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

{"title":"The Krukenberg Procedure: A Scoping Review.","authors":"Joash A Kumar, Samuel Bennett, Luke McCARRON, Brahman S Sivakumar, Neil Jones, David J Graham","doi":"10.1142/S2424835525500663","DOIUrl":"https://doi.org/10.1142/S2424835525500663","url":null,"abstract":"<p><p><b>Background:</b> The Krukenberg procedure involves surgically separating the radius and ulnar to create a pincer-like grasp, providing an alternative for upper limb amputees in resource-limited settings where advanced myoelectric prosthetics are inaccessible. It restores prehension and potentially offers patients' autonomy in daily tasks. This review explores the patient demographics; indications; surgical techniques and outcomes of published reports of the Krukenberg procedure. <b>Methods:</b> A scoping review was conducted following PRISMA guidelines across PubMed, MEDLINE, Cochrane, Web of Science, EMBASE, Scopus, Ovid and Google Scholar. Studies that were peer-reviewed and published outcomes following a Krukenberg procedure were eligible for inclusion. Data on demographics, surgical methods and postoperative results were extracted. <b>Results:</b> Twenty-two studies (1937-2024) were included. Trauma was the primary indication (83.4%), followed by burns (10.4%) and congenital anomalies (5.5%). The Bunnell incision was most frequently employed, with nerve and muscle preservation critical for function. Interosseous membrane dissection and selective muscle resection, preserving vascular integrity, minimised bulk while maintaining function. Most patients regained independence, with a mean pincer strength of 7 kg. Complications were minimal, and were primarily skin necrosis, scarring and rare osseous sequelae, i.e. osteomyelitis, malalignment or bony overgrowth, managed via stump shortening or osteotomy. <b>Conclusions:</b> The Krukenberg procedure improves functional independence and socio-economic reintegration, especially in bilateral amputees. It remains a viable option in resource-limited settings where advanced prosthetics are unavailable. However, the evidence is limited by study heterogeneity. Success depends on vascular and neural preservation and early rehabilitation. <b>Level of Evidence:</b> Level III (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132488","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":"Comparative Outcomes of Revision Carpal Tunnel Release with External Neurolysis versus Primary Carpal Tunnel Release: A Propensity-Matched Study.","authors":"Hyoung Bok Kim, Joong-Won Ha, Hyun Tak Kang, Munsu Park, Jun-Ku Lee","doi":"10.1142/S2424835525500651","DOIUrl":"https://doi.org/10.1142/S2424835525500651","url":null,"abstract":"<p><p><b>Background:</b> Carpal tunnel syndrome (CTS) is a common neuropathy of the upper limb, with carpal tunnel release (CTR) being a widely performed surgical intervention when conservative treatments fail. However, up to 20% of patients experience persistent or recurrent symptoms, and up to 12% may require revision surgery. This study aims to evaluate the outcomes of revision CTR with external neurolysis compared to primary CTR using propensity score matching (PSM). <b>Methods:</b> This retrospective single-centre cohort study included patients who underwent primary and revision CTR between March 2021 and February 2024. A total of 38 patients were analysed, with 19 patients undergoing revision CTR (Group 1) and 19 patients undergoing primary CTR (Group 2). PSM (1:1 nearest-neighbour, calliper 0.2) was used to ensure comparability between the groups based on age, weight, height, body mass index (BMI), comorbidities and the operated arm. Clinical outcomes were assessed using the Visual Analogue Scale (VAS) for pain and the Boston Carpal Tunnel Questionnaire (BCTQ) for symptom severity and functional status. <b>Results:</b> Patients in Group 1 initially presented with significantly higher VAS scores compared to Group 2 (8.1 vs. 6.5, <i>p</i> = 0.001). At an average follow-up of 13.9 months, the BCTQ scores for symptom severity scale (SSS) and functional status scale (FSS) in Group 1 were comparable to those in Group 2 (SSS: 16.0 vs. 17.4, <i>p</i> = 0.393; FSS: 12.2 vs. 14.9, <i>p</i> = 0.101). No significant differences in CTS severity grades on electrodiagnostic studies were observed between the groups preoperatively. One patient in Group 1 experienced symptom recurrence 18 months postoperatively, but no other complications were reported. <b>Conclusions:</b> Revision CTR with external neurolysis can effectively manage persistent or recurrent CTS, though patients may require a longer recovery period to achieve outcomes similar to those undergoing primary CTR. