Journal of Hand Surgery Global Online最新文献

{"title":"The Effect of County-Level Food Insecurity on Baseline Patient-Reported Outcome Measures in Patients Undergoing Carpal Tunnel Release","authors":"Christy Zheng BS, MS ,&nbsp;Leah Demetri MD ,&nbsp;Philip Blazar MD ,&nbsp;Brandon E. Earp MD ,&nbsp;Dafang Zhang MD","doi":"10.1016/j.jhsg.2025.100927","DOIUrl":"10.1016/j.jhsg.2025.100927","url":null,"abstract":"<div><h3>Purpose</h3><div>Patient-reported outcome measures (PROMs) are widely used in hand surgery to assess symptom severity prior to surgical intervention; however, little is known about how food insecurity, an important social determinant of health, influences these scores. We aimed to measure the correlation between county-level food insecurity and baseline PROMs in a cohort of patients undergoing carpal tunnel release (CTR) for idiopathic carpal tunnel syndrome (CTS).</div></div><div><h3>Methods</h3><div>Baseline PROMs were prospectively collected in 114 patients with electrodiagnostic study, ultrasound, or CTS-6 confirmed CTS treated with CTR at a single tertiary referral center. Feeding America’s Map the Meal Gap Dataset was used to identify county-level food-insecurity rate, average meal cost, and percent eligible for Supplemental Nutritional Assistance Program. Correlations between food-insecurity parameters and PROMs were assessed using correlation coefficients; bivariate analyses of continuous explanatory variables were performed using linear regression.</div></div><div><h3>Results</h3><div>Mean age was 61.6 ± 12.7 years. A total of 57.9% were women, and 93.9% were White. In total, 14.9% and 19.3% of our cohort reside in Massachusetts counties falling within the upper quartile and upper half of food-insecurity rates, respectively. No significant correlations were found between food-insecurity variables and Patient-Reported Outcomes Measurement Information System (PROMIS) scores. Younger age was associated with worse Boston Carpal Tunnel Questionnaire–Symptom Severity Scale scores and PROMIS Pain Interference scores.</div></div><div><h3>Conclusions</h3><div>We found no evidence that patients with food insecurity present with greater symptom severity at time of CTR.</div></div><div><h3>Type of study/level of evidence</h3><div>Prognostic IIb.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 2","pages":"Article 100927"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977644","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":"Out-Of-Pocket Expenses of Carpal Tunnel Release","authors":"Derrick W. Williams MD, MBA ,&nbsp;Philip Blazar MD ,&nbsp;Kyra A. Benavent BS ,&nbsp;Laura Byrne BS ,&nbsp;Brandon E. Earp MD ,&nbsp;Dafang Zhang MD","doi":"10.1016/j.jhsg.2025.100846","DOIUrl":"10.1016/j.jhsg.2025.100846","url":null,"abstract":"<div><h3>Purpose</h3><div>Out-of-pocket charges (OOPCs) are growing faster than the total cost of care. Carpal tunnel release (CTR) is performed in variable surgical settings under different anesthetic protocols. OOPC of CTR may impact patient choice and patient perception of the value of their insurance. The primary objective of this study was to identify factors associated with OOPC after CTR.</div></div><div><h3>Methods</h3><div>We retrospectively identified patients who underwent CTR between January 1, 2019, and November 4, 2022 by three hand surgeons at a tertiary referral center in the Northeast United States. The final cohort comprised 808 patients. OOPC was defined as surgical and anesthesia fees billed to the patient for CTR surgery following primary and secondary insurance payment. Multivariable logistic regression analysis was performed to identify explanatory variables independently associated with our response variables.</div></div><div><h3>Results</h3><div>The mean age of the final cohort was 61.7 years, with 66% women, 79% White, and 100% insured. The multivariable logistic regression analysis showed protective factors against OOPC after CTR included Hispanic ethnicity and diabetes mellitus. Risk factors for having OOPC included no secondary insurance, procedure in a minor procedure room, and out-of-state residence.</div></div><div><h3>Conclusions</h3><div>As overall health care costs balloon, patients are bearing more financial responsibility for care. Our results may aid surgeons in shared decision-making discussions about modifiable surgical choices such as surgical setting and anesthesia choice.</div><div><em>Type of study/level of evidence</em>: Economic Analysis IV.