Journal of Hand Surgery Global Online最新文献

{"title":"Enhanced Diagnostic Accuracy of Fast-Field Echo Resembling a Computed Tomography Using Restricted Echo-Spacing for Hand Tendon Injuries: A Comparative Study","authors":"Yukari Matsuzawa MD, PhD ,&nbsp;Yusuke Matsuura MD, PhD ,&nbsp;Kaoru Kitsukawa MD, PhD ,&nbsp;Takahiro Yamazaki MD, PhD ,&nbsp;Kayo Inaguma MD ,&nbsp;Seiji Ohtori MD, PhD","doi":"10.1016/j.jhsg.2025.100773","DOIUrl":"10.1016/j.jhsg.2025.100773","url":null,"abstract":"<div><h3>Purpose</h3><div>Fast-field echo resembling a computed tomography using restricted echo-spacing (FRACTURE), a magnetic resonance imaging (MRI) sequence (Philips Healthcare) providing computed tomography-like bone contrast, enables excellent visualization of bones and tendons. Volume rendering (VR) images created from this sequence show anatomical details of a patient’s actual structures. This study evaluated the diagnostic performance of FRACTURE and its VR images for visualizing wrist tendons on MRI images from patients and healthy individuals.</div></div><div><h3>Methods</h3><div>Twenty subjects were included, 10 patients with tendon injuries and 10 healthy individuals who underwent MRI scanning. The imaging protocols were FRACTURE (with VR images), T2-weighted imaging (T2WI), and proton density-weighted volumetric isotropic turbo-spin-echo acquisition (PD-VISTA). An orthopedic surgeon, a hand-surgery specialist, and a radiologist not involved in the surgeries used three methods to interpret the images: FRACTURE multiplanar reconstruction, FRACTURE VR, and PD-VISTA + T2WI. The assessment criteria included tendon injury diagnostic accuracy, interpretation time, and ease-of-interpretation scoring. Diagnostic accuracy was calculated as the correct diagnosis rate. Interpretation time and scoring were analyzed by paired <em>t</em> tests and Bonferroni correction for multiple comparisons.</div></div><div><h3>Results</h3><div>Fast-field echo resembling a computed tomography using restricted echo-spacing VR showed the highest tendon injury diagnostic accuracy, with considerably better interpretation time performance and ease-of-interpretation scoring versus PD-VISTA + T2WI. In the surgical cases, the tendon rupture sites on FRACTURE images corresponded to the intraoperative findings.</div></div><div><h3>Conclusions</h3><div>Fast-field echo resembling a computed tomography using restricted echo-spacing was excellent across all assessment criteria, and FRACTURE VR had particularly high diagnostic performance and clinical utility. Although obliquely oriented tendons, such as of the thumb and little finger, require consideration of the magic angle effect, clear visualization of these tendons was possible with appropriate positioning. Additionally, FRACTURE’s high tendon visualization capability enabled the identification of anatomical variations, enhancing its usefulness in clinical hand-surgery practice.</div></div><div><h3>Clinical relevance</h3><div>Tendon injury diagnosis was faster and more accurate with FRACTURE VR than with conventional sequences.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773020","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":"Abnormal Presence of Cholesterol Crystals within Poroma","authors":"Brant Hannahs MSII ,&nbsp;Elizabeth A. Helsper MD ,&nbsp;Ben Van Bockern MSII ,&nbsp;Victoria Durkin MD ,&nbsp;Andrew J. Erie MD ,&nbsp;Robert E. Van Demark Jr. MD","doi":"10.1016/j.jhsg.2025.100782","DOIUrl":"10.1016/j.jhsg.2025.100782","url":null,"abstract":"<div><div>Eccrine poromas are small adnexal neoplasms that arise from the lumen of sweat glands. These lesions are typically small and can mimic other skin conditions, complicating their differentiation during physical examination. We present a case involving a 70-year-old Caucasian man who presented with an unusual mass on his left hand that had considerably increased in size. Initially, a diagnosis of a ganglion was considered; however, subsequent surgical removal and histopathological examination confirmed the diagnosis of poroma. Notably, cholesterol crystals were also found in the mass, a finding that is atypical for this type of neoplasm. If not addressed, poromas may undergo malignant transformation into porocarcinoma, which is associated with poor prognostic outcomes. Furthermore, various systemic or metabolic conditions may influence the development and prognosis of these neoplasms, informing their management and treatment strategies.