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132507","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":"Digital Vater-Pacini Corpuscles Neuroma: Where Does it Come from?","authors":"Keiichi Muramatsu, Mon Gabriel Distor, Genuino Karissa Flores, Yo Morita","doi":"10.1142/S2424835525720117","DOIUrl":"https://doi.org/10.1142/S2424835525720117","url":null,"abstract":"<p><p>Until now, we were able to find 38 reports of Vater-Pacini corpuscles (VPC) neuromas of the digital nerve. We reported our first case in 2023. In this article, we present our subsequent three cases of VPC neuromas and discuss their clinical presentations and anatomical origin. Interestingly, the hyperplastic VPC neuromas were found within the epineurium of the digital nerve in two cases. Anatomically, the VPCs extend, like a kite on a string, from the digital nerve and should not exist within the peripheral nerve. The regeneration and remodelling of VPCs over time have been entirely unknown. There may be stem tissue, like seeds of VPCs, in the peripheral nerves. When they receive some stimulation, they may form new VPCs. Moreover, with hyperstimulation, they may excessively form and become a VPC neuroma. <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132483","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":"A Multicentre Outcomes Study of the Diaphyseal Ulnar Osteotomy with a Dedicated Compression Plate.","authors":"Matthew W T Curran, Michael Foster, Wolfgang Heiss-Dunlop, Shirley Collocott, Greg Couzens, Mark Ross","doi":"10.1142/S242483552550064X","DOIUrl":"https://doi.org/10.1142/S242483552550064X","url":null,"abstract":"<p><p><b>Background:</b> Diaphyseal ulna shortening osteotomy (USO) is an accepted treatment for multiple ulnar sided wrist pathologies. Recently, a number of specifically designed compression plates for USO have become available. The purpose of the study was to assess the outcomes of an ulnar osteotomy compression plate system for USO across multiple centres. <b>Methods:</b> A multicentre cohort study was conducted on USO performed for a variety of ulnar-sided wrist pathologies using a USO compression system. Radiographic, clinical and subjective outcomes were assessed postoperatively and compared between aetiologies. <b>Results:</b> A total of 174 USOs were performed with union achieved in 170 osteotomies. Overall satisfaction was high and 83.2% returned to work. And 31.6% of patients required plate removal. <b>Conclusions:</b> The use of a specific USO compression plate provides a reasonable option for USO with similar results across multiple sites. High union rates can be achieved. However, the incidence of plate removal was high and remains a potential concern warranting further study. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132498","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":"Management and Outcomes of Brachial Plexus Injuries after Shoulder Dislocation: A Systematic Review.","authors":"Ramin Shekouhi, Mary Margaret Holohan, Syeda Hoorulain Ahmed, Paola N Piascik, Lindsey Morrow, Harvey Chim","doi":"10.1142/S2424835525500638","DOIUrl":"https://doi.org/10.1142/S2424835525500638","url":null,"abstract":"<p><p><b>Background:</b> Brachial plexus (BP) injuries are a known complication of shoulder dislocation, yet optimal management strategies remain unclear. This systematic review aims to evaluate the outcomes and treatment approaches for BP injuries following shoulder dislocation. <b>Methods:</b> A systematic review was conducted according to PRISMA guidelines across four databases: PubMed/MEDLINE, Embase, Scopus and Web of Science. Eligible studies included human subjects with BP injuries following shoulder dislocation. Data extraction and risk of bias (ROB) assessment were independently performed by two reviewers. Due to heterogeneity amongst the studies, a meta-analysis was not conducted. <b>Results:</b> Out of 2,060 initial studies, 9 met the inclusion criteria, encompassing a total of 255 patients (256 limbs) with a mean age of 55.9 ± 16.0 years. Of these, 193 (75.7%) had BP injuries post