HAND最新文献

{"title":"Outcomes and Complications of Intramedullary Metacarpal Fixation.","authors":"Victoria S Hoelscher, Madison Milhoan, Mark Quiring, Kassidy Fix, Stewart Dalton, William F Pientka","doi":"10.1177/15589447231222518","DOIUrl":"10.1177/15589447231222518","url":null,"abstract":"<p><strong>Background: </strong>Metacarpal fractures are common orthopedic injuries with potentially debilitating outcomes. Ideal surgical treatment remains a topic of debate, with intramedullary fixation becoming popular as a technique to allow for earlier mobilization with few reported complications. The aim of this study was to report observed outcomes and complications of intramedullary metacarpal fixation using the ExsoMed INnate metacarpal nail.</p><p><strong>Methods: </strong>A retrospective chart review of 37 patients with 44 metacarpals treated with the ExsoMed INnate between July 2020 and December 2021 by a single fellowship-trained hand surgeon at a single level 1 trauma center was performed. Variables recorded included both patient and injury demographics, surgical complications, and postoperative outcomes. We also measured metacarpal isthmus diameter of the second to fifth metacarpals on all patients to determine the intramedullary canal diameter to assist in implant size selection.</p><p><strong>Results: </strong>Average follow-up was 5.84 weeks with average time to radiographic healing of 5.5 weeks, and time to full activity 6.32 weeks. The mean postsurgical active total arc of motion was 250°, while passive total arc of motion was 259.74°. A total of 10 complications (22%) were identified, including 4 bent screws which occurred as a result of a punching event postoperatively.</p><p><strong>Conclusions: </strong>Intramedullary fixation of metacarpal fractures using the ExsoMed INnate metacarpal nail has shown to preserve range of motion and quick return to full activity, with a low rate of major complications. Our study highlights the potential major complication of the bent intramedullary screw and its association with an initial punching mechanism.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"428-431"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139097738","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":"Proximal Row Carpectomy With Soft Tissue Interposition: A Systematic Review of Clinical Outcomes.","authors":"Neveadan Aravinthan, Salwa Siddiqui, Moin Khan, Jaydeep Moro, Paula A Pino, Carlos Prada","doi":"10.1177/15589447231221245","DOIUrl":"10.1177/15589447231221245","url":null,"abstract":"<p><p>Proximal row carpectomy (PRC) with soft tissue interposition arthroplasty (STIA) presents an alternative approach to addressing wrist arthritis patterns involving the capitate and/or lunate fossa, in lieu of wrist arthrodesis. This systematic review aimed to evaluate clinical outcomes and techniques associated with PRC-STIA in patients with advanced wrist arthritis. We conducted a systematic review using databases including PubMed, Embase, MEDLINE, and the Cochrane Central Register of Controlled Trials. Inclusion criteria involved articles reporting outcomes of patients who underwent PRC-STIA with at least 1 relevant outcome. The analysis encompassed 8 studies involving 106 patients (108 wrists) meeting the inclusion criteria. A majority of patients were men (69%, n = 88), with a mean age of 54.4 ± 12.7 years and an average follow-up of 4.8 ± 6.3 years. Dorsal capsule was the most commonly interposed tissue (63%, 5 out of 8 studies). Patients receiving STIA achieved comparable patient-reported outcome measures scores to those undergoing PRC alone. Postoperative pain, measured by the Visual Analog Scale, averaged 3.7 ± 0.6. The Disabilities of the Arm, Shoulder, and Hand score averaged 27.8 ± 8, while the Patient-Rated Wrist Evaluation score averaged 41.5 ± 25.9. Five complications were reported in three studies. The addition of STIA into PRC for patients with capitate and/or lunate fossa cartilage degeneration yielded outcomes akin to traditional PRC, improving wrist function, pain, and grip strength in a safe and straightforward manner. Future research should prioritize high-quality comparative studies, extended follow-up periods, and standardized core outcome measures for a more comprehensive understanding of its role in wrist arthritis treatment.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"352-359"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139575321","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-term Efficacy of Corticosteroid Injection for Carpal Tunnel Syndrome: A Systematic Review.","authors":"Peter Y W Chan, Adrian Santana, Todd Alter, Matthew Shiffer, Srikaran Kalahasti, Brian M Katt","doi":"10.1177/15589447231222320","DOIUrl":"10.1177/15589447231222320","url":null,"abstract":"<p><p>Carpal tunnel syndrome (CTS) is a debilitating condition that can cause significant morbidity. Corticosteroid injection (CI) is a popular treatment for CTS. Short-term benefits of CI for CTS have been reported, but there is little evidence on long-term outcomes. We performed a systematic review in the PubMed/MEDLINE and Cochrane Library databases to identify studies which reported outcomes of CI for CTS with at least 1-year follow-up. We identified 20 total studies and extracted data on outcomes such as number of patients needing eventual surgery or reinjection, complications, and functional scores. In included studies, 41.6% of patients underwent eventual carpal tunnel release surgery (CTRS), 29% underwent reinjection, there were no major and approximately 34/1133 (3.0%) minor complications, and median/mean time from CI to eventual CTRS ranged from 128 to 446 days. There was disparity on the long-term efficacy of CI for functional outcomes. The evidence indicates that CI is a very low risk procedure that has potential to improve symptoms enough to either prevent or, in most cases, delay the need for further reintervention. However, our conclusions are limited by the heterogeneity of available studies. There is a need for further, high-quality research on this topic.