Journal of Hand Surgery Global Online最新文献

{"title":"Congenital Mallet Finger: A Case Report","authors":"Ricardo Kaempf de Oliveira MD ,&nbsp;Paula Fischer MD ,&nbsp;Sergi Barrera-Ochoa MD ,&nbsp;Pedro J. Delgado MD","doi":"10.1016/j.jhsg.2024.11.015","DOIUrl":"10.1016/j.jhsg.2024.11.015","url":null,"abstract":"<div><div>This study describes a rare case of congenital hypoplasia of the terminal extensor tendon in the fifth finger, resulting in a mallet finger-like deformity, and presents the surgical technique used to correct the deformity. The case involves a three-year-old girl with a flexion deformity of the distal interphalangeal joint of the left fifth finger. Initial conservative treatment was unsuccessful, leading to surgical intervention, which involved resecting the hypoplastic portion of the extensor tendon and directly suturing the healthy proximal and distal portions. The surgery was reinforced with a periosteal strip from the middle phalanx. Postoperative recovery was monitored with physical therapy, and the patient showed successful correction of the deformity after 12 months. There was no recurrence of the deformity or functional limitations. The surgical technique proved effective in resolving the deformity, restoring function, and providing an excellent cosmetic result.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 1","pages":"Article 100690"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145690822","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":"Cartilage Defect Articulation With the Proximal Phalanx After Retrograde Intramedullary Screw Fixation of Metacarpal Fractures: A Cadaveric Study","authors":"Clayton Hui BS ,&nbsp;Benjamin Watzig MD ,&nbsp;Luke Nicholson MD ,&nbsp;Joshua W. Hustedt MD, MHS","doi":"10.1016/j.jhsg.2025.100847","DOIUrl":"10.1016/j.jhsg.2025.100847","url":null,"abstract":"<div><h3>Purpose</h3><div>Retrograde intramedullary screw fixation for metacarpal fractures has become increasingly popular; however, the technique requires violation of the extensor mechanism at the metacarpophalangeal (MCP) joint and penetration of the metacarpal articular surface. Although prior studies have quantified the proportion of metacarpal articular surface involved in screw placement, none have evaluated how the resulting cartilage defect articulates with the proximal phalanx at the MCP joint as a potential source of altered wear patterns.</div></div><div><h3>Methods</h3><div>In a cadaveric study, six specimens (24 metacarpals) underwent fixation of simulated metacarpal neck fractures with either a 3.6 or a 4.5 mm metacarpal-specific screw inserted via peritendinous or percutaneous approach. The location and percentage of the metacarpal head articular surface damage were measured. The MCP joint was then taken through a full arc of motion in all planes to map contact between the metacarpal defect and the proximal phalanx articular cartilage.</div></div><div><h3>Results</h3><div>Retrograde screw placement resulted in an average of 8% metacarpal articular surface damage. The percutaneous approach produced a significantly more volar starting point compared with the peritendinous approach. Across the simulated arc of motion, 100% of the proximal phalanx articular cartilage came into contact with the cartilage defect on the metacarpal head.</div></div><div><h3>Conclusions</h3><div>Retrograde metacarpal screw fixation produces a focal cartilage defect on the metacarpal head that tracks across the entire proximal phalanx articular surface during MCP joint motion.</div></div><div><h3>Clinical relevance</h3><div>This focal damage articulating with the entire base of the phalanx may alter contact stress, potentially accelerating degradation and predisposing to MCP arthritis over time.