HAND最新文献

{"title":"Incidence of Early Postoperative Complications in Upper Extremity Orthopedic Surgery and Reliability of the Modified Clavien-Dindo-Sink Classification: A Real-World Study.","authors":"Surya V Kohan Fortuna Figueira, Fernando Holc, Pilar Saralegui, Pedro Bronenberg Victorica, Iván Huespe, Jorge G Boretto","doi":"10.1177/15589447251352121","DOIUrl":"10.1177/15589447251352121","url":null,"abstract":"<p><strong>Background: </strong>Upper limb orthopedic surgery has no standardized complication classification system. The adaptations in the Clavien-Dindo classification system have only been validated through the creation of scenarios. We hypothesized that the modified Clavien-Dindo-Sink (CDS) classification of hand and upper extremity surgery complications has good intraobserver and interobserver reliability in real-world scenarios. This study assessed the accuracy of the modified CDS classification in real-world scenarios and the absolute incidence of 30-day complications.</p><p><strong>Methods: </strong>The sample size calculation was based on the modified CDS classification. A kappa value of 0.84, accompanied by a 95% confidence interval (CI) of 0.1 and involving 6 observers, indicated the inclusion of 111 events. To achieve the anticipated sample size of 111 complications, 1850 postoperative procedures will be necessary, given the expected 6% incidence of complications. Six evaluators, each with varying levels of expertise in the field, classified the cases according to the modified CDS classification in 2 rounds.</p><p><strong>Results: </strong>The incidence of early complications was 7.05% (95% CI = 6%-8%) in a tertiary care university hospital. Intraobserver agreement was moderate to almost perfect; however, interobserver agreement was moderate. The less experienced surgeons presented a better interobserver correlation than the more experienced ones.</p><p><strong>Conclusions: </strong>In a real-world scenario of early postoperative complications of upper extremity surgery, the modified CDS classification presented a lower interobserver correlation than reported in the literature. The surgeon's experience could influence its applicability.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251352121"},"PeriodicalIF":1.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698413","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":"Effect of Mental Health Disorders on 30-Day Postoperative Outcomes After Surgical Fixation of Distal Radius Fractures.","authors":"Colin Zieminski, Paul Pottanat, Julia DeSalvo, John A Martino, Dane Daley, Charles Daly","doi":"10.1177/15589447251352012","DOIUrl":"10.1177/15589447251352012","url":null,"abstract":"<p><strong>Background: </strong>There is scarce literature describing the effects of mental health disorders (MHDs) on outcomes of distal radius fractures (DRFs). Major depressive disorder (MDD), generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD) are the leading psychiatric ailments in the United States. This study evaluates how mental health affects postoperative outcomes after surgical for DRFs.</p><p><strong>Methods: </strong>The TriNetX research network was queried for DRFs treated operatively. Patients with MDD, GAD, and PTSD were identified and stratified among the cohorts. Data were collected using <i>Current Procedural Terminology</i> and <i>International Classification of Diseases</i> codes. Cohorts were propensity matched to control for demographics and comorbidities. Demographic information was obtained. Outcomes including reoperation, infection, opioid use, and health care utilization were obtained at 30 days. Prevalence, risk ratios, and associated <i>P</i> values were calculated.</p><p><strong>Results: </strong>The MDD, GAD and PTSD cohorts had 4198, 4527, and 1658 patients each, respectively. Mental health disorder cohorts were more likely to use emergency department (ED) services and have readmissions compared with controls (<i>P</i> < .01). The MHD groups were more likely to use occupational therapy (OT) resources and postoperative visits (<i>P</i> < .01). The MDD group was 9% (<i>P</i> < .01) less likely to use opioids, whereas the PTSD group was 15% (<i>P</i> < .01) more likely.</p><p><strong>Conclusion: </strong>Mental health disorders were associated with more postoperative emergency department and inpatient services. Individuals with MHDs were less likely to attend postoperative visits and use occupational therapy resources, which could explain poorer postoperative outcomes reported in other studies. Post-traumatic stress disorder had a higher opioid usage. Mental health disorders have significant impacts on postoperative outcomes for DRF, and practitioners should direct their efforts at these deficiencies in early postoperative care.