HAND最新文献

{"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}

{"title":"Return to Play After Hook of Hamate Fracture: A Systematic Review and Meta-Analysis.","authors":"Dylan Luxenburg, Nikhil Patel, Manish Narasimman, Jonathan Weinerman, Jean-Paul Russo, Anthony Martin, Arya Minaie, Seth Dodds","doi":"10.1177/15589447241231303","DOIUrl":"10.1177/15589447241231303","url":null,"abstract":"<p><p>In athletes, a hook of hamate fracture is concerning in terms of time to return to sport and effect on performance upon return. This study aims to analyze the treatment of hook of hamate fractures in athletes to determine their rates of return to play, timelines of recovery, and performance level upon return to play. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to perform this analysis. The PubMed database was queried to perform the literature search. Data were pooled and analyzed. <i>P</i> values <.05 were considered significant. Data were analyzed using the Comprehensive Meta-Analysis software to determine heterogeneity. Twenty studies with 823 patients sustaining hook of hamate fractures that reported any competitive level of play were included in the analysis. Of the 823 patients, 778 (94.5%) were able to return to play with 91.2% (506/555) of patients demonstrating similar or improved performance. The mean time to return to play was 45 days (range: 21-168 days). Treatment included surgical excision for 787 patients (95.6%), open reduction and internal fixation for 18 patients (2.2%), stress reduction/casting for 13 patients (1.6%), and loss to follow-up or surgery refusal for 5 patients (0.6%). A very high number of athletes return to play following a hook of hamate fracture at the same or improved level of performance. In our study, the majority of injuries were treated with surgical excision of the fractured hook of hamate fragment. Most athletes returned to their sport at an average of 45 days.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"849-860"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139989806","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":"Association of Timing With Postoperative Complications in the Management of Open Distal Radius Fractures.","authors":"Kerry A Morrison, Madeline C Rocks, Victoria Comunale, Karan Desai, Rebecca S Nicholas, Ali Azad, Omri Ayalon, Jacques H Hacquebord","doi":"10.1177/15589447241257644","DOIUrl":"10.1177/15589447241257644","url":null,"abstract":"<p><strong>Background: </strong>This study investigates whether open distal radius fractures (ODRFs) treated after 24 hours from time of injury have an increased risk of infection or overall complication profile compared with those treated within 24 hours.</p><p><strong>Methods: </strong>Retrospective review was performed of all patients treated for ODRF over a 6-year period at a single large academic institution. Postoperative complications included surgical site infections, need for revision irrigation and debridement, delayed soft tissue healing, loss of reduction, nonunion, and malunion.</p><p><strong>Results: </strong>One-hundred twenty patients were treated for ODRF. Mean (SD) age at time of injury was 59.92 (17.68) years. Twenty patients (16.7%) had postoperative complications. Regarding mechanism of injury, 78 (65.0%) had a low-energy and 42 (35.0%) had a high-energy injury. Age and fracture grade were not significant factors. Mean (SD) open wound size was 1.18 (1.57) cm. Mean (SD) time from injury presentation to the emergency department (ED) and first dose of intravenous antibiotics was 3.07 (4.05) hours and mean (SD) time from presentation to the ED and operative treatment was 11.90 (6.59) hours, which did not show a significant association with postoperative complications. Twenty-four patients (20.0%) were treated greater than 24 hours after presentation to the ED, which was not significantly distinct from those treated within 24 hours.</p><p><strong>Conclusion: </strong>Patients with ODRFs treated after 24 hours were not associated with a greater risk of postoperative complications. Factors including age, energy and mechanism of injury, and fracture grade did not alter outcome in any statistically significant manner.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"972-978"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141295937","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 Sensitivity of the Scapholunate Interval and Bony Landmarks to Wrist Rotation on Posteroanterior Radiographs.","authors":"Maxwell Campbell, Glenn Schurmans, Nina Suh, Gregory Garvin, Emily Lalone","doi":"10.1177/15589447241255705","DOIUrl":"10.1177/15589447241255705","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to examine the effect of wrist rotation on the scapholunate interval in the posteroanterior radiograph and to identify radiographic landmarks on the posteroanterior projection that can be used to assess position.