HAND最新文献

{"title":"Nationwide Medicare and Medicaid Trends in Management of Dupuytren's Contracture.","authors":"Evan S Pistone, Samer W Majeed, Grant B Torres, Rion E Brown, John Faillace","doi":"10.1177/15589447251397016","DOIUrl":"10.1177/15589447251397016","url":null,"abstract":"<p><strong>Background: </strong>In 2020, collagenase clostridium histolyticum (CCH) was withdrawn from markets in Europe, Asia, and Australia for Dupuytren's contracture (DC). The impact of this withdrawal on US treatment patterns remains unclear. This study evaluates national trends in DC management across Medicare and Medicaid populations.</p><p><strong>Methods: </strong>Using data from the Centers for Medicare and Medicaid Services Physician/Supplier Procedure Summary, all DC-related procedure claims from 2012 to 2022 were identified using Current Procedural Terminology (CPT) codes for open partial palmar fasciotomy (26045), open fasciectomy (26121, 26123, 26125), percutaneous needle aponeurotomy (26040), and collagenase injection (20527). Claims were analyzed by year, provider type, and place of service, normalized per 100 000 total claims.</p><p><strong>Results: </strong>Between 2012 and 2022, 189 142 procedures were recorded. Overall intervention rates increased by 36%, from 35.87 to 49.10 per 100 000 claims. Collagenase injections rose 269%, while open fasciotomy declined 26%. Open fasciectomy remained the dominant treatment, accounting for over 60% of procedures. Notably, fasciectomy with digital release (26123, 26125) increased, while isolated palmar fasciectomy (26121) decreased. Office-based procedures rose from 14% to 21%, while ambulatory surgical centers remained most common (46% in 2022). Orthopedic surgeons were the leading providers, though hand specialists saw the largest proportional increase.</p><p><strong>Conclusion: </strong>Unlike international trends, US collagenase use continued to rise through 2022. Open fasciectomy remained primary, with a shift toward minimally invasive treatments and outpatient settings. Hand specialists are increasingly involved, though orthopedic surgeons lead in volume. These findings reflect evolving care models and highlight the need for continued monitoring of provider patterns and access to DC treatment.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1533-1540"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12708309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762701","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 Modified 5-Item Frailty Index Is a Predictor of Perioperative Complications in Digital Replantation.","authors":"Thor S Stead, Neel Vishwanath, Nikhil Sobti, Tareq Kheirbek, Amy C Kite","doi":"10.1177/15589447251366678","DOIUrl":"10.1177/15589447251366678","url":null,"abstract":"<p><strong>Background: </strong>Digit replantation has a significant risk of postoperative complications including an estimated reoperation rate around 14%. This study evaluates the modified frailty index 5 (mFI-5) in predicting postoperative complications including reoperation for digit replantation.</p><p><strong>Methods: </strong>The American College of Surgeons' National Surgical Quality Improvement Program database (2007-2019) was queried to identify patients who underwent upper extremity blood vessel repair distal to the wrist. Demographics, patient characteristics, mFI-5 scores, and all complications, including reoperation and readmission, were analyzed using univariate and multivariate analyses to identify associations between mFI-5 and complications.</p><p><strong>Results: </strong>We identified 1336 patients who underwent digit replantation. Of those, 99 patients (7.4%) had mFI-5 ≥ 3. Frail patients were defined as having mFI-5 ≥ 3 based on prior literature. Higher mFI-5 scores correlated with increased rates of all-cause complications (mFI-5 ≥ 3: 51.5% vs mFI-5 = 0: 9.2%, <i>P</i> < .001), readmission (mFI-5 ≥ 3: 15.8% vs mFI-5 = 0: 2.2%, <i>P</i> < .001), and reoperation (mFI-5 ≥ 3: 8.8% vs mFI-5 = 0: 3.1%, <i>P</i> < .001). Multivariate analysis indicated that an mFI-5 score ≥ 3 significantly increased the rates of any complication (odds ratio [OR] = 9.1, 95% confidence interval [CI], 3.9-21.2, <i>P</i> < .001), mortality (OR = 5.4, 95% CI, 1.1-27.0, <i>P</i> = .04), surgical complications (OR = 7.5, 95% CI, 2.5-22.9, <i>P</i> < .001), and medical complications (OR = 13.4, 95% CI, 3.9-46.7, <i>P</i> < .001). These patients also had lower odds of home discharge (OR = 0.35, 95% CI, 0.22-0.56, <i>P</i> < .001) and higher odds of unplanned readmission (OR = 1.4, 95% CI, 1.3-1.5, <i>P</i> < .001) compared with those with mFI-5 = 0.</p><p><strong>Conclusions: </strong>The mFI-5 is an effective tool for predicting adverse outcomes in digit replantation. It is simple to calculate preoperatively and aids in risk stratification, perioperative counseling, operative planning, and postoperative outcomes.