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251352012"},"PeriodicalIF":1.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12286979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689997","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":"Double Crush Syndrome: A Review of the Literature.","authors":"Miriyam Ghali, Quinn T Ehlen, Eric Kholodovsky, John Cacciatore, James Parrish, Nathaniel Jenkins, Seth D Dodds","doi":"10.1177/15589447251352122","DOIUrl":"10.1177/15589447251352122","url":null,"abstract":"<p><p>Double crush syndrome (DCS) is a condition characterized by multiple compression sites along a single peripheral nerve. The purpose of this review is to provide a focused review of the incidence, the most likely pathology, the best diagnostic tools and parameters, and treatment recommendations for DCS that have evolved in recent years. Currently reported incidence of DCS ranges broadly from 6.7% to 73%, which may be due to lack of established anatomic electrodiagnostic criteria to define DCS. Treatment outcomes were diverse, emphasizing the lack of consensus on optimal management strategies. The review underscores the persistent ambiguity surrounding DCS, with inconclusive evidence on its pathophysiology and diagnostic criteria. This study highlights the need for a multidisciplinary approach, emphasizing thorough diagnostic workup to set properly patient expectations for treatment if DCS is suspected. In addition, conflicting outcomes from treatment modalities highlight the complexity of managing this syndrome. The lack of consensus on various aspects of DCS necessitates further research to guide more effective diagnostic and therapeutic approaches.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251352122"},"PeriodicalIF":1.8,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667566","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":"Is There a Role for Antibiotics in Diabetic Patients Undergoing Carpal Tunnel and Trigger Finger Release? A Retrospective Analysis of 723 Cases.","authors":"Rohan Arora, Armina Azizi, Mitsy Audate, Peter Vonu, Andres Makarem, Robert Matthias, Ellen Satteson","doi":"10.1177/15589447251352004","DOIUrl":"10.1177/15589447251352004","url":null,"abstract":"<p><strong>Background: </strong>This study aims to assess the role of perioperative antibiotic prophylaxis in surgical site infection (SSI) rates and other associated postoperative complications among diabetic patients undergoing carpal tunnel release (CTR) and trigger finger release (TFR) surgeries to address the gap in literature regarding the effectiveness of prophylactic antibiotics specifically in the diabetic population undergoing hand surgery.</p><p><strong>Methods: </strong>An institutional review board-approved retrospective review was performed to evaluate CTR or TFR performed in patients with diabetes between June 1, 2011, and June 1, 2021. Patients were identified using International Classification of Diseases, Tenth Revision codes for diabetes and Current Procedural Terminology codes for the surgeries of interest, with exclusions applied for certain prior conditions. The study focused on postoperative complications, particularly wound healing, examining variables such as demographics, outcomes, and perioperative antibiotic use.</p><p><strong>Results: </strong>The study found an overall postoperative complication rate of 13.9%, with SSIs being the most common. Despite the high prevalence of antibiotic prophylaxis use (82.1%), no significant reduction in postoperative complications or SSIs was observed. The study also examined the impact of glycemic control, body mass index (BMI), and comorbidities on surgical outcomes and found no linear association. However, diabetic patients with a BMI > 29 may have higher complication rates than those with a BMI ≤ 29.</p><p><strong>Conclusions: </strong>The routine use of perioperative antibiotic prophylaxis does not significantly influence the rate of SSIs and associated postoperative complications in diabetic patients undergoing CTR and TFR. A more tailored approach to antibiotic use, considering individual patient factors beyond glycemic control, may be more appropriate in diabetic patients.