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

{"title":"Teaching and Practicing Congenital Hand Surgery in Cambodia - Lessons Learnt.","authors":"Wee L Lam","doi":"10.1142/S2424835524300056","DOIUrl":"10.1142/S2424835524300056","url":null,"abstract":"<p><p>The global burden of surgical conditions is becoming increasingly prevalent in the developing world. Hand surgery, in particular congenital hand surgery, presents with its own challenges, particularly the unique skill sets needed, multidisciplinary nature and heterogeneity of cases. The aim of this review article is to present our experience of practising congenital hand surgery in Cambodia, and to explore the feasibility of teaching this specialty in developing countries within a meaningful and sustainable framework. Since 2013, a group of hand surgeons and therapists have visited the Children Surgical Centre in Cambodia. A community-oriented curriculum was developed following the initial visits, with analysis of data and local surgeon's skill sets. These were further refined using the Pareto analysis and selected competency procedures to develop entrustable professional activities (EPAs). Common paediatric hand cases were identified and taught to the local surgeons. Essential elements of this model include the need for measurable outcomes, clear curriculum goals, long-term partnerships and information technology support.</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"492-499"},"PeriodicalIF":0.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631910","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":"Ten Steps for a Successful Hand Surgery Mission Trip - Experiences from Supporting Paediatric Hand in Vietnam and Honduras.","authors":"Takehiko Takagi, Phi Duong Nguyen, Fraser J Leversedge","doi":"10.1142/S2424835524300081","DOIUrl":"10.1142/S2424835524300081","url":null,"abstract":"<p><p>Domestic and global access to surgical care for paediatric hand and upper limb conditions is challenged by limited resources, increasing direct and indirect costs of care and a growing number of patients who require specialty care. There are numerous barriers for patients from developing countries to receiving medical care in Japan due to the substantial costs, which include travel, uninsured medical expenses and fees imposed by intermediaries. To address this issue, I realised that I needed to take a more direct approach - by travelling to these countries, not only to provide treatment, but also to teach and train local doctors. By emphasising on the education of local clinicians through the sharing of knowledge and skills, it is possible to expand the timely access to paediatric hand surgery and improve outcomes for children in need. Our mission is rooted in the belief that every nation holds its own unique treasures - its culture, food, beauty and joy - that are worth celebrating and preserving. By fostering sustainable relationships built on mutual respect and understanding, we can make a greater impact; engagement with local surgeons will ultimately elevate the level of care that they can provide in their own communities, through improving core competencies of medical knowledge, technical/surgical skills and resource allocation for simple and complex conditions. This work not only reflects my personal commitment, but also my focus on expanding our team of fellows and strengthening organisational support. We aim to actively pursue these efforts throughout Asia, fostering cross-cultural collaboration and, ultimately, helping to heal the hands and futures of children worldwide. The aim of this review article is to share with readers how we started our mission trips to Vietnam and highlight 10 steps that I feel are critical to a successful mission trip.</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"500-507"},"PeriodicalIF":0.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631927","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":"Comparative Study of Trapeziectomy with Weilby Suspensionplasty versus Implant Arthroplasty for Thumb Carpometacarpal Joint Arthritis in an Asian Population.","authors":"Tuan Hao Tan, Hui Ying Gavrielle Kang","doi":"10.1142/S2424835524500401","DOIUrl":"10.1142/S2424835524500401","url":null,"abstract":"<p><p><b>Background:</b> This retrospective study compares the outcomes of trapeziectomy and Weilby suspensionplasty procedure versus implant arthroplasty using the TOUCH^® prosthesis for basilar thumb arthritis in an Asian population. <b>Methods:</b> A total of 15 consecutive thumbs in 13 patients were included in this study. Six patients (2 male, 4 female, mean age of 62 years old) underwent trapeziectomy and Weilby suspensionplasty procedure. Seven patients (4 male, 3 female, mean age 63 years old) underwent implant CMCJ arthroplasty using the TOUCH^® prosthesis. Data collected include demographics, severity of arthritis on plain radiographs of the thumb