Journal of Hand Surgery-Asian-Pacific Volume最新文献

{"title":"Effectiveness and Safety of Brachial Plexus Nerve Stimulation for Refractory Neuropathic Pain in the Upper Extremities: A Systematic Review and Meta-Analysis.","authors":"Ramin Shekouhi, Syeda Hoorulain Ahmed, Mohammed Mumtaz, Birsu Barin, Kevin A Hao, Harvey Chim","doi":"10.1142/S242483552550033X","DOIUrl":"10.1142/S242483552550033X","url":null,"abstract":"<p><p><b>Background:</b> Peripheral nerve stimulation (PNS) has emerged as a promising treatment for refractory neuropathic pain in the upper extremities, particularly for patients unresponsive to conventional therapies. This systematic review and meta-analysis aims specifically to evaluate the effectiveness and safety of nerve stimulation of the brachial plexus (BP) for managing chronic neuropathic pain in the upper extremities. <b>Methods:</b> A comprehensive literature search was conducted following PRISMA guidelines across major databases, including PubMed, Scopus and Embase. Five studies met the inclusion criteria, encompassing a total of 157 patients with BP or other peripheral nerve injuries. The primary outcome measures included pain reduction and quality of life improvement, assessed through validated pain scales such as the Numerical Rating Scale (NRS) and patient-reported outcomes. <b>Results:</b> This meta-analysis demonstrated significant reductions in pain scores following BP nerve stimulation (MD: -4.88, 95% CI: -5.80 to -3.96, <i>p</i> < 0.05). Additionally, improvements in quality of life were observed, with over 30% enhancement in Short Form (SF)-36 scores. The overall complication rate was low, with only 9.2% of patients experiencing adverse events, such as lead migration or postoperative infection. <b>Conclusions:</b> These findings suggest that PNS at the level of the BP is both a safe and effective intervention for the management of refractory neuropathic pain in the upper extremities. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"235-242"},"PeriodicalIF":0.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome of Pulley Release via a Radial Mid-Lateral Approach for the Trigger Finger at the A2 Pulley.","authors":"Naomi Hanaka, Masatoshi Takahara, Junichiro Shibuya, Hiroshi Satake, Michiaki Takagi","doi":"10.1142/S2424835525500365","DOIUrl":"10.1142/S2424835525500365","url":null,"abstract":"<p><p><b>Background:</b> Trigger finger occurs primarily at the A1 pulley. However, triggering of the flexor tendon can also occur at the A2 pulley. The full release of the A2 pulley should be avoided because it may cause bowstringing and flexion weakness. To reduce the incidence of postoperative complications, we have performed a complete release of the A1 pulley via a volar approach and a complete release of the A2 pulley at the radial edge via a radial mid-lateral approach. This study aimed to investigate the outcome of our procedure. <b>Methods:</b> Seventeen fingers underwent A2 pulley release at the radial edge via a mid-lateral approach after complete release of the A1 pulley via a volar approach. The mean age of patients was 68 years. Regarding the Quinnell classification, 15 fingers were grade IV, 1 finger was grade II with triggering at the A2 pulley level and 1 finger was grade I with a ganglion on the A1 pulley. <b>Results:</b> The mean extension loss of the PIP joint was 23° preoperatively and 2° at the final examination, and the respective mean tip-palmar distances were 19 mm and 3 mm. No symptoms or signs suggested the bowstring of the flexor tendon during the observation period (mean: 99 weeks; range: 19-180 weeks). <b>Conclusions:</b> Our procedure is preferable for managing the tenosynovitis at the A1 and A2 pulleys. The release of the A2 pulley at the radial edge via a radial mid-lateral approach yielded a favourable result without bowstringing. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"306-311"},"PeriodicalIF":0.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary Procedures after Closed Reduction Percutaneous Pinning versus Open Reduction Internal Fixation of Phalanx Fractures: A Large Database Analysis.","authors":"Thompson Zhuang, Ellis Berns, Erin Hale, Ines Lin, Andrew D Sobel","doi":"10.1142/S2424835525500341","DOIUrl":"10.1142/S2424835525500341","url":null,"abstract":"<p><p><b>Background:</b> While functional and patient-reported outcomes are similar for closed reduction percutaneous pinning (CRPP) and open reduction internal fixation (ORIF) of phalanx fractures, controversy exists regarding optimal fixation choice. In this study, we tested the null hypotheses that there is no difference in (1) percentage of patients undergoing secondary procedures within 2 years, (2) therapy utilisation and (3) total costs following CRPP and ORIF of phalanx fractures. <b>Methods:</b> Using an administrative claims database, we identified patients undergoing CRPP or ORIF of phalanx fractures from 2011 to 2020. Secondary procedures assessed within 2 years after CRPP or ORIF included phalanx osteotomy, tenolysis, irrigation and debridement, metacarpophalangeal joint arthrodesis and interphalangeal joint arthrodesis or arthroplasty. We calculated therapy utilisation at 6-month intervals after surgery and total cost of care at 90 days post-procedure. Multivariable logistic regression models were used to evaluate