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 2","pages":"Article 100846"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077554","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":"Cellular Bone Matrix for the Treatment of Considerable Bone Loss in Two Metacarpal Fractures","authors":"Serge Andreou MD, MS,&nbsp;Ameen Suhrawardy MD,&nbsp;Pranav Khambete MD,&nbsp;Andrew Tsai MD","doi":"10.1016/j.jhsg.2025.100924","DOIUrl":"10.1016/j.jhsg.2025.100924","url":null,"abstract":"<div><div>High-energy mechanisms that lead to hand fractures can create substantial bony defects that are not amenable to traditional treatments. Management options include autograft, allograft, and bone graft substitutes such as calcium sulfate/phosphate cements, which provide good results when used appropriately however each strategy has limitations. Cellular bone matrices (CBMs) are newer graft substitutes designed to supply osteogenic cells along with scaffold and inductive factors. We present a case series of metacarpal fractures with considerable ballistic-related defects treated with CBM augmentation. Two male patients (mean age 32 years) sustained second metacarpal fractures from high-caliber ballistic injury and were followed for 19 months. One required later tenolysis and dorsal capsulotomy for stiffness. Both demonstrated full radiographic union and CBM incorporation on computed tomography. This series shows excellent radiographic outcomes using CBM for metacarpal defects. Although further study is needed, to our knowledge, this is the first published evidence supporting CBM as an effective option for these injuries.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 2","pages":"Article 100924"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977705","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":"Antidepressant Use and Risk of Reoperation After Distal Radius Open Reduction and Internal Fixation: A Propensity Score-Matched Cohort Study","authors":"Firdavs Kurbanov BS ,&nbsp;Christopher Dussik MD ,&nbsp;Amy Phan MD ,&nbsp;Zion Rouege BS ,&nbsp;Danielle Wilbur MD ,&nbsp;Constantinos Ketonis MD, PhD","doi":"10.1016/j.jhsg.2025.100930","DOIUrl":"10.1016/j.jhsg.2025.100930","url":null,"abstract":"<div><h3>Purpose</h3><div>Antidepressant use is common and has been linked to impaired bone remodeling, but its effect on fracture healing after fixation remains unclear. The purpose of this study was to examine whether selective serotonin reuptake inhibitors (SSRIs) and, separately, agents that modulate serotonergic signaling but are not SSRIs (non-SSRI serotonergic antidepressants) were associated with unplanned return to the operating room (RTOR) after open reduction and internal fixation (ORIF) of distal radius fractures.</div></div><div><h3>Methods</h3><div>We performed a retrospective, propensity score-matched cohort study using TriNetX, a global federated research network that aggregates deidentified electronic health record data from large health care organizations. Adults who underwent surgery within 14 days of distal radius fracture diagnosis were included and the ORIF date served as the index. Two mutually exclusive exposure comparisons were analyzed: SSRI users versus nonusers and non-SSRI serotonergic users (serotonin-norepinephrine reuptake inhibitors), tricyclic antidepressants, serotonergic monoamine oxidase inhibitors, vortioxetine, or vilazodone versus nonusers, defined by ≥2 prescriptions in the 180 days preindex. Cohorts were balanced using 1:1 greedy nearest-neighbor propensity-score matching (caliper 0.10). The primary outcome was unplanned RTOR 30–365 days postindex, defined as nonunion repair or repeat fixation. We estimated absolute risk differences, risk ratios (RRs), and Cox hazard ratios (HRs) with 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>After matching, 2,657 SSRI users and 2,197 non-SSRI serotonergic users were compared with equal numbers of nonusers. Unplanned RTOR occurred in 47 (1.8%) SSRI users versus 20 (0.8%) nonusers (ARD 1.0%, RR 2.35, HR 2.25; 95% CI 1.33–3.79). Non-SSRI serotonergic users had 52 events (2.4%) versus 14 (0.6%) in nonusers (ARD 1.7%, RR 3.71, HR 3.62; 95% CI 2.01–6.54). Findings were consistent across absolute risk comparisons and time-to-event analyses.</div></div><div><h3>Conclusions</h3><div>Preoperative antidepressant exposure to SSRIs or non-SSRI serotonergic agents was associated with a small but clinically relevant increase in unplanned reoperation after distal radius ORIF.</div></div><div><h3>Type of study/level of evidence</h3><div>Prognostic III.