HAND最新文献

{"title":"Compression of the Ulnar Nerve by the Arcade of Struthers: Look and You Shall Find.","authors":"Shady Elmaraghi, Ruby Taylor, Isaac Tung, Megan M Patterson, Susan E Mackinnon","doi":"10.1177/15589447241232013","DOIUrl":"10.1177/15589447241232013","url":null,"abstract":"<p><strong>Background: </strong>The arcade of Struthers was first proposed by Kane et al in 1973. Clinical investigations of this structure have been limited to small case series, focusing on the arcade as an isolated cause of compressive ulnar neuropathy. The purpose of our study was to investigate the incidence of this structure in patients undergoing ulnar nerve transposition.</p><p><strong>Methods: </strong>A retrospective chart review of prospectively maintained data in a single surgeon's practice was performed. Records of patients undergoing surgery for compressive ulnar neuropathy at the cubital tunnel were evaluated for documentation of a compressive arcade of Struthers. In addition, a scoping review of the literature was undertaken to better characterize current understanding of this structure and its recognition in clinical practice.</p><p><strong>Results: </strong>A total of 197 patients underwent ulnar nerve transposition. The overall incidence of a compressive arcade of Struthers was noted to be 67 out of 197 (34%). All patients with a compressive arcade were noted to have an internal brachial ligament running below the nerve. Patients undergoing revision surgery were found to have a compressive arcade 51% of the time (20/39), whereas 30% of patients undergoing primary surgery were found to have a compressive arcade (47/158). Only 12 clinical studies examining the arcade of Struthers have been published in the last 20 years, the majority being single case reports.</p><p><strong>Conclusions: </strong>Compression of the ulnar nerve by the arcade of Struthers is a common finding and can contribute to compressive ulnar neuropathy at the elbow both in primary and revision cases.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"579-587"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139930874","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 Medial Antebrachial Cutaneous Nerve Is a Low-Morbidity Alternative to the Standard Sural Nerve Autograft.","authors":"Stahs Pripotnev, Sai L Pinni, Suzanne Zhou, Gary Skolnick, Susan E Mackinnon","doi":"10.1177/15589447231218459","DOIUrl":"10.1177/15589447231218459","url":null,"abstract":"<p><strong>Background: </strong>Nerve interposition grafting is an important technique in nerve reconstructive surgery that is used when a primary repair is not feasible without significant tension. This study sought to evaluate the long-term morbidity of the medial antebrachial cutaneous (MABC) nerve as an alternative donor nerve in comparison with sural nerve harvest.</p><p><strong>Methods: </strong>A single surgeon and institution retrospective chart review was performed to identify all patients who underwent nerve autografting using the sural and MABC as donor nerves between January 1, 2000 and December 31, 2019. Surveys assessed overall patient satisfaction with surgery, as well as donor and recipient site morbidity, satisfaction, pain, numbness, and cold sensitivity.</p><p><strong>Results: </strong>Of the 73 patients contacted, 54 agreed to participate, and 43 of 73 (58.9%) ultimately completed the survey: 28 MABC (65.1%) and 15 sural (34.9%). There were no significant differences between the sural and MABC groups in overall satisfaction with surgery, donor and recipient site satisfaction, pain, cold sensitivity, and effect on quality of life. Even though 66.7% of sural donor sites and 75% of MABC donor sites had residual numbness, the effect this had on quality of life was very low (2 and 3, respectively).</p><p><strong>Conclusion: </strong>The MABC is a safe alternative to the traditional sural nerve autograft. A small subset of patients undergoing nerve autograft harvest will experience long-term morbidity in the form of pain. Conversely, the more common presence of numbness is not reported as bothersome.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"542-548"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139097740","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 Arthroplasty as Reliable Long-term Solution for Trapeziometacarpal Osteoarthritis: A Minimum of 15 Years of Follow-up.","authors":"Pieter Van Geel, Arne Decramer, Alexander Top, Stijn Muermans, Thomas Ryckaert, Bert Vanmierlo","doi":"10.1177/15589447241233367","DOIUrl":"10.1177/15589447241233367","url":null,"abstract":"<p><strong>Background: </strong>In patients with symptomatic trapeziometacarpal (TMC) joint arthritis resistant to conservative treatment, surgical treatment can be advised. One of the many surgical treatment options is TMC arthroplasty. The Arpe prosthesis is one example of these TMC arthroplasties.</p><p><strong>Methods: </strong>This retrospective study evaluated patients who underwent TMC arthroplasty with the Arpe prosthesis after a minimum of 15 years of follow-up. Clinical, radiologic, and qualitative outcomes were assessed for 43 Arpe arthroplasties in 41 patients, of whom 2 had bilateral arthroplasties. The female to male ratio was 39:4. The mean follow-up time was 197 months (range = 180-225).