Journal of Hand and Microsurgery最新文献

{"title":"Safety and efficacy of outpatient versus inpatient adult brachial plexus surgery.","authors":"Katherine D Drexelius, Eliana B Saltzman, Kirby W Bonvillain, Julia C Mastracci, Kennedy K Gachigi, Daniel R Lewis, Peter M Waters, Bryan J Loeffler, R Glenn Gaston","doi":"10.1016/j.jham.2024.100164","DOIUrl":"10.1016/j.jham.2024.100164","url":null,"abstract":"<p><strong>Purpose: </strong>Outpatient orthopedic surgery is becoming more common as a method of providing safe and cost-effective medical care. The purpose of this study was to compare outcomes between adult patients undergoing outpatient versus inpatient brachial plexus surgery.</p><p><strong>Methods: </strong>A single institution database was queried for patients with brachial plexus injuries undergoing brachial plexus exploration with or without concomitant reconstructive procedures from 2010 to 2022. Outcome measures included 90-day major and minor complications, as well as longer term pain scores and reoperation rates. Multivariate analysis was performed to compare outcomes between the cohorts.</p><p><strong>Results: </strong>In a group of 51 adult patients, 36 (70.6 %) were admitted for at least one night following surgery and 15 (29.4 %) underwent outpatient surgery. The cohorts were similar with respect to demographics. When compared to brachial plexus procedures performed between 2010 and 2016, those performed between 2017 and 2022 were 67 % more likely to be outpatient (OR 0.33; p = 0.11). The overall major complication rate during the 90-day episode of care was 11.8 % (n = 6), all of which occurred in the inpatient cohort<i>.</i> There was no significant difference in minor complication rate. 90-day reoperation rate due to complications was 2.8 % in the inpatient cohort and 0.0 % in the outpatient cohort.</p><p><strong>Conclusion: </strong>No prior study has assessed the safety of brachial plexus exploration and reconstruction in an outpatient setting. This study demonstrates that outpatient brachial plexus surgery is a safe option for properly selected patients. Procedures were more often performed outpatient in recent years, reflecting a continuing evolution of our practice.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 1","pages":"100164"},"PeriodicalIF":0.3,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060912","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":"Pillar pain incidence, duration, and psychological correlations in WALANT. A prospective study of 170 patients.","authors":"Ignacio Rellan, Agustín Guillermo Donndorff, Gerardo Luis Gallucci, Pablo De Carli, Pedro Bronenberg Victorica, Rocio Avanzi, Ivan Alfredo Huespe, Jorge Guillermo Boretto","doi":"10.1016/j.jham.2024.100165","DOIUrl":"10.1016/j.jham.2024.100165","url":null,"abstract":"<p><strong>Purpose: </strong>To prospectively address our patients seeking carpal tunnel release (CTR) to evaluate the incidence, intensity, and duration of pillar pain (PP) and its correlation with catastrophic thinking, depression, and health anxiety.Methods: this is a prospective cohort study consisting of patients who underwent mini-open CTR under WALANT. Pillar pain was evaluated using the table test and was recorded as dichotomous variable and rated with a visual analogue scale (VAS). Patients with a positive result were evaluated on a monthly basis until the test yielded a negative result.To assess catastrophic thinking, health anxiety and depression levels, we employed the Pain Catastrophizing Scale (PCS) the Short Health Anxiety Inventory (SHAI), and the Beck scale respectively.</p><p><strong>Results: </strong>The study enrolled 170 patients who underwent CTR using WALANT technique. Among them, 84 patients (49 %) exhibited a positive table test. With exception of age and diabetes, both groups showed comparable demographic characteristics.The mean pain score for patients with a positive test was 3.5 ± 1.5, and the median duration of it was 3 months (interquartile range [IQR] 2-4). The median PCS score was 8 (IQR 2-14) in patients without PP, compared to 8 (IQR 4-11) in patients with PP. In the logistic regression model, the PCS variable had a crude odds ratio (OR) of 1 (95 % CI: 0.96-1.03) and an adjusted OR of 1 (95 % CI: 0.97-1.04). The SHAI score showed a crude OR of 0.97 (95 % CI: 0.93-1.01) and an adjusted OR of 0.97 (95 % CI: 0.92-1.01). The BECK score had a crude OR of 0.99 (95 % CI: 0.96-1.03) and an adjusted OR of 1.02 (95 % CI: 0.98-1.06).</p><p><strong>Conclusion: </strong>Patients undergoing mini-open CTR have a risk of 49 % of experiencing PP, which typically registers a pain intensity of approximately 3 points and will last for a median of 3 months. The likelihood of experience it does not depend on catastrophic thinking, depression, and health anxiety.</p><p><strong>Type of study/level of evidence: </strong>Prognostic II.