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251352004"},"PeriodicalIF":1.8,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667567","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":"Safety and Cost-Effectiveness of In-Office Digital Mucous Cyst Excisions.","authors":"Philip Femano, Skyler King, Adam Hoffman, Michael R McDermott, H Brent Bamberger","doi":"10.1177/15589447251350168","DOIUrl":"10.1177/15589447251350168","url":null,"abstract":"<p><strong>Background: </strong>Digital mucous cysts are a common lesion of the distal interphalangeal joint that can be treated nonoperatively with steroid injections and aspirations. Those who fail conservative treatment may undergo surgical removal of the cyst in the operating room; however, with rising health care costs, there has been a trend toward in-office-based hand surgery. This study examines the effectiveness, safety, and cost-effectiveness of performing this excision in the office.</p><p><strong>Methods: </strong>A retrospective cohort of consecutive patients who underwent in-office digital mucous cyst excision was established. Patient demographics, perioperative symptoms, and outcomes were recorded to examine the success rate of office-based cyst removal and characterize the postoperative infection/complication rate.</p><p><strong>Results: </strong>Sixty-seven patients underwent in-office cyst removal with a 95.5% success rate, with 3 patients having cyst recurrence. Full resolution of symptoms was seen in 89.4% of patients by 2 weeks and 100% by 12 weeks postoperation. There were 7 postoperative infections (10.4%), 6 of which were superficial and resolved with oral antibiotics. There was one deep infection that resolved following operative irrigation and debridement. There was no significant relationship between the use of perioperative antibiotics and postoperative infection. There was a significant relationship between the presence of medical comorbidities and the development of postoperative infection (<i>P</i> = .027). The cost of a digital mucous cyst excision in the hospital was found to be an 8.5-fold increase compared with the in-office excision.</p><p><strong>Conclusions: </strong>In-office excision is a cost-effective, safe, and successful option for treating digital mucous cysts, demonstrating a low rate of recurrence, infection, and persistent symptoms.Type of Study/Study level: Retrospective Cohort, Level III evidence.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251350168"},"PeriodicalIF":1.8,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667568","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":"Management of Non-thumb Volar Metacarpophalangeal Joint Dislocations: Case Series and Review of Literature.","authors":"Kiera Vrindten, Connor J O'Leary, Hannah Lee, Nishita Amancharla, David Kirschenbaum, Brian M Katt","doi":"10.1177/15589447251339499","DOIUrl":"10.1177/15589447251339499","url":null,"abstract":"<p><p>Volar metacarpophalangeal (MCP) joint dislocations are uncommon yet clinically significant injuries that pose diagnostic and therapeutic challenges. This review synthesizes current knowledge regarding the mechanisms of injury, classification, treatment modalities, outcomes, and complications associated with volar MCP joint dislocations. Insights from 2 case studies, along with previously published case reports, literature reviews, and clinical experiences, are incorporated to provide a holistic understanding of these complex injuries. The review also highlights areas for future research to enhance clinical outcomes and optimize patient care.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251339499"},"PeriodicalIF":1.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659101","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 Is Associated With Fewer Medical Complications After Carpal Tunnel Release in Diabetic Patients.","authors":"Annika N Hiredesai, Carina P Howlett, Sara Kisiel, Krishna Unadkat, Jens T Verhey, Kevin J Renfree, Shelley S Noland","doi":"10.1177/15589447251350181","DOIUrl":"10.1177/15589447251350181","url":null,"abstract":"<p><strong>Background: </strong>Diabetic patients experience carpal tunnel syndrome (CTS) at high rates, have increased symptom severity, and experience prolonged recovery after carpal tunnel release (CTR). This study assessed the association of glucagon-like peptide-1 receptor agonist (GLP-1) therapy with postoperative outcomes after CTR in type II diabetic patients with CTS.