Journal of Hand Surgery Global Online最新文献

{"title":"Trends in Digit Replantation and Revision Amputation in the United States From 2009 to 2019","authors":"Joseph G. Monir MD ,&nbsp;Hayden Cooke BS ,&nbsp;Olivia Jagiella-Lodise BS ,&nbsp;Thomas McQuillan MD ,&nbsp;Eric Wagner MD ,&nbsp;Nicole A. Zelenski MD","doi":"10.1016/j.jhsg.2024.07.012","DOIUrl":"10.1016/j.jhsg.2024.07.012","url":null,"abstract":"<div><h3>Purpose</h3><div>Digit amputations can be managed either with replantation or revision amputation. The advent and refinement of microsurgical techniques allowed for the reliable success of replantation. Despite this, rates of digit replantation have been decreasing over the past several decades. A paucity of data exists on recent trends. The authors hypothesize that rates of both replantation and revision amputation will continue to downtrend.</div></div><div><h3>Methods</h3><div>IBM Watson Health Marketscan Commercial Claims and Encounters and Medicare Supplemental databases were queried for digit replantation and revision amputations from 2009 to 2019. National volumes and incidences were estimated by combining these data with population data from the United States Census Bureau Public Use Microdata Sample. Linear regression was performed to evaluate trends. Subgroup analysis was performed for both volume and incidence to elucidate the role of age, sex, and geographical location.</div></div><div><h3>Results</h3><div>Between 2009 and 2019, there were an estimated 2,207 digit replantations and 53,810 digit revision amputations. The volume of replantations decreased by 42.2%, and the incidence of replantations decreased by 46.3%. The volume of revision amputations decreased by 16.2%, and the incidence of revision amputations decreased by 22.2%. Men were the majority of both groups, accounting for 75.6% of replantations and 83.6% of amputations. The replantation-to-amputation ratio decreased from 0.057 to 0.039 (−31.0%).</div></div><div><h3>Conclusions</h3><div>Both digit replantations and revision amputations continued to decline over the decade from 2009 to 2019. The downtrend in replantations outpaced the downtrend in revision amputations, resulting in a decreased replantation-to-amputation ratio.</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":"6 6","pages":"Pages 855-860"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706770","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":"Impact of Social Deprivation on Cubital Tunnel Syndrome Treatment Timeline","authors":"Akhil Dondapati MD ,&nbsp;Janet Ngoc Tran BA ,&nbsp;Callista Zaronias BA ,&nbsp;Cody C. Fowler MD ,&nbsp;Thomas J. Carroll MD ,&nbsp;Bilal Mahmood MD","doi":"10.1016/j.jhsg.2024.08.019","DOIUrl":"10.1016/j.jhsg.2024.08.019","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to establish the impact of area deprivation index (ADI) on treatment timelines of patients with cubital tunnel syndrome (CuTS). We hypothesize that increased social deprivation will correlate with increased time between care milestones from presentation to surgery.</div></div><div><h3>Methods</h3><div>This is a retrospective study of patients diagnosed with CuTS who underwent surgical intervention at a single academic institution. Variables including age, sex, body mass index, ADI, electrodiagnostic (EDX) severity classification, and time elapsed between treatment milestones were obtained. Treatment milestones included time elapsed between initial presentation to hand surgery and EDX studies, and surgery. Analysis included univariate χ² tests and analysis of variance, as well as multivariate linear and logistic regressions.</div></div><div><h3>Results</h3><div>Six hundred and fifty-three patients were divided by ADI national percentiles from the least to most deprived tertiles. Univariate analysis found no differences in care timelines across ADI tertiles. Multivariate analysis revealed a nonsignificant trend toward higher ADI predicting longer time from presentation to surgery. Moderate EDX rating correlated with increased time from presentation to surgery. Mild EDX ratings correlate with increased time from EDX studies to surgery. Age was a significant predictor of decreased time between initial presentation and surgery and between EDX and surgery. Completion of EDX studies prior to presentation significantly decreased time to surgery.