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 1","pages":"Article 100847"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145690820","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":"Nerve Transfer for Restoration of Ulnar Fingers Flexion Through Pronator Teres Motor Branch: A Cadaveric Feasibility Study","authors":"Paolo Titolo MD ,&nbsp;Alessandro Crosio MD, PhD ,&nbsp;Andrea Fanecco MD ,&nbsp;Erica Cavalli MD ,&nbsp;Francesca Vincitorio MD ,&nbsp;Julien Teodori MD ,&nbsp;Giulia Colzani MD ,&nbsp;Nathalie Bini MD ,&nbsp;Mario Ronga MD ,&nbsp;Michele Rosario Colonna MD, PhD ,&nbsp;Bruno Battiston MD, PhD ,&nbsp;Davide Ciclamini MD","doi":"10.1016/j.jhsg.2025.100844","DOIUrl":"10.1016/j.jhsg.2025.100844","url":null,"abstract":"<div><h3>Purpose</h3><div>Injury to the ulnar nerve above the elbow or other conditions such as brachial plexus injury or cervical spinal cord injury can also affect the extrinsic finger flexors. Numerous techniques have been described to treat this problem, but no specific nerve transfer has been proposed.</div></div><div><h3>Methods</h3><div>Here, we describe the transfer of the motor branch of the pronator teres (PT) to reinnervate flexor digitorum profundi of the ulnar nerve. Eleven fresh frozen upper limbs were used. The anatomical characteristics of the branches to the flexor digitorum profundus and PT were recorded.</div></div><div><h3>Results</h3><div>In all cases, the superficial branch of the PT resulted as the longest between the two and, therefore, was used as a donor. It was passed under the flexor pronator muscles to reach the ulnar nerve. The recipient motor branch was dissected proximally, and a direct nerve suture was made between the two stumps.</div></div><div><h3>Conclusions</h3><div>In all specimens, a direct tension free neurorrhaphy was possible, located close to the target muscle.</div></div><div><h3>Clinical relevance</h3><div>This specific procedure can be suggested in cases where the hand is partially involved to allow patients to regain or strengthen fingers flexion. Direct clinical application should support and confirm this novel procedure.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 1","pages":"Article 100844"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145420244","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":"Proof of Concept for Metacarpal Reconstruction Using a Custom 3-dimensional-Printed Titanium Implant: Design, Manufacturing, Surgical Technique, and Early Postoperative Outcomes","authors":"Ben Wesorick BSE ,&nbsp;Olabamibo Oke MD ,&nbsp;Nadine Elizabeth Withrow CST ,&nbsp;Daniel Herrera BS ,&nbsp;Tara Mann PhD ,&nbsp;Lexi Lewis BSE ,&nbsp;Nur Nurbhai DO","doi":"10.1016/j.jhsg.2025.100874","DOIUrl":"10.1016/j.jhsg.2025.100874","url":null,"abstract":"<div><div>This case report describes the use of a 3-dimensional-printed, custom titanium implant for the reconstruction of a complex post-traumatic metacarpal malunion. A 33-year-old woman with an open fracture of the right second metacarpal progressing to malunion from a motor vehicle accident underwent single-stage hand reconstruction using a custom implant. This report outlines preoperative planning, implant design, manufacturing, and surgical execution. Postoperative imaging confirmed appropriate implant positioning, soft tissue balancing, and deformity correction. The custom implant restored joint alignment and motion, resolving the preoperative fixed hyperextension contracture of the digit. At the 2-year follow-up, the implant demonstrated good incorporation without loosening and maintained digit function. This case demonstrates the unique application of a custom 3-dimensional-printed implant, from implant design through surgical execution, for complex hand reconstruction where alternative off-the-shelf options are not feasible, and highlights advantages in anatomical restoration and surgical precision in challenging patient populations.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 1","pages":"Article 100874"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145420301","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":"CMC Arthroplasty for Treatment of the Painful and Arthritic Thumb: A Review of Surgical Treatment Options with Preferred Technique","authors":"Jon E. Hammarstedt MD ,&nbsp;Yehuda A. Masturov BS ,&nbsp;Sebastian D. Arango MD ,&nbsp;Jacob Zeitlin MD ,&nbsp;Samuel H. Payne MD ,&nbsp;Mark S. Rekant MD","doi":"10.1016/j.jhsg.2025.100864","DOIUrl":"10.1016/j.jhsg.2025.100864","url":null,"abstract":"<div><div>Arthritis of the first carpometacarpal joint is a prevalent and often disabling condition for many older adults. The diagnosis is typically established through a comprehensive patient history, physical examination, and confirmatory radiographs. Nonsurgical management with splinting and anti-inflammatory medication has demonstrated effectiveness. Several surgical options have proven effectiveness for those who fail nonsurgical management. Surgical options include silicone implantation, resection arthroplasty, tendon interposition, ligament reconstruction, denervation, and joint implant arthroplasty. In the following review, we will elaborate upon the array of therapeutic approaches, culminating in the delineation of our preferred method.