</p><p><strong>Methods: </strong>Using the PearlDiver database, 25 229 diabetic patients with CTS who underwent CTR and were prescribed GLP-1 therapy were identified and exact matched to 25 229 controls based on age, sex, Elixhauser comorbidity index, tobacco use, obesity, hypothyroidism, and body mass index where available. Demographic variables and comorbidities were compared between groups using Kruskal-Wallis analyses for continuous variables and chi-square tests for categorical variables. Bivariate logistic regression analysis was conducted for 90-day outcomes and 2-year CTR revision.</p><p><strong>Results: </strong>Patients on GLP-1 therapy had decreased risk of 90-day medical complications (odds ratio [OR] = 0.90; 95% confidence interval [CI], 0.84-0.96) and hospital readmission (OR = 0.85; 95% CI, 0.77-0.94) of 0.5% and 0.4%, respectively, compared with controls. No significant differences were found in 90-day surgical complications or 2-year revision rates between cohorts. There were no cases of aspiration pneumonia. The GLP-1 cohort had increased odds of higher 90-day total costs of care (OR = 2.42; 95% CI, 1.88-3.15).</p><p><strong>Conclusions: </strong>GLP-1 therapy is associated with reduced risk of 90-day medical complications and hospital readmission following CTR in diabetic patients, suggesting these medications may optimize comorbidity profiles via glucose control preoperatively. Future studies may examine whether GLP-1 therapy is associated with minimum clinically important difference in patient-reported outcome measures for CTS in diabetic patients.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251350181"},"PeriodicalIF":1.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642402","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":"Long Thoracic Nerve Decompression and Transfer: Single-Center Case Series of Clinical and Electromyographic Outcomes.","authors":"Martin Li, Jvalant N Parekh, Devanshi Jimulia, Liron S Duraku, Tahseen Chaudhry, Dominic M Power","doi":"10.1177/15589447251343240","DOIUrl":"10.1177/15589447251343240","url":null,"abstract":"<p><strong>Background: </strong>Long thoracic nerve (LTN) decompression is considered in recalcitrant scapular winging secondary to chronic LTN palsy. Nerve transfer, typically from the thoracodorsal nerve (TDN), is suggested if, despite adequate decompression, intraoperative nerve stimulation demonstrates no improvement. Literature concerning transfer is scarce. To evaluate and compare these 2 procedures' clinical and electrical outcomes, we performed a single-center, retrospective case series of all LTN decompression patients with or without transfer for chronic LTN palsy, examining postoperative adapted Medical Research Council (MRC) grades as a primary and electromyography (EMG) stimulation thresholds as a secondary outcome.</p><p><strong>Methods: </strong>We identified 11 decompression-only and 6 patients undergoing additional transfer over an 8-year period, confirmed with preoperative serratus anterior EMG. Decompression involved proximal and distal neurolysis, with transfer, typically the lateral branch of TDN, reserved for irresponsiveness to intraoperative stimulation following decompression. Adapted pre- and postoperative serratus anterior MRC values were evaluated using a 2-tailed Student <i>t</i> test.</p><p><strong>Results: </strong>Preoperative adapted MRC grades for all 17 patients was 0; at median 12-month follow-up, this reached 3. The decompression-only preoperative median was 0 and final grade 3; for the transfers, these were 0 and 3.5 respectively, which were insignificantly different. However, time to first recovery, the first clinical evidence of serratus anterior contraction, was significantly different between the decompression-only cohort, at 3 weeks, and transfer, 7 months. Preoperative EMG thresholds were 1.0 mA pre- and 0.1 mA postoperatively; they did not impact final adapted MRC grades.</p><p><strong>Conclusions: </strong>We conclude nerve transfers achieve comparable long-term outcomes where decompression alone did not improve intraoperative nerve stimulation.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251343240"},"PeriodicalIF":1.