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

{"title":"Clinical Outcomes of Surgical Treatment for Paediatric Forearm Fractures: A Retrospective Analysis of 86 Fractures.","authors":"Akira Kawabata, Yukiko Morimoto, Megumi Ishiko, Kiyohito Takamatsu","doi":"10.1142/S242483552650030X","DOIUrl":"10.1142/S242483552650030X","url":null,"abstract":"<p><p><b>Background:</b> Surgical treatment of paediatric forearm fractures is usually based on age and fracture type. Most patients undergo intramedullary and, occasionally, conventional pinning or plate fixation. However, the optimal fixation method remains controversial. We retrospectively examined the clinical and radiographic outcomes and complications associated with pinning (intramedullary and conventional) and plate fixation. <b>Methods:</b> Surgery was performed for 86 diaphyseal fractures of the forearm in 60 patients aged ≤ 15 years. Their mean age and follow-up duration were 8.7 years and 10.4 months, respectively. Surgical methods, fracture location, Grace and Eversmann rating, bone union, refracture and duration of postoperative immobilisation were retrospectively examined. <b>Results:</b> Pinning fixation using a K-wire was performed in 62 fractures. Intramedullary pinning was performed in 47 fractures, conventional pinning in 12 and combined intramedullary and conventional pinning in 3. Meanwhile, 24 fractures were managed with plate fixation. The outcomes of each technique were often excellent based on Grace and Eversmann ratings. Delayed union or nonunion was observed in five fractures managed with open reduction and pinning fixation (<i>n</i> = 2, distal third of the radius; <i>n</i> = 1, middle third of the radius and <i>n</i> = 2, middle third of the ulna). All fractures treated by pinning with closed reduction or plate fixation exhibited bone union without delay. Refracture occurred in one patient treated with pinning and another treated with plate fixation. The mean postoperative immobilisation duration for plate fixation was significantly shorter than that for pinning fixation (3.2 vs. 6.7 weeks). <b>Conclusions:</b> Pinning and plate fixation yield satisfactory clinical outcomes. However, pinning fixation, which requires open reduction, results in poor bone union. From the standpoint of bone union, plate fixation is recommended after open reduction. <b>Level of Evidence:</b> Level III (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"243-250"},"PeriodicalIF":0.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876567","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":"Repeated Measurements of Ultrasound Median Nerve Cross-Sectional Area Are Associated with Symptomatic and Functional Improvement after Carpal Tunnel Release.","authors":"Ryan T Lin, Shaquille Charles, Hannah Ong, Madalyn Kostyal, John R Fowler","doi":"10.1142/S2424835526500335","DOIUrl":"10.1142/S2424835526500335","url":null,"abstract":"<p><p><b>Background:</b> The potential for ultrasound (US) to be used as an objective measurement of improvement after carpal tunnel release is poorly understood. The purpose of this study is to evaluate whether measurements of US cross-sectional area (CSA) of the median nerve in the postoperative recovery period are associated with improvement of Boston Carpal Tunnel Questionnaire (BCTQ) scores for the Symptom Severity Scale (SSS) and Functional Severity Scale (FSS). <b>Methods:</b> A total of 167 wrists from 137 patients who underwent CTR with availability of US and BCTQ at 2-weeks, 6-weeks, 6-months and 1-year postoperatively were analysed. The primary outcome measurement was the ability to achieve the minimal clinically important difference (MCID) for relative changes in BCTQ. Regression analysis was performed using generalised estimating equations. Either Pearson correlation or Spearman correlation was used at each timepoint to determine the relationship between median nerve CSA and BCTQ scores. <b>Results:</b> Median nerve CSA was found to be significantly associated with achieving MCID cutoff values for SSS (<i>p</i> = 0.002) and FSS (<i>p</i> = 0.041). In men, a postoperative CSA of <10 mm² was associated with improvements in both FSS and SSS. In women, a postoperative CSA of <10 mm² was associated with improvements in SSS and a postoperative CSA of <8 mm² was associated with improvements in FSS. The Spearman correlation coefficient was significant between median nerve CSA and SSS scores at the 2-week and 6-week follow-up timepoints. <b>Conclusions:</b> Measurements of US median nerve CSA in the postoperative setting can provide an objective measure and are independently associated with BCTQ score improvement that achieves MCID. US measurements at the 2-week postoperative timepoint are most correlated with symptomatic patient-reported outcome measures. Thus, in carpal tunnel release patients with poor early outcomes, US may help rule out persistent CTS and guide further treatment or diagnosis. <b>Level of Evidence:</b> Level III (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"298-308"},"PeriodicalIF":0.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876577","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":"Anatomy of the Fingertip.","authors":"","doi":"10.1142/S2424835526970052","DOIUrl":"10.1142/S2424835526970052","url":null,"abstract":"","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"348"},"PeriodicalIF":0.