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

{"title":"Accuracy of a Superficial Landmark of the Recurrent Branch of the Median Nerve and Anatomical Features of Transverse Muscle Fibres Observed During Carpal Tunnel Release.","authors":"Aya Kanazuka, Takane Suzuki, Yusuke Matsuura, Tomoyo Akasaka, Kazuki Kuniyoshi, Seiji Ohtori","doi":"10.1142/S2424835525500250","DOIUrl":"10.1142/S2424835525500250","url":null,"abstract":"<p><p><b>Background:</b> Surgeons use anatomical landmarks like the scaphoid tubercle, pisiform, trapezial tubercle and hook of hamate, along with Kaplan cardinal line (KCL) to avoid injury to the recurrent motor branch (RMB) of the median nerve during carpal tunnel release. The presence of transverse muscle fibres (TMF) overlying the transverse carpal ligament (TCL) may suggest proximity of the RMB, but their anatomical relationship is unclear. In this study, we evaluated the accuracy of anatomical landmarks to the RMB, TMF origin and insertion, and examined the relationship between TMF presence and RMB running patterns. <b>Methods:</b> We dissected 30 hands from 16 fresh-frozen cadavers. After marking the superficial landmarks, we made a skin incision to confirm the presence of TMF and examined their origins and insertions. We then opened the carpal tunnel, dissected the RMB and recorded each position on a coordinate system using a fluoroscopic imaging system. <b>Results:</b> TMF were observed in 18 hands (60%): 13 were continuous with the abductor pollicis brevis (APB), 2 were continuous with the superficial head of the flexor pollicis brevis (FPB) and 3 were continuous with both. The bifurcation point of the RMB was significantly located 4.5 mm ulnar and 7.5 mm proximal to the superficial landmark at the median. The RMB was classified according to Poisel classification: 24 (80%) were of the extraligamentous type, 4 (13%) of the transligamentous type, 1 (3%) of the preligamentous type and 1 (3%) of the subligamentous type. Amongst these, the transligamentous/preligamentous/subligamentous types are at high risk for RMB injury during TCL incision. No significant association existed between TMF presence and these high-risk RMB types.. <b>Conclusions:</b> The actual RMB may be located ulnar and proximal to the superficial landmark, indicating that surgeons should be cautious about RMB damage even in the absence of TMF.</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"172-180"},"PeriodicalIF":0.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973224","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":"Synovial Chondromatosis of the Hand and Wrist: A 35-Year Retrospective Case Review.","authors":"Holly Morris, Victoria Lo, Becky Sheehy, Karen L Smith","doi":"10.1142/S2424835525500213","DOIUrl":"10.1142/S2424835525500213","url":null,"abstract":"<p><p><b>Background:</b> Synovial chondromatosis is a condition that rarely occurs in the hand and wrist. Recurrence and malignant transformation are two potential complications of the disease. We set out to retrospectively review 35 years of practice within our sarcoma and tertiary hand unit and identify recurrence or malignant transformation. <b>Methods:</b> This is a retrospective analysis of patients with synovial chondromatosis seen at our sarcoma and tertiary hand unit for the past 35 years. Incidence of recurrence or malignant transformation was noted. Where possible, patients were clinically and radiologically reviewed with range of motion, grip strength and patient evaluation measures obtained. <b>Results:</b> Of 12 patients presenting to the practice, seven patients were followed up and, of these, two demonstrated recurrences. The recurrence was diagnosed based on patient-reported symptoms, clinical examination and the requisition of further imaging. Of the five who could not be followed up, two demonstrated recurrence and one had malignant transformation with a low-grade chondrosarcoma on histology. <b>Conclusions:</b> While a rare disease, we demonstrated recurrence within our small case series. Fusion to obliterate the joint is an option in the management of recurrence. For the diagnostically challenging, genetic testing may be beneficial, though genetic rearrangements are not seen in all cases. All patients should be counselled on symptoms to watch for as a small proportion may experience recurrence and a small percentage may undergo malignant transformation. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"134-140"},"PeriodicalIF":0.