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642421","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 Ability of Hand Surgeons to Reliably Classify the Percentage of Tearing Based on MRI for Patients With a Partial Distal Biceps Tendon Tear.","authors":"Kyle Plusch, Gabriel I Onor, Jack Abboudi, Daren Aita, Moody Kwok, Frederic Liss, Pedro K Beredjiklian","doi":"10.1177/15589447251352005","DOIUrl":"10.1177/15589447251352005","url":null,"abstract":"<p><p><b>Background:</b> Patients with partial distal biceps tendon tears (PDBT) have both surgical and nonsurgical treatment options. The percentage of the tendon that has torn plays an important role in decision making, although this can be difficult to reliably measure, even with advanced imaging. The purpose of this study was to assess the reliability of hand surgeons within our practice in determining the percentage of the distal biceps tendon that has torn based on magnetic resonance imaging (MRI) in patients with PDBT. <b>Methods:</b> We retrospectively identified 50 patients at our institution who received an MRI for a distal biceps injury and received a diagnosis of PDBT. All of these 50 patients' initial elbow MRI images were reviewed by 4 fellowship-trained hand and upper extremity surgeons within our practice. Each reviewer classified the partial tear into 1 of 3 categories: less than 1/3 torn, between 1/3 and 2/3 torn, and greater than 2/3 torn. In addition, the presence or absence of an FABS view (elbow flexed, shoulder abducted, forearm supinated) was identified. Interobserver agreement and reliability were calculated with Cohen's kappa test. <b>Results:</b> One patient's images were not available in our electronic medical record, resulting in 49 elbow MRIs for PDBT reviewed by 4 reviewers. The flexion, abduction, supination view was available for 11 patients. The 4 reviewers had an overall agreement of 51.4%, with a kappa statistic of 0.27, indicating \"fair\" agreement. Notably, the reviewers only fully agreed on their PDBT grading for 12 patients (24%), and 10 patients received scores across all 3 categories. Among patients with FABS view available, interobserver agreement increased to 62.1%, with a kappa statistic of 0.43, indicating \"moderate agreement.\" <b>Conclusions:</b> Reliable identification of the degree of tearing in partial distal biceps injuries is difficult based on MRI alone. The presence of an FABS view increased both agreement and reliability between the reviewing surgeons.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251352005"},"PeriodicalIF":1.8,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626065","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 Comparison of 1- and 2-Tunnel Suture Suspensionplasty Constructs for Basilar Thumb Arthritis.","authors":"Daniel J Lorenzana, Bijan Abar, Eliseo V DiPrinzio, Elijah Vail, Jessica M Welch, Christopher S Klifto, David S Ruch, Marc J Richard, Ken Gall, Tyler S Pidgeon","doi":"10.1177/15589447251350175","DOIUrl":"10.1177/15589447251350175","url":null,"abstract":"<p><strong>Background: </strong>Trapeziectomy with suture button suspensionplasty (SBS) is a common treatment for thumb carpometacarpal (CMC) osteoarthritis. This study aimed to evaluate the effect of bone tunnel configuration and suture count on the construct stability.</p><p><strong>Methods: </strong>Twelve matched specimens underwent trapeziectomy and randomization to either a 2-strand 1-tunnel (single SBS) or divergent 4-strand 2-tunnel suture button (crossed dual SBS) construct. Mechanical stiffness was measured using material testing machine with a semiconstrained axial load over 5-mm displacement. Trapezial space was measured under no load and in a light and heavy physiologic pinch grip models. Subsequently, specimens were randomized to undergo single SBS or divergent 2-strand 2-tunnel suture (crossed suture) constructs, and loaded pinch testing was performed. Primary outcomes were analyzed using matched-pair <i>t</i>-tests.</p><p><strong>Results: </strong>The crossed dual SBS construct showed significantly higher stiffness compared to the single SBS construct in elastic deformation (19.9 vs 15.5 N/mm, <i>P</i> = .010) and maintained trapezial height better in both light (82% vs 71%, <i>P</i> = .021) and heavy (73% vs 46%, p = .004) pinch grips. The crossed suture technique also preserved trapezial height better than the single SBS construct in light (79% vs 64%, <i>P</i> = 0.021) and heavy (60% vs 44%, <i>P</i> = 0.039) pinch grips.</p><p><strong>Conclusions: </strong>In the immediate postoperative period, a crossed dual SBS construct was stiffer to axial load and more stable in pinch grip compared to a single SBS construct. The novel crossed suture construct better preserved trapezial height then the singe SBS, suggesting that the crossed configuration may be more relevant than suture count in postoperative stability.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251350175"},"PeriodicalIF":1.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608232","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}