Journal of Hand Surgery Global Online最新文献

{"title":"Early Diagnosis and Treatment of Cardiac Amyloidosis by Screening Biopsy During Trigger Finger Release","authors":"Ella Gibson MD ,&nbsp;Imo A. Ebong MD, MS ,&nbsp;Morgan A. Darrow MD ,&nbsp;Ge Xiong MD, PhD ,&nbsp;Angelo B. Lipira MD, MA ,&nbsp;Ravi F. Sood MD, MS","doi":"10.1016/j.jhsg.2024.07.013","DOIUrl":"10.1016/j.jhsg.2024.07.013","url":null,"abstract":"<div><div>Patients undergoing trigger release surgery are known to be at increased risk of amyloidosis and heart failure, and therefore, amyloidosis screening during trigger release surgery may facilitate early diagnosis and treatment of cardiac amyloidosis. However, the reported prevalence of amyloid on biopsies taken during trigger release surgery has varied widely, and no biopsy-positive patients in prior studies have been diagnosed with occult cardiac amyloidosis or started on disease-modifying therapy. We review the existing literature on this topic and present a case of a patient with cardiac amyloidosis diagnosed from a biopsy taken during trigger release surgery and subsequently started on disease-modifying therapy. This case supports the potential role of amyloidosis screening during trigger release and highlights the benefits of collaboration between hand surgeons and amyloidosis specialists in multidisciplinary amyloidosis programs.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 6","pages":"Pages 920-923"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142707193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter Regarding “Xylazine-Associated Wounds of the Upper Extremity: Evaluation and Algorithmic Surgical Strategy”","authors":"Tristan B. Weir MD ,&nbsp;Adam B. Strohl MD ,&nbsp;Andrew J. Miller MD","doi":"10.1016/j.jhsg.2024.06.011","DOIUrl":"10.1016/j.jhsg.2024.06.011","url":null,"abstract":"","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 6","pages":"Page 910"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hook of Hamate Regrowth After Surgical Excision: A Report of Two Cases","authors":"Michele Christy MD ,&nbsp;Charles A. Goldfarb MD ,&nbsp;Douglas Carlan MD","doi":"10.1016/j.jhsg.2024.08.008","DOIUrl":"10.1016/j.jhsg.2024.08.008","url":null,"abstract":"<div><div>Two high-level baseball players sustained a hook of hamate fracture while batting and were treated with excision of the fragment. Both players returned to play, and both had repeat fractures through a regenerated hook. This phenomenon of hook of hamate regeneration has not been well described in the literature. In conclusion, hook of hamate regeneration can occur after fracture fragment excision. The incidence and risk of this sequela as well as its association with surgical technique is uncertain.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 6","pages":"Pages 927-930"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Papillary Adenocarcinoma: A Case Presentation and Literature Review","authors":"Haley F. Pate MD ,&nbsp;David B. Fulton MD","doi":"10.1016/j.jhsg.2024.09.002","DOIUrl":"10.1016/j.jhsg.2024.09.002","url":null,"abstract":"<div><div>Digital papillary adenocarcinoma is a rare cutaneous tumor of eccrine origin that often presents as a papule or nodule on the dorsal aspect of a finger. It is challenging to diagnose because of its rarity, its benign appearance, and the lack of specific clinical or histological features. Excision is recommended, given the malignant nature and variable recurrence rates with metastases well documented in the literature. We present a case of a 49-year-old man with a digital papillary adenocarcinoma on his right middle finger. We discuss this patient’s treatment course and the lack of standardized treatment guidelines. Further research is needed to establish evidence-based management strategies for digital papillary adenocarcinoma.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 6","pages":"Pages 934-936"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical Comparison of Surgical Steel Wiring and Suture Tape Tension Band Techniques for Arthrodesis of the Metacarpophalangeal and Proximal Interphalangeal Joint","authors":"Michael J. McKernan MD ,&nbsp;Miguel A. Diaz MS ,&nbsp;Michael Kucharik MD ,&nbsp;Nino Coutelle MD ,&nbsp;Peter Simon PhD ,&nbsp;Michael C. Doarn MD","doi":"10.1016/j.jhsg.2024.08.014","DOIUrl":"10.1016/j.jhsg.2024.08.014","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to evaluate the biomechanical properties of SutureTape as an alternative technique for arthrodesis of the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joint arthrodesis when compared with surgical steel wire.</div></div><div><h3>Methods</h3><div>A total of 32 fingers (index, long, ring, and small) from two matched pair cadaveric hands were used. K-wire and surgical steel wire were used for MCP and PIP joint arthrodesis of the control group (group I), whereas K-wire and SutureTape were used for the experimental group (group II). Each sample was potted in high strength resin and secured to a custom fixture mounted to a hydraulic test frame. Each sample underwent cantilever bending in four directions (flexion, extension, ulnar, and radial) at a rate of 0.01 mm/s until a maximum force of 10 N. Thereafter, ramp to failure in extension at a rate of 20 mm/min was performed. Metrics of interest were bending stiffness (N/mm), displacement (mm), and peak load to failure (N), along with failure modes.