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958482","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":"Advanced Surgical Training Models for Wrist Surgery.","authors":"Simon B M Maclean, Greg I Bain","doi":"10.1142/S242483552597001X","DOIUrl":"10.1142/S242483552597001X","url":null,"abstract":"<p><p>Globally, surgical exposure for the trainee has become challenging due to changes in shift patterns, increasing medicolegal issues and the recognition of burnout. Simulation models are a crucial adjunct for the development of arthroscopic skills and open procedures. Advanced anatomically precise 3D-printed wrist models are used in our workshops. The models have pathological lesions within, allowing a range of arthroscopic and open procedures to be performed. Pathology can be ordered on-demand. Arthroscopic and open procedures can be performed, including fracture fixation and arthroplasty. For effective teaching, we use a lab-based environment with basic arthroscopic and open equipment and implants available. We use a specific structure in which to teach trainees, including pre-course material, videos, demonstrations, practice and feedback. Advanced surgical training models for wrist surgery allow for safe, repetitive surgical training to allow the trainee to accelerate their learning curve. <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"222-225"},"PeriodicalIF":0.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958569","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":"The Initial Characteristics of Paediatric Supracondylar Humerus Fractures Led to Cubitus Varus Deformity and Delayed Displacement.","authors":"Takehiko Takagi, Noriyuki Aibara, Sakura Yamaguchi, Atsuhito Seki, Shinichiro Takayama","doi":"10.1142/S2424835525500237","DOIUrl":"10.1142/S2424835525500237","url":null,"abstract":"<p><p><b>Background:</b> Supracondylar humerus fractures are the most common type of elbow fracture in children, with a variety of complications such as cubitus varus deformity. The most important goal of the initial treatment is to avoid complicated deformities. In the present study, we investigated cubitus varus deformity and discussed the ideal initial treatment for supracondylar humerus fractures. <b>Methods:</b> There were 58 conservative cases (26 girls and 32 boys) and 115 operative cases (40 girls and 75 boys) with supracondylar humerus fractures. We evaluated the correlation between the following factors on injury in the conservative cases: Gartland classification, presence of comminuted medial fractures, medial shift length, anterior spike length, age, sex, affected side (as explanatory variables) and the factors of cubitus varus deformity as response variables by using the linear regression model for multivariable analysis. Moreover, we evaluated the changes in displacement after the operation in the operative cases, adding the presence of medial pins and the number of pins as explanatory variables. <b>Results:</b> Injury severity (Gartland classification) was a significant factor for cubitus varus deformity. The presence of comminuted bone fragments on the medial side, anterior spike length, age, sex and affected side were not significant factors of cubitus varus deformity. However, medial displacement on injury was a significant factor of both cubitus varus deformity. In the operative case study, medial displacement was a significant factor in cubitus varus deformity. The presence of comminuted bone fragments on the medial side, number of pins and age were also significant factors for cubitus varus deformities. <b>Conclusions:</b> The present study concluded that it is important to perform accurate reduction and fixation, with special attention to medial shift and medial comminuted fragments to avoid cubitus varus deformity. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"148-154"},"PeriodicalIF":0.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958580","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":"Paediatric Locked Middle Finger due to Synovial Osteochondromatosis: A Case Report.","authors":"Shichoh Sonezaki, Hikaru Ogawa, Yoshinao Oda, Tetsuo Kojima","doi":"10.1142/S2424835525720038","DOIUrl":"10.1142/S2424835525720038","url":null,"abstract":"<p><p>Synovial osteochondromatosis is a relatively rare condition of the hand. We present a rare case of a locked finger in a paediatric patient with synovial osteochondromatosis, in which a tumourous lesion was continuous with the flexor tendon and trapped proximal to the A1 pulley. After resection of the tumour and synovium, no recurrence was observed over a 6-month follow-up period. Synovial osteochondromatosis in the hand or fingers can lead to swelling and limited range of motion; however, symptom progression is usually slow. Moreover, it is uncommon for an extra-articular tumour to cause a sudden onset of locking symptoms without prior warning signs. Comprehensive excision of the synovium is essential, and ongoing observation for recurrence is necessary during follow-up. <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"218-221"},"PeriodicalIF":0.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016168","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":"Allen Test, Modified Allen Test and Digital Allen Test.","authors":"Sandeep Jacob Sebastin","doi":"10.1142/S2424835525010039","DOIUrl":"10.1142/S2424835525010039","url":null,"abstract":"","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"226-228"},"PeriodicalIF":0.