</div></div><div><h3>Conclusions</h3><div>Social deprivation does not significantly correlate with delays in the treatment timeline for CuTS. Increased age was significantly correlated with shorter treatment timelines, which may reflect differences in physicians’ approaches to patients of different ages. Electrodiagnostic testing obtained prior to initial presentation expedited care following presentation to hand clinic. However, this could reflect either an overall delay in care (if EDX were obtained because of a delay from referral to presentation) or truly expedited care.</div></div><div><h3>Type of study/level of evidence</h3><div>Prognostic II.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 6","pages":"Pages 894-897"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142707189","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":"Upper-Extremity Injuries in a Level 1 Trauma Center Following Border Wall Height Increase","authors":"Emma Williams BA ,&nbsp;Vivian Hu MD ,&nbsp;Cooper Haaland BS ,&nbsp;Meera Reghunathan MD ,&nbsp;Laura N. Haines MD ,&nbsp;Jay J. Doucet MD ,&nbsp;Todd W. Costantini MD ,&nbsp;Katharine M. Hinchcliff MD","doi":"10.1016/j.jhsg.2024.07.002","DOIUrl":"10.1016/j.jhsg.2024.07.002","url":null,"abstract":"<div><h3>Purpose</h3><div>From 2018–2019, the height of over 400 miles of southern border wall was raised to 30 feet. Our aim was to evaluate the impact of the increase in border wall height on upper-extremity injuries sustained via barrier fall.</div></div><div><h3>Methods</h3><div>A retrospective review of patients admitted with upper-extremity injuries sustained via border wall fall between January 2015 and December 2022 at a Level 1 trauma center serving the United States-Mexico border. Patients admitted between 2015–2018 were included in the preincrease group, and those admitted between 2019–2022 were included in the postincrease group. Demographic data, injury severity metrics, fracture characteristics, operative treatments, hospital charges, and lengths of stay were compared.</div></div><div><h3>Results</h3><div>In total, 110 patients were identified, with 16 preincrease and 94 postincrease. Following the barrier height increase, patients had higher injury severity scores. Radial fractures were most common pre- and postincrease and accounted for nearly one-third of all fractures. Postincrease upper-extremity trauma patients required more operative events (2.15 ± 2.10 vs 1.44 ± 0.73 preincrease). The average cost for each patient’s hospital stay also quadrupled after the increase in wall height ($397,632 ± $1,057,574 vs $98,978 ± $84,169 preincrease).</div></div><div><h3>Conclusions</h3><div>The increase in overall injury severity and costly inpatient treatment of upper-extremity injuries among patients who fell from the border following construction has placed additional stress on an already strained health care system.</div></div><div><h3>Level of Evidence</h3><div>Differential Diagnosis/Symptom Prevalence Study, IV.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 6","pages":"Pages 830-835"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142707362","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":"Ballistic Nerve Injuries: State of the Evidence and Approach to the Patient Based on Experience","authors":"","doi":"10.1016/j.jhsg.2024.01.021","DOIUrl":"10.1016/j.jhsg.2024.01.021","url":null,"abstract":"<div><p>Nerve injuries secondary to gunshot wounds (GSWs) have been traditionally thought of as neurapraxic injuries with high likelihood of complete recovery. A review of the literature, however, highlights the misconceptions surrounding ballistic nerve injuries and their treatments. Contrary to this accepted dogma, approximately 30% to 60% of GSWs to the upper extremity may result in nerve injury requiring repair or reconstruction. Surgical exploration following ballistic injury reveals that 20% to 55% of nerves were lacerated requiring repair or grafting. Despite these numbers, outcomes after nerve repair or grafting are limited, and the limited data show evidence of poor functional recovery. In our experience, delayed exploration of GSW-related nerve injuries in patients without signs of functional recovery demonstrate large neuromas in continuity often requiring meticulous dissection and excision with resulting large gaps that require reconstruction. This has led us to explore options to identify patients with nerve deficits after GSWs who may benefit from earlier exploration. Others advocate for the exploration