</p><p><strong>Methods: </strong>Eleven healthy cadaveric wrists were radiographed in the neutral position and subsequently were rotated and imaged from 30° pronation to 30° supination in 10° intervals. At each interval, the scapholunate interval was measured as well as the following landmarks: (1) the visible perimeter of the base of the hook of the hamate; (2) the radial-ulnar distribution of the dorsal nonarticular surface of the distal third metacarpal head; (3) the radial-ulnar distribution of the pisiform about the longitudinal axis of the ulna; and (4) the overlap of the pisiform and triquetrum.</p><p><strong>Results: </strong>The scapholunate interval was largest in the neutral position and linearly decreased by 34% for every 10° of pronation and decreased nonlinearly by 86% after the first 10° of supination. The appearance of the distal third metacarpal head was shown to be sensitive to both pronation and supination. The perimeter of the hook of the hamate and the distribution of the pisiform compared to the ulna were both shown to be sensitive to supination, whereas overlap of the pisiform and triquetrum was not shown to be sensitive to either direction of rotation.</p><p><strong>Conclusions: </strong>Our results highlight the significant effect of rotation on radiographic landmarks at the wrist, indicating that 10° of supination can drastically alter the developed radiograph.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"958-965"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141174643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Qualitative Research in Hand Surgery.","authors":"Caroline Hircock, Xue-Wei Lin, Rafael P Lansang, Cameron F Leveille, Lucas Gallo, Achilles Thoma","doi":"10.1177/15589447231225271","DOIUrl":"10.1177/15589447231225271","url":null,"abstract":"<p><p>No formal review of qualitative research in hand surgery has been previously performed. The primary objective of this study was to evaluate the reporting quality of hand surgery qualitative research with the Standards for Reporting Qualitative Research (SRQR), a 21-item checklist. The secondary objectives were to describe qualitative research in hand surgery by domain, determine differences in reporting quality based on use of a reporting guideline, publication of SRQR and journal of publication, and to identify important outcomes in hand surgery conditions. Fifty-five studies were included from MEDLINE, Embase, PsycINFO, and Emcare. The median SRQR score was 16. The lowest reported sections were <i>context, data collection methods</i>, and <i>data analysis.</i> Qualitative research was found in multiple domains of hand surgery. There was a significant difference between papers that used a reporting guideline and studies published after the publication of the SRQR. Clinical/medical/basic science journals had the highest median SRQR score. Outcomes identified were pain for carpal tunnel syndrome and pain, function, unintentional harm, recurrence, and recovery time for Dupuytren disease. To further improve reporting quality in hand surgery qualitative research, we recommend that investigators ensure they provide rationale for their methodology and become familiar with the SRQR guidelines.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"840-848"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139542203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of Major Complications of Bridge Plating of Distal Radius Fractures at a Level I Trauma Center.","authors":"A Scott Emmert, Alan K Swenson, Robert N Matar, Phillip R Ross, Peter J Stern","doi":"10.1177/15589447241257964","DOIUrl":"10.1177/15589447241257964","url":null,"abstract":"<p><strong>Background: </strong>Comminuted, markedly displaced distal radius fractures can cause instability requiring advanced stabilization with dorsal bridge plating. However, published complication rates of bridge plating widely vary. We hypothesize that complications of bridge plating of distal radius fractures are more prevalent than published rates.</p><p><strong>Methods: </strong>A retrospective review was performed on all patients at an academic level I trauma center treated with a bridge plate for a distal radius fracture from 2014 to 2022.