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

{"title":"Risk Factors Associated with Collapse of Distal Radius Fractures after Volar Locking Plate Fixation in Older Adults.","authors":"Sanglim Lee, Suk Ha Jeon","doi":"10.1142/S2424835525500298","DOIUrl":"10.1142/S2424835525500298","url":null,"abstract":"<p><p><b>Background:</b> This study aimed to identify the risk factors associated with re-displacement or collapse of distal radius fractures treated using volar locking plates in older adults. <b>Methods:</b> We conducted a retrospective analysis of 131 patients aged ≥65 years with distal radius fractures who underwent volar locking plate fixation. The collapse was classified into three categories: 'radial collapse' was determined as the top decile of patients with the greatest decrease in radial inclination; 'dorsal collapse' was defined by volar tilt angle on lateral or 25° tilted lateral views and 'height collapse' by radial height. To identify the factors related to these three types of collapses, we compared the clinical and radiological parameters between the wrists with each type of collapsed and non-collapsed wrists. <b>Results:</b> Dorsal collapse had no significant associated factors and radial collapse had osteoporosis as a significant different factor. The height collapse group was associated with older age, had a higher prevalence of high-energy injury mechanisms and a limited range of flexion-extension at final follow-up and larger distance between the articular surface and distal screws. <b>Conclusions:</b> The volar locking plate may effectively prevent three types of collapses. Height collapse group included patients with increased age, high-energy injury mechanisms and limited range of flexion-extension at the time of final follow-up. To prevent collapse, the longest possible distal screws must be inserted just beneath the subchondral bone. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"262-270"},"PeriodicalIF":0.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442493","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 Long-Term Effects of Radial Head Excision for Mason Type 3 Radial Head Fracture.","authors":"Ahmad Dashtbozorg, Hooman Shariatzadeh, Sina Shariati, Mahmoud Shariatirad","doi":"10.1142/S2424835525500304","DOIUrl":"10.1142/S2424835525500304","url":null,"abstract":"<p><p><b>Background:</b> Radial head fractures with comminution and displacement present challenges in achieving optimal treatment outcomes in the long term. This study aims to evaluate the long-term effects of radial head excision (RHE) in patients with Mason type 3 fractures. <b>Methods:</b> We conducted a retrospective study of patients with a Mason type 3 radial head fracture who underwent primary RHE between January 2010 and January 2020. The primary outcome was the Mayo elbow performance score (MEPS). Additionally, joint stability and arthritis, and the carrying angle were recorded for each patient. <b>Results:</b> In total, 61 patients (21; 34% female) with a follow-up range of 3-13 years were examined. The mean (SD) total MEPS was 91.8 (9.2). The results were excellent for 46, good for 12 and fair for 3 patients. A model of total MEPS adjusted for sex, age and follow-up time showed a significant effect of patient age on treatment success (<i>p</i> < 0.001). Thirteen patients (21%) showed elbow instability. Six individuals had increased valgus laxity. The mean carrying angle was 19° (range: 11°-27°) on the injured side and 9° (4°-15°) on the uninjured side, <i>t</i>(120) = 12.608, <i>p</i> < 0.001. Overall, 37 patients had degenerative changes in the operative elbow. <b>Conclusions:</b> Benefits of RHE persist for a long time with predominantly excellent elbow function and minimal complications. An increase in the carrying angle, joint instability and degenerative changes are to be expected. Patient age at the time of the surgery can affect treatment outcomes. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"254-261"},"PeriodicalIF":0.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442503","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":"Clinical Evaluation of Trigger Digits.","authors":"Sandeep Jacob Sebastin","doi":"10.1142/S2424835525010040","DOIUrl":"10.1142/S2424835525010040","url":null,"abstract":"","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"331-332"},"PeriodicalIF":0.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152860","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":"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":"299-305"},"PeriodicalIF":0.5,"publicationDate":"2025-06-01","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":"The Effectiveness of Operative Fixation for Comminuted Distal Radial Fractures in the Hyper-aged Patients Over 75 Years Old in South Korea.","authors":"Jisu Park, Jaemin Lee, Jin Rok Oh","doi":"10.1142/S2424835525500377","DOIUrl":"10.1142/S2424835525500377","url":null,"abstract":"<p><p><b>Background:</b> In 2025, South Korea's society is facing the transition into a hyper-ageing society. The effectiveness and functional outcome between surgical operation and conservative treatment of distal radial fractures in the elderly have been consistently debated. The aim of this study is to present the outcomes of surgical fixation for comminuted distal radial fractures in hyper-aged patients aged 75 years or older. <b>Methods:</b> This is a retrospective study of all patients aged 75 years or older who underwent surgical fixation of distal radial fractures in the period from January 2011 to December 2021 with a minimum follow-up of at least 3 months. Data collected included sex, age, residence status, economically active population, osteoporosis, AO/OTA fracture classification and use of bone graft. Functional outcomes were evaluated with Mayo