the association between choice of surgical fixation and incidence of secondary procedures, adjusting for age, sex, region, insurance and Elixhauser comorbidity index. <b>Results:</b> The composite incidence of secondary procedures was 3.1% after CRPP and 4.7% after ORIF (<i>p</i> < 0.001). Within 2 years after CRPP, fewer patients had tenolysis (odds ratio [OR] = 0.57 [95% confidence interval (CI): 0.52-0.63]), interphalangeal joint arthrodesis (OR = 0.51 [95% CI: 0.41-0.62]) or interphalangeal joint arthroplasty procedures (OR = 0.58 [95% CI: 0.38-0.87]). Patients who underwent CRPP had increased therapy utilisation, but similar 90-day total cost of care. <b>Conclusions:</b> CRPP for phalanx fractures is associated with a lower incidence of subsequent procedures compared to ORIF. Further studies are needed to compare CRPP with ORIF for phalanx fractures while accounting for specific fracture patterns as confounders, which was a limitation of this study. <b>Level of Evidence:</b> Level III (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"293-298"},"PeriodicalIF":0.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic Thermal Capsular Shrinkage with Open Dorsal Radiocarpal Ligament Tensioning for Palmar Midcarpal Instability: Surgical Technique and Preliminary Outcomes.","authors":"Chih-Hsun Chang, Chin-Hsien Wu, Jung-Pan Wang, Hui-Kuang Huang","doi":"10.1142/S2424835525500316","DOIUrl":"10.1142/S2424835525500316","url":null,"abstract":"<p><p><b>Background:</b> Palmar midcarpal instability (PMCI) is often neglected in diagnosis and lacks a gold standard treatment. It is primarily associated with dorsal radiocarpal (DRC) ligament insufficiency. We used a combined approach of arthroscopic thermal capsular shrinkage and open DRC ligament suture tensioning for symptomatic PMCI and present our outcomes. <b>Methods:</b> From 2018 to 2022, nine PMCI patients (mean age: 32 years) underwent this treatment. The mean symptom duration was 15.3 months, with a mean follow-up of 16.8 months. Outcomes were measured by wrist ROM, grip strength, VAS for pain, Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) and modified Mayo Wrist scores. <b>Results:</b> All patients showed significant improvement in pain, grip strength and function, with maintained radiocarpal stability at final follow-up. Although wrist ROM showed mild limitation after surgery, all patients returned to their previous work and activities. <b>Conclusions:</b> This approach may provide an effective and less aggressive treatment for PMCI. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"287-292"},"PeriodicalIF":0.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How I Approach a Patient with CRPS - A Shifting Paradigm (History, Examination, Investigations, Classification and Treatment).","authors":"Francisco Del Piñal","doi":"10.1142/S2424835525400028","DOIUrl":"10.1142/S2424835525400028","url":null,"abstract":"<p><p>The author's approach to a patient with CRPS is presented. The key is to classify the patient into any of the following groups: wrong diagnosis, psychogenic-dystonic hand, nerve injury (complex regional pain syndrome [CRPS] 2), flare reaction (FR) and the remaining would comprise the real CRPS 1 patient. The first three do not represent any mysterious condition, but require addressing the underlying problem, while a FR - a minor form of CRPS 1 - is, for the most, self-resolved by physical therapy. The remaining group, i.e. the true CRPS 1 case, have a condition known as irritative carpal tunnel syndrome (ICTS): release of the transverse carpal ligament yields a 94% cure rate. Even though the treatment is the same, carpal tunnel syndrome (CTS) and ICTS are very different conditions. In summary, there is a paradigm shift in handling CRPS patients. Further research to understand the pathophysiology and the failures is needed. <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"229-234"},"PeriodicalIF":0.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pinning the Thumb Carpometacarpal Joint in Abduction Can Reduce Skin Irritation from Suzuki Frame Treatment for Metacarpophalangeal Joint Fractures.","authors":"Yuji Saeki, Sotetsu Sakamoto, Yasunori Hattori, Kazuteru Doi","doi":"10.1142/S242483552572004X","DOIUrl":"10.1142/S242483552572004X","url":null,"abstract":"<p><p>Comminuted intra-articular fractures of the metacarpophalangeal joint (MCPJ) of the thumb are difficult to treat because of challenges with anatomical fixation. The pins and rubbers traction system (PRTS), described by Suzuki et al., is a minimally invasive technique that enables early range-of-motion training while maintaining joint congruency. PRTS exhibits advantages relative to other dynamic external fixation techniques due to its simplicity, low cost and compact design. It has been used mainly in treating primarily proximal interphalangeal joint (IPJ) fractures. We present two patients where we used a PRTS for comminuted intra-articular fractures of the thumb MCPJ with good outcomes. We temporarily pinned the carpometacarpal joint (CMCJ) in maximum abduction to avoid skin irritation from the ulnar aspect of the axial traction wire in thumb adduction. <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"326-330"},"PeriodicalIF":0.