Journal of Hand Surgery Global Online最新文献

{"title":"Sustained Serotonergic Stimulation Platform for Peripheral Axonal Regeneration","authors":"Sara C. Chaker BS ,&nbsp;Ling Yan PhD ,&nbsp;Jugal Kishore Sahoo PhD ,&nbsp;Cengiz H. Acikel MD ,&nbsp;Isaac V. Manzanera Esteve PhD ,&nbsp;David L. Kaplan PhD ,&nbsp;Michael Levin PhD ,&nbsp;Vijay S. Gorantla MD, PhD ,&nbsp;Wesley P. Thayer MD, PhD ,&nbsp;Huseyin Karagoz MD, PhD","doi":"10.1016/j.jhsg.2025.100811","DOIUrl":"10.1016/j.jhsg.2025.100811","url":null,"abstract":"<div><h3>Purpose</h3><div>Limitations remain in peripheral nerve injury treatments. Previous studies suggest that serotonergic signaling promotes nerve regeneration by facilitating reinnervation and modulating neuronal guidance. This study aimed to evaluate the potential of serotonergic peripheral neuroregeneration using Zolmitriptan, a serotonin receptor agonist.</div></div><div><h3>Methods</h3><div>A total of 24 female Sprague-Dawley rats were divided into four nerve injury cohorts. Sciatic nerve transection and primary repair were performed in two groups, whereas a 1-cm nerve defect was created and repaired with the same nerve segment as an autograft in the other two groups. One primary repair group and one nerve graft group received 1 mL of Zolmitriptan directly to the nerve via sonicated silk protein gels. Control groups received gels without Zolmitriptan. At postoperative 8 weeks, the sciatic nerves were collected for histological analysis. Ex vivo diffusion tensor magnetic resonance imaging was also used to assess axonal regeneration.</div></div><div><h3>Results</h3><div>The primary repair cohort treated with Zolmitriptan demonstrated robust regeneration, whereas the control cohort showed poorer regeneration. There was no statistical difference in regeneration between the treated and control autograft groups. When evaluating the regeneration rates of the primary repair groups, 80% of the axons successfully extended to the distal end in the Zolmitriptan group, compared with 57% in the control group. In the autograft groups, these rates were 65% for Zolmitriptan and 42% for the control. Electron microscopy supported the axonal counting results.</div></div><div><h3>Conclusions</h3><div>This pilot study suggests that Zolmitriptan may enhance peripheral nerve regeneration following transection injuries, warranting further investigation for clinical translation.</div></div><div><h3>Clinical relevance</h3><div>This study presents promising results regarding the potential of serotonin agonists to aid in peripheral nerve recovery. Additional investigation into these findings could inform new treatment strategies for peripheral nerve injuries.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 6","pages":"Article 100811"},"PeriodicalIF":0.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903103","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":"High-Pressure Injection Injury Debridement With the Versajet II Hydrosurgery System: Case Study and Literature Review","authors":"Lindsey A. Marks MD ,&nbsp;Alex N. Karanja MBCHB ,&nbsp;William B. O’Callaghan MBBS, FRACS","doi":"10.1016/j.jhsg.2025.100814","DOIUrl":"10.1016/j.jhsg.2025.100814","url":null,"abstract":"<div><div>High-pressure injection injuries to the hand are infrequent but potentially catastrophic injuries that have the potential for amputation or severe functional deficits. This is a case report on the management of a 28-year-old machinery operator who sustained a high-pressure grease gun injury to his dominant hand and underwent surgical debridement with a novel hydrosurgery technique. He had no complications and achieved a good functional outcome with a Disabilities of the Arm, Shoulder and Hand score of 1.67 at the 1-year follow-up. We also present a review of the literature and propose the use of hydrosurgery to address the challenges associated with the surgical treatment of these injuries.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 6","pages":"Article 100814"},"PeriodicalIF":0.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903104","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":"Protecting the Nerve Coaptation: Connector-Assisted Nerve Repair in Complex Injuries","authors":"Nesreen Zoghoul Alsmadi PhD ,&nbsp;Curt Deister PhD ,&nbsp;Peter Evans MD, PhD ,&nbsp;Tamer Ghanem MD, PhD ,&nbsp;Brandon Smetana MD ,&nbsp;Deana Mercer MD","doi":"10.1016/j.jhsg.2025.100816","DOIUrl":"10.1016/j.jhsg.2025.100816","url":null,"abstract":"<div><h3>Purpose</h3><div>This study evaluated differences in outcomes of peripheral nerve repair using connector-assisted repair (CAR) or direct repair (DR) in an injured soft tissue bed.