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"463-473"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139491408","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":"PROMIS Global Physical Health Subscale Strongly Correlates and Performs Similarly to the QuickDASH in Hand and Upper Extremity Patients.","authors":"David N Bernstein, Chinmay V Bakshi, Jonathan Lans, Rohit Garg, Abhiram R Bhashyam, Daniel G Tobert","doi":"10.1177/15589447231211603","DOIUrl":"10.1177/15589447231211603","url":null,"abstract":"<p><strong>Background: </strong>The Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) is a validated, static hand and upper extremity patient-reported outcome measure (PROM) commonly used. However, with the growth of PROM implementation across orthopedic and plastic surgery clinics, it is beneficial to determine whether a more general PROM can be used to capture the same insights. This would ease implementation broadly. There is a paucity of literature assessing whether the QuickDASH and Patient-Reported Outcomes Measurement Information System (PROMIS) Global-10 are correlated and perform similarly.</p><p><strong>Methods: </strong>Between June 2016 and December 2020, hand and upper extremity patients seeking care at clinics associated with a single quaternary academic medical center were identified. Those who completed the PROMIS Global-10 and QuickDASH as part of routine care were identified. The PROMIS Global-10 is divided into the PROMIS Global Physical Health and PROMIS Global Mental Health subscores. Spearman rho (ρ) correlations were calculated across PROMs, and ceiling and floor effects were determined.</p><p><strong>Results: </strong>Across the 18 744 included patients, there was a strong correlation and strong-moderate correlation found between the QuickDASH and PROMIS Global Physical Health (ρ = 0.70, <i>P</i> < .001) and PROMIS Global Mental Health (ρ = 0.69, <i>P</i> < .001), respectively. Although small, QuickDASH demonstrates the worst floor effect (2.6%, [n = 478]), whereas PROMIS Global Mental Health demonstrated a much more notable ceiling effect (11%, [n = 2034]).</p><p><strong>Conclusions: </strong>The PROMIS Global-10 can be used to assess the functional status of patients presenting for hand and upper extremity concerns, while also capturing aspects of mental health. The PROMIS Global-10 may ease PROM implementation broadly.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"487-491"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92153584","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 Safety of the Volar Intraarticular Extended Window (VIEW) Approach for Intra-articular Distal Radius Fractures.","authors":"Robin N Kamal, Giselle I Gomez, Emily A Schultz, Lauren M Shapiro","doi":"10.1177/15589447231210926","DOIUrl":"10.1177/15589447231210926","url":null,"abstract":"<p><strong>Background: </strong>A novel volar approach to intra-articular distal radius fractures has been introduced for treatment of intra-articular distal radius fractures, in which volar extrinsic ligaments are released to create a volar window into the radiocarpal joint (Volar Intraarticular Extended Window [VIEW] approach). Our purpose was to evaluate the safety of VIEW approach for treatment of intra-articular distal radius fractures.</p><p><strong>Methods: </strong>A retrospective chart review was performed for 13 patients with intra-articular distal radius fractures treated operatively with the VIEW surgical technique using an intra-articular window in the volar capsule to aid in reduction and fixation. Postoperative radiographs were reviewed to assess for ulnocarpal translocation by assessing lunate uncovering and radial-carpal distance.</p><p><strong>Results: </strong>Thirteen patients were treated with the VIEW approach with mean follow-up of 28 weeks (range, 7-67 weeks; SD, 18 weeks). The mean postoperative lunate uncovering was 34.6% (SD, 7.7%) and mean radial-carpal distance was 4.6 mm (SD, 1.5 mm). Postoperatively, mean intra-articular step-off was 0.9 mm (SD, 1.2 mm) and mean intra-articular gap was 1.2 mm (SD, 1.0 mm). No patients reported clinical symptoms of wrist instability.</p><p><strong>Conclusions: </strong>Using the VIEW approach during a volar approach to intra-articular distal radius fractures is safe and does not lead to carpal instability. Surgeons can consider using the approach when direct visualization of the articular surface may be beneficial for reduction or fixation.</p><p><strong>Level of evidence: </strong>Therapeutic IV.