Journal of Hand and Microsurgery最新文献

{"title":"From technique to global movement: What the world WALANT symposium 2026 tells us about the future of wide-awake surgery.","authors":"J Terrence Jose Jerome","doi":"10.1016/j.jham.2026.100496","DOIUrl":"10.1016/j.jham.2026.100496","url":null,"abstract":"<p><p>Wide-Awake Local Anesthesia No Tourniquet (WALANT) has evolved from an alternative anesthetic technique into a broader surgical philosophy centered on patient participation, intraoperative functional assessment, efficiency, accessibility, and resource-conscious care. The World WALANT Symposium 2026, held in Tiruchirappalli, India, brought together surgeons from diverse countries and healthcare systems and highlighted both the extraordinary international growth of WALANT and the questions that must define its next phase. The future should move beyond advocacy toward standardization, high-quality comparative evidence, responsible expansion of indications, structured training, and equitable global implementation.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"18 5","pages":"100496"},"PeriodicalIF":0.7,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851458","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":"WALANT beyond anesthesia: The end of physiological silence in hand, microsurgical and peripheral nerve reconstruction.","authors":"J Terrence Jose Jerome","doi":"10.1016/j.jham.2026.100479","DOIUrl":"10.1016/j.jham.2026.100479","url":null,"abstract":"<p><p>Wide Awake Local Anesthesia No Tourniquet (WALANT) is often introduced as an anesthetic technique that avoids general anesthesia, regional blocks, sedation, and tourniquet discomfort. This description is accurate, but incomplete. The deeper significance of WALANT is that it restores living physiology to the operating theatre. For more than a century, reconstructive surgeons repaired tendons, transferred nerves, corrected deformities, balanced muscles, and reconstructed movement in patients whose physiology was temporarily silent. Tendon tension was estimated, nerve function was predicted, muscle balance was assumed, and the final judgment of success was delayed until rehabilitation revealed the truth. WALANT challenges this old paradigm by allowing movement, tension, balance, spasticity, sensory response, and patient-specific biomechanics to be observed during surgery itself. Its expanding role in tendon transfer, thumb reconstruction, peripheral nerve surgery, brachial plexus reconstruction, spasticity surgery, and ambulatory microsurgery suggests that its greatest contribution may not be anesthetic freedom, but the birth of physiology-guided reconstruction. This editorial argues that WALANT has moved beyond tendons and beyond anesthesia. It has become a new way of thinking about reconstructive surgery.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"18 4","pages":"100479"},"PeriodicalIF":0.7,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377554","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":"Stroke, reward, and the reluctant hand: Why nucleus accumbens ultrasound neuromodulation matters to hand surgeons.","authors":"Vaikunthan Rajaratnam, Usama Farghaly Omar, Amr Eisa, J Terrence Jose Jerome","doi":"10.1016/j.jham.2026.100449","DOIUrl":"https://doi.org/10.1016/j.jham.2026.100449","url":null,"abstract":"","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"18 3","pages":"100449"},"PeriodicalIF":0.5,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785136","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":"Measuring the carbon cost of hand surgery: A single-centre observational study.","authors":"Louise Leijonberg, Sandip Hindocha, Kavish Maheshwari","doi":"10.1016/j.jham.2026.100448","DOIUrl":"10.1016/j.jham.2026.100448","url":null,"abstract":"<p><strong>Purpose: </strong>Healthcare contributes considerably to global greenhouse gas emissions, with operating theatres amongst the most energy-intensive hospital environments. While carbon footprints have been quantified for several surgical procedures, the environmental impact of hand surgery, characterised by high case volumes and short procedures, remains poorly studied. This study aims to quantify carbon emissions of hand surgery procedures.</p><p><strong>Methods: </strong>This single-centre observational pilot study quantified the carbon emissions associated with hand surgery procedures performed during two half-day theatre lists at a UK NHS hospital. Data was collected under the Greenhouse Gas Protocol Scopes and emissions calculated using UK Government greenhouse gas conversion factors. Data collected included theatre electricity and heating, anaesthetic use, staff and patient transport, waste incineration, supply-chain emissions, and instrument sterilisation.</p><p><strong>Results: </strong>Five trauma hand surgery cases were analysed. Case-level emissions ranged from 8.32 to 22.56 kg CO₂. When combined at a list level, total emissions were substantial, reaching 311.36 kg CO₂ and 285.30 kg CO₂ per half-day list. Purchased electricity (Scope 2) was the largest contributor, followed by heating and anaesthetic gases (Scope 1). Scope 3 emissions were largely attributed to staff travel and single-use consumable supply-chain emissions, while waste disposal and reusable instrument sterilisation contributed comparatively little.