Journal of Hand Surgery Global Online最新文献

{"title":"Arthroscopic-Assisted Repair of the Triangular Fibrocartilage Complex","authors":"","doi":"10.1016/j.jhsg.2024.03.011","DOIUrl":"10.1016/j.jhsg.2024.03.011","url":null,"abstract":"<div><p>Triangular fibrocartilage complex (TFCC) injuries are a common cause of ulnar-side wrist pain and may progress to persistent pain, instability of the distal radioulnar joint, and arthritis if left untreated. Diagnosis and management of these injuries requires a nuanced understanding of features pertinent to the clinical presentation, imaging, and arthroscopic findings for accurate management. Arthroscopic-assisted repair techniques have revolutionized surgical management, providing detailed visualization and facilitating the repair of TFCC injuries and associated pathologies with minimally invasive techniques. In this review, we discuss the anatomy of the TFCC, history and examination of ulnar-sided pathology, imaging findings, and classification schemes and review surgical techniques for the treatment of TFCC injuries. We also touch on pearls and pitfalls of the techniques, complications, and results of treatment.</p></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 4","pages":"Pages 445-457"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589514124000665/pdfft?md5=31075e42a35238f5ae727af4fd4f0fe1&pid=1-s2.0-S2589514124000665-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140791925","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":"Early Complications of Planned Resection Versus Unplanned Excision of Sarcomas in the Distal Upper Extremity","authors":"","doi":"10.1016/j.jhsg.2024.04.010","DOIUrl":"10.1016/j.jhsg.2024.04.010","url":null,"abstract":"<div><h3>Purpose</h3><p>Unplanned excisions are defined as excisions of malignant tumors performed without preoperative cross-sectional imaging or diagnostic biopsy, frequently resulting in residual disease and re-excision secondary to positive surgical margins. The purpose of this study was to compare the relative morbidity of planned versus unplanned upper-extremity sarcoma excisions.</p></div><div><h3>Methods</h3><p>A single tertiary referral hospital pathology database was queried from January 2015 through 2022 for primary upper-extremity sarcomas (forearm, wrist, hand, and finger). Demographics, tumor features, survival characteristics, and outcomes were retrospectively reviewed.</p></div><div><h3>Results</h3><p>Forty-two upper-extremity sarcoma patients were identified, two-thirds of whom had unplanned excisions. Those with unplanned excisions were more likely to be female (relative risk [RR]: 1.9; <em>P</em> = .002), undergo initial excision at a nonsarcoma center (RR: 14.0; <em>P</em> &lt; .001), have masses distal to the forearm (RR: 1.6; <em>P</em> = .02), and have smaller masses (4.8 vs 7.4 cm, <em>P</em> = .03). 71.4% of tumors were high grade, and 60.7% less than 5 cm in size.</p><p>Unplanned excisions had positive margins in 96.4% of cases and were more likely to undergo re-excision (odds ratio [OR]: 20.0; <em>P</em> = .001), more total resections (2.7 vs 1.4, <em>P</em> = .009), sacrifice of neurovascular structures (OR: 6.1; <em>P</em> = .04), adjuvant radiation therapy (OR: 4.5; <em>P</em> = .05), adjuvant systemic therapy (OR: 10.9; <em>P</em> = .03), or experience a complication (OR: 17.6; <em>P</em> = .002) at an average of 38.0 months of follow-up.</p><p>Nearly half of all unplanned excision patients developed a local recurrence or metastatic disease. Six patients required an amputation versus one in the planned cohort (<em>P</em> = .17), and 26.5% of patients died at an average of 32.5 months from presentation.</p></div><div><h3>Conclusions</h3><p>Distal upper-extremity sarcoma excisions are frequently unplanned, with high rates of morbidity compared with planned excisions. Surgeons should have a low threshold for cross-sectional imaging and core needle biopsy of atypical lesions, irrespective of size, with referral to a sarcoma center.</p></div><div><h3>Type of study/level of evidence</h3><p>Prognostic IV.