Journal of Hand Surgery Global Online最新文献

{"title":"Clinical and Radiographic Outcomes of Gap Osteotomy Versus Dorsal Opening Wedge Osteotomy for Extra-Articular Distal Radius Malunion and Internal Fixation Using a Volar Locking Plate Without Bone Graft","authors":"Suhas Sondur MS (Ortho) ,&nbsp;Anil K. Bhat MS (Ortho), DNB (Ortho) ,&nbsp;Shyamasunder Bhat N MS (Ortho), DNB (Ortho)","doi":"10.1016/j.jhsg.2024.09.001","DOIUrl":"10.1016/j.jhsg.2024.09.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Metaphyseal corrective osteotomy and fixed-angle volar locking plate fixation have reduced the need for additional bone grafting in symptomatic distal radius malunions. This study evaluated the outcomes of gap versus dorsal opening wedge and locking plate fixation without bone grafts for distal radius malunions and the correlation between the osteotomy defect and the osteotomy’s distance from the articular surface with the union time.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 62 patients who underwent corrective osteotomy between 2010 and 2021. Gap osteotomy (n = 44) was performed to correct the coronal deformity predominantly, whereas an opening wedge osteotomy (n = 18) was performed to correct the sagittal deformity. No bone graft was used in any patient. Radiological outcomes comprised of correction of radial height, inclination, ulnar variance, volar tilt and the correlation between the osteotomy defect and the distance from the distal radial articular surface with the union time. The functional assessment comprised the disabilities of arm, shoulder, and hand questionnaire and the patient-rated wrist evaluation scores.</div></div><div><h3>Results</h3><div>All patients had a union of the osteotomy and statistically significant improvement in the radial height, inclination, ulnar variance, and tilt, irrespective of the osteotomy technique (<em>P</em> &lt; .05). The mean defect length of the osteotomy, the time to the union, and the distance of the osteotomy were 4.7 mm (1–8.3 mm), 11.7 weeks (5–24 weeks), and 13.9 mm (1.6–35.8 mm), respectively. Time taken for union showed a weak positive correlation with the defect length of the osteotomy and no correlation with the distance of the distal osteotomy site from the articular surface. Opening wedge osteotomies took less time than the gap osteotomies. The mean postoperative disabilities of arm, shoulder, and hand questionnaire and the patient-rated wrist evaluation scores were 6.89 and 12.18, respectively.</div></div><div><h3>Conclusions</h3><div>Corrective osteotomy and fixed-angle volar plate fixation for distal radius malunion provide satisfactory union rates and clinical and radiological outcomes even without bone graft, irrespective of the osteotomy type, size, or location. However, length of the osteotomy defect influenced the union time.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic IV.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 1","pages":"Pages 14-22"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143172999","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":"Parallel Hatching: A New Method of Hand Deformity Surgery in Epidermolysis Bullosa","authors":"Siamak Farokh Forghani MD ,&nbsp;Rana Irilouzadian MD ,&nbsp;Ali Shabbak MD ,&nbsp;Amir Saraee MD","doi":"10.1016/j.jhsg.2024.10.012","DOIUrl":"10.1016/j.jhsg.2024.10.012","url":null,"abstract":"<div><h3>Purpose</h3><div>In dystrophic epidermolysis bullosa (EB), progressive blistering, scarring, and fusing of digits lead to mitten-hand and pseudosyndactyly in early childhood, inflicting psychosocial stress and low self-esteem in EB patients. Treatment is a challenge in the hand surgery field because of the recurring nature of this inherited disease. We aim to evaluate the results of our surgery method for the hand deformities in EB patients.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed the chart of the EB patients from 2013 to 2023 and included the patients that had the surgery by the same surgeon with the technique of parallel transverse hatching incisions in their hands with using amnion as a dressing and no grafts. The results of the surgery were assessed by using the pseudosyndactyly grading. To compare the data, t test and χ² test were used for variables as appropriate.