dislocation. Conservative management was the most common treatment (149 cases, 67.4%), followed by neurolysis ± nerve transfer (44 cases, 19.9%) and nerve repair (28 cases, 12.7%). Amongst 133 patients with reported BP injury patterns, the posterior cord was most frequently involved (38.3%). Sensory and motor recovery was observed in 51.6% and 45.2% of patients respectively, with 60.4% of patients achieving MRC grade ≥ 4 in studies that reported this metric. The mean follow-up period was 28.4 months. <b>Conclusions:</b> BP injuries following shoulder dislocation are uncommon but clinically significant. Conservative treatment remains the predominant approach, though surgical interventions may offer improved functional recovery in selected cases. <b>Level of Evidence:</b> Level III (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132486","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":"Costo-Osteochondral Autograft for the Non-salvageable Proximal Scaphoid: A Systematic Review.","authors":"Thien Thai, Luke McCARRON, David J Graham, Brahman Sivakumar","doi":"10.1142/S2424835525500626","DOIUrl":"https://doi.org/10.1142/S2424835525500626","url":null,"abstract":"<p><p><b>Background:</b> Scaphoid non-union is a challenging condition that can lead to chronic wrist pain, decreased range of motion (ROM) and functional impairment. One promising approach involves the use of costo-osteochondral rib autografts, offering a non-vascularised and structurally supportive environment for bone regeneration. This systematic review aims to evaluate the current evidence regarding the management of non-salvageable scaphoid proximal poles and non-union using rib costo-osteochondral autografts. <b>Methods:</b> A comprehensive search of electronic databases was conducted. Data extraction was performed independently by two authors. The primary outcomes were ROM, grip strength, pain, functional outcomes and complications. <b>Results:</b> A total of six studies were identified that met the inclusion criteria. A total of 101 patients had undergone scaphoid costo-osteochondral autografting with a rib donor. Postoperative active ROM arc had a mean of 112° (range: 78°-125°), with grip strength mean of 34 kg (range: 22-50 kg). Various functional outcome measures were reported, such as the QuickDASH, Patient Rated Wrist Evaluation (PRWE) and Visual Analogue Scale (VAS), with overall improvement noted for function and pain. Complications were reported in 10% of cases, including four donor site complications. <b>Conclusions:</b> The available literature supports the use of costo-osteochondral rib autografts to treat the non-salvageable proximal scaphoid, with short-term improvement in ROM and function. However, given the heterogeneity of the included studies and the limited number of high-quality randomised controlled trials, further research is needed to establish the optimal graft selection for scaphoid AVN or non-union. <b>Level of Evidence:</b> Level III (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132513","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":"Distal Radioulnar Joint Instability in Distal Radius Fracture.","authors":"Hui-Kuang Huang, Chin-Hsien Wu, Jung-Pan Wang","doi":"10.1142/S2424835525400090","DOIUrl":"https://doi.org/10.1142/S2424835525400090","url":null,"abstract":"<p><p>Distal radioulnar joint (DRUJ) instability following distal radius fracture (DRF) is an increasingly recognised entity, particularly with recent advances in the management of DRF. This review aims to provide a comprehensive appraisal of DRUJ anatomy, methods of assessing instability and current treatment strategies. Both non-operative and operative modalities are considered. In the acute setting, surgical management primarily involves open reduction and internal fixation (ORIF) of the distal radius, which can restore DRUJ stability through correction of translation and distraction of the distal fragment. Management of concomitant injuries, such as ulnar styloid fractures and triangular fibrocartilage complex (TFCC) tears, are also addressed, particularly in cases where instability persists following DRF fixation. In the chronic setting, DRUJ instability is categorised according to underlying pathology: bony abnormalities (including distal radius malunion and ulnar styloid nonunion) and soft-tissue insufficiency (notably TFCC tears). Finally, attention is drawn to associated