of all ballistic nerve injuries, which would represent a logistical challenge in high volume centers and may lead to unnecessary explorations of in continuity nerves. To facilitate identification of nerve injury following GSWs, we have explored the utilization of early ultrasound to identify patients with nerve lacerations that may benefit from early exploration (1–2 weeks after injury). Earlier exploration can lead to less technically challenging surgery, shorter nerve gaps, and more time for the nerve to recover. Herein, we present a series of cases to help illustrate this approach to the patient. Although early exploration and repair versus grafting of nerves may have benefits as outlined above, there are little to no data on outcomes of nerve repair or grafting in ballistic injuries in the more acute setting, 1 to 2 weeks after injury. Further research is needed both with regards to diagnosis and utilization of ultrasound, as well as postoperative outcomes in patients with ballistic nerve injuries to help guide our ever-evolving treatment protocols.</p></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 5","pages":"Pages 743-748"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589514124000513/pdfft?md5=113edcb048790db0d3c6fc306a6dd9ef&pid=1-s2.0-S2589514124000513-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140405019","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 Physiologic Basis of Molecular Therapeutics for Peripheral Nerve Injury: A Primer","authors":"","doi":"10.1016/j.jhsg.2024.01.017","DOIUrl":"10.1016/j.jhsg.2024.01.017","url":null,"abstract":"<div><p>Peripheral nerve injuries affect a significant number of patients who experience trauma affecting the hand and upper extremity. Improving unsatisfactory outcomes from repair of these injuries remains a clinical challenge despite advancements in microsurgical repair. Imperfections of the nerve regeneration process, including imprecise reinnervation, distal axon degradation, and muscular atrophy, complicate the repair process. However, the capacity for peripheral nerves to regenerate offers an avenue for therapeutic advancement. Regeneration is a temporally and spatially dynamic process coordinated by Schwann cells and neurons among other cell types. Neurotrophic factors are a primary means of controlling cell growth and differentiation in the repair setting. Sustained axon survival and regrowth and consequently functional outcomes of nerve repair in animal models are improved by the administration of neurotrophic factors, including glial cell-derived neurotrophic factor, nerve growth factor, sterile alpha and TIR motif containing 1, and erythropoietin. Targeted and sustained delivery of neurotrophic factors through gelatin-based nerve conduits, multiluminal conduits, and hydrogels have been shown to enhance the innate roles of these factors to promote expedient and accurate peripheral nerve regeneration in animal models. These delivery methods may help address the practical limitations to clinical use of neurotrophic factors, including systemic side effects and the need for carefully timed, precisely localized release schedules. In addition, tacrolimus has also improved peripheral nerve regrowth in animal models and has recently shown promise in addressing human disease. Ultimately, this realm of adjunct pharmacotherapies provides ample promise to improve patient outcomes and advance the field of peripheral nerve repair.</p></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 5","pages":"Pages 676-680"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S258951412400032X/pdfft?md5=ccba0f72fe987ef1b39f8555f2ebdcd8&pid=1-s2.0-S258951412400032X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140399419","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 Cost-Utility Analysis of Carpal Tunnel Release With Open, Endoscopic, and Ultrasound Guidance Techniques From a Societal Perspective","authors":"Seper Ekhtiari MSc, MD ,&nbsp;Mark Phillips PhD ,&nbsp;Dalraj Dhillon BSc ,&nbsp;Ali Shahabinezhad MD ,&nbsp;Mohit Bhandari PhD, MD","doi":"10.1016/j.jhsg.2024.06.006","DOIUrl":"10.1016/j.jhsg.2024.06.006","url":null,"abstract":"<div><h3>Purpose</h3><p>The objective of this study was to perform a cost-utility analysis comparing open carpal tunnel release (OCTR), endoscopic carpal tunnel release (ECTR), and carpal tunnel release with ultrasound (CTR-US) guidance. The aim of this study was to determine whether one of the three approaches was dominant from a societal perspective in terms of cost-utility, in order to help inform policy and treatment decision making going forward.