basilar joint, length of follow-up, pre- and postoperative pain levels, Kapandji thumb opposition score, grip and pinch strength and the time taken to return to work. <b>Results:</b> Patients in the trapeziectomy and Weilby suspensionplasty group had a mean follow-up of 4.5 months, while those in the TOUCH^® implant arthroplasty group had a mean follow-up of 14 months. TOUCH^® implant arthroplasty patients showed significantly higher grip strengths at 3 months post-surgery and a shorter return to work. There were no differences in pinch strength at 3 months, pinch or grip strength at 6 months or pain scores. Complications included prolonged scar hypersensitivity in two patients who underwent the Weilby suspensionplasty and a dislocated TOUCH^® implant cup in one patient. <b>Conclusions:</b> Our study suggests that in the short term, CMCJ implant arthroplasty with the TOUCH^® prosthesis produces results comparable to trapeziectomy and Weilby suspensionplasty. <b>Level of Evidence:</b> Level III (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"429-440"},"PeriodicalIF":0.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Surgical Approach to a Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament Injury without Dividing the Adductor Aponeurosis.","authors":"Yannick Goubau, Romy Balcaen, Wim Vanhove","doi":"10.1142/S242483552471005X","DOIUrl":"10.1142/S242483552471005X","url":null,"abstract":"<p><p>An injury to the ulnar collateral ligament (UCL) of the metacarpophalangeal joint (MCPJ) of the thumb is a common injury, widely referred to as a skier's thumb. The rupture usually occurs at the distal insertion. In the classical technique, the adductor aponeurosis is divided to access the torn UCL and the MCPJ and repaired after ligament repair/reinsertion. We describe a surgical approach to the UCL that does not require division of the adductor aponeurosis. <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"477-480"},"PeriodicalIF":0.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114637","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":"Epidemiology of High-Energy Distal Radius Fractures.","authors":"Janice Chin-Yi Liao, Amaris Lim, David Meng-Kiat Tan, Alphonsus Khin-Sze Chong","doi":"10.1142/S2424835524500395","DOIUrl":"10.1142/S2424835524500395","url":null,"abstract":"<p><p><b>Background:</b> High-energy distal radius fractures have not been as well studied as the more common osteoporotic fractures. Differences between these two groups of fractures have implications on the prevention and clinical management of such injuries. <b>Methods:</b> A retrospective review was conducted of all patients in our institution who presented with distal radius fractures within the period of a year. Demographic data, injury mechanism, fracture classification, associated injuries and work-related status were obtained and analysed. <b>Results:</b> High energy fractures made up 27.1% of the cases. Falls from height were the most common cause, followed by motor vehicle accidents. These high-energy fractures were more commonly seen in males, younger patients (average age 41 vs. 61 years), and in workplace accidents. These injuries were also more likely to be bilateral and associated with an additional ipsilateral upper extremity injury. The high-energy group was also more likely to have an AO type B fracture. <b>Conclusions:</b> A substantial proportion of distal radius fractures seen in our population are high-energy injuries. Their contrasting patient and injury profiles suggest that they should be considered separately from osteoporotic fractures. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"424-428"},"PeriodicalIF":0.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114644","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":"Adherence to Non-operative Clinical Quality Measures in Carpal Tunnel Syndrome.","authors":"Julia A Cook, Meghan N Cichocki, Yanlin Tong, Lu Wang, Kevin C Chung","doi":"10.1142/S2424835524500371","DOIUrl":"10.1142/S2424835524500371","url":null,"abstract":"<p><p><b>Background:</b> Clinical quality measures exist for non-operative management of carpal tunnel syndrome (CTS). Factors predicting adherence are unclear. <b>Methods:</b> A retrospective cohort study of patients with chronic CTS using MarketScan Research Database (2015-2020) was conducted. Six logistic regression models were designed to study adherence to quality measures within 1 year after diagnosis. <b>Results:</b> Of 782,717 patients identified, 514,073 (65.7%) were female with an average (SD) age of 51.4 (13.4) years. Only 88 patients (0.01%) met all quality measures. Greatest compliance observed with receipt of nerve conduction study (NCS; 283,959 [36.3%]), no prescription of medications (336,297 [43.0%]) and no laser therapy (772,979 [98.8%]); 294,305 patients (37.6%) received hand surgeon referral. Hand surgeon referral predicted higher likelihood of NCS