Journal of Hand and Microsurgery最新文献

{"title":"ChatGPT 4.0's efficacy in the self-diagnosis of non-traumatic hand conditions: Correspondence.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1016/j.jham.2025.100253","DOIUrl":"https://doi.org/10.1016/j.jham.2025.100253","url":null,"abstract":"","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 3","pages":"100253"},"PeriodicalIF":0.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001334","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":"Exploring reconstructive alternatives to pollicization for modified Blauth type IIIB-V congenital thumb hypoplasia: A systematic review.","authors":"Anish Raman, John A Tipps, John R Vaile, Shaun D Mendenhall","doi":"10.1016/j.jham.2025.100251","DOIUrl":"https://doi.org/10.1016/j.jham.2025.100251","url":null,"abstract":"<p><strong>Background: </strong>Although pollicization remains the traditional treatment strategy for modified Blauth type IIIB-V grade congenital thumb hypoplasia, many patients and parents express interest in alternative reconstructive approaches that maintain a five-digit hand. The aim of this study was to provide a summary of these alternative techniques and to assess for differences in their outcomes, with the hypothesis that techniques featuring vascularized bone grafts would have fewer instances of bone resorption or nonunion relative to non-vascularized techniques.</p><p><strong>Methods: </strong>A systematic literature review was conducted in PubMed, Embase, and CINAHL using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies describing the reconstruction of modified Blauth type IIIB-V hypoplastic thumbs were included. Chi squared tests (or Fisher exact tests where appropriate) were performed to compare aggregate complication data.</p><p><strong>Results: </strong>Twenty-four articles met inclusion criteria, yielding 207 patients with 210 thumbs undergoing reconstruction. Mean patient age at surgery was 3.4 years, while the mean follow-up time was 4.2 years. 203 of the 207 patients underwent reconstruction using one of five techniques: PIPJ/MTPJ transfer, hemi-metatarsal transfer, toe and metatarsal transfer, iliac crest transfer, and toe phalanx transfer. PIPJ and MTPJ transfers were the most performed procedures (n = 54, 26 %). Vascularized grafts were used in 89 cases (43 %), while non-vascularized grafts comprised 114 cases (55 %). Rates of bone resorption and nonunion were higher in non-vascularized grafts, though not significantly so (n = 203, p = 0.19). Conversely, donor site complications were significantly higher in vascularized bone grafting techniques (n = 203, p = 0.0056). The most frequently reported outcome measures were Kapandji scores (46 %) and key pinch strength (46 %). Kapandji scores had a weighted mean of 5.6 (range 3.1-6.7).</p><p><strong>Conclusion: </strong>A variety of alternative techniques exist for reconstructing severely hypoplastic thumbs, though no technique demonstrates clear superiority. Vascularized grafts trend towards a lower bone resorption/nonunion rate relative to non-vascularized grafts, though there is evidence of heightened risks of donor site complications when taking vascularized bone grafts from the foot. Objective outcome measures showed variability across studies limiting comparisons between techniques.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 3","pages":"100251"},"PeriodicalIF":0.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005481","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":"The new solution for the bilateral severe thumb hypoplasia.","authors":"Yu Chen, Chunhua Yin, Xiaofang Shen","doi":"10.1016/j.jham.2025.100246","DOIUrl":"https://doi.org/10.1016/j.jham.2025.100246","url":null,"abstract":"<p><p>Thumb hypoplasia is a manifestation of radial longitudinal dysplasia, ranging from a slight decrease in thumb size to complete absence of the thumb. It has been suggested that distinct treatment approaches be used for various categories of hypoplastic thumb. However, due to cultural preferences in Eastern countries, some parents frequently look for alternative surgical treatments to achieve an aesthetically \"normal\" hand. We describe the surgical technique used in a young boy born with the bilateral severe thumb hypoplasia, a left hand Blauth Ⅳ thumb and a right hand Blauth ⅢB thumb. Thumb reconstruction was done in two stages, and the results were good in terms of both appearance and functionality. This method maximized thumb function as well as the parents' expectations.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 3","pages":"100246"},"PeriodicalIF":0.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024140","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":"Review and algorithmic management of the anatomical variations of the medial sural artery perforator flap.","authors":"Jennifer An-Jou Lin, Joachim N Meuli, Juan Carlos Ignacio Larsson, Mohamed Abdelrahman, Kiron Koshy, Tommy Nai-Jen Chang","doi":"10.1016/j.jham.2025.100252","DOIUrl":"https://doi.org/10.1016/j.jham.2025.100252","url":null,"abstract":"<p><strong>Background: </strong>Perforator variations in the calf region can be found during medial sural artery perforator (MSAP) flap harvest. This article reviews the perforator anatomy of the posterior calf and proposes an algorithmic approach to MSAP flap harvest when there are no favorable perforators, based on the author's experience and literature review.