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 1","pages":"Article 100864"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145384189","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 “Dynamic Tenodesis Technique for Ulnar Drift With Extensor Tendon Subluxation due to Rheumatoid Arthritis” by Oda et al","authors":"Parth Aphale PhD ,&nbsp;Himanshu Shekhar BHMS ,&nbsp;Shashank Dokania BHMS","doi":"10.1016/j.jhsg.2025.100883","DOIUrl":"10.1016/j.jhsg.2025.100883","url":null,"abstract":"","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 1","pages":"Article 100883"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526464","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":"Neuroma Prevention by Nerve to Artery Coaptation: A Pilot Study","authors":"Tyler D. Ragsdale MD ,&nbsp;Peter K. Firouzbakht MD ,&nbsp;Benjamin A. Nwadike MD ,&nbsp;Grant R. Kolar MD, PhD ,&nbsp;John Tracy Watson MD ,&nbsp;Vikas Dhawan MD, PhD","doi":"10.1016/j.jhsg.2024.12.006","DOIUrl":"10.1016/j.jhsg.2024.12.006","url":null,"abstract":"<div><h3>Purpose</h3><div>Neuroma formation is a notable complication that can occur following amputation. Newer techniques are proving to be successful in preventing neuroma formation by providing the proximal nerve segment with an end organ to help with organized growth. Redirecting arterial blood flow to the nerve endings may be an effective mechanism of preventing neuroma formation. The aim of this study was to demonstrate that by coapting the proximal end of a transected nerve with a functional artery as a vascular end organ, neuroma formation can be prevented.</div></div><div><h3>Methods</h3><div>Six Sprague-Dawley rats were used for the control and experimental groups. Subjects underwent hind limb dissection to identify the femoral neurovascular bundle. The control group underwent an in situ neurectomy of the femoral nerve, and the experimental group had the addition of a femoral artery arteriotomy and an end-to-side coaptation of the proximal nerve segment into the functional artery. The rats were killed after 90 days, and a histologic analysis was performed using S100 stains.</div></div><div><h3>Results</h3><div>For the control group, the average number of axons was found to be 13 (3–33). For the experimental group, the average number of axons was 4.6 (1–12). The average diameter of the axons was 109.75 μm (range, 74–230 μm) and 157.37 μm (range, 100–278 μm) for the control and experimental groups, respectively. The average area of neural tissue was 16,707.76 μm² (range, 4,470–59,642 μm²) and 24,709.46 μm² (range, 8,222–64,529 μm²) for the control and experimental groups, respectively. No statistically notable difference was found between the control and experimental groups for mean number, diameter, or area of axons.</div></div><div><h3>Conclusions</h3><div>The nerve-artery coaptation may be able to reliably prevent neuroma formation in acutely transected nerves. Histopathologic analysis showed that the experimental group had more organized growth. Future studies should be performed to see how this technique could be translated to human patients.</div></div><div><h3>Type of study/level of evidence</h3><div>Prevention-Bench Research V.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 1","pages":"Article 100688"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145690938","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":"Functional Outcomes of Miniplate/Screw Versus Suzuki Frame Fixation in Eaton Type III Middle Phalanx Base Fractures: A Case Series","authors":"Ekrem Özdemir MD ,&nbsp;Nasuhi Altay MD ,&nbsp;Fatih Emre Topsakal MD ,&nbsp;Mehmet Koçaslan MD ,&nbsp;Bilal Karabak MD ,&nbsp;Esra Demirel MD","doi":"10.1016/j.jhsg.2025.100866","DOIUrl":"10.1016/j.jhsg.2025.100866","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate and compare the surgical and functional outcomes of dynamic external fixation using the Suzuki frame versus volar miniplate fixation for intra-articular Eaton type III fractures at the base of the middle phalanx.