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 2","pages":"100165"},"PeriodicalIF":0.3,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334103","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":"Clinical results of carpal tunnel Re-release revision surgery and synovial wrap for recurrent carpal tunnel syndrome.","authors":"Mahiro Kimura, Ryosuke Ikeguchi, Takashi Noguchi, Manabu Nankaku, Rie Yamawaki, Koichi Yoshimoto, Daichi Sakamoto, Terunobu Iwai, Kazuaki Fujita, Shuichi Matsuda","doi":"10.1016/j.jham.2024.100162","DOIUrl":"10.1016/j.jham.2024.100162","url":null,"abstract":"<p><strong>Introduction: </strong>Carpal tunnel syndrome is a challenging condition when conventional carpal tunnel revision surgery fails to alleviate symptoms. This study aims to assess the outcomes of combining carpal tunnel revision surgery with a synovial wrap for cases of recurrent carpal tunnel syndrome in patients who had adhered median nerve, with a minimum 1-year follow-up.</p><p><strong>Patients and methods: </strong>A retrospective analysis was conducted on 10 patients (mean age: 73.7 years, nine females and one male) who underwent treatment for recurrent carpal tunnel syndrome. The approach involved carpal tunnel revision surgery coupled with a median nerve synovial wrap. Patients were followed up for a minimum of 1 year. The procedure involved harvesting a 3.5 cm × 4 cm section of the flexor synovial membrane with a distal ulnar pedicle, which was then wrapped around the adherent site of the median nerve. Physical assessments included the pain visual analogue scale (VAS), Tinel sign in the carpal tunnel, thenar muscle atrophy, the Semmes-Weinstein monofilament test (SW test), manual muscle test (MMT) as assessed on the 5-point British Medical Research Council Scale (5/5, normal; 0/5, absent), and the Disabilities of the Arm, Shoulder, and Hand (Quick DASH) questionnaire. The physical variables were compared before surgery and at final follow-up.</p><p><strong>Results: </strong>All patients showed some improvement in SW test. The MMT for the abductor pollicis brevis showed significant improvement at final follow-up (3 for four patients, 4 for four patients, and 5 for two patients) compared to pre-surgery assessments (2 for six patients, 3 for two patients, and 4 for two patients). The mean VAS score and DASH score at final follow-up (13.0 ± 10.3, 19.3 ± 12.7, respectively) were significantly lower than those recorded before surgery (76.5 ± 11.1, 52.4 ± 17.1, respectively). The Tinel sign and the thenar muscle atrophy significantly improved from before surgery to final follow-up.</p><p><strong>Conclusion: </strong>Carpal tunnel release with a synovial wrap demonstrated significant improvements in muscle strength, pain relief and function. The synovial wrap method is an effective procedure for treating recurrent carpal tunnel syndrome.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 1","pages":"100162"},"PeriodicalIF":0.3,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060784","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 systematic review of systematic reviews comparing simple trapeziectomy versus trapeziectomy with ligament reconstruction and tendon interposition for trapeziometacarpal osteoarthritis.","authors":"Evan Fang, Tara Behroozian, Achilles Thoma","doi":"10.1016/j.jham.2024.100160","DOIUrl":"10.1016/j.jham.2024.100160","url":null,"abstract":"<p><strong>Background: </strong>The outcomes of simple trapeziectomy (T) versus trapeziectomy with ligament reconstruction and tendon interposition (LRTI) for trapeziometacarpal (TMC) osteoarthritis have been compared in several systematic reviews (SRs) with conflicting results across the various outcomes studied. Despite a lack of conclusions regarding the superiority of one treatment versus the other, LRTI remains the most popular surgical option. This raises the questions of whether published SRs are of high methodological quality, and whether discordant conclusions can be attributed to differences in methodologic quality. To answer these, a SR of SRs comparing T vs LRTI was conducted.</p><p><strong>Methods: </strong>A search of MEDLINE, EMBASE, and the Cochrane Database of SRs was performed from 1946 to September 18, 2023. SRs directly comparing T vs LRTI for TMC osteoarthritis were selected for inclusion. Methodological characteristics, results and conclusions of the selected SRs were extracted. Outcomes and conclusions were assessed for disagreement in the context of methodological differences. Quality of the included reviews was assessed using the AMSTAR 2 tool.</p><p><strong>Results: </strong>Seven SRs, published between 2004 and 2022, were included. Based on AMSTAR 2 criteria, all seven SRs received a quality rating of \"critically low\" due to weaknesses in more than one critical domain. The most frequent weaknesses in critical domains included: failure to indicate that the review followed an <i>a priori</i> protocol (5 of 7 SRs), failure to provide a list of excluded studies and justification for each (5 of 7 SRs), failure to account for risk of bias from primary studies when discussing results (4 of 7 SRs), and failure to justify methods used for meta-analysis (4 of 5 meta-analyses).