Journal of Hand and Microsurgery最新文献_第8页

Institutional perspectives on the routine use of Interrupted Horizontal Micro-Mattress (IHMM) suturing in microvascular anastomosis. 间断式水平微垫（IHMM）缝合在微血管吻合中的常规应用。

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Journal of Hand and Microsurgery Pub Date : 2025-06-21 eCollection Date: 2025-09-01 DOI: 10.1016/j.jham.2025.100299

Subhendu Khan, Varun Saini, Sanujit Apurv Pawde

引用次数: 0

Managing complex hand, wrist, and forearm injuries with WALANT: A case-based technical report. 用WALANT处理复杂的手、手腕和前臂损伤：一份基于病例的技术报告。

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Journal of Hand and Microsurgery Pub Date : 2025-06-19 eCollection Date: 2025-09-01 DOI: 10.1016/j.jham.2025.100295

Mikko P Räisänen, Mikael S Hytönen, Yrjänä A Nietosvaara, Matti T Juntunen

{"title":"Managing complex hand, wrist, and forearm injuries with WALANT: A case-based technical report.","authors":"Mikko P Räisänen, Mikael S Hytönen, Yrjänä A Nietosvaara, Matti T Juntunen","doi":"10.1016/j.jham.2025.100295","DOIUrl":"10.1016/j.jham.2025.100295","url":null,"abstract":"Wide-Awake Local Anaesthesia No Tourniquet (WALANT) is an effective and increasingly utilised method of anaesthesia for the surgical treatment of injuries to the hand, wrist, and forearm. Despite its proven safety, efficacy, and cost-effectiveness, the adoption of WALANT has been limited, particularly in Western healthcare systems where general and regional anaesthesia predominate, especially in complex injuries. We report the application of WALANT in a variety of hand surgical procedures for the treatment of complex injuries ranging from complex fractures to multiple soft tissue injuries in adult patients. WALANT's benefits includes active intraoperative testing of the strength of tendon repairs and osteosynthesis which applies also to complex injuries. Additionally, nerve repairs can also be actively tested under WALANT, leading to more effective and safer postoperative rehabilitation. We anticipate that WALANT will soon see broader application even in more complex surgeries, extending to the surgical treatment of complex injuries around and above elbow.","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 5","pages":"100295"},"PeriodicalIF":0.5,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676084","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}

引用次数: 0

Knacks and pitfalls for superficial circumflex iliac artery perforator flap. 旋髂浅动脉穿支皮瓣的技巧与缺陷。

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Journal of Hand and Microsurgery Pub Date : 2025-06-14 eCollection Date: 2025-09-01 DOI: 10.1016/j.jham.2025.100296

Shigeki Ishibashi, Toko Miyazaki, Maya Kanasaki, Reiko Tsukuura, Chihiro Matsui, Nana Yamamoto, Takumi Yamamoto

{"title":"Knacks and pitfalls for superficial circumflex iliac artery perforator flap.","authors":"Shigeki Ishibashi, Toko Miyazaki, Maya Kanasaki, Reiko Tsukuura, Chihiro Matsui, Nana Yamamoto, Takumi Yamamoto","doi":"10.1016/j.jham.2025.100296","DOIUrl":"10.1016/j.jham.2025.100296","url":null,"abstract":"Purpose: To review the utility of the Superficial Circumflex Iliac Artery Perforator (SCIP) flap for a wide range of defect reconstructions, emphasizing the groin's vascular anatomy, relevant anatomical variations, and recent advancements overcoming traditional groin flap limitations.Methods: Based on a literature review, anatomical knowledge, and clinical experience, this article summarizes the variations of the superficial circumflex iliac artery (SCIA), surgical techniques for SCIP flap harvesting, and the role of preoperative color Doppler ultrasound mapping for safe and efficient flap elevation.Results: The SCIA displays significant anatomical variations, necessitating thorough preoperative assessment for successful flap harvest. The perforator flap concept and supermicrosurgery have addressed the challenges of the traditional groin flap's short, small pedicle, making the SCIP flap a more reliable option. The SCIP flap offers remarkable versatility by potentially including multiple tissues-skin, fat, lymphatic vessels, lymph nodes, deep fascia, sartorius muscle, lateral femoral cutaneous nerve, and iliac bone-allowing its use as a chimeric flap for a broad spectrum of defects, ranging from simple to complex.Conclusions: With a comprehensive understanding of groin vascular anatomy and appropriate preoperative evaluation, including color Doppler ultrasound, the SCIP flap is a reliable and highly versatile reconstructive tool. Its ability to incorporate various tissues and minimal donor site morbidity, with scars concealable under clothing, make it an excellent choice for various reconstructive challenges.","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 5","pages":"100296"},"PeriodicalIF":0.7,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561463","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}