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044358","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":"What Is the Best Surgical Treatment for Ulnar Styloid Impaction Syndrome? - A Systematic Review.","authors":"Mauro Maniglio, Andreas Weber, Christina Wanivenhaus, Pietro DI Summa, Lisa Reissner, Andreas Schweizer","doi":"10.1142/S2424835526500311","DOIUrl":"10.1142/S2424835526500311","url":null,"abstract":"<p><p><b>Background:</b> Ulnar styloid triquetrum impaction syndrome (USTI) is a rare cause of ulnar-sided wrist pain resulting from a mechanical conflict between an elongated ulnar styloid and the carpal bones. Despite various surgical options, there is no consensus on the optimal treatment. This study aims to systematically review and synthesise the available literature on the surgical treatment of USTI, focussing on clinical presentation, surgical techniques, outcomes and complications. <b>Methods:</b> A systematic review was conducted in accordance with PRISMA guidelines. Four databases (PubMed, Medline, Embase and Ovid) were searched for publications through May 2025 using terms related to USTI. Inclusion criteria were studies in English, French or German reporting surgically treated cases in adult patients. Outcomes assessed included pain, range of motion, grip strength, patient-reported outcome measures (PROMS) and patient satisfaction. Study quality was rated using OCEBM Levels of Evidence. <b>Results:</b> Twelve studies (two cohort, five case series and five case reports) were included. The majority were retrospective and of low methodological quality (Level 4 or 5). Surgical techniques included partial ulnar styloid resection (<i>n</i> = 8), complete resection (<i>n</i> = 2) and osteotomies (<i>n</i> = 2), with variable approaches to triangular fibrocartilage complex (TFCC) management. Postoperative outcomes generally showed pain relief, although data on range of motion, grip strength and PROMS were inconsistently reported. Complication rates were generally low, and patient satisfaction was high (when recorded). <b>Conclusions:</b> Surgical treatment of USTI yields good clinical outcomes in selected patients; however, the literature is limited by methodological weaknesses and heterogeneity in surgical technique and outcome reporting. Prospective studies with standardised measures are needed to optimise management strategies. <b>Level of Evidence:</b> Level III (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"259-267"},"PeriodicalIF":0.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876590","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":"Irreducible Volar Subluxation of the Distal Interphalangeal Joint: An Unrecognised Cause.","authors":"Koji Takamoto, Takayoshi Ono, Yutaka Morizaki, Takashi Ohe","doi":"10.1142/S2424835526720057","DOIUrl":"10.1142/S2424835526720057","url":null,"abstract":"<p><p>This report describes a rare case of irreducible closed volar subluxation of the distal interphalangeal (DIP) joint of the small finger following a sports injury. Closed reduction failed, leading to open surgery, which revealed ulnar condyle entrapment between a partially torn extensor tendon and volarly displaced oblique retinacular ligament (ORL). Flexing the proximal interphalangeal (PIP) joint to 90° while extending the DIP joint relaxed the ORL, enabling dorsal repositioning and successful reduction. Awareness of this mechanism may help hand surgeons achieve effective reduction. <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"337-341"},"PeriodicalIF":0.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312424","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":"Carpal Tunnel Syndrome Caused by Parosteal Lipoma of Carpal Bones: A Case Report.","authors":"Asuka Takeishi, Meisei Takeishi, Shuji Kayano, Hajime Matsumura","doi":"10.1142/S2424835526720045","DOIUrl":"10.1142/S2424835526720045","url":null,"abstract":"<p><p>The aetiology of carpal tunnel syndrome is often idiopathic, and it is seldom caused by a space-occupying lesion. Herein, we report our experience with a case of parosteal lipoma causing carpal tunnel syndrome. A 66-year-old woman with a history of hyperthyroidism and hypertension presented with numbness and pain on the ulnar side of the left index finger without any triggers. A positive Tinel sign in the left carpal tunnel and presence of a space-occupying lesion with fat concentration extending from the carpal tunnel to the central subcutaneous palmar region on computed tomography led to the diagnosis of carpal tunnel syndrome due to lipoma. Subsequently, carpal tunnel release, tumour resection and median nerve dissection were performed. At 1 year and 3 months postoperatively, the disease course was good, without recurrence or sensory disturbance. Although rare, carpal tunnel syndrome may be caused by a space-occupying parosteal lipoma. <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"332-336"},"PeriodicalIF":0.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312237","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":"Risk Factors That Cause Delayed Union after Surgery for Acute Scaphoid Fracture.","authors":"So Kawakita, Kiyohito Naito, Takamaru Suzuki, Norizumi Imazu, Kenjiro Kawamura, Muneaki Ishijima","doi":"10.1142/S2424835526500268","DOIUrl":"10.1142/S2424835526500268","url":null,"abstract":"<p><p><b>Background:</b> It is important to prevent delayed union after surgical treatment for acute scaphoid fractures; however, risk factors remain to be elucidated. We investigated the risk factors for delayed union in cases of scaphoid fractures with surgical treatment at our hospital. <b>Methods:</b> We enrolled 29 patients with scaphoid fracture who underwent percutaneous screw fixation at Juntendo University Hospital between January 2015 and February 2024. Patients were divided into a U group consisting of those who achieved bone union at 6 months after surgery, and a D group consisting of those who had delayed union. The evaluation items were: age, smoking, occupation, fracture type (Herbert