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"394-401"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138433706","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":"National Agenda for Disparities Research in Hand Surgery: Validation of Social Determinant of Health Domains and Measurement Constructs.","authors":"Chiamaka Obilo, Robin N Kamal, Lauren M Shapiro","doi":"10.1177/15589447251336401","DOIUrl":"https://doi.org/10.1177/15589447251336401","url":null,"abstract":"<p><strong>Background: </strong>Social determinants of health (SDOH) encompass various factors of one's environment and have been shown to strongly influence patient health. The effect of SDOH has been evaluated in various medical specialties; however, a paucity of literature exists investigating the effects of SDOH on outcomes in hand surgery. As such, we completed a RAND/University of California Los Angeles (UCLA) Delphi Appropriateness process for the purpose of guiding the inclusion of SDOH domains and measurement constructs in hand surgery clinical research.</p><p><strong>Methods: </strong>A consortium of 9 academic upper-limb surgeons completed a RAND/UCLA Delphi Appropriateness process to evaluate the importance, feasibility, usability, and scientific acceptability of collecting SDOH domains and measurement constructs in hand surgery clinical research. The domains and measurement constructs were collated from frameworks and tools from the U.S. Department of Health and Human Services, the Centers for Medicare and Medicaid Services, and Cochrane. Panelists rated each domain/measurement construct on an ordinal scale between 1 (definitely not important/feasible/usable/supported) and 9 (definitely important/feasible/usable/supported) in 2 rounds with an intervening face-to-face discussion. Agreement and validity were determined according to previously validated and pre-defined criteria.</p><p><strong>Results: </strong>The consortium achieved agreement on the inclusion of 5 SDOH domains (Education Access and Quality, Health care Access and Quality, Neighborhood and Built Environment, Social and Community Context, and Economic Stability) and 21 measurement constructs.</p><p><strong>Conclusions: </strong>As there is growing evidence that SDOH can differentially impact patient health, these validated domains and constructs can help prioritize and guide hand surgery research to evaluate and better inform interventions related to SDOH and outcomes.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251336401"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984056","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":"Buddy Taping as a Treatment Option for Salter-Harris II and Juxta-Physeal Fractures of the Proximal and Middle Phalanx: A Systematic Review.","authors":"Sivim Sohail, Jaskarn Khangura, Nigèle Langlois, Sandy Tse, Kevin Cheung","doi":"10.1177/15589447251329576","DOIUrl":"https://doi.org/10.1177/15589447251329576","url":null,"abstract":"<p><p>Salter-Harris II (SH2) proximal/middle phalanx fractures are common injuries in children and heal well with immobilization. We conducted a systematic review of nonsurgical treatments for SH2 proximal/middle phalanx fractures. The constructed search strategy used descriptors that included synonyms for \"phalanx fracture,\" \"proximal/middle phalanx,\" and \"fracture treatment.\" All steps of the process were performed by 2 independent reviewers. Articles of any study design that included children treated for SH2 proximal/middle phalanx fractures were included. Results were analyzed for summary statistics and interobserver agreement. Findings were reported in keeping with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The initial search yielded 3511 studies. Five studies met the final criteria: 1 randomized controlled trial (RCT), 3 prospective studies, and 1 retrospective study. Three studies employed a combination of taping and splinting strategies. All fractures healed with no reported complications. At the final follow-up, all studies reported full or nearly full range of motion and high rates of patient comfort and satisfaction. The RCT found lower rates of secondary displacement in the taping (6%) versus splinting (23%) group. Due to small sample sizes and heterogeneous study designs, conclusive recommendations cannot be drawn. More research is needed to determine the feasibility, compliance, safety, and effectiveness of taping these injuries.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251329576"},"PeriodicalIF":1.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994587","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":"Structural and Distribution Analysis of Mechanoreceptors and Free Nerve Endings in the Annular Pulleys of the Flexor Tendons of the Hand.","authors":"Sângelo André Ribeiro Abreu, João Pedro Barreto Rocha, João Antônio Soares de Sousa, Lana Lacerda de Lima, Maria Luzete Costa Cavalcante, Diego Ariel de Lima","doi":"10.1177/15589447251334670","DOIUrl":"https://doi.org/10.1177/15589447251334670","url":null,"abstract":"<p><strong>Background: </strong>The hand is essential in enabling physical interaction with the environment, with the annular pulleys playing a key role in its functionality. These fibrocartilaginous structures, located along the flexor tendons, are vascularized and may contain nerve endings and mechanoreceptors, aligning tendons with the bones to optimize finger flexion. However, their innervation remains poorly understood, limiting therapeutic advancements for flexor tendon conditions, such as stenosing tenosynovitis (trigger finger). This study aims to analyze the presence and distribution of mechanoreceptors and free nerve endings in the A1 annular pulley to provide insights for improved surgical and therapeutic approaches.