</div></div><div><h3>Results</h3><div>We presented the results of our surgery method for hand deformities in EB patients. Twenty hands (11 right and 9 left hands) from 11 patients were included. The mean ± SD of grades before and after surgery in all of the patients were 2.2 ± 0.9 and 1.2 ± 1.2, respectively. The differences in grades from baseline in both left and right hands were significant (<em>P</em>-values of .009 and .001, respectively).</div></div><div><h3>Conclusions</h3><div>In this method, we use parallel transverse incisions in epidermis and dermis of the palmar interphalanges without grafting. This will limit the trauma imposed on EB patients who are susceptible to reblistering and poor wound healing. Our patients demonstrated improvement in the function and appearance of their hands with up to 3 years of follow-up.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic, III.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 1","pages":"Pages 79-83"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173055","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 Social Media for Hand Surgeons: A Prevalence and Correlation Study With Online and Academic Reputations","authors":"Sameer R. Khawaja BS ,&nbsp;Krishna N. Chopra MA ,&nbsp;Musab Gulzar BS ,&nbsp;Ozair R. Khawaja HS ,&nbsp;Shammah E. Udoudo BS ,&nbsp;Joseph G. Monir MD ,&nbsp;Michael B. Gottschalk MD ,&nbsp;Adrian L. Huang MD ,&nbsp;Nina Suh MD ,&nbsp;Eric R. Wagner MD, MS","doi":"10.1016/j.jhsg.2024.11.001","DOIUrl":"10.1016/j.jhsg.2024.11.001","url":null,"abstract":"<div><h3>Purpose</h3><div>This study examines the influence of social media use among orthopedic and plastic-trained hand surgeons on patient-reported ratings online and academic productivity.</div></div><div><h3>Methods</h3><div>The American Society of Surgery of the Hand directory was queried for actively practicing orthopedic and plastic surgeons with a hand surgery fellowship. Each name was searched on various social media platforms. Average ratings, number of reviews, and number of comments were collected from Healthgrades, Google reviews, and Vitals. H-index was searched on Scopus. A summated social media presence score was calculated to identify the top 20% of social media users in each cohort.</div></div><div><h3>Results</h3><div>A total of 97 orthopedic and 102 plastic surgeons were included. Overall, plastic surgeons were more active on social media compared to orthopedic surgeons. There was a positive association between having active profiles and Healthgrades ratings. When looking within the subgroups, the top 20% of social media orthopedic users were found to have a significantly higher mean Healthgrades rating and a mean number of comments than the rest of the cohort. On Vitals, the top 20% of social media users had higher mean ratings compared to the remaining 80%. The top 20% of plastics social media users had a significantly higher average Healthgrades rating compared to the rest of the plastics group. On Google reviews, the top 20% also had higher mean ratings, as well as mean number of ratings, compared to the rest of the cohort. Plastic surgeons with a Twitter/X account had a significantly higher h-index than plastic surgeons without a Twitter/X account (14.5 vs 9.2, <em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>Social media involvement is positively associated with surgeon ratings and the number of reviews and comments on physician rating websites. Using web-based marketing tools is still rare in hand surgery, especially among orthopedic surgeons.</div></div><div><h3>Type of study/level of evidence</h3><div>Economic/decision analysis IV.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 1","pages":"Pages 66-71"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173057","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 Joint Arthrodesis in Patients With Systemic Sclerosis","authors":"Melanie Bertolino BS ,&nbsp;Kyra A. Benavent BS ,&nbsp;Zachary Li BS ,&nbsp;Dafang Zhang MD ,&nbsp;Philip E. Blazar MD ,&nbsp;Brandon E. Earp MD","doi":"10.1016/j.jhsg.2024.06.015","DOIUrl":"10.1016/j.jhsg.2024.06.015","url":null,"abstract":"<div><h3>Purpose</h3><div>Systemic sclerosis (scleroderma) is a chronic autoimmune connective tissue disorder that can lead to notable pain and functional limitations of the digits. This study assessed complications and reoperations after interphalangeal (IP) joint arthrodesis in patients with scleroderma.