Journal of Hand Surgery Global Online最新文献

{"title":"A Novel Technique to Assess Soft-Tissue Redundancy Over the Proximal Interphalangeal Joint","authors":"Justine S. Kim MD ,&nbsp;Alexandria A. Bosetti BS ,&nbsp;Elizabeth M. Kenny MD ,&nbsp;Nia Buckner MSc ,&nbsp;Samantha Maliha MD, MS ,&nbsp;Mark E. Baratz MD","doi":"10.1016/j.jhsg.2025.100748","DOIUrl":"10.1016/j.jhsg.2025.100748","url":null,"abstract":"<div><h3>Purpose</h3><div>Loss of redundant soft tissue over the proximal interphalangeal joint (PIPJ) may be a reason for the failed restoration of PIP motion. This study aimed to quantify the area of redundant skin over the PIPJ in normal subjects.</div></div><div><h3>Methods</h3><div>Measurements of 200 healthy volunteers were obtained using a novel technique. Redundant skin over the PIPJ was pinched and marked in a radial-to-ulnar, then proximal-to-distal direction with the PIPJ extended. The area of skin overlying the PIPJ was calculated for the index, middle, ring, and small fingers. A standardized ratio was developed to provide a normative scale to compare post-traumatic skin redundancy.</div></div><div><h3>Results</h3><div>The study population included 82 men and 118 women. Demographics including average height, weight, body mass index (BMI), smoking status, and hand dominance were collected. Skin redundancy or area of skin (mm²) overlying the PIPJ was calculated for bilateral index, middle, ring, and small fingers. Skin redundancy was greater in ring fingers of men compared with those of women. Skin redundancy was examined between BMI greater than 30 and less than 30 and found to be statistically different in the middle, ring, and small fingers. Normative values for skin redundancy by percentiles for each gender and BMI were generated.</div></div><div><h3>Conclusions</h3><div>Establishment of normative values may enable surgeons to explain the lack of progress after surgical joint release, determine progress with hand therapy, and choose the optimal timing of surgical intervention once soft-tissue equilibrium is achieved.</div></div><div><h3>Type of study/level of evidence</h3><div>Prognostic III.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 4","pages":"Article 100748"},"PeriodicalIF":0.0,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184684","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":"Evaluating the Association Between Obesity and Development of Trigger Finger and Carpal Tunnel Syndrome","authors":"Jason Sidrak BS ,&nbsp;Andy Lalka MPH ,&nbsp;Cailin Delaney PA-C ,&nbsp;Frank Scott MD","doi":"10.1016/j.jhsg.2025.100760","DOIUrl":"10.1016/j.jhsg.2025.100760","url":null,"abstract":"<div><h3>Purpose</h3><div>Obesity is known to cause a low-grade inflammatory environment that can influence the development of musculoskeletal disorders. We hypothesized that patients with high body mass index (BMI), defined as ≥30, would develop carpal tunnel syndrome (CTS) or stenosing tenosynovitis (TF) earlier than patients with a normal BMI.</div></div><div><h3>Methods</h3><div>A retrospective chart review was performed for adults diagnosed with CTS or TF between January 2016 and December 2020 at a tertiary center. The primary outcome was age at diagnosis of CTS or TF. A high BMI was considered <span><math><mrow><mo>≥</mo></mrow></math></span> 30, whereas a normal BMI was 18.5–24.9. A stepwise multivariate linear regression model compared the association of BMI with age of CTS or TF diagnosis after adjusting for accelerating covariates.</div></div><div><h3>Results</h3><div>In total, 259 patients met the inclusion criteria. Our analysis revealed that patients with a BMI above 30 were diagnosed with CTS or TF an average of 6.4 years earlier than those with a normal BMI, at 67.5 and 61.1 years, respectively (<em>P</em> = .0053). Furthermore, covariate analysis showed that a BMI above 30 was associated with the onset of CTS or TF 6.2 years sooner than patients with normal BMI (<em>P</em> &lt; .05). Current smokers developed CTS or TF 12.5 years sooner than never smokers (<em>P</em> &lt; .05). Patients with type 1 diabetes developed CTS or TF, on average, 18.8 years sooner than nondiabetic patients (<em>P</em> &lt; .05). Patients with hypertension developed CTS or TF on average 6.0 years later than those without hypertension (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Patients with a high BMI above 30 were diagnosed with CTS or TF at a younger age than normal BMI after covariate adjustment. Obesity is associated with accelerated development of CTS and TF after adjusting for comorbidities such as smoking and type 1 diabetes.