Journal of Hand Surgery-Asian-Pacific Volume最新文献_第3页

Assessing Donor Finger Morbidity in Cross-Finger Flap Surgery: A Comprehensive Longitudinal Study. 评估供指在交叉指瓣手术中的发病率：一项全面的纵向研究。

IF 0.5

Journal of Hand Surgery-Asian-Pacific Volume Pub Date : 2025-08-01 Epub Date: 2025-07-22 DOI: 10.1142/S2424835525500547

N C Madhusudhan, Bharath Kadadi, Niranjan Mallanaik

{"title":"Assessing Donor Finger Morbidity in Cross-Finger Flap Surgery: A Comprehensive Longitudinal Study.","authors":"N C Madhusudhan, Bharath Kadadi, Niranjan Mallanaik","doi":"10.1142/S2424835525500547","DOIUrl":"10.1142/S2424835525500547","url":null,"abstract":"Background: The cross-finger flap is a reliable technique for soft tissue reconstruction in finger injuries, providing pliable tissue and anatomical security. However, donor finger morbidity remains a concern. This retrospective cohort study evaluated donor-site outcomes, focussing on functional recovery and patient-reported measures. Methods: This retrospective cohort study included 30 patients who underwent cross-finger flap surgery, predominantly males (80%) aged 21-40 years, mostly manual labourers with workplace-related injuries. The index finger was most injured (48%), while the middle finger served as the primary donor (66.6%). Assessments included donor finger pain, total active motion (TAM), pinch strength, aesthetic outcomes and complications. Statistical analysis compared donor and control fingers to evaluate functional recovery and patient satisfaction. Results: Patient satisfaction was high (96.7%), with minimal donor site pain (93%). A significant reduction in TAM was observed in donor fingers compared to controls (p = 0.029). Maximal pinch strength showed no significant difference (p = 0.415). Complications included hyperpigmentation (20%) and partial graft loss (10%) and hypertrophic scar (3%). Conclusion: The cross-finger flap remains an effective reconstructive option with high patient satisfaction. However, donor finger morbidity, particularly reduced TAM, underscores the need for structured postoperative rehabilitation. Early flap division and supervised physiotherapy may optimise functional recovery. Study limitations include sample size, but these findings demonstrate the procedure's viability for soft tissue reconstruction. Level of Evidence: Level IV (Therapeutic).","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"408-415"},"PeriodicalIF":0.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700324","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}

引用次数: 0

Computerised Tomographic Analysis of Differences in Scaphoid Trabecular Density in the Intact Bone. 完整骨舟状骨小梁密度差异的计算机层析分析。

IF 0.5

Journal of Hand Surgery-Asian-Pacific Volume Pub Date : 2025-08-01 Epub Date: 2025-07-22 DOI: 10.1142/S2424835525500560

Liliane A Freundt, Ingmar W F Legerstee, Oscar Y Shen, Ryan Weiss, F Joseph Simeone, Yin Wu, Chaitanya Mudgal

{"title":"Computerised Tomographic Analysis of Differences in Scaphoid Trabecular Density in the Intact Bone.","authors":"Liliane A Freundt, Ingmar W F Legerstee, Oscar Y Shen, Ryan Weiss, F Joseph Simeone, Yin Wu, Chaitanya Mudgal","doi":"10.1142/S2424835525500560","DOIUrl":"10.1142/S2424835525500560","url":null,"abstract":"Background: Percutaneous screw placement can treat nondisplaced or scaphoid waist fractures. Screws positioned in areas of highest trabecular density improve fracture stability and bone healing. This study aims to compare the density of six segments of the intact scaphoid bone to facilitate optimal screw positioning. Methods: This study compared the density of six segments of the scaphoid bone in 214 intact scans using the 3D Quantitative Imaging (3DQI) Platform. The scaphoid was divided into proximal, middle and distal regions, each with radial and ulnar segments. Densities were measured in Hounsfield units (HU) and compared using a mixed effects model. Results: The proximal pole had the highest density (proximal radial 551 ± 115 HU; proximal ulnar 546 ± 116 HU), followed by the middle, with the distal pole having the lowest density. The proximal segments were significantly denser than the middle and distal segments. Conclusion: Our study suggests a more ulnar starting point in the distal pole for retrograde percutaneous screw placement, to maximise engagement of the highest trabecular bone density. For the antegrade approach, the proximal pole demonstrates consistently uniform density, permitting screw placement based on fracture plane; however, if possible, the ulnar segment of the distal pole should be engaged.","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"367-375"},"PeriodicalIF":0.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700325","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}