</div></div><div><h3>Methods</h3><div>Thirty patients treated surgically between September 2022 and December 2023 were retrospectively analyzed. Group 1 (n = 15) underwent Suzuki frame application; group 2 (n = 15) received open reduction and internal fixation (ORIF) with a volar miniplate and screws. Operative time, complications, postoperative proximal interphalangeal joint range of motion, Visual Analog Scale, and Disabilities of the Arm, Shoulder, and Hand (<em>Quick</em>DASH) scores were compared. Statistical analysis included Student <em>t</em> tests, chi-square tests, effect size calculations, and minimal clinically important difference (MCID)-based clinical significance analysis, with <em>P</em> &lt; .05 significance threshold.</div></div><div><h3>Results</h3><div>Both groups achieved complete fracture union and a mean postoperative proximal interphalangeal range of motion of 90°. However, the Suzuki group demonstrated shorter operative times (27.1 vs 55.5 min), lower complication rates (6.6% vs 26.6%), reduced pain levels (Visual Analog Scale: 1 vs 2), and better functional recovery (<em>Quick</em>DASH: 2.3 vs 6.8). Disabilities of the Arm, Shoulder, and Hand scores showed statistically significant differences (Suzuki: 2.3 vs ORIF: 6.8, <em>P</em> = .040), but the 4.5-point difference fell below the established MCID threshold of 6.8 points. Visual Analog Scale pain scores also differed significantly (Suzuki: 1 vs ORIF: 2, <em>P</em> = .004), but the 1-point difference was below the MCID threshold of 1.6 points. Responder rate analysis showed similar proportions achieving clinically meaningful improvements (<em>Quick</em>DASH: 53.3% vs 46.7%, <em>P</em> = .742).</div></div><div><h3>Conclusion</h3><div>Despite achieving statistical significance, MCID-based analysis confirmed that the Suzuki frame and ORIF miniplate fixation techniques yield clinically equivalent outcomes in hand surgery. This finding underscores that treatment selection should not be driven by statistical superiority but rather by surgeon expertise, fracture-specific characteristics, patient-centered preferences, and health care resource considerations. Such an equivalence-based perspective provides a more meaningful framework for evidence-based, individualized, and cost-effective decision making in clinical practice.</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 1","pages":"Article 100866"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145420289","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 Splinting in Managing Adult Trigger Finger: A Systematic Review of Short-Term Outcomes","authors":"Elise S. McKenna ,&nbsp;Nathaniel Co ,&nbsp;Hanna Brancaccio ,&nbsp;Blane Soper ,&nbsp;Aryan Borole ,&nbsp;Yuri Han ,&nbsp;David Kirschenbaum MD ,&nbsp;Brian M. Katt MD","doi":"10.1016/j.jhsg.2025.100881","DOIUrl":"10.1016/j.jhsg.2025.100881","url":null,"abstract":"<div><h3>Purpose</h3><div>Trigger finger is a common hand condition often managed conservatively with splinting, which reduces pain and improves function by immobilizing the affected digit. Splinting is a viable alternative for patients wishing to avoid corticosteroid injections or surgery. Short-term studies suggest it effectively relieves symptoms; however, adherence can be challenging. This systematic review evaluates the short-term efficacy of splinting for trigger finger and aims to identify the most effective splint.</div></div><div><h3>Methods</h3><div>A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and registered with the International Prospective Register of Systematic Reviews Registry. Six medical databases were queried, and studies screened using predetermined inclusion criteria. Relevant data were extracted and analyzed.