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 2","pages":"Article 100930"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023226","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":"What Do Patients Want? Outcome Measures in a Diverse World","authors":"Ashley Titan MD ,&nbsp;Elspeth Hill MD, PhD ,&nbsp;Camille Brenac MD ,&nbsp;Tiffany Yue BS ,&nbsp;Elisabet Hagert MD, PhD ,&nbsp;Fabian Köninger MD ,&nbsp;Johnny Chuieng-Yi Lu MD ,&nbsp;Elisabeth Russe MD ,&nbsp;Catherine Curtin MD","doi":"10.1016/j.jhsg.2025.100945","DOIUrl":"10.1016/j.jhsg.2025.100945","url":null,"abstract":"<div><h3>Purpose</h3><div>Quantifying outcomes of medical interventions has evolved but challenges remain in hand surgery. Initially, hand surgeons used concrete assessments like range of motion and/or pinch strength. With a shift toward patient-centered care, numerous pathology–specific patient-reported outcome measures (PROMs) were developed. These measures typically used standardized closed-ended outcomes and mostly originated from western countries. However, it is unclear how well measures with specific items capture diverse patients’ values. Therefore, we used an open-ended PROM, the Patient-Specific Functional Scale (PSFS), to assess patients’ difficulties associated with daily living for two common hand diagnoses, carpal tunnel syndrome (CTS) and trigger finger (TF), allowing us to evaluate the breadth of variation of experiences and treatment goals across cultures.</div></div><div><h3>Methods</h3><div>We conducted a multi-institutional, international study on patients with diagnosis of CTS and TF. Patient desires were recorded using the PSFS. Data were qualitatively interrogated using template analysis.</div></div><div><h3>Results</h3><div>Patient responses from 225 PSFS scores from three continents and five countries were evaluated. Patients provided diverse functional impacts from CTS/TF that were categorized according to the International Classification of Functioning. There were diverse patient responses with variations in the proportion of domains represented in each country. Closed-ended PROMs (Quick Disabilities of the Arm, Shoulder, and Hand [QuickDASH], Boston Carpal Tunnel Score, and Patient-Reported Outcomes Measurement Information System) did not fully capture the priorities identified by patients in each country. Although these PROMs measure specific outcomes, they did not address the broader range of issues that patients in different countries considered most important.</div></div><div><h3>Conclusions</h3><div>This study highlights the diversity of patients’ priorities in hand function. There is a clear cultural influence on the perception and prioritization of specific hand functions in daily life.</div></div><div><h3>Clinical relevance</h3><div>Standardized tools with closed-ended outcomes miss the richness of the individuals’ goals, cannot adapt to new hand uses, and overlook cross-cultural differences. This weakness hinders accurate evaluation of patient satisfaction and limits intercultural comparisons. Achieving truly patient-focused care necessitates more open and inclusive assessment tools.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 2","pages":"Article 100945"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167040","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":"The Reversed Palmaris Longus: Sonographic Findings and Anatomical Correlation With Implications for Carpal Tunnel Syndrome Diagnosis and Management","authors":"Walter I. Sussman DO ,&nbsp;Erek W. Latzka MD ,&nbsp;Jay Smith MD","doi":"10.1016/j.jhsg.2025.100903","DOIUrl":"10.1016/j.jhsg.2025.100903","url":null,"abstract":"<div><div>Anomalous muscles of the forearm, including a reversed palmaris longus, may present as masses or median nerve compression syndromes, such as carpal tunnel syndrome. In both cases, ultrasound may be used as a first-line diagnostic test. This report presents a case of a reversed palmaris longus with sonographic findings and anatomic correlation. The diagnosis of these muscular anomalies, their relationship to compression syndromes, and implications for surgical planning are discussed.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 2","pages":"Article 100903"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841103","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 After Proximal Humerus Surgery: Does Regional Anesthesia Usage Matter?","authors":"Bill Young BS,&nbsp;Amy L. Ladd MD","doi":"10.1016/j.jhsg.2025.100920","DOIUrl":"10.1016/j.jhsg.2025.100920","url":null,"abstract":"<div><h3>Purpose</h3><div>Regional anesthesia is commonly used for intraoperative pain control during proximal humerus fracture surgery. We hypothesized that patients undergoing proximal humerus fracture surgery who received regional anesthesia would have increased postoperative emergency department (ED) utilization, increased perioperative opioid prescriptions, and greater incidence of persistent postoperative opioid prescriptions compared with those who received general anesthesia.