS) risk, the aim of this study was to investigate development of CTS in diabetic patients who both were and were not taking GLP-1 therapy using a large claims database.</p><p><strong>Methods: </strong>A retrospective cohort study used a national claims database to identify diabetic patients. Those prescribed GLP-1 therapy were matched to controls by age, sex, comorbidity index, tobacco use, and obesity. Multivariable logistic regression evaluated the 2-year CTS incidence, controlling for various health conditions and socioeconomic factors. Secondary analysis also evaluated the rate of carpal tunnel release (CTR) after being diagnosed with CTS.</p><p><strong>Results: </strong>Glucagon-like peptide-1 therapy significantly reduced 2-year CTS diagnosis risk (odds ratio [OR] 0.49; 95% confidence interval [CI] 0.46-0.52; <i>P</i> < .001). Independent risk factors for increased CTS incidence included chronic obstructive pulmonary disease, osteoarthritis, coronary artery disease, depression, hypothyroidism, and rheumatoid arthritis (RA). Of patients who developed CTS, GLP-1 therapy was associated with increased odds of undergoing CTR (OR 1.23; 95% CI: 1.08-1.41; <i>P</i> = .002).</p><p><strong>Conclusions: </strong>Glucagon-like peptide-1 therapy is associated with decreased CTS risk in diabetic patients-potentially due to improved metabolic health-and increased odds of undergoing CTR once diagnosed. Further research is needed to clarify GLP-1 therapy's role in reducing nervous system and musculoskeletal disease burden.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251366676"},"PeriodicalIF":1.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951753","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":"Litigation in Cubital Tunnel Surgery.","authors":"Daniel Sculley, Wassim Mourad","doi":"10.1177/15589447251369033","DOIUrl":"10.1177/15589447251369033","url":null,"abstract":"<p><strong>Background: </strong>Medical malpractice is common, costly, and poorly understood within the U.S. health care system. Cubital tunnel release (CuTR) is the second most common nerve surgery and is prone to complication. Malpractice claims associated with carpal tunnel surgery, distal radius fractures, replantation, and the field as a whole have previously been studied. To date, there has been no study of litigation related to CuTR independently; the aim of this paper is to do so.</p><p><strong>Methods: </strong>The Lexis+ (LexisNexis, New York, NY) legal database was queried for all cases relating to CuTR. Thirty-five cases were identified that were directly related to CuTR; these were amended with publicly available data on defendant specialty and training and statistically examined.</p><p><strong>Results: </strong>Around 51% of cases favored the defendant, 37% favored the plaintiff, and 11% were resolved with a settlement. Median, maximum, and minimum award amounts were $415 484, $11 464 991, and $180 000, respectively. Awards significantly differed by claim type, with large awards for incorrect surgery ($1 007 500), negligent surgery ($389 969), and poor post-op care ($11 464 991). There were no significant differences in outcomes or award amounts by specialty type, hand surgery training, years of experience, or simultaneous surgeries; however, surgeons with hand training had lower median awards ($400 854 vs $430 114), and there were lower awards for simultaneous surgeries ($372 997 vs $445 047).</p><p><strong>Conclusions: </strong>Cubital tunnel release appears to carry a higher liability than other procedures within hand surgery such as carpal tunnel release.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251369033"},"PeriodicalIF":1.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951736","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":"Validation of Temperature Sensors to Monitor Thermoplastic Splint Wear in Hand Surgery Patients.","authors":"Tristan B Weir, Lauren DeTullio, Saral J Patel, Daniel J Lorenzana, Sebastian D Arango, Michael G Livesey, Mohit N Gilotra, A Lee Osterman, Andrew J Miller","doi":"10.1177/15589447231217766","DOIUrl":"10.1177/15589447231217766","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to validate the use of temperature sensors to accurately measure thermoplastic volar forearm splint wear in a healthy cohort of volunteers using 5- and 15-minute temperature measurement intervals.