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702004","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":"The Microbiology, Management and Outcomes of Native Joint Septic Arthritis of the Hand in Adults of Southeast Queensland.","authors":"Lee Forman, Ariadne Forman, Kylie Alcorn","doi":"10.1142/S2424835525500201","DOIUrl":"10.1142/S2424835525500201","url":null,"abstract":"<p><p><b>Background:</b> Native joint septic arthritis (NJSA) of the hand is poorly studied. Management guidelines are extrapolated from large joint infections despite differences in epidemiology, anatomy and aetiology. Limited evidence suggests shorter courses of antibiotics can achieve outcomes comparable to longer courses. The aim of our study is to characterise the presentation, management and outcomes of NJSA of the hand in an adult cohort from Southeast Queensland (SEQ) and determine if the route or duration of antibiotics affected the outcome. Our cohort was compared to those in the literature to determine if already published data could be applicable to our population. <b>Methods:</b> A coding based retrospective cohort of adult patients between 2016 and 2022 were assessed. The cohort was divided into short/long course antibiotics and primarily intravenous/oral route for outcome comparison. <b>Results:</b> Seventy-four patients were included with a joint culture positive rate of 75%. The most common aetiology of infection was direct trauma and the most common pathogen was <i>Staphylococcus aureus</i>. Resolution was achieved in 86% of patients after 1-year follow-up, with a median antibiotic duration of 14 days, and 48% had non-infectious sequelae. Failure to achieve resolution was associated with females and taking immunosuppressants. No significant difference was detected when analysed for primary route or duration of antibiotics. <b>Conclusions:</b> There was no difference in the rate of resolution attributable to the route or duration of antibiotics. We demonstrated comparability between our cohorts' demographics, management and outcomes with those in the literature. Based on the findings in our study, noting the retrospective nature and small cohort, the authors conclude for uncomplicated NJSA of the hand, a total antibiotic duration of 14 days in addition to early surgical intervention is likely to be successful in most patients. <b>Level of Evidence:</b> Level III (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"127-133"},"PeriodicalIF":0.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958583","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":"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":"https://doi.org/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":""},"PeriodicalIF":0.5,"publicationDate":"2025-03-17","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":"A Comparison of the Effect of Wrist Immobilisation on the Outcomes of Cerclage Wire Fixation of Spiral or Oblique Metacarpal Fractures.","authors":"Wuttipong Siriwittayakorn, Parod Teantunyakij, Wattanai Atthakorn, Jirawat Chotayakul, Wichit Siritattamrong","doi":"10.1142/S2424835525500353","DOIUrl":"https://doi.org/10.1142/S2424835525500353","url":null,"abstract":"<p><p><b>Background:</b> There are limited studies on cerclage wiring (CW) for simple spiral or oblique metacarpal shaft fractures. It is generally believed that this fixation technique is not rigid and requires postoperative immobilisation. This study aims to compare the effect of wrist immobilisation on the outcomes of cerclage wire fixation of spiral or oblique metacarpal fractures. <b>Methods:</b> The study included 29 patients, divided into two groups: Group A, with 14 patients who had no postoperative immobilisation, and Group B, with 15 patients who were splinted after surgery. The primary outcomes were metacarpophalangeal (MCP) joint range of motion (ROM), quick disabilities of arm, shoulder and hand (Q-DASH) score and patient-rated wrist evaluation (PRWE) score. All patients were followed until 12 weeks post-surgery. <b>Results:</b> Patients in Group A had significantly better MCP joint ROM at 2 and 4 postoperative weeks. The Q-DASH and PRWE scores were significantly better in Group A at 2 postoperative weeks but showed no difference after the splint was removed. All fractures united within 12 weeks after surgery. There were no cases of infection, implant breakage or re-fracture. <b>Conclusions:</b> Postoperative immobilisation after CW in simple spiral or oblique metacarpal shaft fractures led to reduced MCP joint ROM and functional outcomes in the early postoperative period. Early gentle mobilisation can be encouraged immediately following surgery. <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":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665358","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":""},"PeriodicalIF":0.5,"publicationDate":"2025-02-18","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}