</div></div><div><h3>Results</h3><div>Thirteen studies met criteria, investigating various blocking orthoses worn for 6 to 12 weeks. Splinting consistently reduced pain, stopped triggering, and improved function over the short term (within 1 year), with success rates up to 97%, comparable to corticosteroid injections but without risks like skin atrophy or infection. Regardless of splint type, splinting was most effective when worn 24 hours a day. Although the metacarpophalangeal joint blocking orthoses was the most studied orthotic, the proximal interphalangeal joint blocking orthoses (PIP-BO) outperformed the metacarpophalangeal joint blocking orthoses , providing more effective pain reduction and better functional outcome. Patients found the PIP-BO to be more comfortable and aesthetic, leading to greater wear time.</div></div><div><h3>Conclusions</h3><div>Splinting is an effective short-term conservative treatment for trigger finger, offering symptom relief and functional improvement. Although adherence may be challenging for some patients, splinting remains a valuable option for those seeking noninvasive management. PIP-BOs superior functional outcomes, patient satisfaction, and cost-effectiveness, leads our study to recommend a PIP-BO worn continuously for at least 6 weeks, if splinting is chosen as a first-line treatment. Further research is needed to explore long-term outcomes and standardize splinting approaches for broader clinical application.</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 1","pages":"Article 100881"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145576948","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":"Trends in Epidemiology and Reimbursement for Nerve Exploration and Reconstruction After Brachial Plexus Injury in the United States From 2009 to 2019","authors":"Thomas J. McQuillan MD ,&nbsp;Kevin Heo MD ,&nbsp;Olivia Jagiella-Lodise BS ,&nbsp;Joseph G. Monir MD ,&nbsp;Eric R. Wagner MD ,&nbsp;Nicole A. Zelenski MD","doi":"10.1016/j.jhsg.2025.100829","DOIUrl":"10.1016/j.jhsg.2025.100829","url":null,"abstract":"<div><h3>Purpose</h3><div>Brachial plexus injury (BPI) is an uncommon peripheral nerve disorder with a multitude of treatments. Given the relative rarity of this condition, it is difficult to estimate the volume of primary and secondary reconstructive procedures in the United States, as well as demographic and geographic trends in treatment.</div></div><div><h3>Methods</h3><div>The study used a large administrative commercial insurance claims database to estimate the total volume of procedures associated with a diagnosis of BPI from the years 2009 to 2019. Unique Current Procedural Terminology codes were tabulated among beneficiaries with a known diagnosis of BPI and stratified by key variables including age, sex, and geographic region to assess for trends in diagnosis and management. Reimbursement data for specific Current Procedural Terminology codes were adjusted for inflation and evaluated over the follow-up period.</div></div><div><h3>Results</h3><div>The incidence rate of nerve procedures for BPI increased over the study period from 1.26 to 1.91 procedures per 100,000 patient-years, as did the incidence rate of unique patients with BPI treated with nerve procedures, from 0.76 to 1.18. More procedures were performed in the age group 18–34 years (35.1%) and the South geographic region (40.6%). The most common codes included brachial plexus neuroplasty (Current Procedural Terminology codes 64713 and 64861; 64% of total). Reimbursement increased for codes related to brachial plexus neuroplasty over the interval of +26% and decreased for both neuroplasty of peripheral nerves (−23.9%) and nerve transfers (−39.7%).</div></div><div><h3>Conclusions</h3><div>The volume of procedures performed for BPI continues to increase with the dissemination of surgical techniques and knowledge. Relative increases in the older adult patient population, among females, and in the South necessitate a patient-specific approach given that historically most treatment has been provided to young, male patients. Declining reimbursement for certain codes necessitates continued advocacy given the complexity of surgery and technical advances in the field.</div></div><div><h3>Type of study/level of evidence</h3><div>Differential diagnosis/symptom prevalence IV.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 1","pages":"Article 100829"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526517","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}