</p></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 4","pages":"Pages 558-562"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589514124000859/pdfft?md5=076996f538a28d3efc8c63df3187cba4&pid=1-s2.0-S2589514124000859-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141136739","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":"Surgical Firework Injury of the Thumb: Injury Pattern and Treatment Algorithm","authors":"David Cardenas, Muhammad Harirah, A. Dogăroiu, Brandon Bruce, Andrei Odobescu, Douglas Sammer, Andrew Y. Zhang","doi":"10.1016/j.jhsg.2024.04.012","DOIUrl":"https://doi.org/10.1016/j.jhsg.2024.04.012","url":null,"abstract":"","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"15 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141279637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double-Bending Tension Band Wire for Olecranon Fractures: A Novel Technique","authors":"Sora Koiwa MD ,&nbsp;Takeshi Koba MD ,&nbsp;Toshiharu Tsunoda MD ,&nbsp;Koji Nakajima MD ,&nbsp;Yoshiyasu Kokubo MD ,&nbsp;Nobuhiro Hara MD","doi":"10.1016/j.jhsg.2023.12.007","DOIUrl":"10.1016/j.jhsg.2023.12.007","url":null,"abstract":"<div><h3>Purpose</h3><p>This retrospective study aimed to compare the clinical outcomes and complications of conventional tension band wire (TBW), TBW with penetrating technique, and double-bending technique.</p></div><div><h3>Methods</h3><p>A total of 40 patients (17 men and 23 women; mean age: 64.0 ± 19.0 years) who underwent surgery for displaced olecranon fractures between January 2018 and December 2021 were included and divided into three groups based on the surgical method used (group A, conventional TBW; group B, TBW with penetrating technique; and group C, double-bending technique). Thirteen patients were assigned to group A, 17 to group B, and 10 to group C, including 2 Mayo type IB, 30 Mayo type IIA, and 8 Mayo type IIB fractures. Postoperative outcomes (elbow extension and flexion arc) and complications, such as backing out of the Kirschner wire (K-wire), were retrospectively evaluated.</p></div><div><h3>Results</h3><p>No significant difference was found in the general characteristics of the patients and fracture type among the three groups. The mean elbow extension arc values were 6.2°, 10.9°, and 0° in groups A, B, and C, respectively; it was significantly better in group C than in group B (<em>P</em> = .001). The rates of backing out of the K-wire were 84.6% (11/13) in group A, 41.2% (7/17) in group B, and 0% (0/10) in group C; the rate was significantly lower in group C than in group A (<em>P</em> &lt; .001).</p></div><div><h3>Conclusions</h3><p>The double-bending technique may be the best procedure for preventing the backing out of the K-wire and postoperative complications, such as range of motion restriction, for treating olecranon fractures that are treatable by TBW.</p></div><div><h3>Type of study/level of evidence</h3><p>Therapeutic IV.</p></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 3","pages":"Pages 281-288"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589514124000033/pdfft?md5=459f9005696fe34c4bdb95c116da4552&pid=1-s2.0-S2589514124000033-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139820387","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":"Opposition Transfer Using the Extensor Indicis Muscle and the Extensor Pollicis Brevis Tendon","authors":"Yusuke Matsuura MD, PhD ,&nbsp;Takahiro Yamazaki MD, PhD ,&nbsp;Takane Suzuki MD, PhD ,&nbsp;Tomoyo Akasaka MD, PhD ,&nbsp;Seiji Ohtori MD, PhD","doi":"10.1016/j.jhsg.2024.02.010","DOIUrl":"10.1016/j.jhsg.2024.02.010","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aimed to introduce a novel technique using the extensor pollicis brevis and extensor indicis proprius tendons as power sources for thumb opposition reconstruction in cases of severe carpal tunnel syndrome (CTS) associated with thenar muscle atrophy. Furthermore, the efficacy of this novel method and the traditional Camitz technique was compared.</p></div><div><h3>Methods</h3><p>Patients with severe CTS and thumb opposition dysfunction who underwent surgery using the novel technique (<em>n</em> = 7 and 9 surgeries) or the Camitz technique (<em>n</em> = 8 and 8 surgeries) were included in the analysis. The pre- and postoperative palmar abduction angle, thumb-ring finger opposition angle, and Kapandji score were assessed. The repeated measures analysis of variance and the Mann-Whitney U test were used for statistical analysis.