</div></div><div><h3>Methods</h3><div>We retrospectively identified patients ≥18 years of age with a closed proximal humerus fracture undergoing either open reduction internal fixation (ORIF) or shoulder arthroplasty within 21 days of the fracture. We used International Classification of Diseases (ICD) 9/10 codes to identify patients using an administrative claims database. We categorized and then propensity-score matched patients based on receipt of regional anesthesia during surgery. Our first outcome was any instance of an ED visit within 7 and 30 days after surgery. Secondary outcomes included perioperative opioid prescriptions and the incidence of persistent opioid prescriptions. Multivariable regression models were used to assess the risk of an ED visit or persistent opioid usage based on the receipt of intraoperative regional anesthesia, adjusting for demographics and comorbidities.</div></div><div><h3>Results</h3><div>In total, 10,580 (33.3%) ORIF patients and 3,299 (33.6%) shoulder arthroplasty patients received regional anesthesia during surgery. Regional anesthesia was associated with an increased 7-day ED visit incidence compared to no regional anesthesia receipt for ORIF patients (3.3% vs 2.3%) and shoulder arthroplasty patients (2.7% vs 1.9%) (<em>P</em> &lt; .001 for both). In the 30-day postoperative window, regional anesthesia was associated with an increased incidence of an ED visit for ORIF patients (7.1% vs 5.8%) and shoulder arthroplasty patients (6.6% vs 5.2%) (<em>P</em> &lt; .001 for both). Regional anesthesia was also associated with greater perioperative opioid prescriptions across both surgeries (<em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>Further research should explore interventions for proximal humerus fracture surgery patients who receive regional anesthesia to reduce potentially preventable ED visits and opioid-related adverse events.</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":"8 2","pages":"Article 100920"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977645","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 Rare Anatomical Variant Dual Radial Digital Nerves in the Right Ring Finger: Consideration in Hand Dissection","authors":"Nikolas Vlassis BS ,&nbsp;Janse T. Schermerhorn MD ,&nbsp;Genevieve Rambau MD","doi":"10.1016/j.jhsg.2025.100906","DOIUrl":"10.1016/j.jhsg.2025.100906","url":null,"abstract":"<div><div>Digital nerve anatomy in the fingers is considered a predictable pattern of a single radial and ulnar neurovascular bundle, allowing for often safe midline dissection. In complicated cases, such as Dupuytren contracture or trauma, knowledge of digital nerve anatomy is paramount for safe dissection. The patient was a 68-year-old man with bilateral ring finger Dupuytren contractures. On the right hand, he had a 40° flexion contracture of the ring finger and underwent a palmar fasciectomy. Two distinct radial digital nerves were identified intraoperatively, with one branch in the traditional radial aspect of the digit, and a second branch centrally overlying the flexor tendons. This finding was later corroborated on the contralateral ring finger when he underwent subsequent palmar fasciectomy. Dual radial digital nerves are an uncommon anatomical variant that underscores the importance of careful neurovascular dissection. This case also raises concerns about percutaneous procedures distal to the metacarpophalangeal joint crease.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 2","pages":"Article 100906"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927060","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":"Analysis of the CTS-6 Questionnaire and Development of a Carpal Tunnel Syndrome Decision Tree","authors":"Eileen M. Colliton MD ,&nbsp;John R. Fowler MD","doi":"10.1016/j.jhsg.2025.100944","DOIUrl":"10.1016/j.jhsg.2025.100944","url":null,"abstract":"<div><h3>Purpose</h3><div>Carpal tunnel syndrome (CTS) is a common compressive neuropathy with no gold standard for diagnosis. The CTS-6 questionnaire is a previously validated tool used to determine the likelihood that a patient has CTS; however, numbness and tingling in the median nerve distribution is not a required symptom for a positive test result. The purpose of this study was to re-evaluate the components of the CTS-6 questionnaire to determine if a more succinct carpal tunnel screening tool could be developed.