</div></div><div><h3>Methods</h3><div>A retrospective review was performed of all patients who underwent digital joint arthrodesis of the proximal IP (PIP), distal IP, or thumb IP joints between September 1, 2006, and December 31, 2019, at an integrated health system comprising two level-I trauma centers and two community teaching hospitals. Six patients who underwent arthrodesis of 13 IP joints were included in the study. Patient demographics, comorbidities, surgical information, and postoperative outcomes were collected from the medical record.</div></div><div><h3>Results</h3><div>Thirteen digits in six patients were treated with digital joint arthrodesis. Three patients had diffuse scleroderma, and four patients were women. The majority of procedures were performed on the PIP joint with Kirshner wires (nine of 13). No patients experienced intraoperative complications. Three patients experienced postoperative complications including flexion deformity, discomfort, and cellulitis. In patients who had primary arthrodesis, two of nine joints went on to nonunion. One patient who underwent arthrodesis of four PIP joints for failed PIP arthroplasties went on to nonunion of all four digits. Of the patients with complications and nonunion, three required reoperation.</div></div><div><h3>Conclusions</h3><div>Our study suggests that arthrodesis is an acceptable treatment option for patients with joint deformities secondary to scleroderma; however, surgeons and patients should be aware of higher rates of complications.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic III.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 1","pages":"Pages 6-8"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143172997","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":"Timing of Type I Open Distal Radius Fracture Fixation Does Not Affect Early Complication Rates","authors":"Eric R. Taleghani MD ,&nbsp;James Rex MD ,&nbsp;Samuel Gerak BA ,&nbsp;John Velasquez MS ,&nbsp;Kathryn Rost BS ,&nbsp;Sonu A. Jain MD, FACS","doi":"10.1016/j.jhsg.2024.09.004","DOIUrl":"10.1016/j.jhsg.2024.09.004","url":null,"abstract":"<div><h3>Purpose</h3><div>There is limited published evidence regarding the optimal management of type I open fractures of the distal radius. The purpose of this study was to compare short-term complication rates among open fractures of the distal radius, with attention to the timing of management of type I fractures. Our hypothesis was that there would not be a temporal association between treatment and infection for type I open distal radius fractures (DRFs).</div></div><div><h3>Methods</h3><div>A retrospective review of all open DRFs at a single level-1 trauma center over a 10-year period was performed. Patients were grouped based on Gustilo Anderson open fracture classification. The primary outcome measures were superficial and deep infection rates in all patients with a minimum of 6-month follow-up. A subgroup analysis was performed for Gustilo Anderson type I injuries with a 3-month follow-up based on time to surgery.</div></div><div><h3>Results</h3><div>Seventy-one patients with open DRFs were included for analysis with an average follow-up of 16.7 months. There was a higher rate of deep infection (30%) and average number of revision surgeries (3.0) in the type III cohort compared with both type II (4% and 0.6) and type I (0% and 0.39) cohorts. A subgroup analysis of 63 type I fractures with a minimum of 3-month follow-up revealed zero infections, with no difference in other complications or number of revision surgeries among patients definitively managed within 24 hours, 24–72 hours, and greater than 72 hours. Two patients were managed nonoperatively, without complication.</div></div><div><h3>Conclusions</h3><div>Type I open DRFs differ from higher grade DRFs with regard to demographics and injury characteristics, along with infection, complication, and reoperation rates. With no infections in the type I DRF cohort and no difference in complication rates based on time to debridement, our data suggest that it is safe to manage type I open DRFs similarly to closed injuries regarding surgical timing.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic III.