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 5","pages":"Article 100782"},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773018","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":"Comment on “Evaluating the Association Between Obesity and Development of Trigger Finger and Carpal Tunnel Syndrome”","authors":"Amnuay Kleebayoon PhD ,&nbsp;Viroj Wiwanitkit MD","doi":"10.1016/j.jhsg.2025.100800","DOIUrl":"10.1016/j.jhsg.2025.100800","url":null,"abstract":"","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 5","pages":"Article 100800"},"PeriodicalIF":0.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773019","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":"Ballistic Distal Radius Fractures: A Single-Center Experience in Management and Outcomes","authors":"Kanad Ghosh MD ,&nbsp;Manish Pathuri BS ,&nbsp;Jason Strelzow MD ,&nbsp;Jennifer Moriatis Wolf MD, PhD","doi":"10.1016/j.jhsg.2025.100794","DOIUrl":"10.1016/j.jhsg.2025.100794","url":null,"abstract":"<div><h3>Purpose</h3><div>Gunshot wounds (GSWs) to the upper extremities can be devastating and often require surgical treatment. Ballistic injuries to the distal radius in particular present a complex challenge for hand surgeons because of concerns of bony comminution, neurovascular injury, and injury to surrounding structures. This study compares the demographics, management, and complications of nonballistic versus ballistic distal radius fractures (DRFs).</div></div><div><h3>Methods</h3><div>In this retrospective study, patients over the age of 16 years with radiographically confirmed DRFs were reviewed from 2018 to 2023. Demographic data, surgical details, and postoperative complication data were collected. X-ray imaging was evaluated for fracture healing. In addition to comparison of all patients, 1:1 matched cohort comparison was conducted, controlling for age, smoking, and fracture classification.</div></div><div><h3>Results</h3><div>Of the 265 patients, 21 had DRFs due to GSWs, and 244 sustained DRFs from other mechanisms. GSW patients were significantly younger and predominantly male. Arbeitsgemeinschaft für Osteosynthesefragen classification demonstrated higher intra- and extra-articular comminution in GSW patients, and GSW patients had higher rates of distal radioulnar joint instability and carpal fractures. Additional injuries outside the upper extremity and neurovascular symptoms were also more common in GSW patients. GSW patients were more likely to undergo surgery and had longer times to surgery. Despite the delayed surgical intervention, no differences were observed in fixation methods, time to full weight bearing, or complications between groups. After 1:1 matching, there remained a significantly higher proportion of men in the GSW cohort, a higher rate of carpal fractures, a higher rate of nonhand injuries, and a greater time to surgery in the GSW cohort. There remained no significant difference in complications.</div></div><div><h3>Conclusions</h3><div>Because of their complexity, GSWs to the upper extremities present considerable management issues. The present study compares ballistic to nonballistic injuries to the distal radius. Although there were differences in presentation and surgical management, there were no significant differences in complications.</div></div><div><h3>Type of study/level of evidence</h3><div>Prognostic IV.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 5","pages":"Article 100794"},"PeriodicalIF":0.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773021","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":"Extensor Pollicis Brevis Tendon Transfer for Thumb Reconstruction in Radial Nerve Palsy: A Comparative Cadaveric Study","authors":"Yosuke Ito MD ,&nbsp;Yusuke Matsuura PhD ,&nbsp;Takane Suzuki PhD ,&nbsp;Takahiro Yamazaki PhD ,&nbsp;Kenji Kubota MD ,&nbsp;Seiji Ohtori PhD","doi":"10.1016/j.jhsg.2025.100781","DOIUrl":"10.1016/j.jhsg.2025.100781","url":null,"abstract":"<div><h3>Purpose</h3><div>In this study, we proposed a new tendon transfer method for thumb function reconstruction to treat radial nerve injuries. We specifically focused on enhancing thumb radial abduction by transferring the palmaris longus (PL) to the extensor pollicis brevis (EPB) while preserving the first compartment.