</p><p><strong>Conclusions: </strong>SRs comparing T vs LRTI have had methodological or reporting flaws which limit confidence in results. Future SRs should ensure a rigorous methodology is followed and clearly reported in the publication.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 1","pages":"100160"},"PeriodicalIF":0.3,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060778","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":"Vascularised Composite Allotransplantation - A guide to optimal dissemination of scientific outputs.","authors":"C M Hehir, G P Dowling, G G Calpin, M O'Connor, L Kelly, C S Honeyman, H L Stark, R T Dolan","doi":"10.1016/j.jham.2024.100161","DOIUrl":"10.1016/j.jham.2024.100161","url":null,"abstract":"<p><strong>Purpose: </strong>The impact of academic research is not just important within the clinical domain but within society as a whole. Altmetric Attention Score (AAS) offers a means of assessing how scholarly outputs are interacted with online. Vascularised Composite Allotransplantation (VCA) is a modern but rapidly evolving topic which encompasses a broad range of complex and clinically significant surgical interventions. Primarily VCA is utilised in the reconstruction of complex, composite tissue defects, including limb and face transplantation. There is also a growing interest in the role of VCA as an early means of real-time immuno-monitoring, in sentinel skin flap transplant (SSF).</p><p><strong>Materials & methods: </strong>In July 2024, a search was conducted using the <i>Altmetric Explorer (AE)</i> database using the search term 'vascular-composite' AND 'allograft' OR 'allotransplant'. A simultaneous literature search was carried out using Web of Science (WoS) database utilising the same search terms with extraction of traditional citation-based metrics as well as relevant '<i>meso'</i> and '<i>micro'</i> subject headings. Corresponding citation-based metrics were extracted utilising <i>SCImago</i>. Data was compiled and analysed using a linear regression model with level of significance set at p < 0.05.</p><p><strong>Results: </strong>The Top 100 (T100) performing articles relating to VCA displayed a mean Altmetric Attention Score (AAS) of 3.31. All T100 papers were published in the English language. Sixty percent (n = 60) of T100 papers were published in Q1 Journals. News outlet mentions (r = 6.95), blog mentions (r = 6.20), and <i>Twitter/X</i> mentions (r = 0.52) demonstrated the greatest positive impact on AAS upon application of a linear regression model (p < 0.05).</p><p><strong>Conclusion: </strong>Altmetric Scores offer a means of appraising the impact of research outputs in both academic and societal domains. Such modern metrics are useful in evolving topics such as VCA as AAS is not dependent on citation counts. Publishing of outputs in high quartile, open access journals with timely utilisation of news and social media outlets should be utilised by researchers aiming to maximise dissemination of research outputs in the field of VCA.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 1","pages":"100161"},"PeriodicalIF":0.3,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060936","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":"Using machine learning to identify risk factors for short-term complications following thumb carpometacarpal arthroplasty.","authors":"Rohan M Shah, Rushmin Khazanchi, Anitesh Bajaj, Krishi Rana, Saaz Malhotra, Jennifer Moriatis Wolf","doi":"10.1016/j.jham.2024.100156","DOIUrl":"10.1016/j.jham.2024.100156","url":null,"abstract":"<p><strong>Background: </strong>Thumb carpometacarpal (CMC) joint osteoarthritis is among the most common degenerative hand diseases. Thumb CMC arthroplasty, or trapeziectomy with or without tendon augmentation, is the most frequently performed surgical treatment and has a strong safety profile. Though adverse outcomes are infrequent, the ability to predict risk for complications has substantial clinical benefits. In the present study, we evaluated a well-known surgical database with machine learning (ML) techniques to predict short-term complications and reoperations after thumb CMC arthroplasty.</p><p><strong>Methods: </strong>A retrospective study was conducted using data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) years 2005-2020. Outcomes were 30-day wound and medical complications and 30-day return to the operating room. We used three ML algorithms - a Random Forest (RF), Elastic-Net Regression (ENet), and Extreme Gradient Boosted Tree (XGBoost), and a deep learning Neural Network (NN). Feature importance analysis was performed in the highest performing model for each outcome to identify predictors with the greatest contributions.</p><p><strong>Results: </strong>We included a total of 7711 cases. The RF was the best performing algorithm for all outcomes, with an AUC score of 0.61±0.03 for reoperations, 0.55±0.04 for medical complications, and 0.59±0.03 for wound complications. On feature importance analysis, procedure duration was the highest weighted predictor for reoperations. In all outcomes, procedure duration, older age, and female sex were consistently among the top five predictors.