Journal of Hand and Microsurgery最新文献

{"title":"Evaluation of the results of reconstruction of large bony defects of humerus using vascularized bone grafts.","authors":"Mustafa Youssef, Mohamed AbdalMoneim Hafez, Ahmed Elsayed Semaya, Amr El-Sayed","doi":"10.1016/j.jham.2024.100198","DOIUrl":"10.1016/j.jham.2024.100198","url":null,"abstract":"<p><strong>Background: </strong>Vascularized bone grafts (VBGs) are currently the main surgical option for the restoration of humeral bone defects particularly when defects are larger than 6 cm. Because it offers a strong, rapid blood supply, VBGs easily integrate into the recipient sites and undergo active resorption and remodeling into healthy bone through primary bone healing. Additionally, they support the recipient site's immune system in preventing and reducing infection.<b>The Aim</b> was to assess the outcomes of utilizing vascularized bone grafts to reconstruct large humeral bony defects (greater than 6 cm).</p><p><strong>Patients and methods: </strong>This study comprised twenty patients with major humeral bony defects treated by vascularized bone grafts. Under general anesthesia, the procedure was carried out with the patient in the supine position for free fibula harvesting or in the lateral or prone position for pedicled scapular graft harvesting.</p><p><strong>Results: </strong>The union rate was 90 % and the mean healing time was 7.78 ± 3.04 months. Complications were present in 40 % of cases, with non-union being the most common, followed by infection and wound dehiscence.</p><p><strong>Conclusion: </strong>The study suggests that the reconstruction of large bony defects of humerus using vascularized bone grafts is effective, with a predictable healing time and a manageable complication rate.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 2","pages":"100198"},"PeriodicalIF":0.3,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suture suspension arthroplasty for thumb carpometacarpal osteoarthritis under wide-awake anesthesia.","authors":"Shinji Yoshida, Takehiko Takagi, Yuka Kobayashi, Masahiko Watanabe","doi":"10.1016/j.jham.2024.100194","DOIUrl":"10.1016/j.jham.2024.100194","url":null,"abstract":"<p><strong>Intorduction: </strong>There is little difference in the outcome of various surgical treatment for thumb carpometacarpal osteoarthritis. Suture suspension arthroplasty is a very simple technique without sacrifice of tendon or specific implants and can be performed under regional anesthesia. We hypothesize that the technique yields similar good results to an approach under general anesthesia at less medical cost.</p><p><strong>Methods: </strong>Eighteen patients underwent suture suspension arthroplasty by trapezial excision and metacarpal suspension using #2 high-strength suture passed from the attachment of abductor pollicis longus to the most distal part of flexor carpi radialis without tendon transfer or K-wire fixation. Nine patients received wide-awake anesthesia and 9 patients received general anesthesia. Postoperatively, patients were evaluated by clinical and radiographic outcomes. We investigated the first to second metacarpal angle, the first metacarpophalangeal angle, trapezial space ratio, grip strength, pinch strength, Kapandji score, DASH score, medical cost and patient satisfaction.</p><p><strong>Results: </strong>Five of 18 patients were male. Average age was 66.3 (range 53-76). Eleven patients had Eaton stage 3 and 7 had stage 4. The mean follow-up was 17.9 months (range, 7-48 months). Postoperatively, the first to second metacarpal angle, the first metacarpophalangeal angle, grip strength, DASH and Kapandji score showed significant improvements. However, there is no significant difference of clinical and radiographic outcome between wide-awake anesthesia and general anesthesia. Medical cost was significantly less in wide-awake anesthesia than in general anesthesia. Most patients receiving wide-awake anesthesia would hope the same anesthesia if they were to have surgery again.</p><p><strong>Conclusion: </strong>Suture suspension arthroplasty for thumb carpometacarpal osteoarthritis is a very simple technique and has good results. Because of the simplicity, wide-awake surgery is possible and yields similar good results to an approach under general anesthesia at less medical cost. Therefore, Suture suspension arthroplasty for thumb carpometacarpal osteoarthritis under wide-awake anesthesia is highly recommended.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 2","pages":"100194"},"PeriodicalIF":0.3,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334105","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}

