{"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}
Nathan Sarli, Kassem Ghayyad, David Hirsch, Jonas Matzon, Amir R Kachooei
{"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<sup>®</sup> 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<sup>®</sup> 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<sup>®</sup> 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<sup>®</sup> 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":"Trends in the Incidence of Flexor Tendinopathy after Surgical Fixation of Distal Radius Fractures: Analysis of a Population-Based Database.","authors":"Thompson Zhuang, Lauren M Shapiro, Robin N Kamal","doi":"10.1142/S2424835525500390","DOIUrl":"https://doi.org/10.1142/S2424835525500390","url":null,"abstract":"<p><p><b>Background:</b> While early research identified features of volar locking plate design and placement as risk factors for flexor tendinopathy, temporal trends in rates of flexor tendinopathy have not been characterised despite the use of newer generations of volar plates and increased awareness of these risk factors. In this study, we tested the null hypothesis that there is no temporal trend in the incidence of flexor tendinopathy after surgical fixation of distal radius fractures. <b>Methods:</b> Using a national administrative claims database, we identified adults undergoing surgical fixation of isolated, closed distal radius fractures from 2011 to 2020. Patients were grouped by the quarter of the year they underwent surgery. We measured the incidence of flexor tendinopathy, malunion, nonunion and hardware removal at 1 and 2 years after the index procedure. We used a linear regression model to evaluate the association between time (per quarter) and the incidence of each complication. <b>Results:</b> We included 196,194 patients who underwent surgical fixation of distal radius fractures. With respect to 1-year outcomes, the incidence of flexor tendinopathy decreased by 0.6% per quarter, malunion increased by 0.8% per quarter, nonunion decreased by 2.1% per quarter and hardware removal increased by 0.5% per quarter. With respect to 2-year outcomes, the incidence of flexor tendinopathy decreased by 0.6% per quarter, malunion increased by 0.5% per quarter, nonunion decreased by 2.6% per quarter and hardware removal increased by 0.4% per quarter. <b>Conclusions:</b> The incidence of flexor tendinopathy after distal radius fracture fixation decreased from 2011 to 2020, which may reflect developments in volar plate design, improvements in implant selection and/or increased surgeon awareness of the risk of flexor tendinopathy. Further studies are needed to evaluate the aetiology of this trend. <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":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052531","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}
Emily A Schultz, Eli M Snyder, Andrea Tian, Robin N Kamal
{"title":"Outcomes and Quality of Evidence of the Treatment of Upper Extremity Cartilage Injuries: A Systematic Review.","authors":"Emily A Schultz, Eli M Snyder, Andrea Tian, Robin N Kamal","doi":"10.1142/S2424835525500407","DOIUrl":"https://doi.org/10.1142/S2424835525500407","url":null,"abstract":"<p><p><b>Background:</b> Cartilage injuries of the hand, wrist and elbow are common and may be managed by a variety of established procedures. While much literature has been devoted to cartilage injuries in the joints of the lower extremity, what data is available regarding treatment of similar injuries in the upper extremity is unknown. This systematic review assesses current procedures utilised to treat isolated cartilage injuries in the upper extremity and their outcomes. <b>Methods:</b> A systematic review was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed/MEDLINE was searched to identify articles that reported on cartilage procedures of the hand, wrist or elbow. Study demographic information, type of procedure and clinical outcomes (patient-reported outcome measures [PROMs], radiographic measures, return to play [if applicable], complications and follow-up) were collected and reported. <b>Results:</b> The initial search yielded 532 articles. Of these, 118 articles underwent full-text review; 47 articles were ultimately included and analysed. The majority of articles were Level IV evidence and reported on osteochondral autograft transplantation (OATS) in the elbow and hand. The remaining articles for the elbow reported on arthroscopic debridement with microfracture or drilling, arthroscopic debridement alone and core decompression. The remaining articles for the wrist reported on autologous chondrocyte implantation and arthroscopy. One hand article reported on periosteal autografting. <b>Conclusions:</b> The most significant improvements in PROMs, range of motion and return to play were reported for OATS procedures of the elbow, wrist and hand. Studies of a higher level of evidence are important to further standardise the treatment of cartilage injuries of the upper extremity. <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":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040411","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":"Surgical Outcomes of Distal Biceps Brachii Tendon Rupture by Use of a New