引用次数: 0

Management of the Clenched Fist in Adult Patients with Upper Motor Neuron Syndrome. 成人上运动神经元综合征患者握拳的处理。

IF 0.5

Journal of Hand Surgery-Asian-Pacific Volume Pub Date : 2025-08-01 Epub Date: 2025-07-11 DOI: 10.1142/S2424835525400065

Matthew P Fahrenkopf, Peter C Rhee

{"title":"Management of the Clenched Fist in Adult Patients with Upper Motor Neuron Syndrome.","authors":"Matthew P Fahrenkopf, Peter C Rhee","doi":"10.1142/S2424835525400065","DOIUrl":"10.1142/S2424835525400065","url":null,"abstract":"The clenched fist deformity (CFD) in adult patients with upper motor neuron syndrome (UMNS), typically due to a brain or spinal cord injury, can develop from an imbalance of the extrinsic finger flexors relative to the extensors. This brings the fingers into a flexed posture across the metacarpophalangeal (MCP) and interphalangeal (IP) joints and places the fingertips close to or in contact with the palm. The intrinsic musculature of the hand also plays a contributing role to the flexion deformity across the MCP joints whose contribution to the deformity can be masked by the extrinsic flexors. Severity of the CFD is patient specific and ranges over a spectrum dependent upon the involved muscle groups and underlying spasticity, myostatic contracture and/or joint contractures. In addition to markedly decreasing function, patients and caretakers may struggle with hygiene in the hand and even develop wounds within the palm. Surgical correction of the CFD can be classified as procedures implemented for muscles with (functional) or without (non-functional) volitional motor control. Techniques encompass muscle-tendon lengthening, tenotomies, tendon transfers, muscle origin release (slides), joint capsule and/or ligament releases. A comprehensive review of the surgical approach to correcting the CFD for the hand with and without volitional motor control in the fingers will be presented. Level of Evidence: Level V (Therapeutic).","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"346-357"},"PeriodicalIF":0.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638662","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}

引用次数: 0

Correlation of Radiographic and Arthroscopic Staging in Kienböck Disease: Impact on Treatment Decisions and Functional Outcomes. Kienböck疾病的影像学和关节镜分期的相关性：对治疗决策和功能结局的影响。

IF 0.5

Journal of Hand Surgery-Asian-Pacific Volume Pub Date : 2025-08-01 Epub Date: 2025-07-22 DOI: 10.1142/S2424835525500572

Anil K Bhat, Mithun Pai G, Ashwath M Acharya

{"title":"Correlation of Radiographic and Arthroscopic Staging in Kienböck Disease: Impact on Treatment Decisions and Functional Outcomes.","authors":"Anil K Bhat, Mithun Pai G, Ashwath M Acharya","doi":"10.1142/S2424835525500572","DOIUrl":"10.1142/S2424835525500572","url":null,"abstract":"Background: The prognosis of Kienböck disease (KD) depends upon the extent of damage to the articular surface of the lunate and its adjacent articulations. Arthroscopy offers valuable information for management and decision-making by revealing the status of the articular surface, which radiographs cannot visualise. Methods: This study on KD assessed 10 patients, correlating radiographic and arthroscopic evaluations to enhance diagnostic accuracy and determine the decision-making, which may result in improved functional outcomes for patients. Results: Findings have shown that arthroscopy often reveals critical details not visible by imaging, influencing surgical planning. Notably, the management plan changed in 50% of the cases following arthroscopic assessment in our series. The radiological evaluations indicated changes in the lunate, carpal collapse and instability angles, while wrist arthroscopy offered further insights into cartilage damage, lunate fracture and ligament integrity. Additionally, wrist arthroscopic evaluations facilitated minimally invasive procedures, such as scapho-capitate fusion through a mini-incision, potentially resulting in a shorter recovery time and a decreased risk of complications relative to the conventional dorsal approach, thereby providing a much more satisfactory functional outcome. Conclusion: The study concludes that combining radiographic and arthroscopic data enhances comprehensive diagnostic accuracy and guides precise surgical intervention in KD. Level of Evidence: Level IV (Therapeutic).","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"384-391"},"PeriodicalIF":0.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700327","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}