引用次数: 0

Anatomical morphometry of the proximal humerus in the Vietnamese population: A comparative study using multiplanar computed tomography and cadaveric dissection. 越南人群肱骨近端解剖形态测量：多平面计算机断层扫描和尸体解剖的比较研究。

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Journal of Hand and Microsurgery Pub Date : 2025-06-14 eCollection Date: 2025-07-01 DOI: 10.1016/j.jham.2025.100294

Thy Gia Anh Le, Nguyen Tri Phan, Phi Duong Nguyen

{"title":"Anatomical morphometry of the proximal humerus in the Vietnamese population: A comparative study using multiplanar computed tomography and cadaveric dissection.","authors":"Thy Gia Anh Le, Nguyen Tri Phan, Phi Duong Nguyen","doi":"10.1016/j.jham.2025.100294","DOIUrl":"10.1016/j.jham.2025.100294","url":null,"abstract":"Background: Fractures of the proximal humerus are prevalent among the elderly, often posing challenges in anatomical reconstruction and internal fixation. Precise anatomical knowledge tailored to specific populations is essential for optimal surgical outcomes. This study aims to quantitatively evaluate the anatomical characteristics of the proximal humerus in the Vietnamese population through multiplanar computed tomography (CT) and cadaveric measurements, and to determine the consistency between the two modalities.Methods: A prospective descriptive study was conducted on 75 CT scans and 30 shoulder specimens from 15 fresh cadavers. Parameters measured included the neck-shaft angle, diameters of the humeral head (superior-inferior and anterior-posterior), width of the greater tuberosity, deltoid tuberosity index, and distances from the greater tuberosity to anatomical landmarks such as the lesser tuberosity, bicipital groove, and pectoralis major insertion.Results: The average neck-shaft angle was 132.36° ± 2.44°, with most values within 130°-140°. The deltoid tuberosity index averaged 1.76 ± 0.20, exceeding thresholds reported in previous studies. No statistically significant differences were found between CT and cadaveric measurements across most parameters (p > 0.05). The anatomical measurements were found to be smaller than those reported in Western populations but comparable to other Asian populations.Conclusion: The study confirms that CT imaging provides reliable and accurate morphometric data comparable to cadaveric dissection. Key anatomical landmarks such as the pectoralis major insertion, lesser tuberosity, and bicipital groove can serve as consistent intraoperative references for implant positioning in Vietnamese patients.","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 4","pages":"100294"},"PeriodicalIF":0.7,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555294","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}

引用次数: 0

National trends in bone supplement use and vitamin D deficiency - implications for upper extremity surgery. 骨补充剂使用和维生素D缺乏的国家趋势——对上肢手术的影响。

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Journal of Hand and Microsurgery Pub Date : 2025-06-14 eCollection Date: 2025-07-01 DOI: 10.1016/j.jham.2025.100298

Rishub K Das, Brian C Drolet, Wesley P Thayer, Izabela A Galdyn

引用次数: 0

Development of a novel artificial intelligence clinical decision support tool for hand surgery: HandRAG. 开发一种新型人工智能手外科临床决策支持工具：HandRAG。

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Journal of Hand and Microsurgery Pub Date : 2025-06-11 eCollection Date: 2025-07-01 DOI: 10.1016/j.jham.2025.100293