</div></div><div><h3>Methods</h3><div>The sciatic nerve of the right leg in 20 male Lewis rats was exposed and transected. We simulated a traumatized wound bed by cauterizing the underlying muscle bed with a bipolar coagulator. Nerves were repaired with either DR or CAR using porcine small intestine submucosa conduits. At 6 weeks, adhesions were assessed semiquantitiatively, and the gastrocnemius wet muscle weight of each hind limb was recorded to evaluate muscle atrophy. Histology of the nerve was evaluated immediately distal to the nerve repair site. Data were analyzed for differences between repair methods.</div></div><div><h3>Results</h3><div>The DR group had a considerably higher area of foamy phagocytes and CD68-stained macrophages than that of the CAR group. There were considerably more blood vessels and axons in the CAR group than in the DR group. There were no differences between DR and CAR with respect to gastrocnemius muscle wet weight, extraneural adhesions, or intraneural collagen-to-cell ratio.</div></div><div><h3>Conclusions</h3><div>There was less area occupied by macrophages and foamy phagocytes in the CAR group, which was indicative of lower inflammatory response and resolving Wallerian degeneration. The CAR group also had more blood vessels and axons compared to that of the DR group, indicating more robust nerve regeneration. Gastrocnemius muscle weight between groups was similar, indicating that nerve regeneration was incomplete in both groups at the 6-week timepoint. These results highlight the potential benefits of CAR in protecting the nerve during the healing process.</div></div><div><h3>Clinical relevance</h3><div>This in vivo study evaluates histological changes in peripheral nerves during regeneration following transection with either CAR or DR.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 6","pages":"Article 100816"},"PeriodicalIF":0.0,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889849","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":"Artificial Intelligence in Hand Surgery: The Future is Upon Us","authors":"Bryan S. Crook MD ,&nbsp;Eoghan T. Hurley MBBS, PhD ,&nbsp;Marc J. Richard MD ,&nbsp;Suhail K. Mithani MD ,&nbsp;Tyler S. Pidgeon MD","doi":"10.1016/j.jhsg.2025.100793","DOIUrl":"10.1016/j.jhsg.2025.100793","url":null,"abstract":"<div><div>In just the past few years, artificial intelligence (AI) has transformed from a potential disruptive force in health care to a technology being rapidly deployed across multiple fronts in orthopedic care. The growth in AI use and development has largely occurred as computing technology has improved in concert with the massive amounts of data generation made possible by electronic medical records. The resulting impact of these technologies, including machine learning algorithms and large language models, has yet to be fully realized, but has already begun improving patient care, offloading administrative burden, and disrupting clinical research. The purpose of this review is to highlight areas in which AI is poised to change the delivery of surgical care with respect to hand surgery.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 6","pages":"Article 100793"},"PeriodicalIF":0.0,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889821","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":"A Novel Atraumatic Polymer-Assisted Peripheral Nerve Repair Device Compared With Microsurgical Neurorrhaphy","authors":"Diep Nguyen PhD ,&nbsp;Estelle Collin PhD ,&nbsp;Ricardo de Miguel PhD, Dipl. ECVP ,&nbsp;Edouard Reyes-Gomez Dipl. ECVP, PhD ,&nbsp;Ajul Shah MD ,&nbsp;Kyle R. Eberlin MD","doi":"10.1016/j.jhsg.2025.100812","DOIUrl":"10.1016/j.jhsg.2025.100812","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the ability of a polymer-assisted device to repair transected peripheral nerve in comparison to microsuture neurorrhaphy.</div></div><div><h3>Methods</h3><div>Twenty rat sciatic nerves were transected and repaired using either the polymer-assisted system or microsutures. Peripheral nerve functional recovery was evaluated through nerve conduction analysis performed at 1, 2, and 3 months. The gastrocnemius muscle mass ratio was measured. Peripheral nerve samples were imaged using microcomputed tomography. Local tissue response and nerve repair (including axonal density) were assessed through histology.</div></div><div><h3>Results</h3><div>No significant differences in functional outcomes were observed between the polymer-assisted system and microsutures. Both groups showed signs of nerve conduction as early as 2 month, which increased by the 3 month end point where muscle regrowth reached 60% of the nonoperated contralateral leg. Microcomputed tomography and histological analysis revealed a trend of increased intraneural fibrosis and a significantly lower axonal density when microsutures were used for the repair (<em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>The polymer-assisted system may reduce intraneural fibrosis compared to traditional microsutures, whereas functional recovery was found to be equivalent.