</p><p><strong>Conclusions: </strong>We successfully developed ML algorithms to predict reoperations, wound complications, and medical complications. RF models had the highest performance in all outcomes.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"16 5","pages":"100156"},"PeriodicalIF":0.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819727","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":"Dynamic CT features of scapholunate instability during the wrist extension to flexion-An in vivo study.","authors":"Melanie Amarasooriya, Rami Al Dirini, Kimberley Bryant, Gregory Ian Bain","doi":"10.1016/j.jham.2024.100158","DOIUrl":"10.1016/j.jham.2024.100158","url":null,"abstract":"<p><strong>Purpose: </strong>This biomechanical study aimed to assess the change in the radioscaphoid and the radiolunate angles during wrist extension to flexion in scapholunate instability compared to the healthy wrist.</p><p><strong>Methods: </strong>Dynamic CT scans of 19 participants with no history of wrist pathology and 19 patients with scapholunate instability without degenerative changes were selected. Motion sequence studied was wrist extension to flexion. Image segmentation followed by 3D registration techniques were used to calculate the displacement field between scaphoid and lunate models in each time point. The radiocarpal angles and centroid positions were computed in the neutral wrist and throughout wrist motion. Comparisons were made between the normal and the scapholunate instability wrists.</p><p><strong>Results: </strong>The scapholunate instability wrist had less range of extension to flexion compared to the normal wrist. The scapholunate instability scaphoid was flexed and internally rotated in the neutral wrist position and throughout the range of motion. The scapholunate instability scaphoid centroid remained radial and distal in the extended wrist. The scapholunate instability lunate was significantly extended from wrist 20° extension to 50° flexion. The scapholunate instability lunate centroid was more ulnar from 70° wrist extension to 50° flexion.</p><p><strong>Conclusions: </strong>The scapholunate instability scaphoid demonstrated rotational abnormalities in two planes throughout the wrist motion and abnormal centroid positions in the extended wrist. The lunate extension in scapholunate instability was significant mostly during wrist flexion. Radioscaphoid instability appear to be the primary pathology in SLI and can be used to differentiate the SLI wrist from the normal throughout wrist extension to flexion. Lunate extension is not different between the normal and scapholunate instability in the extended wrist.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"16 5","pages":"100158"},"PeriodicalIF":0.3,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819412","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 comparison of handheld versus cart-based ultrasound in the evaluation and diagnosis of carpal tunnel syndrome.","authors":"Shiva D Yagobian, Sean R Wallace, John R Fowler","doi":"10.1016/j.jham.2024.100159","DOIUrl":"10.1016/j.jham.2024.100159","url":null,"abstract":"<p><strong>Background: </strong>Carpal tunnel syndrome (CTS) is responsible for over 90 % of median nerve neuropathies. Though a clinical diagnosis, evaluation of nerve conduction via electrodiagnostic studies (EDX) and median nerve cross sectional area (CSA) through sonographic imaging provides supporting evidence and insight into disease severity. The advent of handheld ultrasound devices offers a portable, cost-effective and non-invasive method for median nerve assessment, yet its accuracy compared to traditional cart-based ultrasound has not been assessed in this setting.</p><p><strong>Methods: </strong>43 consecutive patients who presented to an outpatient orthopedic clinic within a large academic institution for symptoms consistent with CTS between August 2023 and April 2024 were included. Handheld sonography was performed with the Clarius Convex L20 HD3 8-20 MHz transducer. The GE Venue Go with a 4-20 MHz linear transducer was used for conventional cart-based ultrasound evaluation. A paired <i>t</i>-test was performed to compare the mean cross-sectional area (CSA) measured with the GE machine to the mean CSA measured with the Clarius transducer (p < 0.05).</p><p><strong>Results: </strong>The average CSA measurement obtained with the GE was 14.21 ± 4.89 mm². The average CSA measurement obtained with the Clarius handheld transducer was 13.54 ± 4.50 mm². The mean difference between the GE and Clarius groups was 0.62 mm² (95 % CI = -1.47 to 2.71), p = 0.55.</p><p><strong>Conclusion: </strong>CSA measurements of the median nerve obtained by a handheld ultrasound transducer are comparable to those measured by a traditional cart-based ultrasound machine for carpal tunnel diagnosis. The adoption of handheld ultrasounds in clinical settings holds the potential for quicker, more precise diagnoses and broader access to imaging.