</div></div><div><h3>Clinical relevance</h3><div>This study sheds light on the earlier development of CTS and trigger finger in patients with a BMI greater than 30, contributing to a relatively underexplored area of upper-extremity musculoskeletal pathology research and enabling clinicians with more thorough data for preventative talks with patients.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 4","pages":"Article 100760"},"PeriodicalIF":0.0,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184683","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":"Assessing Accuracy of Chat Generative Pre-Trained Transformer’s Responses to Common Patient Questions Regarding Congenital Upper Limb Differences","authors":"Niklaus P. Zeller BS ,&nbsp;Ayush D. Shah BA ,&nbsp;Ann E. Van Heest MD ,&nbsp;Deborah C. Bohn MD","doi":"10.1016/j.jhsg.2025.100764","DOIUrl":"10.1016/j.jhsg.2025.100764","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose was to assess the ability of Chat Generative Pre-Trained Transformer (ChatGPT) 4.0 to accurately and reliably answer patients’ frequently asked questions (FAQs) about congenital upper limb differences (CULDs) and their treatment options.</div></div><div><h3>Methods</h3><div>Two pediatric hand surgeons were queried regarding FAQs they receive from parents about CULDs. Sixteen FAQs were input to ChatGPT-4.0 for the following conditions: (1) syndactyly, (2) polydactyly, (3) radial longitudinal deficiency, (4) thumb hypoplasia, and (5) general congenital hand differences. Two additional psychosocial care questions were queried, and all responses were graded by the surgeons using a scale of 1–4, based on the quality of the response. Independent chats were used for each question to reduce memory–retention bias with no pretraining of the software application.</div></div><div><h3>Results</h3><div>Overall, ChatGPT provided relatively reliable, evidence-based responses to the 16 queried FAQs. In total, 164 grades were assigned to the 82 ChatGPT responses: 83 (51%) did not require any clarification, 37 (23%) required minimal clarification, 32 (20%) required moderate clarification, and 13 (8%) received an unsatisfactory rating. However, there was considerable variability in the depth of many responses. When queried on medical associations with syndactyly and polydactyly, ChatGPT provided a detailed account of associated syndromes, although there was no mention that syndromic involvement is relatively rare. Furthermore, ChatGPT recommended that the patients consult a health care provider for individualized care 81 times in 49 responses. It commonly “referred” patients to genetic counselors (n = 26, 32%), followed by pediatric orthopedic surgeons and orthopedic surgeons (n = 16, 20%), and hand surgeons (n = 9, 11%).</div></div><div><h3>Conclusions</h3><div>Chat Generative Pre-Trained Transformer provided evidence-based responses not requiring clarification to a majority of FAQs about CULDs. However, there was considerable variation across the responses, and it rarely “referred” patients to hand surgeons. As new tools for patient education, ChatGPT and similar large language models should be approached cautiously when seeking information about CULDs. Responses do not consistently provide comprehensive, individualized information. 8% of responses were misguiding.</div></div><div><h3>Type of study/level of evidence</h3><div>Economic/decision analysis IIC.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 4","pages":"Article 100764"},"PeriodicalIF":0.0,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184682","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":"Mechanical Effects of Wrist Position at the Wrist Joint: A Finite Element Analysis","authors":"Takashi Nomoto MD ,&nbsp;Yusuke Matsuura PhD ,&nbsp;Takahiro Yamazaki PhD ,&nbsp;Takane Suzuki PhD ,&nbsp;Seiji Ohtori PhD","doi":"10.1016/j.jhsg.2025.100747","DOIUrl":"10.1016/j.jhsg.2025.100747","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to evaluate the effects of wrist joint angles during flexion–extension and radioulnar deviation on stress distribution using finite element analysis.</div></div><div><h3>Methods</h3><div>Eight fresh-frozen upper limb specimens were analyzed using computed tomography. Finite element models were developed to simulate grip postures in flexion–extension (five positions ranging from 30° flexion to 30° extension) and radioulnar deviation (eight positions from 15° radial deviation to 20° ulnar deviation). Stress distributions (equivalent stress, minimum principal stress, and maximum principal stress) in the distal radius, ulnar head, and proximal carpal bones were assessed.