</p><p><strong>Conclusions: </strong>Individual hand surgery procedures have a relatively low carbon footprint, but the cumulative emissions at list-level are large. Theatre energy use, heating and staff transport represent key targets for emission reduction. Interventions focusing on energy-efficient infrastructure, renewable energy, greener staff travel, and reduced reliance on single-use consumables may result in meaningful environmental benefits. Larger multicentre studies with improved energy metering are needed to refine estimates and guide sustainable surgical practice.</p><p><strong>Clinical relevance: </strong>Quantifying the carbon emissions associated with common hand surgery procedures may help hand surgery teams and healthcare organisations identify opportunities to reduce emissions.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"18 3","pages":"100448"},"PeriodicalIF":0.7,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640076","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":"Dissecting neural anomalies and clinical impact of aberrant median and ulnar nerve pathways in the forearm: A systematic review and meta analysis.","authors":"O R Jeff Walter Rajadurai, P A Prem Regis, S Supadevi, S Vinoth","doi":"10.1016/j.jham.2026.100446","DOIUrl":"10.1016/j.jham.2026.100446","url":null,"abstract":"<p><p>Aberrant communications between the median and ulnar nerves in the forearm and hand are clinically important anatomical variants that can significantly influence electrophysiological interpretation and surgical decision-making. This systematic review and meta-analysis aimed to synthesize available anatomical and electrophysiological evidence on the prevalence, subtypes, and clinical implications of median-ulnar nerve anastomoses, including Martin-Gruber, Marinacci, Riche-Cannieu, and Berrettini connections. A comprehensive search of major databases identified 20 eligible studies encompassing electrophysiological, anatomical, and clinical designs. Meta-analysis was performed using event-rate methodology with logit transformation under a random-effects model. The pooled prevalence of Martin-Gruber anastomosis (MGA), derived from six studies, was approximately 21%, indicating that nearly one in five individuals demonstrates median-to-ulnar nerve communication in the forearm. Subgroup analysis revealed a higher prevalence in healthy populations (≈25%) compared with carpal tunnel syndrome (CTS) populations (≈8-10%), suggesting that median nerve compression may obscure electrophysiological detection of MGA. Cadaveric studies reported lower detection rates (≈6%), reflecting methodological differences. Subtype analysis demonstrated that Type II MGA was more prevalent than Type I, with pooled prevalence estimates of approximately 62% and 31%, respectively, highlighting substantial anatomical variability. Considerable heterogeneity was observed across subgroup analyses, reflecting differences in population characteristics and electrophysiological protocols. Beyond MGA, Marinacci anastomosis was uncommon (≈0.7-4%), whereas Riche-Cannieu and Berrettini anastomoses were frequent, with reported prevalences exceeding 50% in anatomical and electrophysiological studies. Clinically, these variants are highly relevant, as unrecognized nerve communications may lead to pseudo-conduction block, mislocalization of neuropathies, underestimation of CTS severity, and iatrogenic injury during forearm or hand surgery. These findings underscore the necessity of incorporating anatomical awareness and targeted electrophysiological strategies into routine clinical practice.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"18 3","pages":"100446"},"PeriodicalIF":0.7,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13059007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647003","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":"Surgical treatment of hourglass-like nerve constrictions with allogeneic nerve: a series report of 4 cases.","authors":"Minghua Zhao, Cuiping Cao, Meng Wang, Haixia Wang, Haixin Zhang, Yifan Wang, Jian Zhao, Xuyin Gong","doi":"10.1016/j.jham.2026.100447","DOIUrl":"10.1016/j.jham.2026.100447","url":null,"abstract":"<p><strong>Purpose: </strong>Hourglass-like constriction (HGC) is an anatomical finding of peripheral nerves, most commonly associated with immune-mediated inflammatory neuropathies such as neuralgic amyotrophy. Current treatment modalities primarily include conservative observation, neurolysis, autologous nerve grafting, and tendon transfer. Allogeneic nerves, as alternative graft materials for nerve reconstruction, have not been systematically reported in the management of hourglass-like constrictions. This study aimed to report the clinical outcomes of allogeneic nerve reconstruction in carefully selected cases of allogeneic nerve transplantation for treating multi-segmental radial nerve hourglass constrictions.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 4 patients (3 males, 1 female) with idiopathic radial nerve palsy treated in our department from February 2019 to February 2022. All cases presented with severe multi-segmental constrictions. Preoperative evaluation included electromyography and high-frequency ultrasound to assess nerve damage. Intraoperatively, constricted segments were completely resected, and allogeneic nerve grafts were used for reconstruction. Postoperative follow-up duration ranged from 18 to 26 months (mean 22 months).