classification, Schernberg classification), duration from injury to surgery, displacement measurement preoperative intrascaphoid angle (ISA), postoperative ISA, preoperative scapholunate angle (SLA) and postoperative SLA. <b>Results:</b> Delayed union was observed in eight cases. Bivariate analysis showed that duration from injury to surgery, displacement measurement, preoperative ISA and preoperative SLA were significantly associated with delayed union (<i>p</i> = 0.002, <i>p</i> = 0.006, <i>p</i> < 0.001 and <i>p</i> = 0.008, respectively). Furthermore, we found a significant positive correlation between preoperative ISA and the duration from injury to surgery, and between preoperative ISA and preoperative SLA. <b>Conclusions:</b> Delayed union was associated with duration from injury to surgery, humpback deformity and instability between the scaphoid and lunate. While the factors were statistically correlated, both are important clinical considerations for surgeons. <b>Level of Evidence:</b> Level III (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"268-272"},"PeriodicalIF":0.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312422","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":"Targeted Muscle Reinnervation in the Hand for the Management of Symptomatic Neuroma Following Digit and Hand Amputations - A Case Series.","authors":"Mohamed Magdy Ahmed Fouad, Ayman Ibrahim Fathy Aly Howeidy, Ramy Ahmed Diab, Amr Moustafa Mohamed Aly, Ramy Ahmed Aly Soliman, Ahmed Naeem Atiyya","doi":"10.1142/S242483552650027X","DOIUrl":"10.1142/S242483552650027X","url":null,"abstract":"<p><p><b>Background:</b> Targeted muscle reinnervation (TMR) is an emerging surgical technique that reroutes severed peripheral nerves to nearby motor targets to prevent symptomatic neuroma formation and reduce amputation-related pain. This case series evaluates the effectiveness of TMR in managing symptomatic neuromas following digit and hand amputations and reports postoperative outcomes and complications. <b>Methods:</b> Seventeen patients with traumatic or surgical digit/hand amputations distal to the wrist crease presenting with symptomatic neuromas were prospectively enrolled between August 2021 and August 2023. Patients underwent either primary TMR at the time of amputation or secondary TMR following neuroma formation. Surgical technique involved microsurgical coaptation of transected sensory nerves to adjacent motor entry points under loupe or microscopic magnification. Outcomes assessed included operative time, pain recurrence, phantom limb pain (PLP), narcotic usage and upper limb function measured by the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. <b>Results:</b> Primary TMR was performed in 13 patients and secondary TMR in 4 patients. The mean operative time was approximately 90 minutes. All nerve transfers maintained a sensory-to-motor diameter ratio of less than 2:1. Postoperative neuroma-related pain occurred in only one patient due to a slipped suture, which was successfully revised. PLP was reported in three patients, resolving within 2 months in all cases. Narcotic and neuromodulator medication use was required transiently in three patients, with complete cessation achieved by 2 months postoperatively. The mean DASH score was 21 ± 8, indicating mild overall disability and good overall hand function. <b>Conclusions:</b> TMR demonstrates significant promise as an effective intervention to reduce symptomatic neuroma formation and associated pain following digit and hand amputation. Successful implementation requires detailed knowledge of hand microsurgical anatomy and expertise in nerve coaptation techniques. Further studies with larger cohorts and longer follow-up are warranted to validate these findings and optimise patient selection. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"309-318"},"PeriodicalIF":0.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312387","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":"IFSSH Newsletter.","authors":"","doi":"10.1142/S2424835526100028","DOIUrl":"10.1142/S2424835526100028","url":null,"abstract":"","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"345-347"},"PeriodicalIF":0.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876560","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":"Scaphoid Fractures: How to Treat Symptomatic Patients with a Normal X-Ray and When Should We Operate on Acute Fractures?","authors":"Lucy C Walker, Jonathan L Hobby","doi":"10.1142/S2424835526300021","DOIUrl":"10.1142/S2424835526300021","url":null,"abstract":"<p><p>The scaphoid is the most injured carpal bone, with an incidence of 12 per 100,000 per annum in the United Kingdom (UK). Fractures of the scaphoid can be challenging to diagnose, both clinically and radiographically, and have a propensity to fail to unite or develop necrosis. There is debate regarding whether to manage acute fractures conservatively or offer early surgical fixation. The poor predictive value of initial examination and plain imaging not only results in missed fractures but also, conversely, in a fivefold overtreatment, which has subsequent significant socioeconomic consequences. It is estimated that between 1995 and 2010, claims relating to the mismanagement of scaphoid fractures cost the National Health Service in the UK £3.5 million. This review will focus on two main controversies in the diagnosis and treatment of scaphoid fractures: how to manage a symptomatic patient with a negative X-ray and which fractures warrant acute surgical fixation? <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"129-136"},"PeriodicalIF":0.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312400","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}