{"title":"Gender and racial diversity Assumed by text-to-image generators in microsurgery and plastic surgery-related subspecialities.","authors":"Makoto Shiraishi, Chihena Hansini Banda, Mayuri Nakajima, Mildred Nakazwe, Zi Yi Wong, Yoko Tomioka, Yuta Moriwaki, Hakuba Takeishi, Haesu Lee, Daichi Kurita, Kiichi Furuse, Jun Ohba, Kou Fujisawa, Shimpei Miyamoto, Mutsumi Okazaki","doi":"10.1016/j.jham.2024.100196","DOIUrl":"10.1016/j.jham.2024.100196","url":null,"abstract":"<p><strong>Background: </strong>Since the release of ChatGPT by OpenAI in November 2022, generative artificial intelligence (AI) models have attracted significant attention in various fields, including surgery. These advancements have been particularly notable for creating highly detailed and contextually accurate images from textual prompts. A notable area of clinical application is the representation of surgeon demographics in various specialties, particularly in the context of microsurgery and plastic surgery-related subspecialties.</p><p><strong>Methods: </strong>This cross-sectional study, conducted in June 2024, utilized the latest version of the Copilot Creative Mode powered by DALL-E 3 to generate images of surgeons across various plastic surgery subspecialties. Real-world demographic data from the US, Japan, and Zambia were compared with AI-generated images for an accurate representation analysis.</p><p><strong>Results: </strong>Five hundred images (350 from various subspecialties and 150 from geographical sources) were analyzed. The AI model predominantly generated images of male and female surgeons with a statistical underrepresentation of female and Black microsurgeons. Geographical prompts influenced the representation, with an overrepresentation of female (64.0 %; p < 0.001) and Black (16.0 %; p < 0.001) plastic surgeons in the US and exclusively Asian surgeons in Japan. Discrepancies were also observed in the depiction of surgical equipment, with the majority of AI-generated microsurgeons inaccurately portrayed using either surgical loupes (46.0 %) or optical microscopes (32.0 %), not with surgical microscopes (4.0 %).</p><p><strong>Conclusions: </strong>This study revealed significant disparities between AI-generated images and actual demographics in the fields of microsurgery and plastic surgery-related subspecialties, highlighting the need for more diverse and accurate training datasets for AI models.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 1","pages":"100196"},"PeriodicalIF":0.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899228","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":"C5 is shoulder, C6 is elbow flexion, C7 is elbow extension, C8 and T1 are hand functions-Is there a need for MRI and EMG/NCS in adult traumatic brachial plexus injuries?","authors":"J Terrence Jose Jerome, Kanchai Malungpaishrope","doi":"10.1016/j.jham.2024.100177","DOIUrl":"10.1016/j.jham.2024.100177","url":null,"abstract":"","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 2","pages":"100177"},"PeriodicalIF":0.3,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334101","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":"From wide awake surgery to office surgery.","authors":"Shafic Sraj","doi":"10.1016/j.jham.2024.100192","DOIUrl":"10.1016/j.jham.2024.100192","url":null,"abstract":"<p><p>Wide-Awake Local Anesthesia with No Tourniquet shifted how we provide hand surgery and liberated us from anesthesia-related constraints. This change led to the realization that hand surgery can be done in the office setting as long as safety requirements are fulfilled. This review focuses on what we know about office surgery from safety, society, facility, patient, and surgeon perspectives, and looks at the barriers that impede further expansion.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 2","pages":"100192"},"PeriodicalIF":0.3,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334102","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":"\"Solving vessel caliber mismatch in microvascular anastomosis: A comprehensive review, novel techniques, and a surgical guide for optimal outcomes\".","authors":"Riccardo Nocini, Valentina Pinto, Luca Contu, Giorgio De Santis, Marco Pignatti","doi":"10.1016/j.jham.2024.100179","DOIUrl":"10.1016/j.jham.2024.100179","url":null,"abstract":"<p><p>Caliber mismatch in microvascular anastomosis can significantly increase procedural difficulty and elevate the risk of thrombosis. A comprehensive literature search in PubMed, Scopus, Web of Science, and Google Scholar was conducted to identify articles addressing surgical techniques for overcoming caliber mismatch in microvascular anastomosis. Various techniques described in the literature were found: modifications of end-to-end anastomosis, the use of end-to-side anastomosis, the application of vessel grafts and the use of vessel couplers. In this review, we critically analyze these techniques and introduce additional technical variations. We discuss the options and express our preferred choice of methods based on specific clinical scenarios: if an alternative vessel (either new or isolated further away) is not found, the severity of the mismatch guides the choice. When less then 1/3 our choice is for vessel dilation and oblique cut of the smaller vessel end (if necessary with the adjunct of a titanium small Ligaclip in an oblique fashion to avoid a cul-de-sac). If caliber mismatch is around or over 1/3, we would prefer an end to side anastomosis.