</p><p><strong>Results: </strong>All incisions healed primarily without clinically apparent immune rejection or infection. Motor function was evaluated using the British Medical Research Council (BMRC) muscle strength grading scale, combined with electromyography for nerve regeneration assessment. At 18 months postoperatively, all patients achieved significant recovery of active thumb and finger extension: 3 patients demonstrated M4 strength in extensor pollicis longus and extensor digitorum communis, while 1 patient showed M3 for extensor pollicis longus and M4 for extensor digitorum communis.</p><p><strong>Conclusion: </strong>For severe multi-segmental hourglass-like constrictions, resection combined with nerve grafting is recommended. Allogeneic nerve transplantation may represent a safe and effective treatment option in selected cases of radial nerve hourglass constrictions. However, further large-scale randomized controlled trials are required to validate its long-term efficacy in repairing long-segment, thick mixed nerve defects.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"18 3","pages":"100447"},"PeriodicalIF":0.5,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13019915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575808","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":"Reconstruction of the amputated thumb using great toe transfer and dual bone lengthening technique with an Ilizarov mini-fixator.","authors":"Hiroyuki Gotani, Yusuke Miyashima, Thanat Charoenpol, Kosuke Sasaki, Hirohisa Yagi, Sopinun Siripoonyothai, Jun Tsujimoto, Haato Kimura, Yuji Murakami, Takashi Tsuchiya","doi":"10.1016/j.jham.2025.100394","DOIUrl":"https://doi.org/10.1016/j.jham.2025.100394","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to introduce the thumb reconstruction technique both by microsurgical reconstruction using a great toe transfer and dual bone lengthening technique with an Ilizarov mini-fixator for the fingers.</p><p><strong>Methods: </strong>The great toe was transferred to the amputated thumb, followed by a bone lengthening procedure for the residual metacarpal bone to enable easy pinching. During the metacarpal bone lengthening, osteotomy was performed at two sites to shorten the period of bone fusion.</p><p><strong>Results: </strong>The great toe transfer was performed successfully and metacarpal bone fusion was achieved earlier than usual by dual osteotomy technique, allowing the patients to eventually resume their previous jobs.</p><p><strong>Conclusion: </strong>Our procedure reported herein, i.e., great toe transfer by microsurgery + dual osteotomy distraction lengthening, seems to serve as a useful procedure for thumb reconstruction from both cosmetic and functional improvement.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"18 1","pages":"100394"},"PeriodicalIF":0.5,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12796925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971351","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":"Nerve injuries following reconstructive and cosmetic breast surgery: A systematic review and meta-analysis.","authors":"John D Nguyen, Alec J Chen, Jeffrey Khong, Isabel A Snee, Myiah Quach, Ala Elhelali, Sami H Tuffaha, A Lee Dellon","doi":"10.1016/j.jham.2025.100396","DOIUrl":"https://doi.org/10.1016/j.jham.2025.100396","url":null,"abstract":"<p><strong>Background: </strong>Breast surgery carries the risk of intercostal nerve injuries, with symptoms ranging from sensory disturbances to chronic pain. This study characterizes post-operative intercostal nerve injuries following breast surgery and available microsurgical management options.</p><p><strong>Methods: </strong>A systematic review was conducted using PubMed, Embase, Web of Science, and Scopus for the years 2003-2024. The primary inclusion criteria was a patient experiencing any neuropathic symptoms (defined as pain or sensory changes) following mastectomy, breast reconstruction, or aesthetic breast surgery.</p><p><strong>Results: </strong>Of 514 unique studies, 39 (n = 9083 patients) were included. The procedures included breast augmentation (n = 6291, 69.3 %), mastectomy without reconstruction (n = 1701, 18.7 %), mastectomy with reconstruction (n = 654, 7.2 %), and breast reduction (n = 434, 4.9 %). After these procedures, 1144 (12.6 %) patients experienced chronic pain and 135 (1.8 %) had nerve injuries, consisting of intercostal nerves (n = 133, 98.5 %) or brachial plexus nerves (n = 2, 1.5 %). Of patients with nerve injuries, 23 (9.2 %) underwent surgical interventions, which included neurectomy (n = 11, 47.8 %), neuroma excision (n = 10, 43.5 %), implant removal (n = 8, 34.8 %), and dorsal rhizotomy (n = 1, 4.3 %).</p><p><strong>Conclusion: </strong>This study demonstrates a substantial risk of chronic pain and peripheral nerve injuries following breast surgery. The low utilization of surgical options (4.6 %) may indicate limited patient unawareness of the pain relief which microsurgical intervention offers when conservative approaches fail in reduction or resolution of symptoms.