Journal of Hand and Microsurgery最新文献

{"title":"Role of Interrupted Horizontal Micromattress suturing for size discrepancies in free flap vessel anastomosis.","authors":"Gaurav Chaturvedi, Abhinav Singh, Ved Prakash Rao Cheruvu, Ashish Kumar Gupta, Manal Mohd Khan, Kanika Suhag","doi":"10.1016/j.jham.2025.100216","DOIUrl":"10.1016/j.jham.2025.100216","url":null,"abstract":"<p><strong>Aim: </strong>The study aimed to evaluate the effectiveness of the interrupted horizontal micro mattress suturing technique in anastomosing size-mismatched vessels during free flap surgeries.</p><p><strong>Material & method: </strong>The study included patients who underwent free flap surgery and encountered size disparities in vessels intraoperatively. The technique was applied to 24 patients with 28 mismatched blood vessels. Interrupted horizontal micro-mattress sutures were utilized to adjust the diameter mismatch between incongruent vessels. Each suture aimed to reduce the diameter of the larger vessel in comparison to the smaller vessel.</p><p><strong>Results: </strong>During free flap surgeries, the technique was successfully applied across various body regions, from head to toe. Out of the 28 vessels where anastomosis was performed using this technique, two patients experienced thrombosis. This technique enabled anastomosis of vessels with a size mismatched ratio up to 2:1.</p><p><strong>Conclusion: </strong>The interrupted micro mattress suturing technique proves to be a straightforward, secure, and dependable for addressing vessel size discrepancy up to 2:1. An additional benefit of this technique is its ability to circumvent the need for end-to-side repair, enhancing its utility in eversion of margins of repaired blood vessels and practicality in free flap surgeries.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 2","pages":"100216"},"PeriodicalIF":0.3,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411214","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":"ChatGPT 4.0's efficacy in the self-diagnosis of non-traumatic hand conditions.","authors":"Krishna D Unadkat, Isra Abdulwadood, Annika N Hiredesai, Carina P Howlett, Laura E Geldmaker, Shelley S Noland","doi":"10.1016/j.jham.2025.100217","DOIUrl":"10.1016/j.jham.2025.100217","url":null,"abstract":"<p><strong>Background: </strong>With advancements in artificial intelligence, patients increasingly turn to generative AI models like ChatGPT for medical advice. This study explores the utility of ChatGPT 4.0 (GPT-4.0), the most recent version of ChatGPT, as an interim diagnostician for common hand conditions. Secondarily, the study evaluates the terminology GPT-4.0 associates with each condition by assessing its ability to generate condition-specific questions from a patient's perspective.</p><p><strong>Methods: </strong>Five common hand conditions were identified: trigger finger (TF), Dupuytren's Contracture (DC), carpal tunnel syndrome (CTS), de Quervain's tenosynovitis (DQT), and thumb carpometacarpal osteoarthritis (CMC). GPT-4.0 was queried with author-generated questions. The frequency of correct diagnoses, differential diagnoses, and recommendations were recorded. Chi-squared and pairwise Fisher's exact tests were used to compare response accuracy between conditions. GPT-4.0 was prompted to produce its own questions. Common terms in responses were recorded.</p><p><strong>Results: </strong>GPT-4.0's diagnostic accuracy significantly differed between conditions (p < 0.005). While GPT-4.0 diagnosed CTS, TF, DQT, and DC with >95 % accuracy, 60 % (n = 15) of CMC queries were correctly diagnosed. Additionally, there were significant differences in providing of differential diagnoses (p < 0.005), diagnostic tests (p < 0.005), and risk factors (p < 0.05). GPT-4.0 recommended visiting a healthcare provider for 97 % (n = 121) of the questions. Analysis of ChatGPT-generated questions showed four of the ten most used terms were shared between DQT and CMC.</p><p><strong>Conclusions: </strong>The results suggest that GPT-4.0 has potential preliminary diagnostic utility. Future studies should further investigate factors that improve or worsen AI's diagnostic power and consider the implications of patient utilization.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 3","pages":"100217"},"PeriodicalIF":0.