</div></div><div><h3>Clinical relevance</h3><div>The polymer-assisted nerve repair device provides an alternative to microsutures without inducing additional trauma to the damaged peripheral nerve ends because of the nonpenetrative nature of the device.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 6","pages":"Article 100812"},"PeriodicalIF":0.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144887197","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":"Outcomes of Posterior Oblique Medial Epicondylectomy for the Treatment of Cubital Tunnel Syndrome","authors":"Shinsuke Morisaki MD, PhD ,&nbsp;Kengo Yoshii PhD ,&nbsp;Shinji Tsuchida MD, PhD ,&nbsp;Ryo Oda MD, PhD ,&nbsp;Kenji Takahashi MD, PhD","doi":"10.1016/j.jhsg.2025.100809","DOIUrl":"10.1016/j.jhsg.2025.100809","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the clinical outcomes and complication rates after posterior oblique medial epicondylectomy for the treatment of cubital tunnel syndrome (CuTS) and assess its efficacy in improving motor and sensory function with minimal postoperative morbidity.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 48 patients (51 extremities) with CuTS who underwent posterior oblique medial epicondylectomy between 2015 and 2023. All surgeries were performed by a single senior surgeon. Patients were assessed before surgery and at a mean follow-up of 22 months by using the McGowan grading system, the Wilson and Krout classification, grip and pinch strength, two-point discrimination, Quick Disabilities of the Arm, Shoulder, and Hand, and visual analog scale scores. Statistical analysis included the Fisher exact test and the Wilcoxon signed-rank sum test.</div></div><div><h3>Results</h3><div>After surgery, 90% of extremities improved by at least one McGowan grade. Wilson and Krout grading revealed outcomes of “excellent” in 31 patients, “good” in 17 patients, and “fair” in 3 patients. Significant improvements occurred in two-point discrimination (ring/little finger: from 12 to 6 mm) (<em>P</em> &lt; .001), side pinch (from 4.0 to 6.5 kg) (<em>P</em> &lt; .001), tip pinch (from 3.0 to 4.5 kg) (<em>P</em> &lt; .001), and grip strength (from 25 to 30 kg) (<em>P</em> &lt; .001). Quick Disabilities of the Arm, Shoulder, and Hand scores improved from 27 to 9.1, and visual analog scale scores decreased from 30 to 10 (<em>P</em> &lt; .001). No patient had symptomatic ulnar nerve subluxation or elbow instability. Six patients reported mild medial elbow pain.</div></div><div><h3>Conclusions</h3><div>Posterior oblique medial epicondylectomy for CuTS yielded favorable outcomes with significant improvement in motor and sensory function and minimal complications. This technique may offer advantages over traditional medial epicondylectomy by preserving elbow stability and enabling early active range of motion during the postoperative period.</div></div><div><h3>Clinical relevance</h3><div>Therapeutic IV.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 6","pages":"Article 100809"},"PeriodicalIF":0.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144887196","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":"Cubital Tunnel Revision After Transposition: A Single Center Experience","authors":"Kathryn S. King MD ,&nbsp;Reed Wulbrecht MD ,&nbsp;Mariel McLaughlin MD ,&nbsp;Victor T. Hung MD ,&nbsp;Jeffrey Stone MD ,&nbsp;Alfred V. Hess MD ,&nbsp;Michael J. Garcia MD","doi":"10.1016/j.jhsg.2025.100815","DOIUrl":"10.1016/j.jhsg.2025.100815","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to assess the rates of revision after cubital tunnel release with transposition among three different transposition techniques in a single institution.</div></div><div><h3>Methods</h3><div>A retrospective chart review of all cubital tunnel surgeries over a 5-year period was performed via a query of the billing records of three different surgeons who typically perform three different types of transposition. This yielded 937 records. After eliminating records with incomplete clinical information (141 records), a total of 796 records were evaluated, with 540 representing in situ releases and 255 transpositions. The transposition cohort was further evaluated, and 39 records were eliminated as the operation was performed for traumatic or post-traumatic indications, leaving 216 transpositions performed between December 1, 2016, and December 1, 2021.