</p><p><strong>Results: </strong>The cumulative survival rate after a mean of 16.5 years was 84%. Seven failures (16%) were registered, of which 5 during the first 3 years after primary surgery. All patients were successfully converted to a trapeziectomy. Quick Disabilities of the Arm, Shoulder and Hand score improved with 44.9 points and visual analogue pain score with 97% and 91% at rest and during exercise, respectively.</p><p><strong>Conclusions: </strong>This series demonstrates that thumb arthroplasty is a reliable long-term solution for thumb base arthritis, with significant pain reduction and functional improvement, even after 15 years of follow-up.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"588-593"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139930878","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":"Biomechanical Stability of Diaphyseal Ulnar Shaft Fractures and Ulnar Shortening Osteotomies After Fixation.","authors":"Lauren E Dittman, Katharine M Hinchcliff, Alexander W Hooke, Sanjeev Kakar","doi":"10.1177/15589447241233707","DOIUrl":"10.1177/15589447241233707","url":null,"abstract":"<p><strong>Background: </strong>To determine the amount of micromotion during forearm rotation after diaphyseal ulnar shaft fracture or osteotomy.</p><p><strong>Methods: </strong>This was a biomechanical study using 7 paired-matched cadavers. The upper extremity was mounted in a custom rig and the forearm brought through full pronation and supination. A Hall effect sensor was placed at the fracture ends to measure micromotion for all tested conditions. There were 4 conditions tested: (1) intact ulnar shaft with plate to act as a control; (2) transverse fracture/osteotomy without stabilization; (3) fracture/osteotomy with cortical apposition stabilized with plate fixation; and (4) 50% comminuted fracture stabilized with plate.</p><p><strong>Results: </strong>There was a significantly greater amount of fracture site motion in the fracture/osteotomy model without stabilization compared with all other tested conditions (<i>P</i> < .001, .0001, .0003, respectively). The fracture/osteotomy site with cortical apposition and the comminuted fracture models showed no statistically significant differences in the amount of micromotion compared with each another (<i>P</i> = .952) or compared with the intact ulnar shaft (<i>P</i> = .997, .889, respectively).</p><p><strong>Conclusions: </strong>There was no significant difference in the amount of motion between an intact ulnar shaft, an ulnar shaft fracture with cortical apposition stabilized with a plate, and a plated comminuted fracture. These findings may help surgeons decide on their type of postoperative immobilization in the setting of isolated ulnar shaft fractures or ulnar shaft osteotomies stabilized with plate fixation.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"619-623"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971694","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 the Clenched Fist View in Detecting Scapholunate Ligamentous Injury.","authors":"Christine Oh, Michael W Fort, Sanjeev Kakar","doi":"10.1177/15589447231223774","DOIUrl":"10.1177/15589447231223774","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to determine the predictive value of the clenched fist stress views in identifying scapholunate ligament injuries.</p><p><strong>Methods: </strong>An institutional review board-approved retrospective chart review was conducted of adult patients who underwent diagnostic arthroscopy with a ligamentous wrist injury from 2015 to 2020. Standard posteroanterior, lateral, and clenched fist stress radiographs were reviewed and scapholunate ligament gaps recorded.</p><p><strong>Results: </strong>A total of 124 patients were included, of which 88 had normal standard radiographs and clenched fist radiographs. The positive predictive value of the clenched fist view was 69%, whereas the negative predictive value was 58%. The sensitivity of the clenched fist view was 40%, while the specificity was 82%. Of those patients with a negative clenched fist view, 42% were found to have an arthroscopic Geissler classification of 3 or higher scapholunate ligament injury.</p><p><strong>Conclusions: </strong>Despite the emphasis on stress radiographic views, a normal stress clenched fist view does not preclude arthroscopic findings of a Geissler class 3 or greater injury in symptomatic patients. The sensitivity of a clenched fist view is only 40%. These findings question the utility of stress radiographs when assessing for scapholunate ligament injuries.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"607-611"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139485282","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 \"Bag of Bones\" Treatment of Comminuted Intra-articular Distal Humerus Fractures in the Elderly.","authors":"Rohit Garg, Peter S Vezeridis, James T Monica, Chaitanya S Mudgal","doi":"10.1177/15589447231218300","DOIUrl":"10.1177/15589447231218300","url":null,"abstract":"<p><strong>Background: </strong>Extensively comminuted intra-articular distal humerus fractures in the elderly present a challenging therapeutic dilemma. The purpose of this study was to investigate the results of nonoperative treatment of these fractures in a select subset of patients.