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504768","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":"Cost analysis of carpal tunnel release with local anesthesia vs sedation. A survey of the Argentinian Association of Hand Surgery.","authors":"Facundo Delgado, Francisco Príncipe, Verónica Andrea Alfie, Mariano Oscar Abrego, Fernando Holc, Pedro Bronenberg Victoria, Jorge Guillermo Boretto, Ignacio Rellan","doi":"10.1016/j.jham.2025.100215","DOIUrl":"10.1016/j.jham.2025.100215","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the costs of carpal tunnel release (CTR) performed in a minor procedure room using wide awake local anesthesia no tourniquet (WALANT), local anesthesia with a tourniquet (AL-T) and CTR in a conventional operating room (OR) with sedation. Additionally, we aimed to assess the anesthetic preferences of the Argentine Association of Hand and Upper Limb Reconstructive Surgery (AACM) members regarding CTR.</p><p><strong>Material and methods: </strong>This cross-sectional, single-center study involved analyzing specific hospital costs associated with each anesthesia technique in both surgical settings. A report was obtained from the OR chief of our institution. Additionally, an anonymous survey was conducted among certified and main AACM members, gathering data on: (1) practice location, (2) preferred anesthesia type for CTR and reasons for not using WALANT/AL-T regularly, (3) years of practice, (4) preferred CTR surgical technique, and (5) willingness to change anesthesia preference if offered differential fees.</p><p><strong>Results: </strong>Performing CTR with WALANT and AL-T in a procedure room resulted in cost savings of 64 % and 65 %, respectively, compared to sedation in a conventional OR. The average duration for CTR, including cleaning and turnover time, was 34 min (±3) for WALANT, 33 min (±4) for AL-T, and 55 min (±8) for sedation in a conventional operating room.Out of 226 AACM members, 95 (42 %) responded to the survey. Among them, 42 % practiced in Buenos Aires (CABA), and only 35 % preferred using local anesthesia for CTR (16 % WALANT, 19 % AL-T). Nearly half (49 %) had over 16 years of experience. All respondents favored open or mini-approach techniques for CTR. Those who did not use WALANT or AL-T cited discomfort with patient interaction and perceived lack of benefits as reasons. However, 31 % indicated they would change their anesthesia preference if offered differential fees.</p><p><strong>Conclusions: </strong>CTR with WALANT or AL-T in a procedure room reduces costs by over 65 % compared to sedation in a conventional OR. Despite cost benefits, sedation remains the predominant practice in Argentina, hindered by a lack of consensus and institutional incentives.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 2","pages":"100215"},"PeriodicalIF":0.3,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080808","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":"Evaluation of tension-band osteosynthesis for cubitus varus deformity in pediatric patients: A retrospective review.","authors":"Man Duc Minh Phan, Terry Richard Light, Tiep Van Phan, Phi Duong Nguyen","doi":"10.1016/j.jham.2025.100213","DOIUrl":"10.1016/j.jham.2025.100213","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to evaluate the effectiveness and safety of lateral closing wedge osteotomy with tension-band wire fixation for correcting cubitus varus deformity in pediatric patients. The primary objective was to assess the bone union rate, functional outcomes, and potential complications associated with this surgical approach.</p><p><strong>Methods: </strong>We conducted a retrospective review of 104 pediatric cases (ages 7-15) with post-traumatic cubitus varus deformity treated between January 2018 and December 2019 at the Pediatric Orthopedic Department. The surgical technique involved a lateral closing wedge osteotomy with fixation achieved using an 8-figure tension-band wire on the lateral column of the distal humerus. Follow-up assessments were conducted for bone union, correction stability, range of motion, and any post-surgical complications.</p><p><strong>Results: </strong>Out of 104 cases, 63 involved left elbows and 41 right elbows, with an average patient age of 8.12 years. The deformity was severe (>30° varus) in 33.65 % of cases. Successful correction and bone union were achieved in 100 % of cases, with an average follow-up duration of 8 months (range: 3-20 months). Complications included minor recurrence in two cases due to early post-operative trauma, limited range of motion in three cases, K-wire protrusion in three cases, and infection in two cases. Functional outcomes rated as excellent in 94.2 % of cases and good in 5.8 %.</p><p><strong>Conclusion: </strong>Lateral closing wedge osteotomy with tension-band wire fixation is a reliable technique for correcting pediatric cubitus varus deformity, offering stable fixation, high success rates in bone healing, and favorable functional outcomes with minimal complications.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 2","pages":"100213"},"PeriodicalIF":0.