</div></div><div><h3>Results</h3><div>In the flexion–extension model, stress was concentrated in the central area of the distal radius and increased with an increase in flexion–extension angles. Stress values in the ulnar head and triquetrum increased during flexion and extension, whereas stress changes were minimal in the scaphoid and lunate. The scaphoid fossa experienced higher stress than the lunate fossa, with the volar aspect of the distal radius under greater stress during extension and the dorsal aspect during flexion. In the radioulnar deviation model, radial deviation decreased the load on the lunate fossa while increasing the load on the ulnar head, triquetrum, and dorsal lunate. Conversely, ulnar deviation reduced the load on the ulnar head but increased the load on the volar aspect of the lunate fossa.</div></div><div><h3>Conclusions</h3><div>Finite element analysis demonstrated dynamic changes in wrist joint stress distribution at various motion angles.</div></div><div><h3>Clinical relevance</h3><div>These findings enhance the understanding of wrist biomechanics and provide insights into the pathomechanics of degenerative wrist conditions.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 4","pages":"Article 100747"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Epidemiology of Metacarpal Fractures: A Descriptive Study Based on 18,802 Fractures From the Swedish Fracture Register","authors":"Jakob Deuschl MD ,&nbsp;Henrik Alfort MD ,&nbsp;Maria Wilcke MD, PhD","doi":"10.1016/j.jhsg.2025.02.015","DOIUrl":"10.1016/j.jhsg.2025.02.015","url":null,"abstract":"<div><h3>Purpose</h3><div>Hand fractures are common injuries, but there are few large and detailed epidemiological reports describing them.</div></div><div><h3>Methods</h3><div>This study describes the distribution of metacarpal fractures and their impact on patient-reported outcome measures based on 18,802 fractures from the Swedish Fracture Register.</div></div><div><h3>Results</h3><div>The mean age at the time of injury was 39 years (men 33 years and women 52 years). The age distribution for women was bimodal. For men, there was unimodal peaking in early adulthood. Male injuries represented 70% of all metacarpal fractures. In men and children, the most common fracture was a distal extra-articular fracture of the fifth metacarpal, whereas in women, it was a shaft fracture of the fifth metacarpal. Fracture localization differed between metacarpals; 79% of the fractures in the first metacarpal were proximal, compared with 19% to 25% in the other metacarpals. Shaft fractures were the most common in the third and fourth metacarpals, and distal fractures were the most common in the second and fifth metacarpals. The most common cause of injury was a fall. Fractures of the first metacarpal were treated surgically to a greater extent than fractures in the other metacarpals. Men were operated on more often than women (19% vs 14%). Metacarpal fractures did not affect patient-rated hand function or quality of life 1 year after injury.</div></div><div><h3>Conclusions</h3><div>Metacarpal fractures are common and mostly treated nonsurgically and have a minimal effect on patient well-being.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic II.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 4","pages":"Article 100725"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144106280","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":"Surgery for Trapeziometacarpal Joint Arthritis: A Network Meta-Analysis of Randomized Studies","authors":"Dimitris Challoumas MBBCh, FRCS ,&nbsp;Ali Hamad MBChB ,&nbsp;Varun Rana MBChB ,&nbsp;Amit Putti MBBS, FRCS ,&nbsp;Neal L. Millar FRCS, PhD","doi":"10.1016/j.jhsg.2025.100737","DOIUrl":"10.1016/j.jhsg.2025.100737","url":null,"abstract":"<div><h3>Purpose</h3><div>Our aim was to compare the efficacy and safety of the available surgical interventions for trapeziometacarpal joint (TMCJ) arthritis.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and network meta-analysis of randomized studies comparing surgical interventions for TMCJ arthritis. Our primary outcome was patient-reported pain, and secondary outcomes were patient-reported functional disability, key pinch strength, and complications. Mean differences (MD) and standardized mean differences (SMD) were calculated for continuous outcomes and odds ratios (OR) for dichotomous outcomes, all with 95% confidence intervals.