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1416-1424"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12446283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080521","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":"Endoscopic Versus Open Carpal Tunnel Release: Is Early Functional Recovery Different Across Occupational and Recreational Hand Activity Demands?","authors":"Kevin Kuan-I Lee, Alberto Barrientos, Omer Sadeh, Anne Genzelev, Nader Paksima, S Steven Yang, Jonathan M Bekisz, Jacques H Hacquebord","doi":"10.1177/15589447261487486","DOIUrl":"https://doi.org/10.1177/15589447261487486","url":null,"abstract":"<p><strong>Background: </strong>Both endoscopic carpal tunnel release (ECTR) and open carpal tunnel release (OCTR) are effective surgical treatments for carpal tunnel syndrome. Prior studies suggest that ECTR may facilitate faster early recovery and return to both work and activity; however, comparative outcomes among patients with varying occupational and recreational hand demands remain incompletely characterized.</p><p><strong>Methods: </strong>A prospective comparative study was conducted in 125 patients undergoing carpal tunnel release, including 70 ECTR and 55 OCTR procedures. Primary outcomes included changes in Quick Disabilities of the Arm, Shoulder, and Hand scores, time to return to activities of daily living (ADLs), work, and recreational activities. Subgroup analyses were performed according to occupational and recreational hand-demand levels.</p><p><strong>Results: </strong>Patients undergoing ECTR demonstrated greater overall improvement compared with those undergoing OCTR (-7.9 ± 27.2 vs 2.9 ± 25.0, <i>P</i> = .0264) at postoperative follow-up. Time to return to ADLs and work was similar between groups. However, ECTR patients returned to recreational activities significantly earlier than OCTR patients (14 vs 31 days, <i>P</i> = .0022). Subgroup analyses demonstrated earlier return to work following ECTR among patients with medium/heavy occupational demands (14 vs 36 days, <i>P</i> = .0346) and earlier return to recreational activities among those participating in high hand-demand activities (25 vs 60 days, <i>P</i> = .0004).</p><p><strong>Conclusions: </strong>Endoscopic carpal tunnel release was associated with improved early functional recovery and earlier return to high hand-demand occupational and recreational activities compared with OCTR. Although overall return to ADLs and work was similar between groups, ECTR may provide clinically meaningful benefits for patients with physically demanding lifestyles.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261487486"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108836","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":"Flexor Pollicis Longus Palsy Following Both-Bone Forearm Fracture Fixation: A Case-Based and Cadaveric Evaluation.","authors":"Courtney R Carlson Strother, Chelsea C Boe, Nicholas Pulos, Taylor P Trentadue, Marco Rizzo","doi":"10.1177/15589447251366455","DOIUrl":"10.1177/15589447251366455","url":null,"abstract":"<p><strong>Background: </strong>Flexor pollicis longus (FPL) palsy following both-bone forearm fracture (BBFF) is a rare complication.</p><p><strong>Methods: </strong>A retrospective review of acute BBFF treated with open reduction internal fixation by a single surgeon from 2005 to 2023 was performed. Injury and surgical characteristics of patients with documented FPL palsy were reviewed. In addition, 10 cadaveric dissections were performed to evaluate the anatomy of the anterior interosseous nerve (AIN) and its branches. The distance of these branches from palpable elbow landmarks and variability in branching pattern were evaluated.</p><p><strong>Results: </strong>Twenty-nine patients underwent surgery for acute BBFF. Of these, 5 (17%) had evidence of an FPL palsy either at the time of injury presentation (n = 2) or immediately following surgery (n = 3). All patients with FPL palsy sustained fractures in the middle one-third of the radius. All palsies resolved after an average of 33 days of observation. In cadaveric dissections, the average distance from the lateral epicondyle to the AIN takeoff and branch to the FPL was 5.5 and 7.6 cm, respectively. The AIN takeoff and branch to the FPL were never less than 4 and 7 cm from the lateral epicondyle, respectively.</p><p><strong>Conclusion: </strong>Flexor pollicis longus palsy following BBFF can occur at the time of injury or following surgery. All FPL palsies involved midshaft radial fractures and were likely neurapraxia. The etiology of FPL palsy remains unclear, but cadaveric dissection suggests the FPL motor branch may be at risk from mid-to-proximal radius fracture fragments or excessive traction during surgery.