</p><p><strong>Methods: </strong>A prospective diagnostic study was performed to evaluate the diagnostic accuracy of temperature sensors in monitoring splint wear in 8 healthy volunteers between December 2022 and June 2023. Temperature sensors were molded into thermoplastic volar forearm splints. Volunteers who were familiar with the study aims were asked to keep an exact log of the time spent wearing the splint (\"actual wear time\"). Sensors recorded temperatures every 5 or 15 minutes, and separate algorithms were developed to determine the sensor-detected wear time compared with the actual wear time as the gold standard. The algorithms were then externally validated with the total population.</p><p><strong>Results: </strong>The 5-minute and 15-minute algorithms demonstrated excellent sensitivity (99.1% vs 96.6%), specificity (99.9% vs 99.9%), positive (99.4% vs 99.5%) and negative (99.9% vs 99.3%) predictive value, and diagnostic accuracy (99.8% vs 99.3%), respectively. The 5-minute algorithm recorded 99.5% of the total splint hours, whereas the 15-minute algorithm recorded 96.1%. There was no significant difference between the actual time per wear session (5.4 ± 2.7 hours) and the time estimated by the 5-minute algorithm (5.4 ± 2.6 hours; <i>P</i> = .40), but there was a significant difference for the 15-minute algorithm (5.2 ± 2.6 hours; <i>P</i> < .001).</p><p><strong>Conclusion: </strong>Temperature sensors can be used to accurately monitor thermoplastic volar forearm splint wear.</p><p><strong>Level of evidence: </strong>Diagnostic II.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"923-930"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139080490","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":"Risk Factors for Rescue Opioid Prescription After Cubital Tunnel Surgery.","authors":"Carew Giberson-Chen, Christina Liu, Phillip Grisdela, David Liu, Zina Model, Amy Steele, Philip Blazar, Brandon E Earp, Dafang Zhang","doi":"10.1177/15589447241232015","DOIUrl":"10.1177/15589447241232015","url":null,"abstract":"<p><strong>Background: </strong>Concerns regarding the ongoing opioid epidemic have led to heightened scrutiny of postoperative opioid prescribing patterns for common orthopedic surgical procedures. This study investigated patient- and procedure-specific risk factors for additional postoperative opioid rescue prescriptions following ambulatory cubital tunnel surgery.</p><p><strong>Methods: </strong>A retrospective review was performed of patients who underwent cubital tunnel surgery at 2 academic medical centers between June 1, 2015 and March 1, 2020. Patient demographics, comorbidities, prior opioid history, and surgical variables were recorded. The primary outcome was postoperative rescue opioid prescription. Univariate and bivariate statistical analyses were performed.</p><p><strong>Results: </strong>Two hundred seventy-four patients were included, of whom 171 (62%) underwent in situ ulnar nerve decompression and 103 (38%) underwent ulnar nerve decompression with anterior transposition. The median postoperative opioid prescription amount was 90 morphine equivalent units (MEU) for the total cohort, 77.5 MEU for in situ ulnar nerve decompression, and 112.5 MEU for ulnar nerve decompression with transposition. Twenty-two patients (8%) required additional rescue opioid prescriptions postoperatively. Female sex, fibromyalgia, chronic opioid use, chronic pain diagnosis, and recent opioid were associated with the need for additional postoperative rescue opioid prescriptions.</p><p><strong>Conclusions: </strong>While most patients do not require additional rescue opioid prescriptions after cubital tunnel surgery, chronic pain patients and patients with pain sensitivity syndromes are at risk for requiring additional rescue opioid prescriptions. For these high-risk patients, preoperative collaboration of a multidisciplinary team may be beneficial for developing a perioperative pain management plan that is both safe and effective.