</div></div><div><h3>Results</h3><div>Twenty-one randomized studies were included. In pairwise meta-analyses, when simple trapeziectomy was compared with trapeziectomy with ligament reconstruction and tendon interposition (LRTI), all pain, functional disability, and key pinch strength were similar (pain visual analogue scale, MD 0.22 points [−0.66 to 0.21]; functional disability, SMD 0.17 [−0.06 to 0.41]; key pinch strength, MD 0.07 kg [−0.22 to 036], <em>P</em> = .64). Compared with trapeziectomy (with or without LRTI), total joint arthroplasty provided similar short-term pain relief (MD 0.20 points [−0.10 to 0.50], moderate certainty of evidence), statistically greater improvement in short-term functional disability (disabilities of the arm, shoulder, and hand), and key pinch strength (function disabilities of the arm, shoulder, and hand, MD 5.24 points [0.72–9.75], low certainty of evidence; key pinch strength, MD 0.92 kg [0.63,–1.21], and moderate certainty of evidence]). Only the difference in key pinch strength exceeded clinical significance. In network meta-analyses, total joint arthroplasty ranked first for all short-term pain, function, and key pinch strength; however, its superiority over other treatments was only significant for key pinch strength. Short-term complications between simple trapeziectomy and trapeziectomy with LRTI, and between trapeziectomy and total joint arthroplasty were similar; however, longer-term data were not available.</div></div><div><h3>Conclusions</h3><div>Total joint arthroplasty appears to be at least as effective as trapeziectomy for pain relief and functional disability and may be superior for key pinch strength in the short-term. Until long-term efficacy, complication, and survivorship data arising from high-quality comparative studies become available, its widespread use cannot be recommended.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic II.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 4","pages":"Article 100737"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115341","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":"Urgent Versus Delayed Surgical Treatment of Open Distal Radius Fractures: A Multicenter Retrospective Study","authors":"Luke Latario MD ,&nbsp;Matthew DeFazio MD ,&nbsp;Matthew Poorman MD ,&nbsp;Alan Shi MD ,&nbsp;Eric Swart MD ,&nbsp;Marci Jones MD","doi":"10.1016/j.jhsg.2025.03.006","DOIUrl":"10.1016/j.jhsg.2025.03.006","url":null,"abstract":"<div><h3>Purpose</h3><div>Controversy exists on the urgency of operative treatment for low energy open distal radius fractures. Two medical centers shifted practice and no longer take all open distal radius fractures emergently to the operating for debridement. The purpose of this study is to provide preliminary data to evaluate if this is associated with unacceptably high infection rates.</div></div><div><h3>Methods</h3><div>A retrospective chart review was performed for 55 open distal radius fractures in 54 patients at two level one trauma centers. Patients underwent irrigation and closed reduction in the emergency department followed by definitive closed treatment or operative treatment with surgical irrigation, debridement, and fixation, either within 24 hours or after discharge. The main outcome measure was infection, with secondary outcomes of complications or secondary procedures.</div></div><div><h3>Results</h3><div>In this cohort, 4 of 55 patients experienced infections (7.2%.) There were no infections in low energy injuries. Twenty-four patients went to the operating room 2 or more days from presentation or were treated nonoperatively with only 1 postoperative infection (4.2%). All infections were in high energy mechanism injuries with at least one additional risk factor: smoking, polytrauma, or Gustilo Anderson type 2 injury.</div></div><div><h3>Conclusions</h3><div>These data suggest that in patients with low energy injury mechanisms and type 1 injuries, delay in formal operative debridement is not associated with an elevated infection risk in this small case series. Future prospective studies with larger sample sizes are needed to definitively evaluate whether some open distal radius fracture patterns may not require emergent operative debridement.