</div></div><div><h3>Results</h3><div>In the 216 cubital tunnel releases with transposition performed, 82 (38%) were subcutaneous transpositions, 71 (33%) were subfascial transpositions, and 63 (29%) were submuscular transpositions. Twenty of the 216 cubital tunnel releases with transpositions that were performed in this study period represented revision surgeries. Eleven were revisions after an in situ release, and eight were revisions after a transposition. One is unknown as the index operation was performed by an outside physician whose operative note was not available. Of the revision surgeries performed, 10 represented revisions of index cases performed by our institution with six being revisions for an in situ release and four revisions after a transposition. Of those four revisions after a transposition, one was performed for a subcutaneous transposition, two were following subfascial transpositions, and one was following a submuscular transposition. The average time from index operation to revision after a transposition was 16.3 months.</div></div><div><h3>Conclusions</h3><div>The rate of revision surgery following cubital tunnel release with transposition is quite low, and there do not appear to be major differences in the rate of revision among the different types of surgical transposition, indicating that a true subcutaneous transposition may be adequate.</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 6","pages":"Article 100815"},"PeriodicalIF":0.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144887198","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":"Orthosis Followed by Trapeziectomy for Thumb Base Osteoarthritis: A Cohort Pilot Study on Pain and Function","authors":"Kati Jaatinen M.Sc ,&nbsp;Jenni Pajari MD ,&nbsp;Eero Waris MD, PhD ,&nbsp;Jarkko Jokihaara MD, PhD ,&nbsp;Simo Taimela MD, PhD ,&nbsp;Teppo L.N. Järvinen MD, PhD ,&nbsp;Teemu Karjalainen MD, PhD","doi":"10.1016/j.jhsg.2025.100741","DOIUrl":"10.1016/j.jhsg.2025.100741","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to assess how much symptoms resolve during a 6-week continued nonsurgical treatment with an orthosis and after trapeziectomy in people with thumb carpometacarpal joint osteoarthritis (CMC-1 OA) referred for surgical consultation. The data on symptom resolution magnitude and trajectory can help inform patients about postsurgical recovery and assist researchers in designing clinical trials to evaluate surgery’s effectiveness for CMC-1 OA.</div></div><div><h3>Methods</h3><div>We recruited 52 patients with CMC-1 OA referred for surgical consultation. All eligible and willing patients underwent a 6-week treatment period with an orthosis before trapeziectomy. We collected outcome measures at the time of recruitment, after 6-week use of an orthosis (time of surgery), and at 3, 6, 9, and 12 months following the surgery. The Patient-Rated Wrist/Hand Evaluation questionnaire was the primary outcome measure. We used a repeated measures mixed model to estimate the group mean values for continuous outcomes. We compared the estimates with known minimal clinically important difference values.</div></div><div><h3>Results</h3><div>A continued nonsurgical treatment with a 6-week use of an orthosis resulted in no relief from hand disability and pain. After trapeziectomy, a large and clinically important change occurred at 3 months, and a rapid decrease in symptoms continued until 6 months, at which point it was three times the minimal clinically important difference value for Patient-Rated Wrist/Hand Evaluation.</div></div><div><h3>Conclusions</h3><div>This study provides useful estimates for the trajectory and magnitude of the symptom resolution after trapeziectomy. A continued nonsurgical treatment with a 6-week use of an orthosis had a negligible impact on symptoms in patients who were referred for surgical consultation. In contrast, a large improvement can be expected after trapeziectomy. However, it remains unclear how much of this change is attributable to the surgery itself.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic IIb.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 6","pages":"Article 100741"},"PeriodicalIF":0.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144887313","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":"Efficacy of Submuscular Transposition for Revision Cubital Tunnel Release: Comparative Outcomes Analysis","authors":"Joshua Riklan BS ,&nbsp;Alexzandra Mattia BS ,&nbsp;Markos Mardourian BS ,&nbsp;Harvey Chim MD","doi":"10.1016/j.jhsg.2025.100810","DOIUrl":"10.1016/j.jhsg.2025.100810","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess outcomes after revision cubital tunnel release and submuscular transposition and compare these to a cohort of patients undergoing primary release with in situ decompression.