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048220","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":"Top 75 most-cited articles in hand microsurgery: A bibliometric and visualised analysis.","authors":"Zhen Yu Wong, Oluwatobi Adegboye, Pegah Damavandi, Ryan Faderani, Muholan Kanapathy, Ben H Miranda, Dariush Nikkhah, Afshin Mosahebi","doi":"10.1016/j.jham.2025.100214","DOIUrl":"10.1016/j.jham.2025.100214","url":null,"abstract":"<p><strong>Introduction: </strong>Hand microsurgery is an important advancement of the speciality that has improved outcomes in hand trauma and hand surgical conditions. This bibliometric analysis aims to identify the 75 most cited hand microsurgery articles and explore their relevance to contemporary practice.</p><p><strong>Methods: </strong>The Web of Science core collection database was used to screen and identify the top 75 most-cited articles relevant to hand microsurgery. VOSviewer 1.6.18 and CiteSpace 6.2.R4 software were used to analyse and visualise occurrences, authorship, countries, institutions, journals, keywords, and Evidence Level (Oxford Centre for Evidence-Based Medicine).</p><p><strong>Results: </strong>The initial search identified 3024 articles. The top 75 most-cited articles were published between 1980 and 2018, with contributions from 291 authors. Professor Fu Chang Wei from Chang Gung Memorial Hospital, Taiwan, was the most prolific author. Articles originated from 14 countries, with the United States leading (29.3 %), followed by Taiwan (14.6 %), Italy (8.0 %), and Germany (8.0 %). The 75 most-cited articles were published in 22 journals, led by <i>Plastic and Reconstructive Surgery</i>, followed by the <i>Journal of Hand Surgery (American Volume)</i> and <i>Microsurgery</i>. A total of 345 keywords were analysed, with \"Hand,\" \"Defects,\" \"Reconstruction,\" and \"Regeneration\" being the most frequent. Level of Evidence 4 was most common (40 %), followed by Levels 3 (25 %) and 5 (24 %).</p><p><strong>Conclusions: </strong>The top 75 most-cited hand microsurgery articles influence current surgical practice and teaching material. Understanding specific surgical techniques in hand microsurgery and examining their outcomes will benefit patients, surgeons, researchers and policymakers alike.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 2","pages":"100214"},"PeriodicalIF":0.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048224","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":"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":"Linguistic validation and cultural adaptation of Tamil version of oxford shoulder score.","authors":"Senthilvelan Rajagopalan, Rajsirish Bellal Sridharan, Sivaranjani Radhakrishnan, Sathish Muthu","doi":"10.1016/j.jham.2024.100205","DOIUrl":"10.1016/j.jham.2024.100205","url":null,"abstract":"<p><strong>Background: </strong>The Oxford Shoulder Score (OSS) is a well-established and extensively utilized shoulder score translated into Western and Asian languages for use in respective countries. Our study aimed to translate, cross-culturally adapt, and psychometrically validate the OSS in the Tamil language community.</p><p><strong>Methods: </strong>The translation and cross-cultural adaptation were conducted according to previously established standards. We recruited 61 patients with degenerative or inflammatory shoulder pain presenting to a tertiary care hospital between January-August 2021. Patients were evaluated using the Tamil-OSS (OSS-T) and Constant-Murley scores (CMS). We assessed the understanding, acceptability, reproducibility, and reliability of the OSS-T. In addition, we evaluated the intra-observer and inter-observer reproducibility. We also evaluated the correlation of the OSS-T with another validated score namely the CMS.</p><p><strong>Results: </strong>The mean age of the patient included in the study was 43 (±12) years. Patients took an average of 8 (±2) minutes to complete the OSS form. Internal Consistency of the OSS-T was strong (Cronbach's alpha = 0.98). The intraclass coefficient was 0.963 (95 % CI 0.93-0.98, p < 0.001). We noted significant interobserver reliability (r = 0.963, p < 0.001). The Tamil OSS showed a strong significant correlation with the CMS (r = 0.82, p < 0.001) and original OSS (r = 0.98, p < 0.001). The OSS-T has a high level of convergent validity with CMS (p < 0.001). The 12 included translated questions in the OSS-T scored more than 0.95 from the subject experts for inclusion based on the three-point Likert scale.