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"18 1","pages":"100396"},"PeriodicalIF":0.5,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12757640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901166","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":"Vascularized iliac crest reconstruction of the distal fibula after trauma: Technical notes and long term follow up.","authors":"Pierluigi Tos, Davide Ciclamini, Alessandro Crosio, Valentina Cecconato, Bruno Battiston","doi":"10.1016/j.jham.2025.100393","DOIUrl":"https://doi.org/10.1016/j.jham.2025.100393","url":null,"abstract":"<p><strong>Background: </strong>Large post-traumatic defects of the lateral malleolus are uncommon but present major reconstructive challenges, particularly in the presence of segmental bone loss, infection, or soft-tissue compromise. The lateral malleolus is essential for ankle stability, and its absence leads to mechanical imbalance and early degenerative changes. Traditional solutions-including non-vascularized grafts, allografts, arthrodesis, or fibular transfers-may be inadequate when biological conditions are poor or when three-dimensional reconstruction is required. Vascularized bone flaps offer improved union rates and enhanced resistance to infection. The vascularized iliac crest flap, although well-established in limb reconstruction, remains infrequently reported for distal fibula restoration.</p><p><strong>Methods: </strong>Three patients with severe post-traumatic lateral malleolar defects were treated between 2002 and 2015 at two microsurgical centers. Reconstruction was performed using free vascularized iliac crest flaps based on the deep circumflex iliac artery. Flap configuration (osteo-muscular or osteo-cutaneous) was adapted to defect size and soft-tissue requirements. Technical details-including flap harvest, shaping of the iliac crest segment, fixation, and vascular anastomoses-are described. Clinical and radiographic outcomes were evaluated over 8-14 years.</p><p><strong>Results: </strong>All flaps survived without major postoperative complications. Radiographs demonstrated consistent osseous union between the iliac crest graft and tibia. All patients achieved full weight-bearing and stable ankle function. Mild-to-moderate radiographic osteoarthritis occurred at long-term follow-up but remained asymptomatic. Soft-tissue coverage was reliable, and no secondary flap procedures were required.</p><p><strong>Conclusions: </strong>The free vascularized iliac crest flap is a dependable and versatile reconstructive option for extensive lateral malleolar defects. It provides stable ankle restoration, predictable union, and durable function, and should be considered when conventional grafting or fibular transfers are unsuitable, particularly in complex post-traumatic or infected environments.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"18 1","pages":"100393"},"PeriodicalIF":0.5,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12768900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918809","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":"Changing trends in peripheral nerve repair: A two-decade TriNetX analysis of grafting techniques and the ascendancy of allografts.","authors":"Tyler Reinoso, Emerson Rowe, David Kirby, Sina Ramtin, Asif M Ilyas","doi":"10.1016/j.jham.2025.100395","DOIUrl":"https://doi.org/10.1016/j.jham.2025.100395","url":null,"abstract":"<p><strong>Background: </strong>Various modalities exist for repairing transected nerves not amenable to primary repair; including, autograft, vein graft, conduit, and allograft. The study was hypothesis was that there is increasing utilization of allografts for peripheral nerve repairs.</p><p><strong>Materials & methods: </strong>The TriNetX Research Network was queried from 2002 to 2022 for all patients undergoing peripheral nerve repair. Demographic information, usage patterns, and comorbidities associated with different grafting methods by CPT were extracted and analyzed.</p><p><strong>Results: </strong>Out of 33,262 patients undergoing peripheral nerve repair, 31,756 with available demographic data were identified and included. Primary repair cases totaled 17,159, followed by conduit (n = 9282), allograft (n = 3582), autograft (n = 2886), and vein autograft (n = 353). Noting that a cpt for an allograft was introduced in 2017, a logistical regression analysis was performed to further sub-analyze allograft usage. The utilization of allografts significantly increased in 2021-2022 compared to 2019-2020, with an odds ratio (OR) of 1.4 (95 % confidence interval [CI]: 1.1-1.7; P = 0.001), indicating a greater increase compared to autograft utilization during the same interval. The mean per-year rate of change (range) between 2017 and 2022 for nerve allograft, conduit, autograft and vein autograft was +93.4 (+16.5 to +176.5), +6.3 (-37 to +45), -1.4 (-7.5 to +7.5), and +2 (-2.5 to +6.5), respectively.</p><p><strong>Conclusion: </strong>This study presents a twenty-year analysis of the changing trends in nerve repair and grafting techniques employed by nerve surgeons. Conduit repair has remained a major grafting technique used among surgeons. However, since its introduction, nerve allograft repair demonstrates a consistent positive upward trend in usage within the last 6 years, In contrast, autograft usage has decreased while vein graft usage is least common with a less relevant change in usage. These trends suggest an increasing preference for allograft, potentially displacing other nerve grafting methods, including autografting.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"18 1","pages":"100395"},"PeriodicalIF":0.5,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12754199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890427","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}