</p><p><strong>Material and methods: </strong>The PubMed database was searched for anatomic and/or clinical studies describing the perforator anatomy of the posterior calf. Clinical studies reporting the use of alternative flaps for cases in which perforator anatomy was unfavorable were also analyzed. We summarized the study's characteristics and identified the main anatomical challenges faced during flap harvest. We present our algorithm to address these situations, illustrated with three cases in which perforator variations were found intraoperatively and/or difficulties were encountered during MSAP flap harvest.</p><p><strong>Results: </strong>The anatomical studies from the literature review showed a mean of 3.2 ± 0.8 (1-7) perforators in the posterior calf. The presence of MSAPs and lateral sural artery perforators (LSAPs) have been reported to be 97.2 % and 62.5 % respectively. The mean number of MSAPs was 1.8 ± 0.32 while LSAPs were 1.3 ± 0.3, favoring a medial dominance. Perforators from MSA and LSA were found at a similar distance below the popliteal crease and from the mid-calf. Our clinical experience showed that MSAPs found anterior to the incision can still be used and even as a chimeric flap. Posterior tibial artery perforator flaps can also be harvested from the same anterior incision. Direct septal perforators from the MSA represent a newly identified anatomical variation. An algorithmic approach is presented for managing MSAP intra-operative perforator variations.</p><p><strong>Conclusion: </strong>The proposed approach of MSAP flap harvest can provide a useful guide for the microsurgeon to raise alternative flaps in the posterior calf region. We advocate an anterior approach that also gives access to perforators of the sural artery itself and posterior tibial artery perforators. These back-up flaps provide similar tissue characteristics and potential for head and neck and extremity composite tissue reconstruction.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 3","pages":"100252"},"PeriodicalIF":0.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049954","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":"Decision making in Thumb Hypoplasia - Our perspective.","authors":"Samuel C Raj Pallapati, D R Kathir Joyson, Sasi P Kiran, Binu Prathap Thomas","doi":"10.1016/j.jham.2025.100250","DOIUrl":"https://doi.org/10.1016/j.jham.2025.100250","url":null,"abstract":"","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 3","pages":"100250"},"PeriodicalIF":0.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054327","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":"Management of thumb hypoplasia in Vietnam: Challenges in a developing country and future directions.","authors":"Phi Duong Nguyen, Takehiko Takagi, Terry Richard Light, Dinh Quang Truong, Nam Quang Dinh Vo, Tai Chieu Vo, Tuan Ngoc Le, Ha Dinh Doan, Khang Trien Truong, Man Duc Minh Phan","doi":"10.1016/j.jham.2025.100249","DOIUrl":"https://doi.org/10.1016/j.jham.2025.100249","url":null,"abstract":"<p><p>Thumb hypoplasia, a congenital malformation characterized by an underdeveloped or absent thumb, presents significant functional and aesthetic challenges. In Vietnam, a low-middle income developing country, the management of thumb hypoplasia is shaped by limited resources, geographic disparities, and reliance on international collaborations. This article reviews the current state of diagnosis, surgical treatment, and rehabilitation of thumb hypoplasia in Vietnam, with a focus on the unique challenges faced by healthcare providers in resource-constrained settings. The role of international experts, including Dr. Terry Light, Dr. Takehiko Takagi, Dr. Alain Gilbert, and Dr. Philippe Valenti, is emphasized for their contributions in shaping advanced surgical techniques and mentoring local surgeons. We also discuss the critical involvement of the Vietnam Pediatric Orthopaedic Association (VPOA) in promoting pediatric orthopedic care. Future recommendations include expanding access to specialized care, improving surgical training, decentralizing services to rural areas, and encouraging the publication of local research to foster global collaboration. By addressing these areas, Vietnam can continue to enhance outcomes for children affected by thumb hypoplasia.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 3","pages":"100249"},"PeriodicalIF":0.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11982951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033646","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":"Improvement of thenar bulk appearance in index finger pollicization with adipofascial flap fashioned from pouce flottant/rudimentary thumb.","authors":"Caleb Bercu, Brianna Rosner, Hannah Korah, Weston Thomas, Aaron Berger","doi":"10.1016/j.jham.2025.100248","DOIUrl":"https://doi.org/10.1016/j.jham.2025.100248","url":null,"abstract":"<p><strong>Purpose: </strong>Index finger pollicization is a surgical technique used for Blauth Types IIIB and IV thumb hypoplasia reconstruction. Traditionally, index finger pollicization techniques have not addressed management of the rudimentary thumb/pouce flottant; with no improvements made to the thenar eminence, it often remains flat and hypoplastic. This case series aims to contribute to the body of literature supporting the technique of index finger pollicization with use of the pouce flottant to create a vascularized adipofascial flap for reconstruction of the thenar eminence.</p><p><strong>Methods: </strong>From 2018 to 2024, a single surgeon performed a modified index finger pollicization technique on seven patients with Blauth Type IIIB and IV thumb hypoplasia. The skin incision technique incorporates the vascular pedicle to the pouce flottant to allow for creation of a vascularized adipofascial flap. This approach utilizes the soft tissue components of the remnant thumb to reconstruct the thenar eminence with a filet flap derived from portions of the typically discarded hypoplastic thumb. Cosmetic and functional outcomes were evaluated by the surgeon, the occupational therapist and the patients' parents. Functional outcomes assessed include evaluation of thumb opposition, stability, and pinch.