</p><p><strong>Results: </strong>Sixty-five wrists were included in the final analysis: average age 53 years, male 51%, average plate retention 4 months, and average follow-up 6 months. Carpal tunnel release (CTR) was performed at time of primary procedure in 7 (10%) cases. Radial height, radial inclination, dorsal tilt, and ulnar variance were all significantly improved (<i>P</i> < .001). Grip strength, flexion, extension, and supination were significantly limited (<i>P</i> < .03). Twenty-one patients (32%) developed 35 major complications requiring unplanned reoperation, including mechanical hardware-related complication (15%), deep infection (11%), nonunion/delayed union (9%), adhesions (6%), median neuropathy (6%), symptomatic arthritis (5%), and tendon rupture (2%). Plate breakage occurred in 3 patients (5%) and was always localized over the central drill holes of the bridge plate.</p><p><strong>Conclusions: </strong>Major complications for bridge plating of distal radius fractures were higher at our institution than previously published. Plate breakage should prompt reconsideration of plate design to avoid drill holes over the wrist joint. Signs and symptoms of carpal tunnel syndrome should be carefully assessed at initial presentation, and consideration for concomitant CTR should be strongly considered.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"979-988"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Florida Law HB21 on Opioid Prescribing Patterns After Outpatient Hand Surgery.","authors":"Joseph S Geller, Moses I Markowitz, Juan J Lizardi, Sinan K Jabori, Seth D Dodds","doi":"10.1177/15589447231217763","DOIUrl":"10.1177/15589447231217763","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study is to evaluate the effects of Florida lae House Bill 21 (HB21) on opioid prescribing patterns by a single orthopedic hand surgeon after outpatient hand and upper extremity surgery.</p><p><strong>Methods: </strong>The following variables were evaluated with retrospective chart review before and after implementation of HB21: type of opioid, number of pills, morphine milligram equivalents (MMEs), emergency department visits, and readmissions. In addition, the Florida Prescription Drug Monitoring Program (E-FORCSE [Electronic-Florida Online Reporting of Controlled Substance Evaluation]) was queried to determine the number of pills and MMEs prescribed and sold for the latter cohort. Student <i>t</i> tests, Fisher exact tests, and binary logistic regression were used for statistical analysis. <i>P</i> < .05 was considered significant.</p><p><strong>Results: </strong>We reviewed 231 consecutive patients who underwent hand or upper extremity surgery from July 2017 to July 2018 and 207 consecutive patients from January 2020 to January 2021. The average age was significantly different between the cohorts (48.41 vs 44.98 years, <i>P</i> = .025); however, there were no significant differences across other demographic variables. After controlling for age, the average number of pills prescribed per patient decreased significantly after HB21 (25.11 vs 21.6 pills, <i>P</i> < .001). The number of MMEs prescribed per patient decreased as well, but the decrease was not statistically significant (167.8 vs 154.1 MMEs, <i>P</i> = .054). There was an association between preoperative opioid prescriptions filled and prolonged opioid use (odds ratio 6.438, <i>P</i> = .003).</p><p><strong>Conclusion: </strong>Florida law HB21 resulted in significantly fewer pills prescribed per patient, suggesting that legislation likely changed prescriber behavior and/or patient demand regarding postoperative opioid prescriptions after outpatient hand and upper extremity surgery.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"871-876"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thumb Pronation Angle in Thumb Opposition Evaluated by the Nail Tip Angle of Thumb-Ring Finger Opposition.","authors":"Shinji Taniguchi, Yusuke Matsuura, Tatsuya Takehara, Ayae Yamada, Yuki Shiko, Koichi Nakagawa, Seiji Ohtori","doi":"10.1177/15589447241236249","DOIUrl":"10.1177/15589447241236249","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to devise the method for the evaluation of the thumb pronation angle and calculate its reference value.</p><p><strong>Methods: </strong>The study was conducted from October 2021 to March 2022, and 600 hands of 300 healthy volunteers were included in this study. The participants were divided into 6 age groups with 50 participants each. In study 1, 12 participants from group 1 were randomly selected, which included 6 male and 6 female participants. We measured the thumb pronation angle using FASTRAK system and the nail tip angle of thumb-ring finger opposition (T-R angle) and also evaluated the relation between them. In study 2, we measured the T-R angle of 600 hands of 300 healthy volunteers. The T-R angle mean (SD) and 95% confidence interval (CI) of each age group were calculated as reference values.