</p><p><strong>Methods: </strong>Patients treated with nonoperative management for a comminuted intra-articular distal humerus fracture between 2007 and 2018 were reviewed. Patients were administered 3 elbow-specific functional outcomes instruments.</p><p><strong>Results: </strong>A total of 8 patients (2 men, 6 women) were treated with brief immobilization followed by early range of motion. All had fractures with extensive comminution of the articular surface such that open reduction and internal fixation was not feasible. Average age was 70 years. At an average of 33 months postinjury, average flexion was 124°, and extension was -27°, with full forearm rotation. No patients required pain medications at the latest follow-up. At 33 months of follow-up, the average Mayo Elbow Performance Score was 92/100 (100 optimal), Oxford Elbow Score was 43/48 (48 optimal), and Quick Disabilities of the Arm, Shoulder, and Hand Score was 10/100 (0 optimal). All patients were satisfied with the nonsurgical treatment that they received.</p><p><strong>Conclusions: </strong>Nonoperative treatment for comminuted intra-articular distal humerus fractures results in acceptable functional outcome in elderly patients and should be considered when the fracture is not amenable to internal fixation and in lower-demand patients with higher surgical risk.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"624-633"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139097739","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":"Arthroscopic Hemitrapeziectomy: Is an Internal Brace Worth It?","authors":"Miguel Tovar-Bazaga, María Pérez-Cuesta Llaneras, Alejandro Badia","doi":"10.1177/15589447241231301","DOIUrl":"10.1177/15589447241231301","url":null,"abstract":"<p><strong>Background: </strong>This article's purpose was to analyze clinical results obtained with thumb carpometacarpal (CMC) arthroscopic hemitrapeziectomy with temporary suspension with a Kirschner wire (K-wire).</p><p><strong>Methods: </strong>Seventy thumb CMC arthroscopic hemitrapeziectomies with a mean age of 59 and 18 months of follow-up were performed in our center during a 13-year period. All of them followed the same protocol. Surgical technique is described.</p><p><strong>Results: </strong>All patients were arthroscopically classified as Badia's III stage. No tendon interposition was used, and a K-wire was temporarily implanted for 5.1 weeks. Mean postsurgical Visual Analogue Scale of 1.6, Kapandji Opposition Score of 8.1, grip strength of 42.2 lbs, lateral pinch of 9.5 lbs, tip-to-tip pinch of 4.2 lbs and tripod pinch of 7.8 lbs were measured. All previous active workers resumed their previous job.</p><p><strong>Conclusions: </strong>We conclude that thumb CMC arthroscopic hemitrapeziectomy with temporary suspension with K-wire reaches good results in terms of pain reduction, strength, and functionality, without the necessity of an internal brace which increases risks of a second metacarpal fracture.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"594-601"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139912527","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":"Dynamic Computed Tomography of the Distal Radioulnar Joint Versus Magnetic Resonance Imaging in Detecting Foveal Tears of the Triangular Fibrocartilage Complex.","authors":"Zachary V Braig, Lauren E Dittman, Kimberly K Amrami, Sanjeev Kakar","doi":"10.1177/15589447241232012","DOIUrl":"10.1177/15589447241232012","url":null,"abstract":"<p><strong>Background: </strong>Diagnosis of foveal triangular fibrocartilage complex (TFCC) tears remains difficult. The purpose of this study was to evaluate whether dynamic computed tomography (CT) of the distal radioulnar joint (DRUJ) has a higher sensitivity in detecting foveal tears of the TFCC when compared with magnetic resonance imaging (MRI).</p><p><strong>Methods: </strong>A database query identified all patients above the age of 18 years with suspected foveal TFCC injuries who underwent bilateral dynamic CT imaging of the DRUJ, static 3T MRI, and subsequent wrist arthroscopy. All patients had evidence of foveal tenderness on clinical examination. The imaging results were validated with wrist arthroscopy.</p><p><strong>Results: </strong>Twelve patients with a mean age of 31 years (range, 18-53 years) were identified. Eight patients were diagnosed with a complete foveal detachment of the TFCC on wrist arthroscopy. Of the 8 patients with a foveal tear on DRUJ arthroscopy, only 3 had a preoperative physical examination suggestive of DRUJ instability. Magnetic resonance imaging identified foveal injuries in 4 of these 8 patients (sensitivity, 50%), and 3 of these were identified as only partial tears. Dynamic CT identified instability of DRUJ in 6 of 8 patients (sensitivity, 75%). Seven of 8 patients had imaging findings suggestive of a foveal tear when including either MRI or CT imaging (sensitivity, 88%). Of the 4 patients with an intact foveal attachment on arthroscopy, 3 (specificity, 75%) had a stable DRUJ on CT and all 4 (specificity, 100%) had an intact foveal attachment on MRI.