</p></div><div><h3>Methods</h3><p>This study was performed using a decision tree model, with three potential treatment decisions (OCTR, ECTR, and CTR-US). A cost-utility analysis was performed, using the incremental cost-effectiveness ratio. The willingness-to-pay threshold was set at $50,000/quality-adjusted life year (QALY) as per previous literature.</p></div><div><h3>Results</h3><p>The total payer episode costs for OCTR, ECTR, and CTR-US were $4,324, $4,978, and $3,249, respectively. The cost of time off work for each procedure was $4,376.14, $3,650.24, and $622.20, respectively. The overall QALYs gained from each procedure were 0.42, 0.42, and 0.43, respectively (the maximum possible being 0.5 for a 6-month period). Compared with OCTR, ECTR and CTR-US were both less costly from a societal perspective (−$71.90 and −$4,828.94, respectively) and associated with greater QALYs gained (+0.0004 and +0.0143, respectively).</p></div><div><h3>Conclusions</h3><p>Overall, the key finding of this study is that, from a societal perspective, CTR-US is less costly and provides greater QALY improvement when compared with OCTR and ECTR, and thus, CTR-US is considered a dominant intervention over both OCTR and ECTR.</p></div><div><h3>Type of study/level of evidence</h3><p>Economic and decision analysis; IIb.</p></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 5","pages":"Pages 659-664"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589514124001270/pdfft?md5=a66f5ea84cfb85e40b19765926cb17e4&pid=1-s2.0-S2589514124001270-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141708401","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":"Dorsal Translocation of the Flexor Pollicis Longus Tendon Following Pediatric Both Bone Forearm Fracture","authors":"Jenny Stephanie Ventura MPH ,&nbsp;Karlos Manzanarez Felix BS ,&nbsp;Joshua Taylor Lackey MD ,&nbsp;Amber Rachel Leis MD","doi":"10.1016/j.jhsg.2024.06.007","DOIUrl":"10.1016/j.jhsg.2024.06.007","url":null,"abstract":"<div><p>Tendon entrapment is a rare complication of closed forearm fractures. A 16-year-old boy sustained a type 1 open both bone forearm fracture after falling from a skateboard. The injury was initially managed with irrigation, debridement, and flexible intramedullary nailing. Seven weeks after surgery, a flexion contracture of the ipsilateral thumb interphalangeal joint was noted. Subsequent hardware removal and hand therapy failed to improve thumb extension. The patient was taken to the operating room for planned tenolysis and possible tendon reconstruction. Intraoperatively, the flexor pollicis longus tendon was found to be wrapped around the radial shaft as an apparent complication of the initial procedure, which necessitated division and reconstruction of the tendon. To our knowledge, this is the first pediatric reported case of dorsal flexor pollicis longus tendon entrapment through the fracture site in a both bone forearm fracture requiring tendon reconstruction. This case highlights a unique surgical approach to a novel complication of pediatric both bone forearm fracture.</p></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 5","pages":"Pages 670-673"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589514124001282/pdfft?md5=10846c59e5a8cd512f684bef66596548&pid=1-s2.0-S2589514124001282-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141695510","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":"Polyethylene Glycol Fusion and Nerve Repair Success: Practical Applications","authors":"","doi":"10.1016/j.jhsg.2024.01.016","DOIUrl":"10.1016/j.jhsg.2024.01.016","url":null,"abstract":"<div><p>Peripheral nerve injuries are potentially devastating injuries leading to pain and impairment in motor and sensory functions. Since the first published use of microsurgical epineural repair of peripheral nerves in 1964, a wide variety of adjuncts have been studied. Polyethylene glycol is a fusogen that has been shown to restore axolemmal membranes. The use of polyethylene glycol in nerve injuries was first described in 1986, and animal studies have shown fusion of transected sensory and motor nerves following early application at the time of surgical repair with improved motor and sensory outcomes. Early human clinical trials have shown promising results, although more data are needed to provide specific indications and protocols. This article summarizes the background, current evidence, and future directions as well as potential applications of polyethylene glycol–mediated nerve fusion.