wrist score system (MWSS) and radiologic outcomes between preoperative, postoperative and unaffected sides of each patient was measured. <b>Results:</b> The study included 38 patients (35 females) with a median age of 79.7 years (range: 75-92). MWSS at postoperative 6 months showed that 30 patients (78.9%) expressed excellent or good outcomes. Postoperative parameters indicated radial height 6.90 mm (4.82-9.08), radial inclination 15.5° (13.0°-19.9°) and volar tilt 10.8° (7.2°-14.5°). These values were significantly different compared with preoperative values. We identified with McNemar's test that in all time periods (2 weeks, 1 month and 3 months), there were no significant difference in the proportion of acceptable reduction in all parameters. <b>Conclusions:</b> Although treatment of distal radial fractures in the elderly is still controversial, operative treatment showed significantly improved functional and radiological outcomes and showed possibilities to reduce socioeconomic burden and to aid in early functional restoration and aesthetic deformity correction. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"271-280"},"PeriodicalIF":0.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005363","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":"Efficacy and Safety of Gabapentinoids in the Treatment of Carpal Tunnel Syndrome: A Systematic Review and Meta-Analysis.","authors":"Saara Raatikainen, Kati Jaatinen, Teemu Karjalainen, Vieda Lusa","doi":"10.1142/S2424835525500328","DOIUrl":"10.1142/S2424835525500328","url":null,"abstract":"<p><p><b>Background:</b> The off-label use of gabapentinoids for carpal tunnel syndrome (CTS) is increasing despite limited evidence of efficacy and known risks of adverse effects. This systematic review and meta-analysis aimed to synthesise the evidence of the benefits and harms of oral gabapentinoids in treating CTS. <b>Methods:</b> We searched Medline and Cochrane Central Register of Controlled Trials for randomised controlled trials (RCT). Based on the search results, we formed three comparisons assessing the effect of oral gabapentinoid interventions against (1) placebo (primary comparison), (2) open label no-treatment (with co-interventions in both arms) or (3) splinting. The primary outcome was symptom severity. The secondary outcomes were pain, function, clinical improvement, health-related quality of life, adverse effects and need for surgery. We adhered to the Cochrane and GRADE methodology throughout conducting this systematic review and meta-analysis. <b>Results:</b> Gabapentinoids probably do not improve CTS symptoms (moderate certainty) compared with placebo. The benefit was 0.08 points better (95% confidence interval [CI] 0.33 better to 0.17 worse; two studies, 286 randomised participants) expressed on the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) Symptom Severity Scale (1-5 points, lower is better; minimal clinically important difference [MCID] 1.14 points) with gabapentinoids at 8 weeks. Secondary comparison to no treatment aligned with this finding. Gabapentinoids probably cause more fatigue (risk ratio [RR] 1.67 [95% CI 1.06-2.63]) and may cause more dizziness (RR 1.96 [95% CI 0.93-4.13]) compared to placebo. When compared to no-treatment at short term, gabapentinoids may provide minor benefits for pain but not for hand function. <b>Conclusions:</b> Current evidence does not support the use of oral gabapentinoids for CTS. There were no clinically important benefits in symptom relief when compared to placebo or no-treatment, and gabapentinoids caused adverse effects, particularly fatigue and maybe also dizziness. <b>Level of Evidence:</b> Level II (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"243-253"},"PeriodicalIF":0.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442958","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":"Malignant Transformation of Multiple Hand Enchondromas Secondary to Ollier Disease: A Case Report.","authors":"Daniela Kristina Carolino, Keiichi Muramatsu, Yasuhiro Tani, Masaya Ueda","doi":"10.1142/S2424835525720087","DOIUrl":"https://doi.org/10.1142/S2424835525720087","url":null,"abstract":"<p><p>Enchondromatosis secondary to Ollier disease (OD) is rare, with secondary chondrosarcomas (CS) accounting for only 1% of malignant osseous tumours. This is one of only two reports documenting four enchondromas of different bones of the same hand developing malignant transformation, with long-term follow-up. This is a 72-year-old female with histologically proven CS from multiple enchondromas of the index finger metacarpal and proximal phalanx, and middle finger proximal and middle phalanges. Six years following curettage and bone grafting, she showed no recurrence or metastases from CS. While CS of the hand behaves aggressively, they rarely metastasise and show good 5-year survival rates. Due to good prognosis, function-sparing surgical options are acceptable over amputation, accompanied by close surveillance. <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":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144462","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":"Morbidity and Unplanned Secondary Surgery Following All-Inside Transosseous Flexor Tendon Repairs in Jersey Finger Injuries.","authors":"Nathan Sarli, Kassem Ghayyad, David Hirsch, Jonas Matzon, Amir R Kachooei","doi":"10.1142/S2424835525500432","DOIUrl":"https://doi.org/10.1142/S2424835525500432","url":null,"abstract":"<p><p><b>Background:</b> We hypothesised that the complication rate is correlated with the technique and the type of suture in all-inside transosseous flexor digitorum profundus (FDP) tendon repairs. <b>Methods:</b> A retrospective review of our database identified zone 1 injuries of FDP or flexor pollicis longus (FPL) that were repaired