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1488-1493"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951685","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":"Global Hand Surgery Fellowship Education: Program-Reported Characteristics and Competencies.","authors":"Andrew D'Elia, Armaan Dhanoa, Barbara Jemec","doi":"10.1177/15589447251406922","DOIUrl":"10.1177/15589447251406922","url":null,"abstract":"<p><strong>Background: </strong>Hand Surgery Fellowship is the mainstay for training of hand surgeons globally. Despite this, a standardized curriculum for hand surgeons has yet to be established, and discrepancies between Hand Fellowship offerings, including operative exposure and program requirements, persist. The purpose of this study was to characterize what Fellowship programs globally promise to teach their Fellows, and how they do this.</p><p><strong>Methods: </strong>An Internet search for Hand Surgery Fellowship programs was conducted between March 3, 2024 and February 8, 2025. In addition to the primary search, programs were found through the International Federation of Societies for Surgery of the Hand and affiliate society websites. Only Fellowships that were recognized by national regulatory bodies were included.</p><p><strong>Results: </strong>A total of 218 program websites were identified across the United States, the United Kingdom, Canada, Europe, Australia/New Zealand, Asia, Africa/Middle East, and South America. Mentorship/apprenticeships and rotation-based programs were the most common training approaches. Trauma surgery was a universal focus of Hand Fellowships globally. Programs supervised by orthopedic faculty were more likely to offer training in shoulder, elbow, and arthroscopic surgery, whereas programs supervised by plastics/mixed departments were more likely to include peripheral nerve, congenital, microsurgery, and replantation surgery.</p><p><strong>Conclusions: </strong>Program websites in various regions globally possess different levels of detail and emphasize different aspects of surgical training in their descriptions. The United States had the most programs and included the greatest level of detail in their program descriptions. Reported obtainable clinical competencies varied with geographical region and faculty specialization. Recommendations are suggested.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1541-1550"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12764421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145892346","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 of Injury to the Superficial Branch of the Radial Nerve in Dorsal and Anterolateral Approaches to the First Carpometacarpal Joint.","authors":"Irene Pérez de Gracia-Velázquez, Javier De Torres-Urrea, Olga Roda, Clarisa Simón-Pérez, Natividad Martín-Morales, Francisco O'Valle, Pedro Hernández-Cortés","doi":"10.1177/15589447251392940","DOIUrl":"10.1177/15589447251392940","url":null,"abstract":"<p><strong>Background: </strong>Complications of thumb basal joint arthritis surgery include surgical wound pain and <i>cheiralgia paresthetica</i> through involvement of the radial nerve superficial branch (RNSB). The aim of this study is to compare the risk of nerve injury between anterolateral and dorsal approaches to the first carpometacarpal joint (1CMCJ) by measuring the distance between the incisions and RNSB, recording crosses between them, and evaluating the density of skin nerve endings at incision sites.</p><p><strong>Methods: </strong>In this descriptive study of 20 cryopreserved cadaver specimens, the anatomical distribution of the RNSB and its relationship with 1CMCJ anterolateral and dorsal approaches were determined by macro-dissection, and histomorphological analysis and digital imaging were used to measure cutaneous nerve ending density at the 1CMCJ and incision sites.</p><p><strong>Results: </strong>In comparison to dorsal approach, the minimum distance from the RNSB was significantly shorter (1.30 ± 1.94 mm vs 3.70 ± 2.71 mm), and the total number (16.60 ± 8.50 vs 9.97 ± 7.51) and density (2.00 ± 0.83 vs 1.29 ± 0.77 mm²) of nerve endings were significantly higher with anterolateral approach. With the anterolateral approach, more nerve structures were observed in the distal <i>versus</i> proximal section of the incision, although the difference was only close-to-significant.</p><p><strong>Conclusion: </strong>The incision is closer to the RNSB pathway with Wagner's anterolateral approach than with Gervis' dorsal approach, crossing with nerve branches in 50% of cases. The density of nerves is higher in the skin overlying the anterolateral <i>versus</i> dorsal aspect of the carpometacarpal joint. The risk of neuropathic wound pain after 1CMCJ surgery could be higher with the anterolateral approach, which should therefore be avoided.