and splinting (OR, 1.83; 95% CI: 1.81-1.84; OR, 2.53; 95% CI: 2.50-2.56) and medication over-prescription (OR, 1.05; 95% CI: 1.00-1.10). Females were more likely to be referred to a hand surgeon and be referred for splinting (OR 1.02; 95% CI: 1.01-1.03; OR 1.19; 95% CI: 1.18-1.21) but less likely to have no prescriptions or avoid laser therapy (OR 0.85, 95% CI: 0.84-0.85; OR 0.82, 95% CI: 0.79-0.86). Medicare recipients adhered less to quality measures compared to patients with fee-for-service insurance. As comorbidities increased, patients were less likely to receive hand surgeon referral and carpal tunnel release. <b>Conclusions:</b> Findings suggest that hand surgery referrals increased adherence to quality measures. Females, Medicare recipients and multimorbid patients should be targeted for improved care. Future quality care efforts should incentivise adherence for Medicare beneficiaries and improve guideline recognition amongst physicians. <b>Level of Evidence:</b> Level III (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"408-417"},"PeriodicalIF":0.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114639","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":"Dual Mobility Trapeziometacarpal Joint Arthroplasty: A Survey on Variations in Surgical Techniques and Patient Management.","authors":"Agata Durdzińska Timóteo, Kunal Kulkarni, Nina Fee Knie, Mahdi Siala, Johan VAN DER Stok","doi":"10.1142/S2424835524500413","DOIUrl":"10.1142/S2424835524500413","url":null,"abstract":"<p><p><b>Background:</b> Dual mobility total joint arthroplasty is gaining popularity for trapeziometacarpal joint (TMCJ) arthritis, with evolving indications, surgical technique and rehabilitation. The aim of this study was to obtain detailed insight into the variations in indications, surgical technique and rehabilitation for TMCJ arthroplasty with dual mobility implants, across a large international cohort of surgeons. The secondary aim was to analyse if there were differences in TMCJ arthroplasty between highly and less experienced surgeons. <b>Methods:</b> An anonymised online survey was developed and distributed to the international hand surgery community of surgeons performing TMCJ arthroplasty. Responses were summarised, and a sub-analysis comparing indications, contra-indications, surgical technique, implant placement, rehabilitation and complications between highly and less experienced surgeons was performed. <b>Results:</b> Of the 203 included respondents, 59 were considered highly experienced. Most respondents perform TMCJ arthroplasty under regional anaesthesia (84%), via a dorsolateral approach (78%) and with image-guidance for cup placement (84%). However, there is considerable variation in handling of scaphotrapeziotrapezoidal (STT) arthritis, cup positioning landmarks, postoperative immobilisation, first extensor compartment release and revision techniques. Highly experienced surgeons performed TMCJ arthroplasty for a larger proportion of their patients undergoing surgery for TMCJ arthritis, and a trapezium smaller than 8 mm or STT-OA was less frequently considered a contra-indication. Highly experienced surgeons preferred freehand osteotomy of the metacarpal and allowed office workers to return to work earlier. <b>Conclusions:</b> This survey shows that there is considerable variation in (contra)indications, surgical technique and rehabilitation amongst surgeons performing TMCJ arthroplasty, but only a few differences between highly and less experienced surgeons were identified. This data provides a reference for surgeons who want to familiarise themselves with increasingly popular procedure and may help surgeons already performing TMCJ arthroplasty to identify potential topics for future research to optimise its outcome. <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"441-448"},"PeriodicalIF":0.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114642","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":"Predictors of Radial Head Dislocation in Patients with Multiple Hereditary Exostoses.","authors":"Kosuke Shintani, Chinatsu Ohira, Yuma Onishi, Ryo Hosomi, Keisuke Nakagawa, Kiyohito Takamatsu","doi":"10.1142/S242483552450036X","DOIUrl":"10.1142/S242483552450036X","url":null,"abstract":"<p><p><b>Background:</b> Radial head dislocation in patients with multiple hereditary exostoses (MHE) is associated with loss of function and cosmetic problems. The treatment of the deformity with radial head dislocation is difficult and the timing of surgical intervention is important. The aim of this study was to evaluate the factors predictive of radial head dislocation in patients with MHE. <b>Methods:</b> Patients diagnosed with forearm deformity due to MHE between 1995 and 2021 were retrospectively evaluated. Radiographic parameters including radial bow (RB), ulnar bow (UB), total radial bow (TRB), total ulnar bow (TUB), percent ulnar length (PUL), ulnar