using the transosseous technique. In this method, two limbs of the nonabsorbable sutures are passed from volar to dorsal via transosseous tunnels and tied just proximal to the germinal matrix over the proximal aspect of the distal phalanx (dorsal to the terminal band). Demographics, operative details and complications were compiled. <b>Results:</b> Eleven patients met inclusion criteria with an average age of 35 years (range: 13-66) and an average follow-up of 7 months (range: 4-16). Sutures used included two Prolene, three Supramid and six FiberWires (Arthrex, USA). Three of these injuries were associated with distal phalanx fractures. Infection-like symptoms, including painful flare-ups of swelling of the eponychium, occurred in six patients (55%) in whom a braided suture was used, which included all three patients with Supramid and three patients with FiberWire (Arthrex, USA). Three of the patients experienced multiple episodes of painful swelling of the eponychium that were managed with antibiotics. Three patients (27%) experienced nail deformities. Eight (73%) of the eleven patients experienced complications, five requiring incision, drainage or subsequent suture removal. <b>Conclusions:</b> All-inside transosseous flexor tendon repair is correlated with a high complication rate mainly associated with suture abscess and nail deformity, with a high risk of needing additional intervention. We speculate that the braided sutures are more likely to cause recurrent symptoms of suture abscess. Although antibiotics may control the symptoms, the suture material should be occasionally removed in cases of recurrent suture abscesses. <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":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144463","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":"Short-Term Results of the Hammock Method Combined with the Mini TightRope^® for Thumb Carpometacarpal Arthrosis.","authors":"Ikuo Nakai, Denju Osada","doi":"10.1142/S2424835525500420","DOIUrl":"https://doi.org/10.1142/S2424835525500420","url":null,"abstract":"<p><p><b>Background:</b> Suspension arthroplasty using the abductor pollicis longus (APL) tendon for advanced thumb carpometacarpal (CMC) arthrosis is known as the hammock method. We retrospectively investigated the short-term results of a previous attempt to use this method combined with the Mini TightRope^® to improve CMC joint stability. <b>Methods:</b> We included 22 hands of 19 patients (4 men and 15 women; mean age: 61.7 years) with primary advanced thumb CMC arthrosis who underwent this procedure during the past 4 years. All patients had Eaton stages II-IV thumb CMC arthritis. The Mini TightRope^® was inserted before APL tendon fixation to the metacarpal bone. After a 2-week immobilisation, the patients were permitted unrestricted hand usage. We assessed the grip and pinch strength; radial and volar abduction angles; the quick disabilities of the arm, shoulder and hand (quick DASH), hand 20 and Kapandji scores; trapezial height before surgery and at the final follow-up; postoperative complications and operative time. <b>Results:</b> The mean follow-up was 24.2 months, and the mean operative time was 58.1 minutes. The grip, tip pinch and side pinch strengths increased postoperatively. Additionally, the radial and volar abduction angles improved. The Kapandji, quick DASH and hand 20 scores showed improvements. The mean trapezial height was 8.4 mm preoperatively and 6.4 mm at the final follow-up. Postoperative complications included superficial radial neuropathy (<i>n</i> = 3), thumb flexor tendinitis (<i>n</i> = 2) and flexor carpi radialis (FCR) tendinitis (<i>n</i> = 3). <b>Conclusions:</b> The hammock method combined with the Mini TightRope^® shows good short-term results. <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":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144464","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":"Restoration of Hand Function in Birth Brachial Plexus Injury.","authors":"Bharath K Kadadi, Madhusudhan N C","doi":"10.1142/S242483552540003X","DOIUrl":"https://doi.org/10.1142/S242483552540003X","url":null,"abstract":"<p><p>Birth brachial plexus palsy (BBPP) can lead to significant functional impairment of the upper limb, particularly affecting hand function. Despite advancements in primary nerve reconstruction, many patients require secondary procedures to optimise hand use. This study evaluates surgical strategies aimed at restoring hand function in BBPP, emphasising the timing of intervention, nerve transfer options and reconstructive techniques. A comprehensive review of direct root transfers, secondary tendon transfers, along with an analysis of sensory re-education and long-term functional outcomes. Early nerve reconstruction, particularly nerve transfers to the lower trunk or medial cord, demonstrated superior functional recovery when performed within the critical period of motor endplate viability. Secondary tendon and free muscle transfers proved beneficial in patients with persistent deficits, particularly for enhancing grasp, pinch and intrinsic hand function. Sensory recovery remained a key determinant of overall hand utility, with targeted nerve transfers improving protective sensation. Optimising hand function in BBPP requires a multimodal approach tailored to each patient's residual deficits. Early nerve surgery provides the best potential for meaningful recovery, while secondary procedures play a crucial role in refining outcomes. Understanding the interplay between motor and sensory recovery is essential for achieving the best functional restoration. <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":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032473","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}