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1439-1446"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12711530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767851","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":"Utility of 3-Dimensional Printed Models for Distal Radius Fracture Classification.","authors":"Aine M Gallahue, Parker Johnsen, Puvin Dhurairaj, John Epoh Dibato, David A Fuller, Steven D Kozusko","doi":"10.1177/15589447251378681","DOIUrl":"10.1177/15589447251378681","url":null,"abstract":"<p><strong>Background: </strong>This comparative observational study evaluated the reliability of 3-dimensional (3D) models versus radiograph imaging for distal radius fracture classification by measuring inter- and intraobserver agreement.</p><p><strong>Methods: </strong>Twelve distal radius fractures were selected from our institution and 3D printed models were created using computed tomography (CT) data imaging. Each fracture model was printed in both resin and filament material. 3D models and radiograph images were randomized, and participants independently classified each based on the AO classification for distal radius fractures. Inter- and intraobserver agreement was measured by kappa coefficient and reliability was compared between radiograph and 3D model for each fracture using 95% confidence intervals. Results were analyzed by 3-level classification AO types (A, B, C) and 9-level classification using AO types and groups (A1-A3, B1-B3, C1-C3).</p><p><strong>Results: </strong>Among 24 participants, 3D printed models showed improved inter-observer agreement when compared with radiographs using the 3-level AO classification system, although not statistically significant. Significant improvement in agreement was observed using the 3-level AO classification amongst the orthopedic providers in this study. Agreement in all above-mentioned groups improved from \"none/slight\" with radiograph images to \"fair\" or \"moderate\" agreement when using the 3D models.</p><p><strong>Conclusions: </strong>3D-printing enhanced inter- and intrasurgeon reliability for distal radius fracture classification when compared with radiograph imaging alone. However, overall agreement with either method of classification was low. Statistical significance was achieved only with subgroup analysis. These findings suggest that while 3D-printed models offer some value, their impact on clinical practice may be limited in their current form.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1501-1508"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307858","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":"Outcomes of Epiphysiodesis About the Distal Radius and Distal Ulna.","authors":"Catherine C May, Omar Ahmed, Natasha S McKibben, Julia L Conroy, Joshua M Abzug","doi":"10.1177/15589447251391376","DOIUrl":"10.1177/15589447251391376","url":null,"abstract":"<p><strong>Background: </strong>Wrist fractures comprise nearly 30% of all fractures in children. Fractures that damage the distal radius and/or distal ulnar growth plates may require epiphysiodesis to prevent skeletal deformity and/or length discrepancy. Epiphysiodesis is commonly used to correct leg-length discrepancies in children but has not been extensively studied for its use on the distal radius and ulna. The purpose of this study is to present the outcomes of epiphysiodesis procedures about the distal radius and/or distal ulna.</p><p><strong>Methods: </strong>A retrospective review identified pediatric patients (<18 years) who underwent a distal radius and/or distal ulna epiphysiodesis over a 12-year period. Data collection included patient demographics, mechanism of injury, physeal arrest cause, time to complete physeal closure, return to activities, and complications. Associations between patient characteristics and outcomes were determined using univariate regressions.</p><p><strong>Results: </strong>Thirty-four patients with an average age of 13 years (SD: 1 year; range: 10-16 years) were identified. Initial physeal arrest was caused by a fracture in 30 (88.2%) patients. Seventeen (50.0%) epiphysiodesis procedures involved only the distal ulna, 2 (5.9%) only the distal radius, and 15 (44.1%) were performed concomitantly in both. The median time to physeal closure was 8.4 weeks (interquartile range [IQR]: 7.1-10.9 weeks). Four patients (11.8%) experienced transient complications after distal ulnar epiphysiodesis. No complications were identified following distal radius epiphysiodesis. All physes closed completely following the epiphysiodesis procedures.</p><p><strong>Conclusions: </strong>Epiphysiodesis of the distal radius and/or distal ulna is a well-tolerated and beneficial procedure. The physis completely closes around 8 weeks following the procedure. This series did not identify any cases that required a return to the operating room due to an incomplete closure of the physis.