引用次数: 0

Objective Assessment of Function in a Two-Digit Hand - A Comparison of the Functional Outcome between the Little Finger and the Index Finger as the Ulnar Post. 双指手功能的客观评价——小指与食指作为尺后功能结果的比较。

IF 0.5

Journal of Hand Surgery-Asian-Pacific Volume Pub Date : 2025-08-01 Epub Date: 2025-07-11 DOI: 10.1142/S2424835525500511

N C Madhusudhan, Praveen Bhardwaj, Vigneswaran Varadharajan, Gobinath Kannan, Hari Venkatramani, S Raja Sabapathy

{"title":"Objective Assessment of Function in a Two-Digit Hand - A Comparison of the Functional Outcome between the Little Finger and the Index Finger as the Ulnar Post.","authors":"N C Madhusudhan, Praveen Bhardwaj, Vigneswaran Varadharajan, Gobinath Kannan, Hari Venkatramani, S Raja Sabapathy","doi":"10.1142/S2424835525500511","DOIUrl":"10.1142/S2424835525500511","url":null,"abstract":"Background: In mutilated hand reconstruction, the choice between index or little finger as the sole ulnar post to oppose a functional thumb remains controversial. This study objectively compares functional outcomes between these two configurations in basic two-digit hand. Methods: This retrospective study (2013-2020) evaluated 11 patients with a functional two-digit hand. Inclusion criteria included an uninjured thumb and the presence of only one uninjured digit serving as an ulnar post, either little finger (group 1) or index (group 2), characterised by good web space, sensate perception, painlessness and the ability to oppose each other in movement. Assessments included pinch and grip strength measurements, Jebsen-Taylor Hand Function Test (JHFT) and disabilities of arm, shoulder and hand (DASH) score. Non-parametric tests (Mann-Whitney U) compared continuous variables with significance at p < 0.05. Results: Objective testing revealed superior function in group 2 patients (index finger ulnar post) patients versus group 1 patients (JHFT: 1.39 vs. 1.91 minutes; grip: 4 vs. 1.2 kg; pinch: 2.5 vs. 0.4 kg). DASH scores favoured group 2 patients (25.2 vs. 37.4), though not statistically significant (p = 0.144). Conclusions: Our findings challenge traditional ulnar-digit preference, demonstrating the index finger provides significantly better strength and functional outcomes as the ulnar post in basic two-digit hands. These results support prioritising radial-digit reconstruction when the first web space is uncompromised, though individual patient factors and occupational demands should be considered. Level of Evidence: Level III (Therapeutic).","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"430-435"},"PeriodicalIF":0.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638664","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}

引用次数: 0

Evaluating the Effectiveness of Distraction Lengthening in Traumatic Hand Amputations. 评价牵张延长术在外伤性手部截肢中的效果。

IF 0.5

Journal of Hand Surgery-Asian-Pacific Volume Pub Date : 2025-08-01 Epub Date: 2025-07-11 DOI: 10.1142/S2424835525500535

Iqbal Rasool Wani, P Umar Farooq Baba, Adil Bashir Sheikh, Mohammad Inam Zaroo, Altaf Rasool, Adil Hafeez Wani