</p></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 5","pages":"Pages 740-742"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589514124000318/pdfft?md5=9b133558b9256235658e4adf7e2378e7&pid=1-s2.0-S2589514124000318-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140404925","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":"Magnetic Resonance Imaging Findings of Extensor Carpi Radialis Brevis Origin and Synovial Fold in Lateral Epicondylitis","authors":"Kenta Inagaki MD ,&nbsp;Nobuyasu Ochiai PhD ,&nbsp;Eiko Hashimoto PhD ,&nbsp;Yu Hiraoka MD ,&nbsp;Shohei Ise PhD ,&nbsp;Seiji Ohtori PhD","doi":"10.1016/j.jhsg.2024.06.005","DOIUrl":"10.1016/j.jhsg.2024.06.005","url":null,"abstract":"<div><h3>Purpose</h3><p>Magnetic resonance imaging (MRI) is the most widely used imaging to diagnose lateral epicondylitis (LE). However, the importance of MRI findings in LE remains unclear. This study aimed to classify the signal intensity changes of the extensor carpi radialis brevis origin and the shape and length of the synovial fold using MRI and compare them with clinical symptoms. We hypothesized that MRI findings in LE are not associated with clinical symptoms.</p></div><div><h3>Methods</h3><p>Two hundred and forty-three patients (261 elbows, mean age: 51.2 ± 8.5 years, mean duration of LE: 18.2 ± 11.3 months) who were evaluated using pretreatment MRI were included. The signal change of the extensor carpi radialis brevis origin was classified using coronal T2-weighted (T2) imaging and coronal fat-suppressed proton density T2 imaging, and the shape and length of the synovial folds were evaluated using coronal and sagittal T2 imaging. Furthermore, MRI findings were compared with clinical symptoms at the first visit.</p></div><div><h3>Results</h3><p>The number of elbows with high signal intensity on fat-suppressed proton density T2 was 252 of 261 (96.5%), and those on T2 were 207 of 261 (79.3%). Synovial folds were observed in 231 of 261 (88.5%) of the elbows, and synovial folds having a dull shape were observed in 95 of 261 (36.4%) elbows. The length of the synovial fold was &gt;1/3 of the radial head in 87 of 261 (33.3%) of the elbows. There was no statistically significant correlation between the MRI findings and clinical symptoms.</p></div><div><h3>Conclusions</h3><p>A high rate of high signal intensity changes of the extensor carpi radialis brevis origin was observed, and fat-suppressed proton density T2 could detect finer signal changes than T2. Furthermore, synovial folds were found in many cases of LE. However, there was no association between MRI findings and clinical symptoms at first visit.</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 5","pages":"Pages 654-658"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589514124001269/pdfft?md5=443b5a072057363840f5199a564e47e8&pid=1-s2.0-S2589514124001269-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141696745","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 Role of Tissue Engineering and Three-Dimensional–Filled Conduits in Bridging Nerve Gaps: A Review of Recent Advancements","authors":"","doi":"10.1016/j.jhsg.2024.01.024","DOIUrl":"10.1016/j.jhsg.2024.01.024","url":null,"abstract":"<div><p>Tissue-engineered nerve guidance conduits (NGCs) are an area of research interest and investment. Currently, two separate three-dimensional, filled NGCs have Food and Drug Administration approval in the management of nerve gaps up to 3 cm in length, with more on the horizon. Future NGC options will leverage increasingly intricate designs to mimic the natural biology and architecture of native nerve tissue. To enhance the development of next-generation NGCs, experimental protocols and models should be standardized. For the NGCs currently on the market, more clinical data and randomized comparative studies are needed.</p></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 5","pages":"Pages 700-704"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589514124000549/pdfft?md5=ae057f6bb44beda66b8a75c6de8230ec&pid=1-s2.0-S2589514124000549-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140405288","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}