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

{"title":"International Perspectives on the Management of Acute Mallet Finger Injuries: A Cross-Sectional Survey.","authors":"Max McCARTHY, Luke McCARRON, Spencer B Chambers, Brahman Sivakumar, David J Graham, Randy Bindra","doi":"10.1142/S2424835525500419","DOIUrl":"https://doi.org/10.1142/S2424835525500419","url":null,"abstract":"<p><p><b>Background:</b> Mallet fingers are common injuries with management often being guided by presence of fracture, joint subluxation, chronicity and patient requirements and surgeon preferences. The purpose of this study was to understand current trends of management of mallet finger injuries. <b>Methods:</b> This study surveyed an international group of English-speaking hand surgeons (<i>n</i> = 244) with different types of mallet finger injury patterns to assess current trends and identify any regional variations in practice. <b>Results:</b> Nonoperative management with extension splinting was the preferred treatment for soft tissue (93%) and congruent bony (87%) mallet finger injuries amongst surgeons from all regions. Similarly, most surgeons (76%) preferred operative treatment for incongruent bony injuries. The management of subtle joint subluxation was contentious with 36% recommending splinting and the rest opting for closed reduction and wiring or open reduction. <b>Conclusions:</b> While there is no consensus on treatment, surgeons seem to prefer nonoperative treatment for most soft tissue mallet injuries. Surgeon preference seems to dictate the management of bony mallet injuries especially with incongruent joints. Prospective randomised studies would be beneficial in providing evidence-based guidelines for management of this common injury. <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":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531080","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 of Ulnar Wrist Pain Without Ulnar Plus Variance: A Comparative Study of Arthroscopic Triangular Fibrocartilage Complex Repair and Ulnar Shortening Osteotomy.","authors":"Katsuhiro Tokutake, Masahiro Tatebe, Katsuyuki Iwatsuki, Hidemasa Yoneda, Keiichiro Nishikawa, Michiro Yamamoto","doi":"10.1142/S2424835525500444","DOIUrl":"https://doi.org/10.1142/S2424835525500444","url":null,"abstract":"<p><p><b>Background:</b> Managing ulnar wrist pain without ulnar plus variance presents a clinical challenge. This study aimed to compare the causes of symptom onset and surgical outcomes between arthroscopic triangular fibrocartilage complex (TFCC) repair and ulnar shortening osteotomy (USO) and analyse factors influencing pain reduction following arthroscopic TFCC repair. <b>Methods:</b> Twenty-four patients without ulnar plus variance who underwent either arthroscopic TFCC repair or USO at our institution were retrospectively reviewed. Demographic data, symptom onset causes, time from onset to surgery, pre- and postoperative range of motion (ROM), grip strength ratio (injured to uninjured wrist), numeric pain rating scale (NRS), change in NRS and Hand20 scores were compared between the two treatment groups. For TFCC repair, correlations were investigated between NRS change and time from onset to surgery and between NRS change and age. <b>Results:</b> Of 24 patients, 14 underwent arthroscopic TFCC repair and 10 underwent USO. Only two patients in the USO group had no clear onset trigger, whereas most had identifiable triggers. Both groups showed no significant differences in pre- and postoperative ROM, grip strength ratio, NRS and Hand20 score. The change in NRS was significantly greater in the USO group (<i>p</i> = 0.049). For the TFCC repair group, NRS change was significantly negatively correlated with age (Spearman's rank correlation coefficient -0.603, <i>p</i> = 0.029). <b>Conclusions:</b> Our findings indicate that patients without ulnar plus variance who experience symptom onset including trauma often have an underlying degenerative component as well as instability. USO provides significant pain relief in such cases. Arthroscopic TFCC repair was effective in young patients in whom instability was the primary cause of pain and age was associated with pain reduction rather than time from onset to surgery. Effective treatment strategies for ulnar wrist pain without ulnar plus variance should consider both age and wrist arthroscopy findings to optimise outcomes. <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":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531081","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 Role of Interposition Composite Arteriovenous Bundles in Free Tissue Transfer.","authors":"Pedro Carlos Cavadas, Tina Munn Yi Lee","doi":"10.1142/S2424835525400053","DOIUrl":"https://doi.org/10.1142/S2424835525400053","url":null,"abstract":"<p><p>Free flaps have become