</div></div><div><h3>Results</h3><div>For MCP arthrodesis, during cantilever bending in flexion direction, surgical steel construct was found to be stiffer when compared with suture tape (<em>P</em> = .036) and have less displacement (<em>P</em> = .040). No significant differences were detected for stiffness or displacement in extension, ulnar, or radial bending. During the ramp to failure, no significant differences were found for force, stiffness, or displacement. For PIP arthrodesis, the only significant difference detected was for displacement during ulnar bending (<em>P</em> = .035).</div></div><div><h3>Conclusions</h3><div>For MCP and PIP arthrodesis, the biomechanical performance of the SutureTape arthrodesis was similar to that of the steel wire across all loading conditions except for flexion and ulnar loading.</div></div><div><h3>Clinical relevance</h3><div>The use of SutureTape for MCP and PIP joint arthrodesis may provide equivalent biomechanical performance to that of steel wire, making it a viable alternative clinically.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 6","pages":"Pages 898-902"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142707190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Series of Traumatic Peripheral Nerve Injuries in Pediatric Patients Treated with Allograft Repair","authors":"Jacqueline Van Gheem MD ,&nbsp;Alexis Rounds MD ,&nbsp;Taylor Blackwood DO ,&nbsp;Cameron Cox BA ,&nbsp;Evan J. Hernandez MBA ,&nbsp;Desirae McKee MD ,&nbsp;Brendan MacKay MD","doi":"10.1016/j.jhsg.2024.05.008","DOIUrl":"10.1016/j.jhsg.2024.05.008","url":null,"abstract":"<div><h3>Purpose</h3><div>In the adult literature, allograft reconstruction of gapped peripheral nerve injuries has gained popularity over autologous nerve grafting. Allografts have demonstrated similar recovery while eliminating donor site morbidity. There is no well-defined incidence or treatment of such injuries in children. Our study explores the epidemiology and outcomes of traumatic pediatric peripheral nerve injuries treated with allograft.</div></div><div><h3>Methods</h3><div>This is a retrospective case series of a prospectively maintained database of all pediatric patients who underwent nerve allograft reconstruction at a Level I trauma center between September 2011 and July 2021.</div></div><div><h3>Results</h3><div>We identified 24 allograft nerve reconstructions in 18 patients, average age 12.9 years (range 1.5–17.0) and 78% male. Five patients (28%) were injured in a motor vehicle accident, and four were injured by sharp laceration, machinery, and blast injury (22%). The most injured nerve was digital (n = 10, 42%) followed by 8 (33%) ulnar, and 4 (17%) median. The average gap length was 30.3 ± 23.8 mm (range 4–87 mm). Fifteen nerves were repaired within 24 hours (63%). Average follow-up was 13.7 ± 14.5 months (range 1.6–46.8 months). At final follow-up, 9 (38%) had full sensory recovery, 6 (25%) protective sensation, 2 (8%) deep pressure, and 1 (4%) no sensation but a positive Tinel’s sign.</div></div><div><h3>Conclusions</h3><div>Allograft reconstruction is a viable option for the treatment of traumatic pediatric peripheral nerve injuries with gaps not amenable to direct repair.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic IV.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 6","pages":"Pages 801-807"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Numbness and Tingling Play a Role—Sexual Function in Compressive Neuropathy","authors":"Tiffany N. Bridges DO ,&nbsp;Adam S. Kohring DO ,&nbsp;Alexis A. Kasper BS ,&nbsp;Amir R. Kachooei MD, PhD ,&nbsp;Rick Tosti MD ,&nbsp;Michael Rivlin MD","doi":"10.1016/j.jhsg.2024.08.011","DOIUrl":"10.1016/j.jhsg.2024.08.011","url":null,"abstract":"<div><h3>Purpose</h3><div>Compressive neuropathies such as carpal tunnel and cubital tunnel syndrome can lead to sensation loss, muscle weakness, joint contractures, and disrupted sleep. The interplay between these conditions and the effect on patients’ intimacy is unknown. The purpose of this study was to examine sexual function before and after surgery in patients undergoing carpal tunnel release or cubital tunnel release.</div></div><div><h3>Methods</h3><div>All patients 18 years or older who underwent unilateral or bilateral carpal tunnel release and/or cubital tunnel release, performed either open or endoscopically, between January 2021 and August 2022, were retrospectively identified. An anonymous 21-question survey assessing pre- and post-operative sexual function was sent electronically to patients who were between 3 months and 2 years postprocedure.</div></div><div><h3>Results</h3><div>A total of 47% of respondents reported that their upper extremity symptoms disrupted their sexual activity. Before surgery, various challenges were reported: paresthesia (84%), pain (61%), reduced strength (53%), and reduced motion (40%). A total of 65% of patients changed positions before surgery, most frequently by avoiding weight-bearing (79%) and using the affected arm (55%). After surgery, 61% reported an easier time engaging in sexual activity, which was most frequently attributed to diminished paresthesia (69%) and pain (67%). A total of 73% of patients resumed sexual activities within 3 weeks of surgery. Ultimately, 32% of patients were more satisfied with their sexual function after surgery.