Journal of Hand Surgery Global Online最新文献

{"title":"Treating a Scar-Tethered Median Nerve Neuroma in Continuity With a Fly-Over Nerve Grafting Technique","authors":"Eleni Karagergou MD, PhD ,&nbsp;Emmanouil Pantelidis MD ,&nbsp;Dimitrios Kitridis MD ,&nbsp;Panagiotis Givissis MD, PhD","doi":"10.1016/j.jhsg.2024.08.001","DOIUrl":"10.1016/j.jhsg.2024.08.001","url":null,"abstract":"<div><div>Peripheral nerve neuromas may present significant therapeutic challenges especially when neuromas in continuity are scar-tethered to adjacent vital structures. We report a case of a patient who presented with delayed neurotmesis of median and ulnar nerves in the arm while extensive scarring of the median nerve was found in close proximity to the repaired brachial artery. For the surgical restoration of the continuity of the median nerve, the scarred segment was left in situ to avoid reinjury of the brachial artery and a “fly-over” nerve grafting technique with sural nerve autografts was employed.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 6","pages":"Pages 924-926"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142707194","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":"Suture Suspensionplasty Compared With Ligament Reconstruction and Tendon Interposition for Surgical Treatment of Thumb Carpometacarpal Arthritis","authors":"David A. Rivetti MD, MS ,&nbsp;Maria A. Munsch MD ,&nbsp;Jeffrey C. Wera MD ,&nbsp;Duc M. Nguyen MD ,&nbsp;John R. Fowler MD","doi":"10.1016/j.jhsg.2024.07.014","DOIUrl":"10.1016/j.jhsg.2024.07.014","url":null,"abstract":"<div><h3>Purpose</h3><div>Thumb carpometacarpal (CMC) arthritis is the most common arthritis of the hand, with most studies demonstrating little difference in outcomes between various surgical treatment techniques. However, trapeziectomy, followed by ligament reconstruction and tendon interposition (LRTI), remains the technique of choice among hand surgeons in the United States. In 2009, suture suspensionplasty (SS) was first described as a less invasive alternative to LRTI. The purpose of this study was to compare surgical details as well as patient-reported and radiographic outcomes between SS and LRTI for thumb CMC arthroplasty.</div></div><div><h3>Methods</h3><div>Following Institutional Review Board approval, 111 extremities were retrospectively identified in 104 patients who underwent carpometacarpal arthroplasty. Two age-matched cohorts were developed for patients having undergone LRTI (n = 58) or SS (n = 53) by one of three fellowship-trained hand surgeons. Tourniquet times were compared, and outcome measures included first metacarpal scaphoid space (FMSS) measured on 2-week postoperative radiographs, as well as Quick Disabilities of the Arm, Shoulder, and Hand (<em>Quick</em>DASH) score and pain score on a 10-point visual analog scale (VAS) from the preoperative visit as well as at 2 weeks, 6 weeks, and 3 months following surgery.</div></div><div><h3>Results</h3><div>There were no demographic differences between the two cohorts. There was no statistical difference between cohorts in VAS scores at any point in time. The SS cohort reported better <em>Quick</em>DASH scores at the 6-week postoperative visit; otherwise, <em>Quick</em>DASH scores did not differ between cohorts. The SS technique had shorter tourniquet times, and patients had less radiographic subsidence as evidenced by larger postoperative FMSS.</div></div><div><h3>Conclusions</h3><div>The SS arthroplasty technique demonstrated comparable early clinical results to LRTI. Furthermore, SS arthroplasty, which alleviates the need for tendon transfers and additional incisions with LRTI, had shorter tourniquet time, with less subsidence of the first metacarpal in the first 2 weeks.</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 861-864"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706716","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":"Unicortical Versus Bicortical Proximal Locking Screw for Prevention of Peri-Implant Fracture: A Biomechanical Analysis of an Osteoporotic Distal Radius Model","authors":"Mitchell C. Harris MD ,&nbsp;Ryan J. Bickley MD ,&nbsp;Pooyan Abbasi MSc ,&nbsp;Gabriel J. Yohe MS ,&nbsp;Kenneth R. Means MD ,&nbsp;Scott M. Tintle MD ,&nbsp;Aviram M. Giladi MD, MS","doi":"10.1016/j.jhsg.2024.07.004","DOIUrl":"10.1016/j.jhsg.2024.07.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Osteoporotic patients are at risk of peri-implant fractures after distal radius fixation. A unicortical screw in the proximal hole of the plate can theoretically decrease stress riser formation by eliminating the hole in the far bone cortex. This construct has been proposed in orthopedic literature to prevent peri-implant fractures but has not been tested in an osteoporotic distal radius model.