</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 4","pages":"Article 100732"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115342","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":"Safety and Efficacy of Carpal Tunnel Release Using a New Surgical Knife With and Without Ultrasound Guidance: Comparative Study in 100 Cadaveric Specimens","authors":"Jérôme Garret MD ,&nbsp;Jean-Michel Cognet MD ,&nbsp;Floris van Rooij MSc ,&nbsp;Thomas Apard MD","doi":"10.1016/j.jhsg.2025.02.019","DOIUrl":"10.1016/j.jhsg.2025.02.019","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to compare the safety and efficacy of the carpal tunnel release surgery in cadaveric specimens, using a newly developed surgical knife incorporating a guide, with and without ultrasound guidance.</div></div><div><h3>Methods</h3><div>For this study, 100 fresh frozen human cadaveric hands, free from fractures or surgical antecedents, were used (mean age: 71.3 ± 15.8 years, 60 men and 40 women). The specimens were allocated into two groups of 50 to undergo carpal tunnel release with or without ultrasound guidance, using the knife and guide (KeriKnife, KeriMedical) by four experienced hand surgeons. Donor demographics and operated side were recorded. Following surgery, every surgeon reported the difficulty of cutting the ligament on a scale of 1 (easy) to 5 (difficult), whether the ligament was completely cut, and whether the intervention caused any injuries to the surrounding structures.</div></div><div><h3>Results</h3><div>There were no differences between the groups in terms of age, sex, weight, or side. Following surgery, the surgeons rated the difficulty similarly between the groups. The ligament was incompletely cut in one (2%) specimen that underwent the surgery with ultrasound, whereas it was incomplete in two (4%) that underwent the surgery without ultrasound, although the difference was not statistically significant. Furthermore, there was one injury in the group without ultrasound.</div></div><div><h3>Conclusions</h3><div>The KeriKnife has shown its effectiveness for carpal tunnel release with or without ultrasound control. The only iatrogenic injury happened during the surgical release without ultrasound control.</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":"7 4","pages":"Article 100729"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of VACTERL Association With Thumb Polydactyly Requiring Surgical Treatment","authors":"Kazuki Shimada MD, PhD ,&nbsp;Takako Komiya MD, PhD ,&nbsp;Kouhei Aoki MD, PhD ,&nbsp;Rei Omura MD ,&nbsp;Sohachi Toriyabe MD, PhD ,&nbsp;Hajime Matsumura MD, FACS","doi":"10.1016/j.jhsg.2024.10.009","DOIUrl":"10.1016/j.jhsg.2024.10.009","url":null,"abstract":"<div><div>We report a case of a rare type of polydactyly associated with VACTERL association (verebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula,renal anomalies, and limb abnormalities) that was treated surgically in infancy with good results. In this case, the patient had radial and ulnar thumbs of almost equal size, and mild thumb hypoplasia. This thumb is as classified Blauth type Ⅰ thumb hypoplasia and as a type IV triphalangeal thumb in the Rotterdam classification. The radial thumb had one phalanx with no distal phalanx or nail plate, whereas the ulnar thumb had three phalanges, including a distal phalanx and nail plate. On-top plasty was performed, joining the ulnar thumb top to the radial thumb base. One year after surgery, the appearance of thumb is good, and the child can use the affected digit well in daily activities. However, flexion and extension of the interphalangeal joint of the thumb is weak. Follow-up will be continued to monitor growth of the reconstructed thumb.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 4","pages":"Article 100665"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115344","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":"Triangular Fibrocartilage Complex Repair All Arthroscopic Knotless","authors":"Mollie Manley MD, MS","doi":"10.1016/j.jhsg.2025.100742","DOIUrl":"10.1016/j.jhsg.2025.100742","url":null,"abstract":"<div><div>Triangular fibrocartilage complex repair is an evolving technique. There are techniques to repair the tissue back to capsule or bone. It has been considered the gold standard to repair foveal tears back to bone. This first started as a fully open procedure and evolved to an arthroscopic-assisted procedure with drill holes and tunnels in the ulna. With this current technique, the incisions do not have to be any larger than the arthroscopic port holes.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 4","pages":"Article 100742"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144106211","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}