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"877-884"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139735054","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":"Scaphoid Fractures in Adults Aged 50 Years or Older: Epidemiology and Association With Osteopenia and Nonunion.","authors":"Julia C Mastracci, R Randall McKnight, Gabriella E Ode, Brianna Caraet, Susan M Odum, Erika G Gantt","doi":"10.1177/15589447241235342","DOIUrl":"10.1177/15589447241235342","url":null,"abstract":"<p><strong>Background: </strong>Scaphoid fractures are less commonly reported in adults older than 50 years. The association between bone density and outcomes following scaphoid fractures has not been explored in this patient population. The second metacarpal cortical percentage (2MCP) has been shown to predict low bone density. The purpose of this study is to describe the epidemiology and radiographic characteristics associated with scaphoid fractures in adults older than 50 years, determine the prevalence of osteopenia defined by 2MCP, and evaluate the characteristics associated with scaphoid nonunion in this population. We hypothesized that osteopenia defined by 2MCP would be common in this patient population and associated with scaphoid nonunion.</p><p><strong>Methods: </strong>Patients older than 50 years with an acute, closed scaphoid fracture were identified. Demographic data, radiographic characteristics, and outcome data were collected. The 2MCP was measured using standard hand radiographs.</p><p><strong>Results: </strong>A total of 111 patients were identified. Most fractures were nondisplaced and occurred in women via low-energy mechanism. Fifty-six patients (50.5%) had osteopenia defined by a 2MCP less than 60%. Nondisplaced fractures achieved union faster than displaced fractures (<i>P</i> < .05). Displaced, unstable fractures were statistically associated with nonunion (<i>P</i> < .001). 2MCP did not correlate with nonunion.</p><p><strong>Conclusions: </strong>In adults older than 50 years, scaphoid fractures may represent a fragility fracture cohort given they occur more frequently in female patients via low-energy mechanisms and over half of the cohort had osteopenia defined by a 2MCP less than 60%. Displaced and unstable fractures were statistically more likely to go on to nonunion. Nonunion was not found to be associated with osteopenia.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"944-950"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140174468","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":"An Examination of Complication Rates and Surgery Durations in Elective Hand Surgery During the COVID-19 Pandemic.","authors":"Lawrence J Lin, Eric Mai, Ali Azad","doi":"10.1177/15589447241257645","DOIUrl":"10.1177/15589447241257645","url":null,"abstract":"<p><p><b>Background:</b> The COVID-19 pandemic presented unique challenges to hand surgeons as hospitals worked to adapt to unprecedented demands on resources and personnel. The purpose of this study is to evaluate the impact of COVID-19 on outcomes in elective hand surgery using a large national database. <b>Methods:</b> This is a retrospective review of the American College of Surgeons National Surgery Quality Improvement Program (ACS-NSQIP) dataset for patients undergoing elective hand procedures in 2019 and 2020. Demographics, comorbidities, procedural factors, and outcomes were compared between cases occurring in 2019 and 2020. Multivariable regressions were performed to evaluate the association between operative year and 30-day outcomes. <b>Results:</b> A total of 8971 patients were included with a mean age of 52.2 ± 16.7 and 52.8 ± 16.4 years for the 2019 and 2020 cohorts, respectively. Compared to the 2019 cohort, the 2020 cohort demonstrated higher prevalence of obesity (43.3% vs 40.8%, <i>P</i> = 0.019), hypertension requiring medication (32.9% vs 35.0%; <i>P</i> = 0.046), and American Association of Anesthesiologists (ASA) class ≥ 3 (30.4% vs 27.0%; <i>P</i> < 0.001). There were no significant differences in outcomes including 30-day readmissions, reoperation, or complications between cohorts on unadjusted or multivariable analysis. <b>Conclusions:</b> Elective hand cases performed during the pandemic were associated with longer operating times and more frequently involved patients with greater comorbidities. Despite these differences, patients undergoing surgery during the pandemic demonstrated similar outcomes including complications, readmissions, and reoperations compared to those undergoing surgery the year prior, suggesting that even in the setting of a pandemic, performing elective surgery is safe without an increased risk to the patient.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"966-971"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310604","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}