</div></div><div><h3>Methods</h3><div>Patients who underwent revision cubital tunnel release and submuscular transposition (n = 16) were enrolled. Mean follow-up was 21.4 months (range 12.8–55.6). Patients were evaluated in person using the Michigan Hand Outcomes Questionnaire (MHQ) and Disabilities of the Arm, Shoulder and Hand (DASH). Dellon stage, McGowan grade, visual analog scale for pain, and improvement of symptoms using the Messina’s criteria and Modified Bishop score were assessed. Comparative analysis was performed with a cohort of primary patients who underwent in situ decompression (n = 18), with a mean follow-up of 26.6 months (range 13.3–63.3).</div></div><div><h3>Results</h3><div>In revision patients, postoperative improvement in Dellon stage was seen in 13 (81.3%) and McGowan grade in 12 (75.0%). Messina’s criteria showed inferior but still satisfactory outcomes in the revision compared to primary cohort. Median MHQ was 57.1 (48.8–79.4) in the revision cohort and 76.3 (71.6–93.7) in the primary cohort. Median DASH was 26.3 (16.1–45.3) in the revision cohort and 11.7 (5.6–14.2) in the primary cohort. Differences between MHQ and DASH in both cohorts were statistically significant (<em>P</em> &lt; .05). Median visual analog scale was 2.5 (0–6) in the revision cohort and 1.5 (0–4.5) in the primary cohort.</div></div><div><h3>Conclusions</h3><div>The majority of patients undergoing revision cubital tunnel release and submuscular transposition have relief of symptoms. However, improvement is incomplete and inferior compared to patients undergoing primary release.</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 6","pages":"Article 100810"},"PeriodicalIF":0.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144887314","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":"Calculating Value in Hand and Wrist Care: A Systematic Review on the Current Literature","authors":"Zachary Chen BS ,&nbsp;Mithil Gudi BS ,&nbsp;Alex Lindahl BS ,&nbsp;Charles S. Day MD, MBA","doi":"10.1016/j.jhsg.2025.100735","DOIUrl":"10.1016/j.jhsg.2025.100735","url":null,"abstract":"<div><h3>Purpose</h3><div>Global health care systems are shifting toward value-based care models, with the hand and wrist field presenting a notable opportunity to enhance quality and efficiency because of large patient volumes, a variety of pathologies, and diversity in treatment options. This systematic review aimed to investigate the literature on calculations of value between different treatment options in hand and wrist care.</div></div><div><h3>Methods</h3><div>Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, two reviewers searched three databases to identify, screen, and evaluate research articles within hand and wrist care comparing the value between treatment groups based on real-world clinical data.</div></div><div><h3>Results</h3><div>Nineteen of 181 hand and wrist articles screened met our predetermined inclusion criteria. Studies primarily employed the EuroQol 5-Dimension survey for quality metrics with the payer or societal cost perspective. The incremental cost-effectiveness ratio formula was the most used value calculation. The majority of included studies originate from Europe. Studies assessing distal radius fracture care highlighted reduced imaging strategies as more cost effective than traditional methods and bandaging as more cost effective than rigid immobilization. Studies assessing scaphoid fractures identified immediate magnetic resonance imaging intervention to outperform standard care and cast treatment combined with early fixation to be superior to standalone surgery or no treatment.</div></div><div><h3>Conclusions</h3><div>Global literature on value-based comparative studies in hand and wrist care demonstrates variability in methodology, limiting direct comparisons. Most real-world studies were conducted within single-payer systems, highlighting the potential for further investments in value analysis protocols in multipayer systems.</div></div><div><h3>Clinical relevance</h3><div>Establishing a standardized methodology for value assessment, will enable better comparisons and improvements in hand and wrist care. As global health care costs continue to rise, conducting research that identifies high-value care across diverse health care systems is essential to ensure sustainable, effective, and patient-centered care for all stakeholders.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 5","pages":"Article 100735"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879589","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}