</p><p><strong>Results: </strong>The use of an adipofascial flap from the rudimentary thumb provided sufficient bulk to improve the appearance of the thenar eminence and hand without complications. All patients achieved satisfactory cosmetic results. All the parents were satisfied with the appearance of the hand. Two patients initially showed disfavor to utilizing the newly created thumb and restraint therapy was successfully employed to encourage use of the new thumb. The thenar eminence was maintained at latest follow-up for all patients. At one-year follow-up, all seven patients demonstrated opposition, strong pinch, flexion, and extension with continued satisfactory cosmetic results.</p><p><strong>Conclusion: </strong>For patients with Type IIIB and IV thumb hypoplasia, soft tissue components of the remnant thumb/pouce flottant can be used as an adipofascial flap to improve the cosmetic result of pollicization. All patients demonstrated satisfactory functional and cosmetic results with improved appearance of the thenar eminence. The technique was reproducible, suggesting its implementation should be incorporated into standard practice for treatment of Types IIIB and IV thumb hypoplasia.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 3","pages":"100248"},"PeriodicalIF":0.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11982962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049934","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":"Current surgical outcomes of free functional muscle transfer for Volkmann's ischemic contracture: A scoping review.","authors":"John R Vaile, John A Tipps, Sarah L Struble, Niki K Patel, Anchith Kota, Shaun D Mendenhall","doi":"10.1016/j.jham.2025.100242","DOIUrl":"https://doi.org/10.1016/j.jham.2025.100242","url":null,"abstract":"<p><strong>Purpose: </strong>Free functional muscle transfer (FFMT) is a versatile surgical option for restoring function in cases of acute trauma, ischemic contracture, or tumor resection. FFMT is often considered a last resort due to procedural complexity and lack of microsurgical availability. While FFMT is well described for brachial plexus injury and facial trauma, its application in Volkmann's ischemic contracture (VIC) is underexplored, with variable operative timelines and postoperative outcomes.</p><p><strong>Methods: </strong>Following PRISMA-ScR guidelines, PubMed and Ovid electronic databases were searched using the following keywords: \"Volkmann,\" \"compartment syndrome,\" \"muscle transfer,\" \"muscle transplantation,\" and/or \"reconstruction.\" Studies were imported into Covidence, and screening was performed by two independent reviewers. Patient characteristics, surgery information, and postoperative clinical data were extracted.</p><p><strong>Results: </strong>The scoping review included 21 studies. In total, 163 FFMTs for VIC were performed, most commonly using the gracilis muscle (64.4 %) for finger flexion deficits (91.4 %). Nerve selection was variably reported, with the anterior interosseus nerve (AIN) used most frequently. Grip strength, range of motion, and total active motion were the most frequently utilized outcome measures. FFMT success rates were high (96 %), and 34.6 % of all-comers experienced tendon or muscle adhesions that required subsequent tenolysis or adhesiolysis. Several studies recommended early exploration within 3 weeks, and FFMT within 6 months of the initial injury; however, successful FFMT cases were reported up to 20 years post-injury.</p><p><strong>Conclusions: </strong>FFMT remains a viable option for VIC treatment, with a 96 % success rate. There is a relatively high incidence of tendon or muscle adhesions (34.6 %) that require secondary procedures.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 3","pages":"100242"},"PeriodicalIF":0.3,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990782","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":"\"Median nerve hand\": Replacing \"T1 hand\" in brachial plexus injuries.","authors":"J Terrence Jose Jerome","doi":"10.1016/j.jham.2024.100206","DOIUrl":"https://doi.org/10.1016/j.jham.2024.100206","url":null,"abstract":"","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 3","pages":"100206"},"PeriodicalIF":0.3,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209847","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":"Dual-mobility thumb carpometacarpal joint arthroplasty. Keypoints of surgical procedure for a satisfying outcome.","authors":"Efstratios D Athanaselis, Filippos Zigras, Theofilos Karachalios, Sokratis Varitimidis","doi":"10.1016/j.jham.2024.100195","DOIUrl":"10.1016/j.jham.2024.100195","url":null,"abstract":"<p><p>Thumb carpometacarpal (CMC) arthritis is a prevalent pathology, particularly among elderly women, with a significant impact on patients' quality of daily life. Total joint replacement can provide a shorter rehabilitation period and satisfying function, at least in the short term with encouraging findings according to recent studies concerning its complications (e.g., dislocation, loosening) and longevity. TOUCH® is a second-generation, dual mobility prosthesis with promising results. Step-by-step surgical technique and keypoints for successful implantation and satisfying thumb function are presented in this article.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 1","pages":"100195"},"PeriodicalIF":0.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886192","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}