</div></div><div><h3>Methods</h3><div>Eight freshly frozen cadaver specimens were used to compare our proposed technique (transferring the PL to the EPB while preserving the first compartment) with the Tsuge method (transferring the extensor pollicis longus (EPL) and fixing the abductor pollicis longus to the flexor carpi radialis). Thumb radial deviation, palmar abduction, and interphalangeal joint extension angles were measured at various traction forces.</div></div><div><h3>Results</h3><div>This method demonstrated superior efficiency in thumb radial abduction (especially at traction forces of 15 N and 20 N) compared to the Tsuge method.</div></div><div><h3>Conclusions</h3><div>Using the proposed method, the thumb extension and abduction functions can be reconstructed without requiring a pulley. However, concerns were raised about potential inadequate interphalangeal joint extension, although this can be mitigated by suturing the EPB and EPL. Our findings indicate that this method is suitable for our biomechanics study, suggesting its potential applications for cases in which radial nerve injuries necessitate tendon transfer.</div></div><div><h3>Clinical relevance</h3><div>The proposed method of transferring the PL to the EPB achieves more effective radial deviation of the thumb than the Tsuge method, highlighting its clinical applicability.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 5","pages":"Article 100781"},"PeriodicalIF":0.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721210","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":"Hyaluronate-Alginate Gel-Coated Porcine Small Intestine Submucosa for Nerve Protection Minimizes Extraneural Collagen Deposition in a Preclinical Model","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.2025.100784","DOIUrl":"10.1016/j.jhsg.2025.100784","url":null,"abstract":"<div><h3>Purpose</h3><div>This study evaluated the use of a hyaluronate-alginate gel-coated small intestine submucosa (HA-SIS) to protect a nontransected nerve in an adhesion rodent model.</div></div><div><h3>Methods</h3><div>The sciatic nerve of 60 male Lewis rats underwent neurolysis, with subsequent surgical treatments varying according to their assigned groups. The sham group (n = 20) was surgically closed immediately after neurolysis. The muscle bed of the untreated group (n = 20) was traumatized with a bipolar coagulator and then surgically closed. The muscle bed of the HA-SIS group (n = 20) was traumatized with a bipolar coagulator, the nerve was wrapped with HA-SIS, and the site was surgically closed. Ten animals in each group were terminated at each timepoint, 6 and 26 weeks. Surgical sites were assessed by gross pathology and histology.</div></div><div><h3>Results</h3><div>Gastrocnemius muscle wet weight was significantly higher in the HA-SIS group than in the untreated and sham groups at 26 weeks. At both timepoints, adhesion scores were highest in the untreated group. At both timepoints, extraneural collagen deposition was significantly higher in the untreated group than in the sham and the HA-SIS groups. At 26 weeks, CD68-positive macrophages were significantly higher in the untreated group than in the HA-SIS group. No significant differences were noted across groups for intraneural collagen-to-cell ratio and blood vessel count.</div></div><div><h3>Conclusions</h3><div>These results demonstrate that nerve wrapping with HA-SIS in an injured muscle bed reduces external nerve adhesions, extraneural collagen deposition, and long-term inflammation (CD68-positive macrophages) compared with the results of unwrapped nerves.</div></div><div><h3>Clinical relevance</h3><div>This level five study examines the impact of a hostile environment on nerve health, as well as the influence of a nerve protection device on diminishing its detrimental effects.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 5","pages":"Article 100784"},"PeriodicalIF":0.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724443","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":"Regarding “Relationship Among Postoperative Arthritis, Ischemic Changes in Subchondral Bone on Postoperative MR Images, and Central Impaction Fragment on Preoperative Computed Tomography Scans in Patients With Intra-articular Distal Radius Fracture: A Preliminary Report”","authors":"Stuart H. Kuschner MD","doi":"10.1016/j.jhsg.2025.100801","DOIUrl":"10.1016/j.jhsg.2025.100801","url":null,"abstract":"","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 5","pages":"Article 100801"},"PeriodicalIF":0.