{"title":"Evaluating the Effectiveness of Distraction Lengthening in Traumatic Hand Amputations.","authors":"Iqbal Rasool Wani, P Umar Farooq Baba, Adil Bashir Sheikh, Mohammad Inam Zaroo, Altaf Rasool, Adil Hafeez Wani","doi":"10.1142/S2424835525500535","DOIUrl":"10.1142/S2424835525500535","url":null,"abstract":"Background: Fingers are highly susceptible to injuries, leading to functional impairment, particularly in the thumb and index finger. While traditional reconstructive methods exist, they often involve multiple surgeries and complications. Distraction lengthening, a minimally invasive technique, promotes bone and soft tissue regeneration, making it a promising alternative for digital lengthening. This study aims to assess the efficacy and functional results of distraction lengthening in patients with traumatic shortening of digits. Methods: This was a prospective observational cohort study conducted at a tertiary care centre. This study evaluated distraction histogenesis in 11 trauma patients with digital shortening. A unilateral mini external fixator was used for gradual distraction following osteotomy. Distraction began 5-7 days post-surgery at 1 mm/day, with healing monitored via radiographs. Functional recovery, length gained, healing index and patient satisfaction were assessed over a 1-year follow-up. Results: Patients (73% male, aged 16-30) primarily sustained machinery-related injuries. The mean preoperative shortness was 20.4 mm, with an average length gain of 20.2 mm. The mean external fixation and consolidation times were 111.3 and 91.36 days, respectively. The healing index averaged 47.5 days/cm. Functional grip, thumb web space and hand utility improved significantly, with success influenced by stable fixator use, surgical technique and patient adherence. Conclusions: Distraction lengthening is a reliable and effective method, offering functional restoration with minimal invasiveness. Despite prolonged treatment, it preserves sensitivity, prevents stiffness and eliminates the need for bone grafting. Level of Evidence: Level IV (Therapeutic).","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"422-429"},"PeriodicalIF":0.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638660","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}

引用次数: 0

Analysis of Plate Position and Factors Associated with Time to Flexor Tendon Rupture Following Volar Plate Fixation of Distal Radius Fractures. 掌侧钢板固定桡骨远端骨折后屈肌腱断裂时间与钢板位置的相关因素分析。

IF 0.5

Journal of Hand Surgery-Asian-Pacific Volume Pub Date : 2025-07-14 DOI: 10.1142/S2424835525500481

Koichi Yano, Masataka Yasuda, Takuya Yokoi, Yasunori Kaneshiro, Takuya Uemura, Kiyohito Takamatsu

{"title":"Analysis of Plate Position and Factors Associated with Time to Flexor Tendon Rupture Following Volar Plate Fixation of Distal Radius Fractures.","authors":"Koichi Yano, Masataka Yasuda, Takuya Yokoi, Yasunori Kaneshiro, Takuya Uemura, Kiyohito Takamatsu","doi":"10.1142/S2424835525500481","DOIUrl":"https://doi.org/10.1142/S2424835525500481","url":null,"abstract":"Background: Distal radius fractures are the most common fractures in the upper extremity. Volar plate fixation is a commonly performed surgical procedure for this fracture. Flexor tendon rupture is a serious postoperative complication due to attrition between the plate and tendon. This study aimed to analyse the factors associated with the time from surgery to tendon rupture, classify plate position and determine the incidence of flexor tendon rupture in relation to plate position. Methods: This multicentre retrospective study included 28 patients (24 women) with flexor tendon rupture following volar plate surgery for distal radius fractures. Plate positions were classified into four types based on plain radiographs. They were distal position (DP), dorsal angulation (DA), screw protrusion (SP) and proximal position (PP). The associations between the time to rupture and factors, including patient backgrounds and radiological parameters, were examined. Results: Thirty-five flexor tendons ruptured. All cases included Soong grade 1 or 2 plate prominence. The average time to tendon rupture was 101.5 months (SD 60.2, range: 1.1-202.1). No factors were significantly associated with time to rupture. Flexor tendon ruptures were associated with DA in 17 ruptures, DP in 11, SP in 6 and PP in 2. SP was observed in the non-locking system only. Conclusions: Attention must be paid to the possibility of tendon rupture in patients with Soong grade 1 or 2. The risk of flexor tendon rupture was highest in patients with prominent plates due to DA. Level of Evidence: Level IV (Therapeutic).","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627695","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}