</div></div><div><h3>Methods</h3><div>Eleven paired cadaver radii were harvested and plated with four-hole titanium volar distal radius plates. No osteotomies were created. The fixation constructs were identical except that group A used a bicortical proximal locking screw and group B used a unicortical proximal locking screw. Bone mineral density was estimated using radiographic measurements. The samples were potted and tested for four-point bending stiffness, torsion stiffness, and load to failure.</div></div><div><h3>Results</h3><div>Between the bicortical and unicortical screw groups, there was no significant difference in four-point bending stiffness (110.8 vs 106.2 N/mm, apex volar bending; 105.4 vs 107.1 N/mm, apex dorsal bending) or torsional stiffness (430.6 vs 427.6 N-mm/degree, internal rotation; 430.8 vs 429.7 N-mm/degree, external rotation). There was also no significant difference in load to failure with apex dorsal four-point bending (795.3 vs 770.0 N).</div></div><div><h3>Conclusions</h3><div>This study shows that a healed osteoporotic distal radius volar plate construct with a proximal unicortical locking screw is not statistically different from a bicortical screw in stiffness or load to failure in apex dorsal bending. Although a unicortical locking screw has been proposed as a mechanism to prevent stress risers at the proximal aspect of the distal radius plate, this study suggests no significant difference when compared with a bicortical locking screw.</div></div><div><h3>Clinical relevance</h3><div>There is no significant biomechanical advantage to unicortical over bicortical locking screws in the proximal hole of a distal radius plate to prevent diaphyseal peri-implant fractures in osteoporotic patients.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 6","pages":"Pages 842-846"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706771","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":"Scaphoid Fractures and Nonunion: A Survey-based Review of Hand Surgeon’s Practice and the Evidence","authors":"Jason A. Strelzow MD ,&nbsp;W. Kelsey Snapp MD ,&nbsp;Aviram M. Giladi MD, MS ,&nbsp;Robert Wysocki MD ,&nbsp;Charles C. Jehle MD","doi":"10.1016/j.jhsg.2024.06.013","DOIUrl":"10.1016/j.jhsg.2024.06.013","url":null,"abstract":"<div><h3>Purpose</h3><div>The Evidence-Based Practice Committee of the American Society for Surgery of the Hand set out to assess the membership’s practice patterns (PPs) and familiarity with evidence-based principles for scaphoid fracture and nonunion management.</div></div><div><h3>Methods</h3><div>Using a consensus-generated 25-item online survey, all the American Society for Surgery of the Hand members were invited to participate via email in September 2023. Two question types were used including evidence-based practice (EBP) and PPs. The survey was divided into the following subtopics: minimally displaced scaphoid fracture, operative options for scaphoid fixation, and treatment of scaphoid nonunion.</div></div><div><h3>Results</h3><div>Of 9 EBP questions, only one was answered with the preferred response by &gt;80% of surgeons. The remaining seven EBP questions had greater frequencies of less preferred responses. These questions concerned the current evidence for initial imaging options, optimal nonsurgical immobilization, percutaneous management, and the identification and treatment of nonunion. Of the PP questions, there were substantial differences of opinion on the choice of bone graft for nonunion, revisions, and patients with avascular necrosis. Nearly unanimous agreement was found for the use of headless compression screws for scaphoid fixation; however, the choice of approach for waist fixation was split between dorsal and volar percutaneous techniques and an open dorsal approach.</div></div><div><h3>Conclusions</h3><div>Scaphoid fracture and nonunion management continues to be an area of expanding evidence. There remain opportunities for our community to improve knowledge and familiarization with current evidence-based data. Many PPs areas demonstrated substantial agreement among the membership; however, there are areas of differences particularly graft choice, optimal approach for waist fixation, and postfixation protocols. Knowledge and familiarity with peer practices may help develop future areas of research and help to optimize patient care through a critically review and interpretation of the evidence.</div></div><div><h3>Type of study/level of evidence</h3><div>Economic/decision analyses V.