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"16 5","pages":"100159"},"PeriodicalIF":0.3,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819501","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":"Ganglion cysts of the wrist: A bibliometric analysis review of the top 50 highly cited publications.","authors":"Abdulmalek W Alhithlool, Ibrahim R Halawani, Zainalabden E Jefri, Amjad W AlHithlool, Raghad Yasir Shosho, Maha Sulaiman Albarrak, Mohammed Essam Kattan, Sarah W Alkhonizy, Amr Youssef Arkoubi, Abdulaziz Saleh Almodumeegh, Hatan Mortada","doi":"10.1016/j.jham.2024.100155","DOIUrl":"10.1016/j.jham.2024.100155","url":null,"abstract":"<p><strong>Introduction: </strong>Ganglion cysts (GCs) are a form of benign soft tissue mass commonly seen on the dorsum of the wrist that could also form in the hand. They can cause pain and impede physical activities. Despite extensive studies, there has not been a thorough analysis of the top 50 GC articles. This bibliometric analysis examines the most cited research on GC of the wrist with the aim of uncovering existing trends and future directions in the field.</p><p><strong>Methods: </strong>The authors conducted a comprehensive search utilizing the Web of Science Core Collection on November 16, 2023, to identify the top 50 cited articles on wrist GC published between 1988 and 2023. Subsequently, data were extracted from each article encompassing details such as the title, authors, first/senior authors, publication year, country, journal, total citations, annual average citations, research setting, funding, study design, level of evidence, and primary outcome.</p><p><strong>Results: </strong>The predominant publication venue was identified as The Journal of Hand Surgery, with (44 %) originating from the United States, followed by contributions from the United Kingdom (14 %), South Korea (8 %), and China (4 %). Key findings included surgical techniques, diagnostic investigations, patient outcomes, treatment plans, epidemiology, and comparative analyses. Notably, there was a peak in citations in the early 2010s.</p><p><strong>Conclusion: </strong>In recent decades, significant progress has been made in the study of wrist GC, mostly driven by the United States with an emphasis on surgical techniques and diagnostic investigations.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"16 5","pages":"100155"},"PeriodicalIF":0.3,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819419","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 vs standard anaesthesia in the management of flexor tendon injuries: A systematic review and meta-analysis.","authors":"Rahy Farooq, Muhammad Yasir Raufi, Bryan Soe, Amir-Humza Suleman, Shaikh Sanjid Seraj, Abida Arif, Shafiq Rahman, Waseem Bhat","doi":"10.1016/j.jham.2024.100157","DOIUrl":"10.1016/j.jham.2024.100157","url":null,"abstract":"<p><p>Wide awake local anaesthesia no tourniquet (WALANT) surgery has gained increasing popularity in recent years for hand surgery fast-tracked by the COVID pandemic. It involves infiltration of lidocaine with adrenaline to the operative region ensuring a good visual field owing to the vasoconstrictive effects of epinephrine. It has numerous advantages over traditional anaesthetic (TA) for flexor tendon repairs including testing of tendon strength on table as well as immediate revision of the repair if needed. Currently there are a number of studies in the literature evaluating WALANT versus TA in flexor tendon injuries with continuing debate on the optimal modality but no amalgamated synthesis of data. The authors report the first systematic review and meta-analysis on the topic. The authors conducted the review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards (PRISMA) guidelines. All studies comparing flexor tendon repairs under WALANT versus TA were included. The primary outcome measure was range of movement (ROM) with secondary outcomes including adhesions/tenolysis, rupture as well as re-operation rates. OpenMeta[Analyst] software was utilised for data synthesis. Five studies in total met the inclusion criteria with an overall assessment of 624 fingers. There was no significant difference observed between WALANT and TA for tendon rupture; odds ratio 1.027 (0.450, 2.342) p-value = 0.950, the incidence of adhesions/tenolysis; odds ratio 0.601 (0.172, 2.093) p-value = 0.424 or re-operation rates; odds ratio 1.193 (0.544, 2.618) p-value = 0.659. ROM was reported to be better in the WALANT cohort; odds ratio: 1.641 (1.010, 2.669) p-value = 0.046. WALANT offers a safe and effective mode of anaesthetic over traditional modalities with comparable outcomes for flexor tendon repairs. Although ROM appears superior, the number of randomised control trials are currently low and more high quality studies are necessitated to enhance the current evidence base.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"16 5","pages":"100157"},"PeriodicalIF":0.3,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819736","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}