引用次数: 0

The Relationship between Carpal Tunnel Syndrome and Wild-Type ATTR Amyloidosis. 腕管综合征与野生型ATTR淀粉样变的关系。

IF 0.5

Journal of Hand Surgery-Asian-Pacific Volume Pub Date : 2025-07-14 DOI: 10.1142/S2424835525500559

Kenji Goto, Ryosuke Ikeguchi, Takashi Noguchi, Kiyohito Naito, Muneaki Ishijima, Syuichi Matsuda

{"title":"The Relationship between Carpal Tunnel Syndrome and Wild-Type ATTR Amyloidosis.","authors":"Kenji Goto, Ryosuke Ikeguchi, Takashi Noguchi, Kiyohito Naito, Muneaki Ishijima, Syuichi Matsuda","doi":"10.1142/S2424835525500559","DOIUrl":"https://doi.org/10.1142/S2424835525500559","url":null,"abstract":"Background: Carpal tunnel syndrome (CTS), which is frequently encountered in orthopaedic practice, is an early symptom of wild-type transthyretin amyloidosis (ATTRwt). ATTRwt has a high misdiagnosis rate, making early detection difficult, which in turn delays treatment and results in a poor prognosis. Therefore, we herein investigated whether the early diagnosis of CTS leads to the early detection and treatment of ATTRwt, ultimately improving its prognosis. Methods: This study included 42 patients diagnosed with ATTRwt (34 males, 8 females; mean age: 77.7 years). We investigated the presence of a history of CTS, the affected side, the duration from the CTS diagnosis to ATTRwt confirmation, the number of deaths and the number of referrals from orthopaedic surgeons to cardiologists. Results: A history of CTS was present in 26 cases, with 15 being bilateral CTS. The average duration from the CTS diagnosis to ATTRwt confirmation was 6.4 years. Four patients died, and there were no referrals from orthopaedic surgeons to cardiologists. Conclusions: The present results showed that 61.9% of patients diagnosed with ATTRwt had a history of CTS, suggesting that CTS is a predictive factor for ATTRwt. However, the average duration from the CTS diagnosis to ATTRwt confirmation was 6.4 years, indicating a significant delay. One reason for this delay is that orthopaedic surgeons may not be aware of the relationship between CTS and ATTRwt, as suggested by the result showing no referrals from orthopaedic surgeons to cardiologists. Level of Evidence: Level IV (Diagnostic).","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627696","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}

引用次数: 0

Weeding Out the Problem: Associations of Cannabis and Tobacco Use with Complications of Surgical Fixation of Metacarpal Fracture. 消除问题：大麻和烟草使用与掌骨骨折手术固定并发症的关系。

IF 0.5

Journal of Hand Surgery-Asian-Pacific Volume Pub Date : 2025-06-30 DOI: 10.1142/S2424835525500456

Arman Kishan, Victoria E Bergstein, Ansh Kishan, Pawel Jankowski, Sami H Tuffaha, Dawn M Laporte