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 6","pages":"Pages 836-841"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706694","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":"A Prospective Study Comparing Wide-Awake Local Anesthesia No Tourniquet Versus General Anesthesia in Hand Fracture Fixation","authors":"Shalimar Abdullah MS (Ortho), Dip Hand Surgery ,&nbsp;Khairul Azmi bin Ghazali MBBS (Ortho & Traumatology) ,&nbsp;Elaine Zi Fan Soh MBBS (Ortho & Traumatology) ,&nbsp;Jamari Sapuan MD, MS (Ortho) ,&nbsp;Parminder Singh Gill MBBS, MS (Ortho) ,&nbsp;Chia Hua Lim MD (Ortho & Traumatology)","doi":"10.1016/j.jhsg.2024.06.008","DOIUrl":"10.1016/j.jhsg.2024.06.008","url":null,"abstract":"<div><h3>Purpose</h3><div>Fixation of metacarpal or phalanx bone fractures is usually performed under general anesthesia (GA) or regional anesthesia and with the use of a tourniquet to minimize bleeding. However, the use of tourniquet causes pain and discomfort after surgery. Wide-awake local anesthesia no tourniquet (WALANT) enables the surgery to be performed with the patient fully awake and without a tourniquet, which allows intraoperative assessment of function during surgery. This study aims to compare the perioperative parameters and clinical outcomes between GA versus WALANT in hand fracture fixations.</div></div><div><h3>Methods</h3><div>Forty-eight patients with hand fractures were recruited over a period of 15 months. Twenty-one patients had undergone fracture fixation under GA, whereas another 27 patients had the surgery under WALANT. Parameters including vital signs (heart rate and systolic blood pressure), surgery duration, estimated blood loss, visual analog scale, and quick disabilities of the arm, shoulder, and hand (QuickDASH) questionnaire were evaluated.</div></div><div><h3>Results</h3><div>Wide-awake local anesthesia no tourniquet group had significantly higher systolic blood pressure values and higher estimated blood less than GA group. Wide-awake local anesthesia no tourniquet group also documented shorter surgical time compared with GA group, but the difference was not significant. In terms of clinical outcomes, WALANT group recorded significantly lower visual analog scale score at 2 hours and 2 weeks postsurgery. However, WALANT has a comparable QuickDASH score with GA group except at 3 months postsurgery.</div></div><div><h3>Conclusions</h3><div>Wide-awake local anesthesia no tourniquet surgery for hand fracture fixation provides a similar analgesic effect and comparable QuickDASH score except at 3 months postsurgery compared with GA.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic IIb.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 6","pages":"Pages 814-817"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142707197","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":"A Comprehensive Review of Topography and Axon Counts in Upper-Extremity Peripheral Nerves: A Guide for Neurotization","authors":"Ethan Paulin MD ,&nbsp;Evan C. Bowen BS ,&nbsp;Shireen Dogar DO ,&nbsp;Muntazim Mukit MD ,&nbsp;Michael S. Lebhar MD ,&nbsp;Laura I. Galarza MD ,&nbsp;Shelley R. Edwards BS ,&nbsp;Marc E. Walker MD, MBA","doi":"10.1016/j.jhsg.2024.08.002","DOIUrl":"10.1016/j.jhsg.2024.08.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Currently, no comprehensive database detailing topography and axon counts exists. This study aims to review the axon counts and topography of the major peripheral motor nerves of the upper extremity to allow for optimal surgical planning for peripheral nerve reconstruction via neurotization.</div></div><div><h3>Methods</h3><div>Peer-reviewed journal articles were identified through PubMed, ScienceDirect, Google Scholar, and CENTRAL. Studies were included for review based upon the identification of the described topography or axon count of any upper-extremity peripheral motor nerve. Animal research, laboratory studies, and unpublished studies were excluded from our review. A total of 43 studies were identified, and 38 of these met the inclusion criteria. Statistical analysis was performed to determine axon count averages for all upper extremity motor nerves identified in the included studies.</div></div><div><h3>Results</h3><div>Thirty-eight studies were reviewed, giving insights into the topography and axon counts of the major peripheral nerves of the upper extremity, including the brachial plexus and its terminal branches as well as common donor nerves such as the spinal accessory nerve and intercostal nerves. Studies showed considerable variability in reported axon counts.</div></div><div><h3>Conclusions</h3><div>Existing data were relatively weak and included several case reports and series. Taking this into consideration, we posit that there is a need for further studies of upper-extremity nerve axon counts that include large study populations and more consistent methods of nerve specimen analysis.</div></div><div><h3>Clinical relevance</h3><div>Understanding the topographical anatomy of donor and recipient nerves, as well as appropriately matching the motor axon counts for each donor and recipient, is helpful in upper-extremity nerve reconstruction.