</div></div><div><h3>Methods</h3><div>A database of 295 upper extremities who had previously undergone CTS-6 testing were analyzed. All charts were reviewed to determine which patients were offered carpal tunnel release, used as the reference standard for a true positive diagnosis. We split the data into training (80%) and test (20%) sets that were used to develop and validate a decision tree for CTS, respectively. The performance metrics for this decision tree, the CTS-6 questionnaire, and variations of the questionnaire were calculated.</div></div><div><h3>Results</h3><div>The CTS-6 had a sensitivity of 76%, specificity of 60%, and overall accuracy of 71%. Variations of the CTS-6 had sensitivity of 72% to 93% and specificity of 37% to 65%, where a higher sensitivity came at the cost of lower specificity. The CTS decision tree had the best performance metrics, with 100% sensitivity, 65% specificity, and 88% overall accuracy.</div></div><div><h3>Conclusions</h3><div>A simple CTS decision tree has the potential to be an efficient screening tool to assist in determining which patients may be a good candidate for carpal tunnel release. Further investigation into this screening tool in a larger patient population should be performed to determine its usefulness in a clinical setting.</div></div><div><h3>Type of study/level of evidence</h3><div>Diagnostic IV.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 2","pages":"Article 100944"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077555","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":"Reported Minimal Clinically Important Differences for Patient-Reported Outcome Measures in Hand and Upper-Extremity Surgery: A Systematic Review","authors":"Jenna L. Dvorsky MS ,&nbsp;Michael R. Kann BE ,&nbsp;Christopher Gonzalez BS ,&nbsp;Andrew Gordon BS ,&nbsp;James Kim BS ,&nbsp;Angela Hardi MS ,&nbsp;John Fowler MD","doi":"10.1016/j.jhsg.2025.100942","DOIUrl":"10.1016/j.jhsg.2025.100942","url":null,"abstract":"<div><h3>Purpose</h3><div>In hand and upper-extremity surgery, there are many patient-reported outcome measures (PROMs) used to quantify symptom severity and track patient progress. However, there remains variability and uncertainty regarding the true or most appropriate minimal clinically important difference (MCID) values for each. This systematic review summarized the reported MCIDs for the most commonly used outcome instruments in hand and upper-extremity surgery.</div></div><div><h3>Methods</h3><div>The published literature was searched using strategies designed by a medical librarian for the concepts of MCID; the Boston Carpal Tunnel Questionnaire; the Disabilities of the Arm, Shoulder, and Hand Score (DASH); the Michigan Hand Outcomes Questionnaire; carpel tunnel syndrome; and other hand/upper limb disorders with related synonyms. These strategies were executed in Embase, Ovid-Medline All, CINAHL Plus, Scopus, and Web of Science from database inception. Studies retrieved from the database literature search were imported to Endnote. Any duplicate citations were identified and removed. The remaining citations were imported to Covidence screening software for further screening analysis.</div></div><div><h3>Results</h3><div>In total, 25 studies published from 1998 to 2025 were included in final data extraction and analysis. Among these, 9 (36.0%) reported the MCID value for BCTQ, 4 (16.0%) reported the MCID value for the MHQ and DASH, and 12 (48.0%) reported the MCID value for the Quick Disabilities of the Arm, Shoulder, and Hand.</div></div><div><h3>Conclusions</h3><div>This comprehensive systematic review summarized the reported MCIDs for the Boston Carpal Tunnel Questionnaire, DASH, Quick Disabilities of the Arm, Shoulder, and Hand, and Michigan Hand Questionnaire, all of which are commonly used hand and upper-extremity PROMs. Reported MCIDs for a given PROM can vary not only with the population or diagnosis of patients included but also with the methods used to calculate meaningful change in these patients.</div></div><div><h3>Clinical relevance</h3><div>This systematic review reports the MCIDs for common hand and upper-extremity outcome measures, providing surgeons with reference values to interpret patient-reported changes, while also demonstrating variability in MCID based on diagnosis and methodology. This can help distinguish meaningful improvement for different clinical and patient settings in addition to aid design of studies with clinically relevant end points in upper-extremity surgery.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 2","pages":"Article 100942"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077556","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}