Instrument, PushLock<sup>®</sup> Knotless Suture Anchor.","authors":"Keiichi Muramatsu, Yosuke Yamashita, Daniela Kristina D Carolino, Yasuhiro Tani, Masaya Ueda, Hideaki Sugimoto","doi":"10.1142/S2424835525500389","DOIUrl":"https://doi.org/10.1142/S2424835525500389","url":null,"abstract":"<p><p><b>Background:</b> Ruptures of the distal biceps brachii tendon (DBT) have only a few published reports in Asia. In this study, we report on the diagnosis and surgical outcomes of six acute traumatic cases surgically treated using a new internal fixation instrument, PushLock<sup>®</sup> Knotless Suture Anchor. <b>Methods:</b> In the past 3 years, we treated six patients with DBT rupture. All were males, aged 39-67 years at the time of surgery. Three patients had complete rupture of both the long and short head and three patients had only rupture of the long head. The ruptured DBT tendon was tightly fixed to the anatomical insertion in the radial tuberosity by use of a 2.9 mm PushLock<sup>®</sup> Knotless Suture Anchor. <b>Results:</b> All patients had recovered to MMT 5 in elbow flexion post-operatively and there was no limitation of ROM in elbow or forearm. The DASH score significantly improved from a mean of 28.5 points to 17.5. One patient had a transient complaint of numbness in the area of the superficial radial nerve. <b>Conclusions:</b> Even if the long head of DBT is injured alone, pain and consequent elbow flexion weakness will occur. Repair of the injured tendon should be considered even for partial rupture of DBT, especially in manual workers. The SutureTape and 2.9 mm PushLock<sup>®</sup> Knotless Suture Anchor are new internal fixation instruments, and their usefulness for repair of ruptured DBT has not been reported yet. In this case series, excellent outcomes were obtained. Pain relief and recovery of muscle strength were achieved early after surgery. Our technique is simple, safe and reliable for surgical repair of the ruptured DBT. <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":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025142","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 of Nerve Wrapping and Capping with a Nerve Conduit and Blocking Splint Therapy for a Painful Neuroma at the Metacarpophalangeal Joint.","authors":"Kosuke Shintani, Yutaka Kubota, Daisaku Matsuda","doi":"10.1142/S2424835525720026","DOIUrl":"10.1142/S2424835525720026","url":null,"abstract":"<p><p>A 42-year-old man suffered an avulsion amputation of his right middle finger. He had undergone several surgeries since the age of 24, including amputation plasty and implantation of the injured nerve into fat and bone, but had difficulty returning to work due to persistent severe pain. He underwent nerve capping with an artificial nerve conduit at a university hospital, and his symptoms improved slightly, but immediately flared up again. Therefore, he was referred to our hospital and was treated with a blocking splint in addition to resection of the traumatic neuroma, covering with an artificial nerve conduit and wrapping with an adiposal flap. The lumen of the conduit was observed without collapse until it was resorbed, and he returned to work without pain 10 months after surgery. The blocking splint to an angle that preserves the lumen of the conduit was useful for artificial nerve surgery near the joint. <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"213-217"},"PeriodicalIF":0.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958573","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":"Reliability of Hand-Held Dynamometer Measurement for Thumb Palmar Abduction Strength in Carpal Tunnel Syndrome.","authors":"Kazuteru Doi, Noritada Yasui, Yuya Isomura, Masafumi Tagawa, Yasunori Hattori, Sotetsu Sakamoto","doi":"10.1142/S2424835525500262","DOIUrl":"10.1142/S2424835525500262","url":null,"abstract":"<p><p><b>Background:</b> In carpal tunnel syndrome (CTS), pain and sensory disturbance are the main symptoms, but thumb palmar abduction (TPA) paralysis cannot be ignored as a concurrent symptom. The reliable quantitative measurement of TPA power was not established. The purpose of this study was to report on the reliability of TPA strength measurements by the hand-held dynamometry (HHD) in large samples of CTS and its superiority over other tests, including grip, pinch powers, TPA angles and manual muscle testing, in terms of clinical progress indicators. <b>Methods:</b> We examined the relative and absolute reliabilities of the perioperative TPA strength measured by HHD (HHD-TPA) in 566 participants with CTS and the correlation coefficient between the HHD-TPA and other clinical tests. <b>Results:</b> The reliability of the HHD-TPA was intraclass correlation coefficients: 97% or higher. The Bland-Altman absolute reliability showed a random pattern of bias, and the minimal detectable changes (MDC) of the inter-rater and intra-rater reliabilities indicated 9.0 N and 7.0 N individually. The HHD-TPA showed statistically significant recoveries between perioperative stages; however, the mean difference larger than the MDC was recognised only between the preoperative and 12-month postoperative stages by intra-rater comparison. More individual patients showed recovery of HHD-TPA beyond the MDC when the same examiner continuously measured HHD-TPA than when multiple examiners continuously measured HHD-TPA. Grip strength and pinch strength measurements showed a strong correlation with HHD-TPA and did not show statistically significant improvement during the perioperative period. <b>Conclusions:</b> HHD-TPA is the most reliable method for quantifying muscle strength in the perioperative course of TPA force in CTS. HHD-TPA is a more reliable assessment of CTS motor recovery when measured consistently for each patient by the same hand therapist. <b>Level of Evidence:</b> Level IV (Diagnostic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"155-165"},"PeriodicalIF":0.