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensory Nerve Transfer for Intractable Neuropathic Pain in a Case of C₈-T₁ Root Avulsion in Brachial Plexus Injury.","authors":"Sanjay Maurya, Shivam Beniwal, Onkar Singh","doi":"10.1142/S2424835525720051","DOIUrl":"10.1142/S2424835525720051","url":null,"abstract":"<p><p>Neuropathic pain in root avulsion brachial plexus injury (BPI) is severe and unrelenting. Routine analgesics and other described methods often provide inadequate pain relief. We report a patient with neuropathic pain following C₈T₁ root avulsion injury, which was successfully managed with end-to-side ulnar sensory branch transfer to the median nerve. Postoperatively, there was a marked reduction in pain score as determined by visual analogue score (VAS) and a marked improvement in the daily sleep interference scale (DSIS). This option may be considered in patients with severe neuropathic pain in lower root avulsion injury in BPI. <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"317-320"},"PeriodicalIF":0.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concomitant Ipsilateral Hourglass-Like Constrictions of Suprascapular and Axillary Nerves: Report of a Rare Case.","authors":"Gugri Manjunatha Sunay, Samayam Srinath-Kiran, Praveen Bhardwaj, S Raja Sabapathy","doi":"10.1142/S2424835525720075","DOIUrl":"10.1142/S2424835525720075","url":null,"abstract":"<p><p>Hourglass-like constriction (HGC) of the nerve is a rare cause of nerve palsy and has been reported for many nerves. We were unable to find previous reports of concomitant constriction of the suprascapular and axillary nerve in literature. Our patient was a young male with shoulder paralysis of 7-months duration. On exploration we found two HGCs of the suprascapular and axillary nerves. A neurolysis of the suprascapular nerve was carried out. The axillary nerve constriction was deemed to be severe and a nerve transfer using the branch innervating the medial head of the triceps motor was done. Patient recovered excellent shoulder function at 1-year post-surgery. Awareness about this rare occurrence will prevent poor outcome from addressing the constriction at only one site. Nerve surgery should be considered for patients who do not show any improvement in 6 months. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"312-316"},"PeriodicalIF":0.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palmar Z-Osteotomy for Distal Radius Fractures.","authors":"Hui Neng Lim, Mala Satku, Jieying Xu, Lam-Chuan Teoh","doi":"10.1142/S2424835525500286","DOIUrl":"10.1142/S2424835525500286","url":null,"abstract":"<p><p><b>Background:</b> Distal radius fractures (DRFs) are a common injury with fracture parameters guiding surgical treatment. Palmar plating is the most common method of fixation in patients needing surgical fixation. However, in fractures with a complete or nearly intact volar cortex, reduction of the fracture fragments may be challenging with the palmar approach. We use a novel Z-osteotomy technique to address this issue and report on our outcomes. <b>Methods:</b> This is a retrospective review of all patients where a volar Z-osteotomy technique was used. We assessed pre-, intra- and postoperative radiographic parameters, fracture union and final wrist range of motion of all patients. <b>Results:</b> Twelve DRFs in 11 patients were analysed. All fractures were successfully plated palmarly with volar tilt 9-14 (average: 11.3) and all achieved fracture union. This was maintained in the final radiographs with good clinical wrist range of motion. <b>Conclusions:</b> The volar Z-osteotomy technique described allows surgeons to achieve anatomical reduction of volar tilt in DRFs where the volar cortex is intact with good clinical and radiological outcomes. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"281-286"},"PeriodicalIF":0.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Silicone Locking-Liner Socket with a Lightweight Aesthetic Prosthesis for Short Congenital Forearm Stumps: A Report of Two Patients.","authors":"Michael El Leow, Mark E Puhaindran, Alphonsus K S Chong","doi":"10.1142/S2424835525720063","DOIUrl":"10.1142/S2424835525720063","url":null,"abstract":"<p><p>Conventional prosthetic sockets can be uncomfortable and restrictive to elbow flexion when fitted on short forearm stumps due to their high trimline. We report improved patient experience after switching to a locking silicone-liner socket in conjunction with a lightweight aesthetic prosthesis in two congenital transradial amputees with short stumps who were previously dissatisfied with their conventional prosthesis. To reduce weight, the forearm section of the prosthesis was constructed using a lightweight design. Seven of eight attributes, namely aesthetics, comfort, suspension, ease of donning/doffing, weight, range of motion, skin issues and overall satisfaction, were rated by both patients as having improved versus their conventional prosthesis, with no change reported regarding issues of the skin. Our experience suggests that transradial amputees with short stumps who had problems with conventional fittings due to socket impingement and prosthesis weight may benefit from an approach combining a locking-pin liner suspension with a lightweight prosthesis. <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"321-325"},"PeriodicalIF":0.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}