</p></div><div><h3>Results</h3><p>The novel technique was associated with a significant postoperative improvement in palmar abduction angle, thumb-ring finger opposition angle, and Kapandji score. In particular, the thumb-ring finger opposition angle of patients who underwent surgery using this technique was superior to that of patients who underwent surgery using the Camitz technique. Therefore, the novel technique was highly effective in improving thumb pronation.</p></div><div><h3>Conclusion</h3><p>The novel technique using the extensor pollicis brevis and extensor indicis proprius tendons is promising for thumb opposition reconstruction in severe CTS cases. Unlike the traditional Camitz technique, this approach promotes stable thumb opposition function without requiring a pulley, thereby yielding satisfactory outcomes. Nevertheless, further studies with a larger sample size should be conducted to validate these findings.</p></div><div><h3>Type of study/level of evidence</h3><p>Therapeutic 4; Surgical technique.</p></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 3","pages":"Pages 383-389"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589514124000446/pdfft?md5=cc4191514e36fbc3414d073d5558632d&pid=1-s2.0-S2589514124000446-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140401803","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 Prescriber Adherence to a Standardized Postoperative Opioid Prescription Protocol for Cubital Tunnel Surgery","authors":"Carew Giberson-Chen MD ,&nbsp;Christina Liu MD ,&nbsp;Phillip Grisdela Jr MD ,&nbsp;David Liu MD ,&nbsp;Zina Model MD ,&nbsp;Amy Steele MD ,&nbsp;Philip Blazar MD ,&nbsp;Brandon E. Earp MD ,&nbsp;Dafang Zhang MD","doi":"10.1016/j.jhsg.2024.02.007","DOIUrl":"10.1016/j.jhsg.2024.02.007","url":null,"abstract":"<div><h3>Purpose</h3><p>Concerns regarding the ongoing opioid epidemic have led to the implementation of standardized postoperative opioid-prescribing protocols for many common hand surgical procedures. This study investigated patient- and procedure-specific factors affecting adherence to a standardized postoperative opioid-prescribing protocol after cubital tunnel surgery.</p></div><div><h3>Methods</h3><p>A retrospective review of patients who underwent primary cubital tunnel surgery within one academic medical system between October 1, 2016 (after the implementation of a standardized postoperative opioid-prescribing protocol) and March 1, 2020 was performed. Patients aged &lt;18 years or with a history of revision surgery, prior traumatic ulnar nerve injury, additional concurrent surgical procedures, or a surgeon not participating in the protocol were excluded. Patient demographics, comorbidities, prior opioid history, and surgical variables were recorded. The primary outcome was adherence to the standardized postoperative opioid-prescribing protocol. A bivariate statistical analysis was performed.</p></div><div><h3>Results</h3><p>Ninety-eight patients were included. The median initial postoperative prescription amount was 75 morphine equivalent units (100% of protocol target) for 78 patients (80% of cohort) who underwent in situ decompression and 75 morphine equivalent units (50% of protocol target) for 20 patients (20% of cohort) who underwent decompression with ulnar nerve transposition. Forty-nine percent of initial opioid prescriptions adhered to protocol, compared with 26% below target and 26% above target. In the bivariate analysis, recent opioid prescriptions within 3 months preoperatively were associated with improved prescriber protocol adherence; longer tourniquet time and anterior transposition were associated with prescriptions below target, and in situ decompression was associated with prescriptions above target.</p></div><div><h3>Conclusions</h3><p>Variation in postoperative opioid-prescribing patterns persists despite the implementation of a standardized postoperative opioid-prescribing protocol. Recent opioid prescriptions were associated with protocol adherence, possibly reflecting increased provider vigilance in this patient population. Differing target prescription amounts for in situ decompression versus decompression with anterior transposition may be unnecessary.</p></div><div><h3>Type of study/level of evidence</h3><p>Therapeutic IV.