</p><p><strong>Conclusion: </strong>This study indicated that the Tamil version of the OSS is a reliable and valid, self-reported questionnaire, which can be applied to patients with shoulder disorders. Furthermore, the very good psychometric properties of the OSS-T score would allow for its use in clinical practice in national and international research projects concerning Tamil-speaking patients.</p><p><strong>Level of evidence: </strong>4.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 2","pages":"100205"},"PeriodicalIF":0.3,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11743114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013745","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":"Long-term outcomes and resource Utilization related to upper extremity off-roading vehicle injuries.","authors":"Gretchen Maughan, Alekhya Madiraju, Hernan Roca, Brittany N Garcia, Nikolas H Kazmers","doi":"10.1016/j.jham.2024.100202","DOIUrl":"10.1016/j.jham.2024.100202","url":null,"abstract":"<p><strong>Purpose: </strong>We aim to evaluate outcomes after off-roading injuries to determine their impact on patients' pain and function. Further, we aim to evaluate the burden on the healthcare system that result from these injuries.</p><p><strong>Methods: </strong>Patients treated surgically for an off-roading injury at a single tertiary academic center completed surveys about their current level of upper extremity pain and function using QuickDASH and VAS-Pain scores. Qualitative questions were used to assess work status. Patients were classified as having acceptable versus unacceptable pain and upper extremity function in reference to previously published PASS (Patient Acceptable Symptom State) thresholds. Descriptive statistics were calculated to describe the burden these injuries place on the healthcare system.</p><p><strong>Results: </strong>Of 23 included patients, mean age was 38 ± 12 and 70 % (16/23) were male. At a mean follow-up of 2.0 ± 1.2 years post-injury, 40 % (9/23) patients reported that they were unable to work, or this ability was severely impaired. The mean VAS pain and QuickDASH scores were 2.8 ± 2.9 and 19.8 ± 21.7 respectively. Nearly half of patients were classified as having unacceptable levels of pain and upper extremity function [48 % (11/23) and 43 % (10/23) respectively]. Patients required an average of 2.7 ± 2.6 surgeries and 100 % were admitted with a mean length of stay of 10.2 ± 12.1 days.</p><p><strong>Conclusions: </strong>Off-roading related upper extremity injuries have lasting impacts on patients and their abilities to work. Treatment of these injuries is resource-intensive based on the number of required surgeries and length of admission.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 2","pages":"100202"},"PeriodicalIF":0.3,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048221","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 case report of microsurgical penile replantation: Engaging multi-disciplinary expertise to optimise patient outcomes.","authors":"Ellen Geary, Eamon Francis, David Menzies, Gerry Lennon, Colin M Morrison, Roisin T Dolan","doi":"10.1016/j.jham.2024.100203","DOIUrl":"10.1016/j.jham.2024.100203","url":null,"abstract":"","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 2","pages":"100203"},"PeriodicalIF":0.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068621","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":"Finger reconstruction with vascularized partial osteo-onycho-cutaneous great toe transfer: It's time to address the donor site.","authors":"Nikhil Jhunjhunwala, Amitabh Dutta, Gourav Siwas, Mahesh Mangal","doi":"10.1016/j.jham.2024.100204","DOIUrl":"10.1016/j.jham.2024.100204","url":null,"abstract":"<p><p>Free vascularized partial great toe is a composite tissue consisting of the osteo-onycho-cutaneous component with neurovascular pedicle and is used for reconstructing amputated fingers at different levels. The half-big-toe nail flap represents that while it provides a good match and functional results; it also conserves the donor foot by having all five toes intact. The aesthetic and functional aspects of the amputated thumbs and fingers can be worked upon and significantly improved. We feel that all amputated fingers or thumbs at different zones or levels of amputation can be functionally reconstructed using vascularized tissue from the partial great toe and PIP joint from the 2nd toe. This conservative yet decisive surgery option keeps donor site functional morbidity to the minimum. Only that surgery must still look up to and progress in improving aesthetic reflection and functional elements for the larger benefit of the patients.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 2","pages":"100204"},"PeriodicalIF":0.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013743","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}