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1494-1500"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12660120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145632628","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":"Predictors and Incidence of Requiring Subsequent Injection or Surgery in the Same Digit Following Trigger Finger Release.","authors":"Nicholas B Pohl, Evan Derector, James Russo, Evan Johnson, Pedro K Beredjiklian, Daniel J Fletcher","doi":"10.1177/15589447251404976","DOIUrl":"10.1177/15589447251404976","url":null,"abstract":"<p><strong>Background: </strong>Currently, there is limited literature that highlights the rate of reoperation or requiring additional corticosteroid injections following surgical trigger finger release. This study determined the incidence of additional corticosteroid injection or reoperation of the same digit in patients who underwent trigger finger release. Risk factors for requiring subsequent treatment in the same digit following trigger finger release were also identified.</p><p><strong>Methods: </strong>This retrospective cohort study evaluated patients who underwent primary trigger finger release from 2015 to 2017. The incidence of further treatment with either steroid injection or reoperation of the same digit following trigger finger release was determined. Multivariate regression was performed to identify independent risk factors for requiring further treatment with injection or surgery.</p><p><strong>Results: </strong>In total, 2.68% of patients required further treatment with either surgery or injection in the same digit following initial surgical release. Specifically, 0.76% of patients underwent reoperation while 1.92% required an additional injection. Multivariate regression demonstrated that releasing the index, middle, or multiple fingers during the initial trigger finger release was predictive of requiring further treatment.</p><p><strong>Conclusions: </strong>The incidence of reoperation following trigger finger release is less than 1% of patients, which supports previous research. We also established the rate of injection in the same digit following surgery to be 1.92%. This study may provide valuable information for surgeons when communicating with patients about the necessity of additional treatment following trigger finger release. In addition, it can help patients understand the outcomes of surgical management for severe trigger finger symptoms.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1481-1487"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12756057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145862867","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":"Non-tobacco Nicotine Dependence Is Associated With Increased Perioperative Complications After Carpal Tunnel Release.","authors":"William H Rankin, Alejandro M Holle, M Lane Moore, Kevin J Renfree","doi":"10.1177/15589447261487702","DOIUrl":"https://doi.org/10.1177/15589447261487702","url":null,"abstract":"<p><strong>Background: </strong>While tobacco use is a well-known risk factor for adverse outcomes after carpal tunnel release (CTR), the impact of non-tobacco nicotine products remains unclear. This study evaluated complications in CTR patients with non-tobacco nicotine dependence (NTND) compared with tobacco users and controls.</p><p><strong>Methods: </strong>Patients who underwent CTR with ≥2-year follow-up were identified using a large national database. After 1:1 propensity score matching, patients with NTND (n = 6319) were matched to controls, tobacco users (n = 86 430) were matched to controls, and patients with NTND (n = 6325) were matched to tobacco users. Matching was based on age, gender, Charlson comorbidity index, and comorbidities. Outcomes including 90-day medical complications, infection, emergency department (ED) visits, readmissions, and 2-year revision rates were compared using multivariable logistic regression.</p><p><strong>Results: </strong>Compared with controls, patients with NTND demonstrated higher 90-day medical complication rates (2.4% vs 1.7%; odds ratio [OR], 1.35; 95% CI, 1.04-1.77) and ED visits (10.3% vs 8.1%; OR, 1.16; 95% CI, 1.02-1.32). Compared with tobacco users, patients with NTND had decreased ED visits (10.4% vs 14.2%; OR, 0.74; 95% CI, 0.66-0.83) and revision surgery (1.9% vs 2.5%; OR, 0.78; 95% CI, 0.62-0.99), with no significant differences in medical complications, infection, or readmissions.</p><p><strong>Conclusions: </strong>Non-tobacco nicotine dependence was associated with increased medical complications and ED visits compared with controls, but decreased ED visits and revision surgery compared with tobacco users. There were no significant differences in medical complications, infections, or readmissions between tobacco users and patients with NTND. These findings underscore the importance of screening for non-tobacco nicotine use during preoperative evaluations for CTR.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261487702"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108859","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}