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 1","pages":"100179"},"PeriodicalIF":0.3,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814250","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 retrospective comparison of absorbable versus non-absorbable sutures for elective hand surgery wound closures.","authors":"Daniel Nemirov, Eva Dentcheva, Taylor Thurmond, Abdo Bachoura, David Hirsch, Rick Tosti","doi":"10.1016/j.jham.2024.100178","DOIUrl":"10.1016/j.jham.2024.100178","url":null,"abstract":"<p><strong>Background: </strong>Suture selection in elective hand surgery closures has traditionally been non-absorbable sutures (NAS) rather than absorbable sutures (AS). The goal of this study was to evaluate absorbable versus non-absorbable closures of various primary elective hand procedures. Our group hypothesized that no differences in major short-term outcomes would exist.</p><p><strong>Methods: </strong>A retrospective review of 867 patients was conducted. Patients were identified using Current Procedural Terminology (CPT) codes specific to surgical cases from forearm to fingertip. Patients undergoing emergent trauma operations or debridement for infection were excluded. Two experimental groups were evaluated: one in which surgical wound closures were performed with non-absorbable suture (nylon) vs one in which closures were performed with absorbable suture (monocryl). Outcomes measured were wound dehiscence, need for postoperative antibiotics, 30-day general complications, and reoperations within 60 days.</p><p><strong>Results: </strong>A total of 867 patients were investigated in this study. The AS cohort consisted of 455 patients whereas the NAS group contained 412. No significant differences were noted between the AS and NAS groups with regards to age, gender, or diabetes. Postoperatively, there was no significant difference in rates of dehiscence, infections, or antibiotic prescription. Furthermore, rates of 30-day complications (1.36 % vs 1.47 %; p = 1.000), 60-day complications (0.68 % vs 2.19 %; p = 0.113) and reoperation (1.13 % versus 1.46 %; p = 0.903) were similar between the AS and NAS cohorts.</p><p><strong>Conclusion: </strong>Wound closure in hand surgery using absorbable suture appears to have comparable outcomes with non-absorbable suture.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 1","pages":"100178"},"PeriodicalIF":0.3,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060764","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":"Arthroscopic algorithm for acute traumatic triangular fibrocartilage complex (TFCC) tears.","authors":"Sze Ryn Chung, Khian Wan Sarah Joy Huan, Jie Hui Nah, Terrence Jose Jerome","doi":"10.1016/j.jham.2024.100175","DOIUrl":"10.1016/j.jham.2024.100175","url":null,"abstract":"<p><p>The triangular fibrocartilage complex (TFCC) is crucial for stability and acts as a shock absorber and load transmitter at the distal radioulnar joint (DRUJ). It is often injured in wrist trauma, particularly in young athletes. Clinical assessment involves patient history, physical examination, and imaging modalities like MRI, with wrist arthroscopy as the gold standard for diagnosing TFCC tears. Multiple classification systems categorize TFCC tears based on location and arthroscopic appearance, guiding treatment decisions. Surgical options are recommended for tears refractory to conservative management or severe tears. Despite numerous arthroscopic treatments available in the literature, this article aims to simplify the approach. It presents the authors' surgical algorithm for managing acute traumatic TFCC tears arthroscopically. The choice of technique depends on the lesion's location, with various options for peripheral and foveal tears. Post-operative rehabilitation is crucial for optimal recovery. This article provides a comprehensive review of acute traumatic TFCC injuries, covering anatomy, classification, assessment, and treatment options. Emphasis is placed on accurate diagnosis and appropriate arthroscopic management through a structured approach.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 1","pages":"100175"},"PeriodicalIF":0.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807971","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":"Advanced Tips and Tricks for the Microvascular Coupler Anastomosis.","authors":"Sarah J Lonie, Georgios Pafitanis, Timothy P Crowley, Maniram Ragbir, Juan Enrique Berner","doi":"10.1016/j.jham.2024.100174","DOIUrl":"10.1016/j.jham.2024.100174","url":null,"abstract":"<p><p>Microvascular anastomotic couplers are a safe alternative to traditional vein suture techniques. They are versatile and widely used for flap vein anastomoses; however, the technique has limitations. Most problems which can arise, have reasonable solutions that we have learned using this device. We describe advanced tips to avoid pitfalls and aid successful venous anastomoses with couplers in challenging situations.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 2","pages":"100174"},"PeriodicalIF":0.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334100","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}