</p></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 3","pages":"Pages 369-376"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589514124000367/pdfft?md5=84e1459cbacbc680c593f506c665c88b&pid=1-s2.0-S2589514124000367-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140400839","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":"Use of Botulinum Toxin Injections in the Treatment of Cold Intolerance","authors":"Kohila Vani Sigamoney MBChB, MD ,&nbsp;Shetha Naji MBChB, BSc ,&nbsp;Zahid Hassan BM, MD, Dip Hand Surg (Br) ,&nbsp;Paul McArthur MBBS, PhD","doi":"10.1016/j.jhsg.2024.01.014","DOIUrl":"10.1016/j.jhsg.2024.01.014","url":null,"abstract":"<div><p>There is currently no consensus on the treatment of cold intolerance in extremities in post-trauma patients. We aim to present two cases where botulinum toxin type A injections were used to improve symptoms of cold intolerance. Botulinum toxin type A (Allergan) was injected into the area around the palmar digital neurovascular bundle on both sides of the affected finger. We performed this in two patients, and both had good improvement of symptoms. One patient was discharged, and the other remained under routine follow-up with potential yearly botulinum injections to aid symptoms during the winter months. Both patients are pleased with their outcomes and report significant improvement from the low-risk treatment. In both described cases, injections of botulinum toxin had a significant effect on their symptoms. We conclude that botulinum toxin type A may be used as a treatment modality to improve symptoms of cold intolerance after trauma.</p></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 3","pages":"Pages 415-417"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589514124000239/pdfft?md5=8d6e5f8416da48510cfce640d940de5f&pid=1-s2.0-S2589514124000239-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140468217","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":"Post-Traumatic Chylous Wrist Effusion: A Case Report","authors":"Je-Chan Lee MD ,&nbsp;Sang Ki Lee MD","doi":"10.1016/j.jhsg.2024.02.008","DOIUrl":"10.1016/j.jhsg.2024.02.008","url":null,"abstract":"<div><p>Chylous joint effusion is a rare condition characterized by the presence of a milky, viscous synovial fluid with abnormal lipid concentrations. The thorax is the most common site of involvement. Only a handful of cases have been reported in the field of orthopedic surgery and even fewer have been reported involving uncommon locations such as the knee. Treatment of chylous joint effusion may require surgical intervention along with the use of somatostatin or octreotide and a low-fat diet. We present herein a case of post-traumatic chylous effusion in the wrist treated with surgical incision and drainage, octreotide, and a low-fat diet. There have been few reports of chylous effusion in the knee; however, to our knowledge, this is the first report of post-traumatic chylous effusion in the wrist.</p></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 3","pages":"Pages 425-429"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589514124000422/pdfft?md5=953ae0c827f2a25ee93bf152c616bad1&pid=1-s2.0-S2589514124000422-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140272473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Educational YouTube Videos for Distal Radius Fracture Treatment","authors":"Brandon S. Chai ,&nbsp;Taewoong Chae B.Sc. ,&nbsp;Adrian L. Huang MBBChBAO, FRCSC","doi":"10.1016/j.jhsg.2024.02.009","DOIUrl":"10.1016/j.jhsg.2024.02.009","url":null,"abstract":"<div><h3>Purpose</h3><p>Distal radius fractures (DRFs) are one of the most common fractures in adults. Adequate patient education is crucial for adherence to treatment. YouTube is a popular, accessible resource that has become a valuable tool for obtaining health information. The current study evaluated the top 50 YouTube videos on DRF treatment for patient education.</p></div><div><h3>Methods</h3><p>A systematic search was conducted on YouTube using three searches to obtain 150 videos. Duplicate, nonrelevant, paid, and non-English videos were removed, and the top 50 rank-ordered videos were reviewed and characterized in terms of general (views, likes, video length, and publication date), source (publisher affiliation, presenter type, and target audience), and content (media type, topic coverage, advertisements, and bias) parameters.