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 6","pages":"Pages 784-795"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142707364","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":"Inter- and Intraobserver Reliability for the Computed Tomography Scan Assessment of Union After Surgery for Scaphoid Fractures and Nonunion","authors":"Morten Kjær MD ,&nbsp;Dimitar Ivanov Radev MD ,&nbsp;Robert Gvozdenovic MD, PhD","doi":"10.1016/j.jhsg.2024.08.005","DOIUrl":"10.1016/j.jhsg.2024.08.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Assessment of scaphoid union after operative treatment might be associated with uncertainty, disagreement, and misinterpretation. Union is defined as consolidation on three of four X-ray views. Computed tomography (CT) scans are increasingly used to evaluate union of scaphoid fractures and nonunion. It allows multiplanar assessment of the scaphoid. Reliability in CT scan assessment of union after operative intervention is limited. We hypothesized that inter- and intraobserver reliability of the CT scan assessment of union after operative treatment for scaphoid fracture and nonunion are substantial and better in fracture cases.</div></div><div><h3>Methods</h3><div>An institutional search identified 230 patients with operative intervention. According to the sample size, we randomly selected 60 patients (30 fractures and 30 nonunion), with age above 18 years and CT scans 6–26 weeks after surgery, when uncertainty about healing status is most pronounced. Three observers evaluated the CT scans on two occasions 6 weeks apart. Observers classified the scaphoid into two categories: No/partial/full union and &gt;/&lt;50% union.</div></div><div><h3>Results</h3><div>Interrater agreement in no/partial/full union was overall substantial, substantial in fractures, and moderate for nonunion cases. Interobserver agreement for &gt;/&lt;50% union was overall moderate and moderate for both fractures and nonunion groups. The interrater agreement of no/partial/full union with CT scans ≥12 weeks after surgery was substantial versus fair for the cases below. Intrarater agreement was overall better in cases with CT scans ≥12 weeks postoperative versus earlier.</div></div><div><h3>Conclusions</h3><div>CT scans show substantial agreement in the assessment of no/partial/full union after operative intervention, although the presence of metal artifacts and bone grafts potentially impair visibility among observers. The agreement was better in scaphoid fractures. CT scan assessment of &gt;/&lt;50% union is with overall moderate agreement. Inter- and intrarater agreement is improved when CT scans are taken 12 weeks or later after operative treatment, blinded to the clinical information.</div></div><div><h3>Level of Evidence</h3><div>Diagnostic, III.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 6","pages":"Pages 865-869"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706717","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":"Electrodiagnostic Testing Predicts Postdecompression Outcomes in Patients With Cubital Tunnel Syndrome","authors":"Kevin R. Cuneo BS ,&nbsp;Thomas J. McQuillan MD ,&nbsp;Constance M. Sullivan BS, BA ,&nbsp;Hayden L. Cooke BS ,&nbsp;Sabryn A. Kapp BS ,&nbsp;Eric R. Wagner MD, MSc ,&nbsp;Michael B. Gottschalk MD","doi":"10.1016/j.jhsg.2024.08.013","DOIUrl":"10.1016/j.jhsg.2024.08.013","url":null,"abstract":"<div><h3>Purpose</h3><div>Electrodiagnostic (EDX) testing is commonly used in conjunction with symptoms and physical examination findings to diagnose cubital tunnel syndrome (CuTS). The purpose of this study was to investigate the relationship between preoperative EDX diagnosis and the degree of Disabilities of the Arm, Shoulder, and Hand (<em>Quick</em>DASH) improvement after surgery within the CuTS patient population.</div></div><div><h3>Methods</h3><div>A retrospective review was designed to analyze patients from a single institution who underwent a cubital tunnel release. Patients who had preoperative EDX testing, as well as preoperative and 3-month postoperative <em>Quick</em>DASH scores were eligible for inclusion. These patients were divided into two groups, EDX-positive or EDX-negative, based on the findings of their EDX testing for CuTS. Demographics, preoperative <em>Quick</em>DASH, postoperative <em>Quick</em>DASH, and changes in <em>Quick</em>DASH were compared between the two groups.</div></div><div><h3>Results</h3><div>Fifty-seven patients were included—34 EDX-positive and 23 EDX-negative. The EDX-negative cohort had higher preoperative <em>Quick</em>DASH scores, which approached but did not reach significance (<em>P</em> = .06). Both groups had significant improvement in <em>Quick</em>DASH following cubital tunnel release (<em>P</em> = .021, <em>P</em> &lt; .01). Patients with EDX-negative testing had a significantly greater improvement in <em>Quick</em>DASH from before surgery to 3 months after surgery (25 points vs 11, <em>P</em> &lt; .01).