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 1","pages":"Pages 1-5"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173002","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":"Novel Surgical Approach for Fingertip Deformity: Reconstruction of a Small Finger Hook Nail in a Child Using a Hypothenar Flap and Distal Phalanx Osteotomy","authors":"Caleb Bercu BA ,&nbsp;Antoun Bouz MD ,&nbsp;Sarah Stavros MD ,&nbsp;Weston Thomas PA-C ,&nbsp;Aaron Berger MD, PhD","doi":"10.1016/j.jhsg.2024.08.018","DOIUrl":"10.1016/j.jhsg.2024.08.018","url":null,"abstract":"<div><div>Hook nail deformity generally occurs after traumatic amputation of the distalmost extent of the finger. The nail bed then extends over the tip and occasionally onto the volar aspect of the digit. An absence of distal support leads to volar hooking of the nail, a cosmetic deformity that can be painful and interfere with function. Treatment of this deformity is typically conservative, as there is little consensus on ideal treatment, and most techniques described in the literature are complex. We present a novel technique for the treatment of hook nail (and other fingertip) deformity in the small finger using a hypothenar flap combined with distal phalanx osteotomy.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 1","pages":"Pages 92-97"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173067","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 Comparative Analysis of Endoscopic Carpal Tunnel Release Performed Under Wide-Awake, Local Anesthesia, No Tourniquet in an Office-based Procedure Room Versus Operating Room Setting","authors":"Madison Milhoan MD ,&nbsp;Winston Scambler BS ,&nbsp;William F. Pientka II MD","doi":"10.1016/j.jhsg.2024.09.007","DOIUrl":"10.1016/j.jhsg.2024.09.007","url":null,"abstract":"<div><h3>Purpose</h3><div>Wide-awake, local anesthesia, no tourniquet (WALANT) techniques represent a notable advancement in hand surgery by reducing costs and enhancing patient satisfaction. This study aims to compare Disabilities of the Arm, Shoulder, and Hand (DASH) and pain score improvements in patients undergoing endoscopic carpal tunnel release (ECTR) in an office setting under WALANT versus those performed in the operating room under general or regional anesthesia.</div></div><div><h3>Methods</h3><div>We conducted a retrospective chart review of all patients aged ≥18 years who underwent ECTR during the period November 2020 to December 2022 by a single hand surgeon at a single level-1 trauma center. A total of 286 procedures in 229 patients were included. We recorded patient demographics, procedure setting, preoperative and postoperative outcome scores, DASH scores, visual analog pain scores, and follow-up duration.</div></div><div><h3>Results</h3><div>Average follow-up was 6.8 weeks. One hundred and twenty-four in-office WALANT procedures and 162 in-operating room procedures were included. Patients undergoing in-office procedures were significantly older (average age of 58 vs 53 years) (<em>P</em> = .004). A significant sex difference was noted between the groups, with more women undergoing in-office (<em>P</em> &lt; .00001). There was no difference in preoperative pain or DASH scores between groups or in postoperative DASH score improvement; however, postoperative pain scores were significantly lower at 6 weeks in the in-office WALANT cohort (<em>P</em> &lt; .00001).</div></div><div><h3>Conclusions</h3><div>In-office WALANT ECTR shows similar improvements in DASH scores compared with operating room–based procedures, irrespective of anesthesia type. Postoperative pain was significantly (<em>P</em> &lt; .00001) less in the WALANT cohort at 6 weeks. Widespread adoption of office-based WALANT ECTR release could offer substantial financial benefits to both patients and the health care system at large, without compromising patient outcomes.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic IV.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 1","pages":"Pages 33-36"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173005","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":"Freestanding Osteolipoma of the Left Upper Extremity: A Case Report","authors":"Manuel Rodriguez-Leiva APRN-BC ,&nbsp;Rajshri Shah MD ,&nbsp;Elizabeth Anne Ouellette MD, MBA","doi":"10.1016/j.jhsg.2024.10.010","DOIUrl":"10.1016/j.jhsg.2024.10.010","url":null,"abstract":"<div><div>A 65-year-old woman presented to clinic with a lump at the dorsal aspect of left distal forearm. On clinical examination an oval, soft tissue mass without pulsation was found at the dorsal aspect of left distal forearm. The diagnosis was a rare osteolipoma found underneath the fascia of the muscles extending all the way down to the interosseous membrane and the periosteum of the radius and ulna. The mass was not connected with the interosseous membrane. Osteolipoma are uncommon but have distinguishing radiological and pathological appearances. It is important to keep this differential in mind when a lesion enclosing fatty tissue with ossification is encountered.