the standard of treatment for complex tissue defects following trauma or oncological resection. At times, there is a lack of available recipient vessels near the defect. Classically, this problem has been circumvented with the use of vein grafts, either as interpositional grafts or arteriovenous (AV) loops. Other solutions include the use of bridging flaps, or, more recently, interpositional composite AV bundles (ICAVB). This is a relatively new technique with few publications in the literature. In this article, we share our experience of 18 successful ICAVB cases and discuss the indications, choice of donor and technical tips for the execution of this technique. <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":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531083","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":"Translation and Cross-Cultural Adaptation of the Six-Item Carpal Tunnel Syndrome Symptoms Scale Questionnaire into Persian.","authors":"Hesam Alitaleshi, Younes Noshadi, Armin Soleymani Fard, Sahar Amirzadeh, Sina Heydari","doi":"10.1142/S2424835525500468","DOIUrl":"https://doi.org/10.1142/S2424835525500468","url":null,"abstract":"<p><p><b>Background:</b> Numerous medical questionnaires exist to assess the quality of life in patients with carpal tunnel syndrome (CTS). However, most of these instruments are available exclusively in English. Therefore, we decided to translate and culturally adapt the Six-Item CTS Symptoms Scale (CTS-6 SS) into Persian. This questionnaire was selected because it offers a subjective evaluation with a concise set of questions. <b>Methods:</b> The translation followed the World Health Organization's four-step protocol, including forward and backward translation, expert panel review and pre-testing. The cultural adaptation involved a multidisciplinary team ensuring relevance and comprehensibility for Iranian patients. The questionnaire's validity and reliability were assessed. The questionnaire was revised and then administered to 60 randomly selected patients diagnosed with CTS. <b>Results:</b> The translated CTS-6 demonstrated high comprehension and completion rates. The adaptation process addressed cultural nuances and ensured the scale's effectiveness in the Iranian context. Cronbach's α was computed at 0.903 to evaluate internal consistency. The test-retest data for the CTS-6 showed a normal distribution. <b>Conclusions:</b> The Persian version of the CTS-6 is a reliable and efficient tool for assessing CTS symptoms, facilitating accurate diagnosis and treatment in Persian-speaking populations. The brevity and clarity of the questionnaire enhance patient compliance and the reliability of collected data. <b>Level of Evidence:</b> Level IV (Diagnostic).</p>","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":"144531084","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":"10.1142/S242483552550033X","url":null,"abstract":"<p><p><b>Background:</b> Peripheral nerve stimulation (PNS) has emerged as a promising treatment for refractory neuropathic pain in the upper extremities, particularly for patients unresponsive to conventional therapies. This systematic review and meta-analysis aims specifically to evaluate the effectiveness and safety of nerve stimulation of the brachial plexus (BP) for managing chronic neuropathic pain in the upper extremities. <b>Methods:</b> A comprehensive literature search was conducted following PRISMA guidelines across major databases, including PubMed, Scopus and Embase. Five studies met the inclusion criteria, encompassing a total of 157 patients with BP or other peripheral nerve injuries. The primary outcome measures included pain reduction and quality of life improvement, assessed through validated pain scales such as the Numerical Rating Scale (NRS) and patient-reported outcomes. <b>Results:</b> This meta-analysis demonstrated significant reductions in pain scores following BP nerve stimulation (MD: -4.88, 95% CI: -5.80 to -3.96, <i>p</i> < 0.05). Additionally, improvements in quality of life were observed, with over 30% enhancement in Short Form (SF)-36 scores. The overall complication rate was low, with only 9.2% of patients experiencing adverse events, such as lead migration or postoperative infection. <b>Conclusions:</b> These findings suggest that PNS at the level of the BP is both a safe and effective intervention for the management of refractory neuropathic pain in the upper extremities. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"235-242"},"PeriodicalIF":0.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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

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

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

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

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