Berk B Ozmen, Nishant Singh, Kavach Shah, Ibrahim Berber, Damanjit Singh, Eugene Pinsky, Antonio Rampazzo, Graham S Schwarz

{"title":"Development of a novel artificial intelligence clinical decision support tool for hand surgery: HandRAG.","authors":"Berk B Ozmen, Nishant Singh, Kavach Shah, Ibrahim Berber, Damanjit Singh, Eugene Pinsky, Antonio Rampazzo, Graham S Schwarz","doi":"10.1016/j.jham.2025.100293","DOIUrl":"10.1016/j.jham.2025.100293","url":null,"abstract":"Purpose: Hand surgery decision-making requires integration of complex anatomical understanding, diverse patient-specific factors, and nuanced operative techniques. While artificial intelligence (AI), large language models (LLMs), and retrieval-augmented generation (RAG) models have advanced significantly in various fields, no AI-driven clinical decision support systems currently exist for hand surgery. A novel retrieval-enhanced AI large language model specifically tailored for hand surgery was developed, capable of effectively utilizing peer-reviewed published hand surgery literature for clinical decision support in real-time at point of care.Methods: An AI clinical decision support system was developed integrating all available open-access 4510 peer-reviewed hand surgery publications from 2000 to 2024 identified through hand surgery-relevant keywords. Documents were processed using a hierarchical pipeline based on the RAPTOR methodology, which breaks down large texts into smaller segments to enhance accurate retrieval. The system was evaluated using 15 standardized clinical queries assessed using automated computational metrics for correctness and semantic similarity to source documents.Results: The AI system demonstrated consistent performance with an average G-Eval correctness score of 0.79, SEM with an average similarity score of 0.75 (range: 0.54-0.86) and average maximum similarity score of 0.80 (range: 0.56-0.91), predominantly at moderate confidence levels. Generated recommendations were contextually appropriate and reliably linked to relevant hand surgery literature, providing accurate and clinically meaningful guidance.Conclusion: The AI system, HandRAG, incorporating RAG and LLM approach offers potential benefits for evidence-based clinical decision support and education in hand surgery.","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 4","pages":"100293"},"PeriodicalIF":0.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555295","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}

引用次数: 0

Advances in shoulder surgical education. What are the realities? 肩外科教育进展。现实是什么？

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Journal of Hand and Microsurgery Pub Date : 2025-06-10 eCollection Date: 2025-09-01 DOI: 10.1016/j.jham.2025.100290

Rae Tarapore, Sierra Lindsey, Anand M Murthi, Ryan A Hoffman

引用次数: 0

Reliability and validity of Camry dynamometer for isometric hand grip strength measurement in healthy Indian adults. 凯美瑞测功机在健康印度成人等距握力测量中的信度和效度。

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Journal of Hand and Microsurgery Pub Date : 2025-06-10 eCollection Date: 2025-07-01 DOI: 10.1016/j.jham.2025.100291

Vrushali Panhale, Raveena Kini, Shreya Kothale

{"title":"Reliability and validity of Camry dynamometer for isometric hand grip strength measurement in healthy Indian adults.","authors":"Vrushali Panhale, Raveena Kini, Shreya Kothale","doi":"10.1016/j.jham.2025.100291","DOIUrl":"10.1016/j.jham.2025.100291","url":null,"abstract":"Background: The Jamar dynamometer is the gold standard to assess hand grip strength, but is expensive. The Camry dynamometer is relatively cost-effective. There is a dearth of literature on Camry's validation in healthy Indian adults, which is important to establish as hand grip is known to vary with age, gender and race.Objectives: To establish the reliability and validity of the Camry dynamometer in comparison to the Jamar handheld dynamometer among healthy Indian adults in the age group of 20-59 years.Methods: Following basic demographics, occupation and hand dominance, three trials of each dynamometer were performed in standardised positions for the non-dominant and dominant hand of each participant and the best value was recorded. A gap of 10 min was provided between the 2 dynamometers. Data was then recorded and analyzed.Results: 120 participants were recruited, with an equal males and females. The mean isometric hand grip strength for the non-dominant hand was 26.71 ± 9.29 kgf, and for the dominant hand was 27.66 ± 9.12 kgf using the Camry hand-held dynamometer, while it was 26.43 ± 9.07 kgf for the non-dominant and 27.37 ± 9.26 kgf for the dominant side using the Jamar Hand Held dynamometer. Data was further analyzed with age and gender stratification. The Camry hand-held device had excellent reliability (ICC>0.97) and good validity with Pearson's correlation index of 0.97 (p < 0.05) for the dominant hand and 0.99 (p < 0.05) for the nondominant hand, and Bland-Altman's graphics showing more than 90 % of measures within confidence limits.Conclusion: Camry digital dynamometer is a reliable and valid device to measure isometric handgrip strength in healthy Indian adults compared to the Jamar hydraulic handgrip dynamometer.","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 4","pages":"100291"},"PeriodicalIF":0.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530303","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}