</div></div><div><h3>Conclusions</h3><div>Sexual function is intimately tied to the physical and mental health of individuals. Surgical release improves sexual function and satisfaction.</div></div><div><h3>Type of study/level of evidence</h3><div>Retrospective Case–Control Cohort, Therapeutic III.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 6","pages":"Pages 796-800"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142707195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large Language Models in the Diagnosis of Hand and Peripheral Nerve Injuries: An Evaluation of ChatGPT and the Isabel Differential Diagnosis Generator","authors":"Abdullah AlShenaiber BHSc ,&nbsp;Shaishav Datta HBSc, MD ,&nbsp;Adam J. Mosa MD, MSc ,&nbsp;Paul A. Binhammer MD, MSc ,&nbsp;Edsel B. Ing MD, MPH, PhD","doi":"10.1016/j.jhsg.2024.07.011","DOIUrl":"10.1016/j.jhsg.2024.07.011","url":null,"abstract":"<div><h3>Purpose</h3><div>Tools using artificial intelligence may help reduce missed or delayed diagnoses and improve patient care in hand surgery. This study aimed to compare and evaluate the performance of two natural language processing programs, Isabel and ChatGPT-4, in diagnosing hand and peripheral nerve injuries from a set of clinical vignettes.</div></div><div><h3>Methods</h3><div>Cases from a virtual library of hand surgery case reports with no history of trauma or previous surgery were included in this study. The clinical details (age, sex, symptoms, signs, and medical history) of 16 hand cases were entered into Isabel and ChatGPT-4 to generate top 10 differential diagnosis lists. Isabel and ChatGPT-4’s inclusion and median rank of the correct diagnosis within each list were compared. Two hand surgeons were then provided each list and asked to independently evaluate the performance of the two systems.</div></div><div><h3>Results</h3><div>Isabel correctly identified 7/16 (44%) cases with a median rank of two (interquartile range = 3). ChatGPT-4 correctly identified 14/16 (88%) of cases with a median rank of one (interquartile range = 1). Physicians one and two, respectively, preferred the lists generated by ChatGPT-4 in 12/16 (75%) and 13/16 (81%) of cases and had no preference in 2/16 (13%) cases.</div></div><div><h3>Conclusions</h3><div>ChatGPT-4 had significantly greater diagnostic accuracy within our sample (<em>P</em> &lt; .05) and generated higher quality differential diagnoses than Isabel. Isabel produced several inappropriate and imprecise differential diagnoses.</div></div><div><h3>Clinical relevance</h3><div>Despite large language models’ potential utility in generating medical diagnoses, physicians must continue to exercise high caution and use their clinical judgment when making diagnostic decisions.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 6","pages":"Pages 847-854"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Possible Bupivacaine Induced Hepatitis Following Wide Awake, Local Anesthesia, No Tourniquet Carpal Tunnel Surgery: A Case Report","authors":"Michael G. Flood MD ,&nbsp;Rebecca Tananbaum BA ,&nbsp;Tyler J. Tantillo DO ,&nbsp;Marci D. Jones MD","doi":"10.1016/j.jhsg.2024.08.010","DOIUrl":"10.1016/j.jhsg.2024.08.010","url":null,"abstract":"<div><div>In this case report, we present a novel occurrence of acute hepatitis 2 weeks after local bupivacaine injection for wide awake, local anesthesia, no tourniquet carpal tunnel release. Laboratory and biopsy analysis confirmed cholestatic, drug-induced hepatitis that was successfully managed with conservative treatment. With a paucity of potential bupivacaine-induced hepatitis cases reported within the literature, the importance of broad differential diagnosis, meticulous medication reconciliation, and consideration of this rare complication should not be understated by the astute hand surgeon.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 6","pages":"Pages 931-933"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomic C Scapholunate Reconstruction Technique: For Complete Dissociation of the Scapholunate Interval","authors":"Robert Kalapos MD ,&nbsp;Mollie Manley MD","doi":"10.1016/j.jhsg.2024.08.015","DOIUrl":"10.1016/j.jhsg.2024.08.015","url":null,"abstract":"<div><div>This surgical technique article describes the anatomic C scapholunate reconstruction technique. It is indicated for complete acute or chronic scapholunate ligament dissociation. The technique addresses severe scapholunate interval gapping, ulnar translocation of the lunate, and rotational/dorsal intercalated segment instability. The C-shaped ligament is cradled from dorsal to volar using a symmetric four anchor/synthetic tape construct through a single dorsal incision and hyperflexion of the wrist. It does not require any volar incision/approach, as previously described techniques, and also avoids vascular disruption of the scaphoid ridge. An athlete patient case with illustration is also presented, who was treated with anatomic C scapholunate reconstruction on one wrist and all-dorsal scapholunate reconstruction on the other wrist. The two wrists are compared, and postoperative management with technique pearls and pitfalls are described.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 6","pages":"Pages 903-909"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142707191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}