{"title":"Weeding Out the Problem: Associations of Cannabis and Tobacco Use with Complications of Surgical Fixation of Metacarpal Fracture.","authors":"Arman Kishan, Victoria E Bergstein, Ansh Kishan, Pawel Jankowski, Sami H Tuffaha, Dawn M Laporte","doi":"10.1142/S2424835525500456","DOIUrl":"https://doi.org/10.1142/S2424835525500456","url":null,"abstract":"Background: Given the increasing prevalence of cannabis use, it is critical to understand its association with postoperative complications. We investigated association between cannabis use and complications after metacarpal fracture fixation. Methods: We identified 80,787 patients from a US insurance claims database who underwent metacarpal fracture fixation from 2010 to 2022; 5,043 (6.7%) had diagnosed cannabis use disorder, dependence or addiction. Cannabis users were compared with patients with history of tobacco use and those with no history of using either substance ('control group'). Propensity matching was used to control for age, sex and Charlson Comorbidity Index (CCI) value. Demographic and comorbidity profiles, 90-day medical complications and 6-month surgical complications were compared using chi-squared tests (α = 0.05). Results: Compared with the control group, cannabis users had a higher incidence of acute kidney injury, cardiac arrest, deep venous thrombosis, hypoglycemia, myocardial infarction, pneumonia, sepsis, stroke and urinary tract infection (all, p < 0.01) within 90 days after surgery. After matching the cannabis and control groups, the cannabis group had a higher incidence of nerve injury (p < 0.01), fracture nonunion (p = 0.04) and fracture malunion (p = 0.002). Compared with tobacco users, cannabis users had a lower incidence of pneumonia (p = 0.002), urinary tract infection (p < 0.01) and hypoglycemia (p = 0.03) within 90 days. Conclusions: Compared with patients who had no history of drug use, cannabis users had a higher incidence of several medical and surgical complications. Compared with tobacco users, cannabis users had a lower incidence of some medical complications. These differences underscore the need for tailored perioperative care strategies for cannabis users. Level of Evidence: Level III (Therapeutic).","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531085","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}

引用次数: 0

Rib-Sparing Scalenectomy versus First Rib Resection for the Treatment of Neurogenic Thoracic Outlet Syndrome: Comparison of Patient-Reported Outcomes. 保留肋骨的斜角肌切除术与第一肋骨切除术治疗神经源性胸廓出口综合征：患者报告结果的比较。

IF 0.5

Journal of Hand Surgery-Asian-Pacific Volume Pub Date : 2025-06-30 DOI: 10.1142/S2424835525500493

Ramin Shekouhi, Syeda Hoorulain Ahmed, Mohammed Mumtaz, Samir Shah, Harvey Chim

{"title":"Rib-Sparing Scalenectomy versus First Rib Resection for the Treatment of Neurogenic Thoracic Outlet Syndrome: Comparison of Patient-Reported Outcomes.","authors":"Ramin Shekouhi, Syeda Hoorulain Ahmed, Mohammed Mumtaz, Samir Shah, Harvey Chim","doi":"10.1142/S2424835525500493","DOIUrl":"https://doi.org/10.1142/S2424835525500493","url":null,"abstract":"Background: Neurogenic thoracic outlet syndrome (nTOS) is caused by compression of the brachial plexus (BP). Surgical intervention is pursued when conservative treatments fail. The present study aimed to investigate the mid-term functional outcomes of patients with nTOS who underwent first rib resection (FRR) compared to rib-sparing scalenectomy (RSS) using standardised patient-reported outcome measures (PROMs). Methods: The PROMs used included the Visual Analogue Scale (VAS), Patient Satisfaction Scale (PSS), Disabilities of the Arm, Shoulder and Hand (DASH) score, Michigan Hand Outcomes Questionnaire (MHQ) and Cervical Brachial Symptom Questionnaire (CBSQ). Statistical analyses compared outcomes between the RSS and FRR groups, with regression models accounting for confounding factors. Results: This study included 20 patients with supraclavicular nTOS, with a mean age of 42.5 ± 13.1 years and a mean BMI of 28.1 ± 5.5. There were 11 females (55.0%) and 9 males (45.0%). Mean postoperative follow-up before PROMs was 29.3 ± 13.9 months. The overall mean DASH, CBSQ and MHQ scores were 50.1 ± 34.1, 45.0 ± 42.1 and 59.8 ± 23.6, respectively. A significant positive correlation was observed between the Derkash score and time from symptom onset to surgery. Comparing FRR (n = 10) and RSS (n = 10), the DASH score was significantly higher in the FRR group (66.8 ± 36.2) compared to the RSS group (33.4 ± 22.9). No other significant differences in PROMs were found between the FRR and RSS groups. Conclusion: RSS and FRR were both effective in improving symptoms in nTOS, with RSS having a significantly lower DASH score postoperatively. Level of Evidence: Level III (Therapeutic).","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531082","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}

引用次数: 0