</p><p><strong>Conclusion: </strong>Sixty-two percent of patients with foveal tears on arthroscopy have a stable DRUJ on clinical examination. When combining MRI and dynamic CT imaging of the DRUJ, the sensitivity of detecting a foveal TFCC tear approaches 88% compared with a gold standard of wrist arthroscopy.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"612-618"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139930875","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":"Patients With and Without Double Crush Syndrome Achieve Similar Rates of Clinical Improvement Following Carpal Tunnel Release.","authors":"Logan M Hansen, Eric X Jiang, Noah M Hodson, Nicholas Livingston, Ani Kazanjian, Mitchell Wu, Charles S Day","doi":"10.1177/15589447241233764","DOIUrl":"10.1177/15589447241233764","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study is to compare outcomes of carpal tunnel release (CTR) in patients with and without double crush syndrome (DCS), defined as concurrent carpal tunnel syndrome (CTS) and cervical radiculopathy at C5-T1 on preoperative nerve conduction studies.</p><p><strong>Methods: </strong>Patients with preoperative nerve conduction studies who underwent unilateral, isolated CTR were retrospectively identified. All patients completed preoperative and 3-month postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) upper extremity (UE) and pain interference (PI), and Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaires, and responded to the anchor question: \"Since your treatment, how would you rate your overall function?\" (much worse, worse, slightly worse, no change, slightly improved, improved, much improved). Preoperative, postoperative, and changes in scores for UE, PI, and QuickDASH were compared, as were the anchor question responses and rates of achieving the minimal clinically important difference (MCID).</p><p><strong>Results: </strong>Sixty-three patients with DCS and 115 patients with CTS only were included. At 3- to 4-month follow-up, absolute and change in UE, PI, and QuickDASH scores were not statistically different between patients with DCS and CTS. Rates of anchor question response and MCID achievement were comparable for patients with CTS only and DCS on each questionnaire. The MCID achievement ranged from 48.4% to 68.8% in the unmatched cohort and 48.4% to 60% in the matched group.</p><p><strong>Conclusions: </strong>At 3 to 4 months, patients with DCS experience similar patient-reported symptomatic and functional improvement, and achieve MCID of outcome measures at comparable rates to patients with CTS only. For patients with nerve compression at the carpal tunnel and cervical spine, CTR is a reasonable first step prior to proceeding with cervical spine decompression.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"549-554"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139989805","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 Readability Study of Carpal Tunnel Release in 2023.","authors":"Ankur Kayastha, Kirthika Lakshmanan, Michael J Valentine, Hunter D Kramer, James Kim, Nicholas Pettinelli, Robert C Kramer","doi":"10.1177/15589447241232095","DOIUrl":"10.1177/15589447241232095","url":null,"abstract":"<p><strong>Background: </strong>The National Institutes of Health (NIH) and the American Medical Association (AMA) recommend a sixth-grade reading level for patient-directed content. This study aims to quantitatively evaluate the readability of online information sources related to carpal tunnel surgery using established readability indices.</p><p><strong>Methods: </strong>Web searches for \"carpal tunnel release\" and \"carpal tunnel decompression surgery\" queries were performed using Google, and the first 20 websites were identified per query. WebFX online software tools were utilized to determine readability. Indices included Flesch Kincaid Reading Ease, Flesch Kincaid Grade Level, Coleman Liau Index, Automated Readability Index, Gunning Fog Score, and the Simple Measure of Gobbledygook Index. Health-specific clickthrough rate (CTR) data were used in order to select the first 20 search engine results page from each query.</p><p><strong>Results: </strong>\"Carpal tunnel release\" had a mean readability of 8.46, and \"carpal tunnel decompression surgery\" had a mean readability of 8.70. The range of mean readability scores among the indices used for both search queries was 6.17 to 14.0. The total mean readability for carpal tunnel surgery information was found to be 8.58. This corresponds to approximately a ninth-grade reading level in the United States.</p><p><strong>Conclusion: </strong>The average readability of carpal tunnel surgery online content is three grade levels above the recommended sixth-grade level for patient-directed materials. This discrepancy indicates that existing online materials related to carpal tunnel surgery are more difficult to understand than the standards set by NIH and AMA.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"562-571"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982814","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}