shortening (US), radial articular angle (RAA), modified Masada classification and irregularity of proximal radioulnar joint (PRUJ) of the dislocated group (group D), that is subluxation or dislocation of the radial head, and the located group (group L) were compared. <b>Results:</b> A total of 18 patients and 25 limbs (5 girls and 13 boys) with a mean age of 10.5 years were included. There were significant differences in TUB (22.8° ± 5.6° vs. 10.7° ± 6.5°), PUL (97.5% ± 5.5% vs. 108.2% ± 7.7%) between group D and group L (<i>p</i> < 0.05). Moreover, irregularity of PRUJ on radiographs was more in group D (<i>p</i> < 0.05). <b>Conclusions:</b> It is possible that appropriate radiographic assessment in relation to radial head dislocation may prevent delayed surgical treatment of forearm deformities in MHE. <b>Level of Evidence:</b> Level IV (Diagnostic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"392-396"},"PeriodicalIF":0.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114646","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":"Validation of the Chicken Femur as a Model for the Human Metacarpal: An In-Vitro Analysis.","authors":"Abhirup Lobo, David Ackland, Dale Robinson, Stephen K Y Tham","doi":"10.1142/S2424835524500383","DOIUrl":"10.1142/S2424835524500383","url":null,"abstract":"<p><p><b>Background:</b> The aim of this study was to evaluate the chicken femur as a laboratory model for the human metacarpal by comparing the bone microarchitecture and mechanical properties of chicken femurs to human cadaveric metacarpals. <b>Methods:</b> Sixteen fresh chicken femora and 20 fresh frozen cadaveric human metacarpals were imaged using a micro computed tomography scanner. The bones were then mechanically tested using four-point-bending and torsional testing. <b>Results:</b> There were no significant differences in macroscopic features between chicken femora and human metacarpals, including overall length, external radius, internal radius, cortical width and cross-sectional area of the diaphyseal cortex (<i>p</i> > 0.05). There were no significant differences in the trabecular number and spacing in the distal metaphysis of both groups (<i>p</i> > 0.05). The diaphysis and proximal metaphysis did not share any microarchitectural similarities. Four-point bending tests resulted in significantly higher yield forces, ultimate force, failure points and stiffness in human metacarpals (<i>p</i> < 0.05). Torsion tests resulted in significant higher ultimate torque and torsional rigidity in human metacarpals (<i>p</i> < 0.05). <b>Conclusions:</b> The chicken femur has structural and biomechanical differences to the fresh frozen human metacarpal despite the similarity in their macroscopic features.</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"418-423"},"PeriodicalIF":0.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114649","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":"Postoperative Radiographic Outcomes Following Abduction-Extension Metacarpal Osteotomy: A Comparison between Early and Advanced Carpometacarpal Arthritis.","authors":"Ken Shirakawa","doi":"10.1142/S2424835524500437","DOIUrl":"10.1142/S2424835524500437","url":null,"abstract":"<p><p><b>Background:</b> This study aimed to investigate the effect of thumb metacarpal osteotomy on dorsal subluxation of the carpometacarpal (CMC) joint and compare the effects of early and advanced osteoarthritis (OA). <b>Methods:</b> We retrospectively reviewed 42 thumbs of 37 patients who underwent metacarpal osteotomy with a postoperative extension angle of 90° or more between January 2018 and October 2021 and were followed up for more than 2 years. The thumbs were classified into two groups: early OA (Eaton stage I or II) and advanced OA (Eaton stage III). We measured the reduction ratio, which was defined as the ratio of improvement in dorsal subluxation, at 3 months and 1 year postoperatively, and at the latest follow-up. We statistically compared the reduction ratio between the two groups and investigated the factors affecting the reduction ratio using correlation analysis. <b>Results:</b> The reduction ratio was significantly higher in the early OA group than in the advanced OA group at 3 months after surgery, whereas no significant difference was found between the two groups at 1 year after surgery and at the latest follow-up. A significant positive correlation was detected between the reduction ratio and the postoperative extension angle. <b>Conclusions:</b> First metacarpal osteotomy reduces dorsal subluxation in both early- and advanced-stage CMC OA. This procedure yields immediate marked reduction in early-stage OA, while improvement of the subluxation progressed gradually in advanced-stage OA. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"449-457"},"PeriodicalIF":0.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074534","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}