</p><p><strong>Results: </strong>The thumb pronation angle was correlated with the T-R angle. The T-R angle mean (SD) and 95% CI of the 6 groups were as follows: group 1, 142.5° (12.4) and 117.7 to 167.3; group 2, 139.9° (10.1) and 119.7 to 160.1; group 3, 142.3° (9.7) and 122.9 to 160.5; group 4, 140.2° (12.6) and 115.0 to 165.4; group 5, 138.3° (11.9) and 114.5 to 162.1; and group 6, 135.4° (13.0) and 109.4 to 161.4. The 95% CI tended to decrease with an increasing age.</p><p><strong>Conclusions: </strong>The T-R angle was a suitable evaluation method for the thumb pronation angle, and it should be evaluated by age groups.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"938-943"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iatrogenic Irreducible Pediatric Salter-Harris II Middle Phalanx Base Fracture With Dorsal Dislocation of the Proximal Interphalangeal Joint: A Case Report.","authors":"Daniel Urness, SeHoon Park, Jordan Miller, David Fadell","doi":"10.1177/15589447241278957","DOIUrl":"10.1177/15589447241278957","url":null,"abstract":"<p><p>Pediatric phalangeal Salter-Harris (SH)-type fracture dislocations are rare injuries that often require open reduction and stabilization. We present a case of a 14-year-old male who sustained an iatrogenic irreducible SH II dorsal fracture dislocation of the small-finger proximal interphalangeal joint (PIPJ) after an attempted closed reduction of a small-finger PIPJ dislocation by a community emergency medicine physician. Following the reduction attempt, the epiphysis was noted on radiographs to be rotated approximately 90° with persistent dorsal dislocation and an associated SH II fracture of the base of the middle phalanx. The patient was sent to our trauma center for further evaluation by our on-call hand surgeon and required open reduction and pinning of the fracture dislocation. To our knowledge, this pattern of iatrogenic PIPJ fracture dislocation has not been previously described in the literature. We outline the case presentation, treatment method, and learning points for both the on-call hand surgeon as well as the community emergency medicine physicians in this report.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"NP1-NP5"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345528","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":"Evaluation of a Large Language Model's Ability to Assist in an Orthopedic Hand Clinic.","authors":"Travis Kotzur, Aaron Singh, John Parker, Blaire Peterson, Brian Sager, Ryan Rose, Fred Corley, Christina Brady","doi":"10.1177/15589447241257643","DOIUrl":"10.1177/15589447241257643","url":null,"abstract":"<p><strong>Background: </strong>Advancements in artificial intelligence technology, such as OpenAI's large language model, ChatGPT, could transform medicine through applications in a clinical setting. This study aimed to assess the utility of ChatGPT as a clinical assistant in an orthopedic hand clinic.</p><p><strong>Methods: </strong>Nine clinical vignettes, describing various common and uncommon hand pathologies, were constructed and reviewed by 4 fellowship-trained orthopedic hand surgeons and an orthopedic resident. ChatGPT was given these vignettes and asked to generate a differential diagnosis, potential workup plan, and provide treatment options for its top differential. Responses were graded for accuracy and the overall utility scored on a 5-point Likert scale.</p><p><strong>Results: </strong>The diagnostic accuracy of ChatGPT was 7 out of 9 cases, indicating an overall accuracy rate of 78%. ChatGPT was less reliable with more complex pathologies and failed to identify an intentionally incorrect presentation. ChatGPT received a score of 3.8 ± 1.4 for correct diagnosis, 3.4 ± 1.4 for helpfulness in guiding patient management, 4.1 ± 1.0 for appropriate workup for the actual diagnosis, 4.3 ± 0.8 for an appropriate recommended treatment plan for the diagnosis, and 4.4 ± 0.8 for the helpfulness of treatment options in managing patients.</p><p><strong>Conclusion: </strong>ChatGPT was successful in diagnosing most of the conditions; however, the overall utility of its advice was variable. While it performed well in recommending treatments, it faced difficulties in providing appropriate diagnoses for uncommon pathologies. In addition, it failed to identify an obvious error in presenting pathology.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"900-909"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440427","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}