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721211","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":"Associations of Demographic, Lifestyle, and Clinical Factors With the Presence of Dupuytren Disease: Results from the Lifelines Cohort Study","authors":"Michel F.N. Noordman BSc ,&nbsp;Sophie A. Riesmeijer MD, PhD ,&nbsp;Paul M.N. Werker MD, PhD ,&nbsp;Ilja M. Nolte PhD","doi":"10.1016/j.jhsg.2025.100786","DOIUrl":"10.1016/j.jhsg.2025.100786","url":null,"abstract":"<div><h3>Purpose</h3><div>Many risk factors have been associated with Dupuytren disease (DD), but their contribution is still unclear. Therefore, we aimed to investigate the associations of a wide range of risk factors with the presence of DD in Lifelines, an ongoing prospective population-based cohort study with &gt;165,000 participants initiated in 2006.</div></div><div><h3>Methods</h3><div>The presence of DD was determined through questionnaires by self-reported doctor’s diagnosis. The association between demographic, lifestyle, and clinical factors and DD was analyzed using logistic regression adjusted for age, age², and sex. If <em>P</em> &lt; .25, the variable was selected for inclusion in multivariable logistic regression models. Related risk factors were grouped into blocks to overcome multicollinearity. Stepwise hierarchical modeling was applied. Nested models were compared using log-likelihood ratio tests. Sensitivity analysis using controls &gt;55 years was performed to assess the robustness of the findings.</div></div><div><h3>Results</h3><div>Overall, 1,320 (2.1%) Lifelines participants reported to have DD. Age, age², and sex accounted for 7.8% of the variability observed in DD risk. Other risk factors for DD were (osteo)arthritis, anti-inflammatory or antirheumatic products, high-density lipoprotein levels, triglyceride levels, alcohol use, and diabetes and diabetes medication, while anthropometric measures of adiposity were negatively associated with DD. Their contribution was relatively small, with the explained variance increasing only to 8.76%.</div></div><div><h3>Conclusions</h3><div>Older age and male sex were the predominant factors increasing DD risk, but anthropometric measures of adiposity, (osteo)arthritis, anti-inflammatory and antirheumatic drugs, high-density lipoprotein levels, triglyceride levels, alcohol use, diabetes and diabetes medication also contributed significantly to the final risk model for DD. In particular, the joint related factors are of interest because previous evidence for these risk factors was inconclusive.</div></div><div><h3>Clinical relevance</h3><div>Our risk model presents an opportunity for prevention of DD. Future studies should elucidate the role of rheumatoid arthritis in DD. Risk models may possibly enable the creation of accurate individual risk profiles of DD leading to optimization of care.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 5","pages":"Article 100786"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695137","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":"Incidence and Risk Factors for Soft Tissue Hand and Wrist Conditions in Pregnancy and Postpartum","authors":"Gabriella B. Smith BA ,&nbsp;Bill Young BA ,&nbsp;Ashley L. Titan MD ,&nbsp;Deborah E. Kenney MS, OTR/L ,&nbsp;Amy L. Ladd MD","doi":"10.1016/j.jhsg.2025.100778","DOIUrl":"10.1016/j.jhsg.2025.100778","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to identify the incidence of and risk factors associated with soft tissue hand conditions in pregnancy and postpartum. We hypothesized that the incidence of de Quervain tenosynovitis (DQT) and possibly carpal tunnel syndrome (CTS) and trigger finger would be higher in pregnancy and postpartum and that gestational diabetes would be a risk factor for these conditions.</div></div><div><h3>Methods</h3><div>Using the PearlDiver administrative claims database, we identified pregnant females undergoing vaginal or Cesarean delivery from 2011 to 2022. This cohort was propensity score matched based on age and Elixhauser comorbidity index to females who were not pregnant. We identified pregnant females with a diagnosis of gestational diabetes. Multivariate regression models were used to assess the risk of developing a hand condition within the first year postpartum, adjusting for age, geographical region, insurance plan, comorbidity index, and inflammatory arthritis or diabetes diagnosis. We applied these models to evaluate the risk of developing a hand condition in gestational diabetes patients.