引用次数: 0

Long-term outcomes of arthroscopic radial styloidectomy for the treatment of radioscaphoid impingement, including SLAC and SNAC wrists. 关节镜桡骨茎突切除术治疗桡舟突撞击，包括SLAC和SNAC手腕的长期疗效。

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Journal of Hand and Microsurgery Pub Date : 2025-06-03 eCollection Date: 2025-09-01 DOI: 10.1016/j.jham.2025.100292

Philip N d'Ailly, Laurien Waaijer, J Carel Goslings, Zulfiquar O Rahimtoola, Niels W L Schep

{"title":"Long-term outcomes of arthroscopic radial styloidectomy for the treatment of radioscaphoid impingement, including SLAC and SNAC wrists.","authors":"Philip N d'Ailly, Laurien Waaijer, J Carel Goslings, Zulfiquar O Rahimtoola, Niels W L Schep","doi":"10.1016/j.jham.2025.100292","DOIUrl":"10.1016/j.jham.2025.100292","url":null,"abstract":"Introduction: This study aimed to evaluate the patient-reported outcomes following arthroscopic radial styloidectomy (ARS) in patients with symptomatic radioscaphoid impingement (RSI).Materials and methods: All arthroscopically treated patients with symptomatic RSI were retrospectively included. Arthroscopy was performed using four portals (3-4, 6 R, MC-U and MC-R) and the radial styloid was removed with a burr. Primary outcome was wrist function measured with the Patient-Rated Wrist Evaluation (PRWE) score with a minimal follow-up of two years. Secondary outcomes were Numeric Rating Scale (NRS) for pain, complications, secondary surgery, patients satisfaction and lost workdays.Results: Seventeen RSI patients were included with a median age of 47 years: four with scapholunate advanced collapse, six with scaphoid nonunion advanced collapse, four with a healed scaphoid fracture and three with a radial styloid fracture nonunion. Follow-up assessments were performed at 22 months and 59 months. The median PRWE score was 8 and the median NRS was 0, which both showed continuous improvement until the final follow-up. Among the two complications were hypertrophic scar tissue and a septic arthritis which was treated with arthroscopic drainage and antibiotics. Four patients required secondary surgery, which included repeated ARS, open radial styloidectomy, posterior interosseous nerve neurectomy and wrist arthroplasty. Out of the 17 patients, 15 reported satisfaction with the treatment. The median number of lost workdays was eight.Conclusion: We conclude that ARS results in good long-term patient-reported outcomes with an acceptable risk of complications and need for secondary surgery. ARS should be considered before opting for more invasive procedures.Evidence level: IV therapeutic.","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 5","pages":"100292"},"PeriodicalIF":0.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576609","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}

引用次数: 0

Median nerve entrapment in a callus fracture following an elastic stable intramedullary nailing for treatment of pediatric both-bone forearm shaft fracture: A case report and literature review. 弹性稳定髓内钉治疗小儿前臂双骨骨折后骨痂骨折正中神经夹持：1例报告及文献回顾。

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Journal of Hand and Microsurgery Pub Date : 2025-05-31 eCollection Date: 2025-09-01 DOI: 10.1016/j.jham.2025.100289

Patrick Houvet, Laurent Bourcheix

引用次数: 0