</div></div><div><h3>Conclusions</h3><div>Patients who underwent cubital tunnel release had a significant short-term improvement in their <em>Quick</em>DASH scores, regardless of EDX diagnosis. However, negative preoperative EDX studies in the setting of strong clinical suspicion of CuTS do not exclude diagnosis and may in fact be a positive, rather than a negative, predictive factor for short-term postoperative functional improvement.</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":"6 6","pages":"Pages 779-783"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706768","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":"Presenteeism and Absenteeism Before and After Carpal Tunnel Release or Open Reduction and Internal Fixation for Distal Radius Fracture","authors":"David N. Bernstein MD, PhD ,&nbsp;Alexy Ilchuk BA ,&nbsp;Monica M. Shoji MD ,&nbsp;Carl M. Harper MD ,&nbsp;Tamara D. Rozental MD","doi":"10.1016/j.jhsg.2024.08.009","DOIUrl":"10.1016/j.jhsg.2024.08.009","url":null,"abstract":"<div><h3>Purpose</h3><div>The use of a person’s hands is crucial to their ability to succeed at work. Hand pathologies can impact work success by increasing absenteeism (ie, not being able to go to work) and presenteeism (ie, being able to work but in a reduced capacity). In this study, we quantified employed patients’ presenteeism and absenteeism following carpal tunnel release or surgical fixation of a distal radius fracture (DRF).</div></div><div><h3>Methods</h3><div>In this prospective cohort study, 91 patients (carpal tunnel syndrome [CTS]: n = 62; DRF: n = 29) from June 2022 to December 2023 were included. Baseline patient characteristics and patient-reported outcome measures (PROMs) were collected. Presenteeism and absenteeism were calculated using the World Health Organization’s Health and Work Performance Questionnaire. Questionnaires were sought before surgery and at 3 and 6 months after surgery. Clinical improvement was determined using minimal clinically important difference (MCID) cutoff range estimates. The employee value of lost work was calculated as a percentage of the average patient in each group before surgery and at 6 months after surgery.</div></div><div><h3>Results</h3><div>The average change in PROMs scores from before to after surgery at 6 months surpassed the low-end MCID estimates for all functional and pain-related PROMs. For patients undergoing surgery for CTS and DRF, retained employee value rose from 85.6% to 130.2% (ie, worked more than expected) and 52.7% to 56.9%, respectively.</div></div><div><h3>Conclusions</h3><div>Patients undergoing surgery for CTS or DRF have clinically appreciable improvement in functional and pain symptoms by 6 months after surgery. However, by 6 months after surgery, carpal tunnel release results in greater than complete employee value recovery, compared with surgical fixation of DRFs in which greater than 40% of the employee value remains lost after surgery. These findings can assist with preoperative expectation setting.</div></div><div><h3>Type of study/level of evidence</h3><div>Prognostic II.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 6","pages":"Pages 882-887"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706720","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":"Bilateral Hemi-Hamate Autograft for Two Proximal Interphalangeal Joint Fracture Dislocations: A Case Report","authors":"Levonti Ohanisian MD ,&nbsp;Michael P. Kucharik MD ,&nbsp;Kathryn S. King MD ,&nbsp;Tantien Nguyen BS ,&nbsp;Michael Doarn MD","doi":"10.1016/j.jhsg.2024.07.001","DOIUrl":"10.1016/j.jhsg.2024.07.001","url":null,"abstract":"<div><div>A 27-year-old man sustained right ring and little finger proximal interphalangeal joint fracture dislocations. He subsequently underwent bilateral hemi-hamate autograft to treat these intra-articular injuries. The patient was followed periodically and demonstrated return of normal grip strength and radiographic union of the hemi-hamate reconstruction arthroplasties. This is the first reported case of a patient who underwent bilateral hamates as donor grafts for two proximal interphalangeal joint fracture dislocations. When patients present with multiple unrepairable proximal interphalangeal joint fracture dislocations, surgeons can consider bilateral hemi-hamate reconstruction arthroplasty as a consideration to restore normal function.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"6 6","pages":"Pages 915-919"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142707192","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}