</div></div><div><h3>Results</h3><div>We identified a cohort of 357,534 postpartum patients and 357,803 control patients. We observed a 1.5% incidence of hand conditions postpartum compared to 1.3% in the control population (<em>P</em> &lt; .001). Pregnancy was associated with an increased risk of diagnosis with DQT (odds ratio [OR], 5.11; 95% confidence interval [CI], 4.47–5.85; <em>P</em> &lt; .001). Gestational diabetes was also associated with an increased risk of a hand condition diagnosis (OR, 1.34; 95% CI, 1.26–1.42; <em>P</em> &lt; .001), specifically increased odds of CTS (OR, 1.40; 95% CI, 1.29–1.51; <em>P</em> &lt; .001) and DQT (OR, 1.23; 95% CI, 1.12–1.34; <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Pregnancy is a significant risk factor for hand conditions and was associated with increased odds of DQT. Gestational diabetes is a significant risk factor for CTS and DQT. Our findings can inform screening and patient education efforts for high-risk pregnant patients.</div></div><div><h3>Type of study/level of evidence</h3><div>Prognostic IIIb.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 5","pages":"Article 100778"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695133","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":"Developing a Consensus-Based Core Set of Outcome Measures for Ulnar Nerve Surgery: A Delphi Study With Focus on the Supercharged End-to-Side Anterior Interosseous Nerve to Ulnar Nerve Transfer","authors":"Tachit Jiravichitchai MD, MSc ,&nbsp;Joy MacDermid PhD ,&nbsp;Maryam Farzad PhD ,&nbsp;Pulak Parikh PhD ,&nbsp;Stahs Pripotnev MD","doi":"10.1016/j.jhsg.2025.100788","DOIUrl":"10.1016/j.jhsg.2025.100788","url":null,"abstract":"<div><h3>Purpose</h3><div>The supercharged end-to-side (SETS) anterior interosseous to ulnar nerve transfer is increasingly used to augment intrinsic muscle recovery in patients with severe ulnar neuropathy. However, there is a lack of standardized outcome measures to evaluate the effectiveness of this procedure. This study aimed to develop a consensus-based core set of outcome measures applicable to ulnar nerve surgery, with a specific focus on the SETS transfer.</div></div><div><h3>Methods</h3><div>A two-round modified Delphi process was conducted involving 15 multidisciplinary experts in hand surgery and upper limb rehabilitation. The initial survey was informed by a comprehensive literature review and expert opinion. Participants ranked outcome domains and corresponding measurement tools based on their relevance in both clinical and research settings. Consensus was defined as ≥75% agreement. A second-round survey was conducted to refine the results and focus specifically on outcomes applicable to SETS procedures.</div></div><div><h3>Results</h3><div>In Round 1, experts reached consensus on several key domains including motor function, functional ability, quality of life, pain, dexterity, and sensory evaluation. In Round 2, a refined core outcome set for SETS procedures was established. Lateral pinch strength and daily living function self-assessment were prioritized across both settings. Validated tools endorsed included the Patient-Rated Ulnar Nerve Evaluation, Short Form-12, visual analog scale, nine-hole peg test, and two-point discrimination.</div></div><div><h3>Conclusions</h3><div>This Delphi study established a consensus-based core outcome set for evaluating surgical outcomes following ulnar nerve reconstruction, with specific application to SETS procedures. The proposed framework integrates patient-reported and clinician-rated measures and may support standardization in future research and clinical practice.</div></div><div><h3>Clinical relevance</h3><div>The lack of standardized outcomes for ulnar nerve transfers limits cross-study comparisons and evidence synthesis. This study provides a structured outcome set to support consistent evaluation and improve decision making in patients undergoing SETS or related procedures.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 5","pages":"Article 100788"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695138","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}