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 1","pages":"Pages 114-116"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173064","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":"Epithelioid Hemangioma of the Carpus Presenting as Aneurysmal Bone Cyst","authors":"Juston Fan DO ,&nbsp;William H. Fang DO, MS ,&nbsp;Evelyn Thomas DO ,&nbsp;Ali Nael MD ,&nbsp;Mark N. Halikis MD ,&nbsp;Amirhossein Misaghi MD","doi":"10.1016/j.jhsg.2024.07.003","DOIUrl":"10.1016/j.jhsg.2024.07.003","url":null,"abstract":"<div><div>Epithelioid hemangioma is a rare neoplasm characterized by locally aggressive behavior and composed of small vessels lined by epithelioid endothelial cells. Its varied presentation poses diagnostic challenges because of its ability to mimic other tumors. An 18-year-old boy presented with a painful dorsal mass on the right wrist, exhibiting features on preoperative imaging consistent with an expansile, radiolucent lesion. Initial bone biopsy suggested potential diagnoses of aneurysmal bone cysts or enchondromas. Surgical intervention, including debridement, adjuvant therapy, and bone graft, was performed. Postoperative immunohistology on intraoperative samples showed the presence of vascular markers, providing a confirmatory diagnosis of epithelioid hemangioma The patient was followed and was able to perform activities without pain for 6 months after surgery. Epithelioid hemangioma of the bone, although uncommon, demands cautious diagnosis, employing advanced techniques like immunohistochemical staining for accurate identification.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 1","pages":"Pages 88-91"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173066","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":"Intraoperative Electrical Nerve Stimulation as a Prognostic Tool in Patients Undergoing Peripheral Nerve Neurolysis","authors":"Christoph A. Schroen BS ,&nbsp;Yufan Yan MD ,&nbsp;Christian E. Awah MD ,&nbsp;Unwana Abasi MD ,&nbsp;Paul J. Cagle MD ,&nbsp;Michael R. Hausman MD ,&nbsp;Steven M. Koehler MD","doi":"10.1016/j.jhsg.2024.10.004","DOIUrl":"10.1016/j.jhsg.2024.10.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Functional recovery from peripheral nerve injuries remains unpredictable and continues to pose a major clinical challenge to surgeons. This study sought to investigate the utility of intraoperative nerve stimulation following neurolysis surgery as a prognostic indicator of functional recovery.</div></div><div><h3>Methods</h3><div>A retrospective chart review of adult patients who underwent peripheral nerve neurolysis between September 2021 and December 2022 was performed. A handheld nerve stimulator was used intraoperatively before and after neurolysis. Patients with preoperative motor deficits corresponding to the nerve that underwent neurolysis, intraoperative nerve stimulation, and postoperative follow-up length of at least 3 months were included. Muscle strength as measured by the Medical Research Council scale was used to evaluate nerve function. A scale grade of 0 or 1 meant “no recovery,” between 2 and 4 was classified as “partial recovery,” and 5 was classified as “full recovery.” Fisher exact tests were employed to test for an association between stimulation thresholds and functional recovery.</div></div><div><h3>Results</h3><div>A total of 27 patients and 45 nerves were included in the study, with a mean follow-up of 8.0 months. Intraoperative stimulation at 0.5 mA was observed in 73% (33/45) of nerves, with 76% achieving full recovery, 18% partial recovery, and 6% no recovery. Two nerves stimulated at 2 mA and one at 20 mA, with both showing partial recovery. In contrast, 22% (10/45) of nerves showed no stimulation, leading to full recovery in 20%, partial recovery in 30%, and no recovery in 50% of cases. A significant (<em>P</em> &lt; .001) association was found between stimulation thresholds and functional recovery.</div></div><div><h3>Conclusions</h3><div>Intraoperative nerve stimulation is strongly linked to functional recovery postneurolysis, demonstrating its potential as a prognostic tool for guiding surgical decisions.</div></div><div><h3>Type of study/level of evidence</h3><div>Prognostic, IV.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 1","pages":"Pages 61-65"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173008","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}