</p></div><div><h3>Results</h3><p>Only 56% of videos were directed toward patients versus 40% for health care providers, highlighting a gap in patient-oriented educational content on YouTube. Most (86%) videos included effective visual aids, aligning with best practices for educational videos. Surgical management was overrepresented in 64% of the videos as opposed to nonsurgical management in 34% of videos. Only 31% of patient-oriented videos discussed surgical complications. Home exercises were emphasized in 75% of the videos discussing recovery topics.</p></div><div><h3>Conclusions</h3><p>Although YouTube has the potential to be an effective resource for disseminating health information to patients, it has several limitations for education in DRF treatment including the lack of patient-oriented educational videos, overrepresentation of surgical treatment, and lack of information on surgical complications. Nonetheless, YouTube may have an important role as a supplementary resource, especially in certain topics such as guiding postoperative recovery with home exercises.</p></div><div><h3>Clinical relevance</h3><p>This study allows health care providers and content creators to proactively address information gaps identified in educational YouTube videos on DRF treatment. It helps characterize the role of YouTube in supporting the treatment and recovery of patients experiencing DRFs.</p></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 3","pages":"Pages 377-382"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589514124000434/pdfft?md5=1473b944b618f6f259e4d2db6eb4a0f6&pid=1-s2.0-S2589514124000434-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140404582","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":"ChatGPT-4 Can Help Hand Surgeons Communicate Better With Patients","authors":"Robert Browne MRCSI ,&nbsp;Khadija Gull MB ,&nbsp;Ciaran Martin Hurley MRCSI ,&nbsp;Ryan M. Sugrue FRCS (Plast) ,&nbsp;John Barry O’Sullivan FRCS (Plast)","doi":"10.1016/j.jhsg.2024.03.008","DOIUrl":"10.1016/j.jhsg.2024.03.008","url":null,"abstract":"<div><p>The American Society for Surgery of the Hand and British Society for Surgery of the Hand produce patient-focused information above the sixth-grade readability recommended by the American Medical Association. To promote health equity, patient-focused content should be aimed at an appropriate level of health literacy. Artificial intelligence–driven large language models may be able to assist hand surgery societies in improving the readability of the information provided to patients. The readability was calculated for all the articles written in English on the American Society for Surgery of the Hand and British Society for Surgery of the Hand websites, in terms of seven of the commonest readability formulas. Chat Generative Pre-Trained Transformer version 4 (ChatGPT-4) was then asked to rewrite each article at a sixth-grade readability level. The readability for each response was calculated and compared with the unedited articles. Chat Generative Pre-Trained Transformer version 4 was able to improve the readability across all chosen readability formulas and was successful in achieving a mean sixth-grade readability level in terms of the Flesch Kincaid Grade Level and Simple Measure of Gobbledygook calculations. It increased the mean Flesch Reading Ease score, with higher scores representing more readable material. This study demonstrated that ChatGPT-4 can be used to improve the readability of patient-focused material in hand surgery. However, ChatGPT-4 is interested primarily in sounding natural, and not in seeking truth, and hence, each response must be evaluated by the surgeon to ensure that information accuracy is not being sacrificed for the sake of readability by this powerful tool.</p></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 3","pages":"Pages 436-438"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S258951412400063X/pdfft?md5=5b7b96595804db9e77fefd7af0b30836&pid=1-s2.0-S258951412400063X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140786665","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}