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016169","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":"Nerve Capping Using Renerve® Synthetic Collagen Conduits for Hand Amputation Neuroma Pain.","authors":"Shinsuke Takeda, Shigeru Kurimoto, Ryutaro Shibata, So Mitsuya, Hideki Okamoto, Hideki Murakami","doi":"10.1142/S2424835525500195","DOIUrl":"10.1142/S2424835525500195","url":null,"abstract":"<p><p><b>Background:</b> Amputated neuromas, a common consequence of peripheral nerve injury, can cause significant pain and may impair daily life. Herein, we conducted a retrospective study on patients who underwent a nerve-capping technique using the bioabsorbable nerve conduit Renerve®, with a minimum follow-up period of 6 months. <b>Methods:</b> We conducted a retrospective study to assess patients with amputation neuromas of the finger or palm who underwent surgical treatment using the capping technique with the Renerve® conduit between October 2018 and September 2022. The data on demographics, operative details, pre- and postoperative evaluations (visual analogue scale [VAS] pain scores and Tinel sign) and complications were analysed. <b>Results:</b> Seven patients (seven nerves) with a median age of 51 years (three men and four women) were assessed. The median follow-up duration was 15 months. Renerve® conduits of varying sizes (1.0-2.3 mm) and lengths (15-25 mm) were used. The median duration until surgery was 195 days. After the procedure, VAS pain scores significantly decreased from a baseline of 53.1 mm to 5.7 mm at the 6-month follow-up. Tinel sign persisted in four patients, and no postoperative complications occurred. <b>Conclusions:</b> Our study demonstrates the clinical usefulness of the Renerve® conduit as a nerve-capping technique for amputation neuroma. Considering the limited availability of real-world data on Renerve® conduits for nerve capping, our findings provide valuable insights for clinical practitioners. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"189-195"},"PeriodicalIF":0.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958627","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}
Benjamin Pautler, Charles Marchese, Makayla Swancutt, Bryan G Beutel
{"title":"Generative Artificial Intelligence Responses to Common Patient-Centric Hand and Wrist Surgery Questions: A Quality and Usability Analysis.","authors":"Benjamin Pautler, Charles Marchese, Makayla Swancutt, Bryan G Beutel","doi":"10.1142/S2424835525500171","DOIUrl":"10.1142/S2424835525500171","url":null,"abstract":"<p><p><b>Background:</b> Due to the rapid evolution of generative artificial intelligence (AI) and its implications on patient education, there is a pressing need to evaluate AI responses to patients' medical questions. This study assessed the quality and usability of responses received from two prominent AI platforms to common patient-centric hand and wrist surgery questions. <b>Methods:</b> Twelve commonly encountered hand and wrist surgery patient questions were inputted twice into both Gemini and ChatGPT, generating 48 responses. Each response underwent a content analysis, followed by assessment for quality and usability with three scoring tools: DISCERN, Suitability Assessment of Materials (SAM) and the AI Response Metric (AIRM). Statistical analyses compared the features and scores of the outputs when stratified by platform, question type and response order. <b>Results:</b> Responses earned mean overall scores of 55.7 ('good'), 57.2% ('adequate') and 4.4 for DISCERN, SAM and AIRM, respectively. No responses provided citations. Wrist question responses had significantly higher DISCERN (<i>p</i> < 0.01) and AIRM (<i>p</i> = 0.02) scores compared to hand responses. Second responses had significantly higher AIRM (<i>p</i> < 0.01), but similar DISCERN (<i>p</i> = 0.76) and SAM (<i>p</i> = 0.11), scores compared to the first responses. Gemini's DISCERN (<i>p</i> = 0.04) and SAM (<i>p</i> < 0.01) scores were significantly higher than ChatGPT's corresponding metrics. <b>Conclusions:</b> Although responses are generally 'good' and 'adequate', there is variable quality with respect to platform used, type of question and response order. Given the diversity of publicly available AI platforms, it is important to understand the quality and usability of information patients may encounter during their search for answers to common hand and wrist surgery questions. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"205-212"},"PeriodicalIF":0.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958594","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}