conditions - such as DRUJ subluxation and stiffness - which may complicate management or remain underrecognised in clinical practice. <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132523","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":"Distal Radioulnar Joint Instability.","authors":"Simon Bruce Murdoch Maclean","doi":"10.1142/S2424835525400089","DOIUrl":"https://doi.org/10.1142/S2424835525400089","url":null,"abstract":"<p><p>The articulation of the distal radioulnar joint (DRUJ) has minimal osseous constraint and relies on a number of other primary and secondary structures for stability and normal function. DRUJ instability is a challenging clinical problem, and osseous, chondral and ligamentous factors can all contribute to the pathology - often in combination. A thorough understanding of the aetiology, clinical presentation and imaging findings of DRUJ instability are important when determining the best management strategy. This review covers anatomy, kinematics, aetiology, imaging findings and surgical management of DRUJ instability for both acute and chronic presentations. <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978199","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":"Masson Tumour - A Rare Cause of a Hand Lump.","authors":"Thilina Gunawardena, Waruni Dissanayaka","doi":"10.1142/S2424835525720099","DOIUrl":"https://doi.org/10.1142/S2424835525720099","url":null,"abstract":"<p><p>Intravascular papillary endothelial hyperplasia, also known as Masson tumour, is a rare proliferative vascular lesion that can affect the hand. We report a patient who was operated on for a progressively enlarging soft tissue lump at the base of his thumb. Initially, it was thought to be a post-traumatic false aneurysm arising from a branch of the radial artery following blunt trauma. Subsequent histology revealed it to be a Masson tumour. We aim to highlight this rare pathology that can affect the hand and the diagnostic confusion we faced during the evaluation and management of this patient. <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978192","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":"Mobiloblast - An Emerging Societal Menace.","authors":"Surendrakumar Bhagwatrao Patil, Mayank Bhasin, Anshoo Gandhi, Neha Gupta, Sukhen Doshi","doi":"10.1142/S2424835525500523","DOIUrl":"10.1142/S2424835525500523","url":null,"abstract":"<p><p><b>Background:</b> In 50 years since mobile phones were invented, their number has surpassed the global population, with India being the second-largest user after China. Although the lithium-ion battery failure rate is 1 in 10 million, high production increases related injuries. This study presents a series of hand injuries caused by mobile phone battery explosions at a tertiary care centre in central India. <b>Methods:</b> A retrospective audit was conducted at our institute from January 2020 to March 2024. Medical records were reviewed for demographics, clinical history, management and postoperative complications. Hand function was assessed at a minimum of 6 months post-op using the Michigan Hand Outcomes Questionnaire (MHQ). Spearman's correlation test was used for statistical analysis using Jamovi Statistical software. <b>Results:</b> Twelve patients (mean age: 24.8 years, range: 8-55) with lower and middle socioeconomic backgrounds were included. Paediatric cases resulted from playing with discarded batteries, while adult cases occurred during charging. Nine (75%) patients had dominant hand involvement, one (8%) had a non-dominant hand injury and two (17%) had bilateral injuries. Injuries were classified as mild (three patients, 25%), moderate (two patients, 16%) and severe (seven patients, 58%). MHQ scores averaged 80.7 for mild, 68.5 for moderate and 52.9 for severe injuries. Statistical analysis showed an inverse correlation between injury severity and hand function (rho = -0.809, <i>p</i> < 0.005). <b>Conclusions:</b> Mobile phone battery explosions pose a growing health hazard, causing severe trauma. Most cases are preventable through proper disposal of electronic waste and discarded batteries. Awareness and adherence to safe practices are essential for reducing such injuries. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"416-421"},"PeriodicalIF":0.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638663","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}