</p><p><strong>Methods: </strong>Twenty A1 pulleys from the ring fingers were obtained from fresh-frozen cadavers. The pulleys were submitted to cryostat sectioning. The sections were subjected to immunofluorescence with the PGP 9.5 (protein gene product 9.5) and confocal microscopy analysis.</p><p><strong>Results: </strong>The analysis revealed the presence of type I mechanoreceptors (Ruffini corpuscles) in a subset of samples, while type IV free nerve endings were consistently found in all specimens. Both types of neural structures were primarily located at the medial and lateral fibrocartilaginous insertions of the A1 pulley, highlighting specific areas of sensory innervation within the structure.</p><p><strong>Conclusion: </strong>This study contributes to the anatomical characterization of the A1 pulley, highlighting the presence and distribution of mechanoreceptors and free nerve endings. While the clinical implications of these findings remain uncertain, they may serve as a basis for future research on proprioception, sensory feedback, and potential surgical considerations.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251334670"},"PeriodicalIF":1.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008077","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":"Bent Intramedullary Metacarpal Implants.","authors":"Arin A Drtil, Whitaker C Reid, William F Pientka","doi":"10.1177/15589447251333818","DOIUrl":"https://doi.org/10.1177/15589447251333818","url":null,"abstract":"<p><strong>Background: </strong>Metacarpal fractures are common injuries that can lead to debilitating outcomes if not treated appropriately. Intramedullary fixation has gained popularity as a treatment option, allowing for earlier mobilization with few reported complications.</p><p><strong>Methods: </strong>A retrospective chart review of all patients treated with intramedullary implants for a metacarpal fracture between August 2018 and February 2024 at a single center was performed. Medical records and radiographs were reviewed to identify instances of hardware failure/bent implant. In patients with bent implants, the mechanism of re-injury was recorded.</p><p><strong>Results: </strong>648 total metacarpal fractures were surgically treated during the study period, with 90 patients receiving intramedullary fixation (56 ExsoMed INnate, 31 Acumed acutrak, 3 Arthrex headless compression screw). Five patients (7 screws) experienced postoperative hardware failure/bending of the implant, all resulting from a punching mechanism. Furthermore, all patients with postoperative hardware failure sustained their initial metacarpal fracture as a result of a punching mechanism. Additionally, 1 patient initially treated at an outside hospital presented with a bent implant following a punching-related reinjury. All affected patients were male, and the time from initial surgery to implant failure ranged from 4 weeks to 7 months.</p><p><strong>Conclusion: </strong>This series highlights a notable complication (bent implant) associated with intramedullary fixation of metacarpal fractures and includes our strategy for implant removal. Furthermore, we now consider patients with a history of closed-fist striking as a mechanism of injury as a contraindication to intramedullary metacarpal fixation due to this complication.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251333818"},"PeriodicalIF":1.8,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017105","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":"Proximal Olecranon Free Flap for Cystic Scaphoid Nonunion: An Anatomical Feasibility Study.","authors":"Laura C Burlage, Liron Duraku, Tim Wang, Brahman Shankar Sivakumar","doi":"10.1177/15589447251329569","DOIUrl":"https://doi.org/10.1177/15589447251329569","url":null,"abstract":"<p><strong>Background: </strong>The treatment of scaphoid nonunion is challenging, with one approach aiming to provide vascularized bone to encourage union. While the iliac crest and medial femoral condyle are well-described donor sites for osseous flaps, they require violation of a separate limb and confer particular donor site morbidities. We investigate the viability of using a proximal olecranon osseous free flap in the setting of scaphoid nonunion.</p><p><strong>Methods: </strong>Ten proximal olecranon free flaps were harvested in cadaveric specimens, and the length of the pedicle, diameter of the pedicle, number of perforators and quality of bone graft harvested were recorded. Furthermore, a volar approach to the scaphoid was performed, and the shortest distance from the scaphoid to the radial artery noted, to determine whether utilization of the olecranon free flap was possible without grafting.</p><p><strong>Results: </strong>The posterior ulnar recurrent artery [PURA] was present in all specimens. The median pedicle length from take-off of the PURA to the olecranon flap was 65 (62.2-71.0) mm. The number of visible periosteal perforators varied between 1 and 2 per specimen. The median diameter of the main perforator before dividing into subperiosteal branches was 2 (2.1-2.5) mm. The quality of the bone graft harvested was mainly assessed as good (n = 5) or moderate (n = 4). The mean shortest distance from scaphoid to radial artery was 10 mm.</p><p><strong>Conclusions: </strong>The olecranon free flap is a suitable alternative source of vascularized bone for scaphoid nonunion.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251329569"},"PeriodicalIF":1.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963123","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}