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

{"title":"Treatment Patterns and Disparities in Thumb Collateral Ligament Surgery: A 10-Year New York State Analysis.","authors":"Joseph Saleh, Michelle A Richardson, Matthew T Kingery, Charles C Lin, Utkarsh Anil, Matthew V Abola","doi":"10.1142/S2424835526500177","DOIUrl":"10.1142/S2424835526500177","url":null,"abstract":"<p><p><b>Background:</b> Thumb metacarpophalangeal (MCP) collateral ligament injuries are common and can be debilitating, with prolonged recovery and functional limitation of the injured hand. The aim of this study is to identify potential demographic differences between patients treated operatively and nonoperatively and identify trends in the surgical management of thumb MCP ligament injuries in New York (NY) State. <b>Methods:</b> Using the Statewide Planning and Research Cooperative System (SPARCS) database and relevant diagnosis codes, 18,171 patients diagnosed from 2010 through 2020 in NY State were identified. Demographic information, including age, sex, race and insurance type, was collected. Comparisons between the operative and nonoperative groups were performed using <i>t</i>-tests or Chi-squared tests as appropriate. The change in percentage of injuries treated operatively, as well as the effects of age, sex, race and insurance type on odds of undergoing surgery, were evaluated using linear regression analysis. Statistical significance was set at <i>p</i> < 0.05. <b>Results:</b> From 2010 to 2020, there were 18,230 collateral ligament injuries. The percentage of injuries treated operatively increased over the study period, with a minimum of 25.7% in 2011 and a maximum of 35.8% in 2017. Compared to patients with Medicaid insurance, patients were significantly more likely to be treated surgically if they had private insurance (OR = 4.15, 95% CI [3.64, 4.75], <i>p</i> < 0.001), worker's compensation (OR = 5.28, 95% CI [4.50, 6.20], <i>p</i> < 0.001) or Medicare (OR = 2.73, 95% CI [2.28, 3.26], <i>p</i> < 0.001). Black and Hispanic patients were less likely to undergo operative management than white patients (OR = 0.52, 95% CI [0.47, 0.58] and OR = 0.45, 95% CI [0.40, 0.51], <i>p</i> < 0.001). <b>Conclusions:</b> Demographic factors, including private insurance, workers' compensation and race, appeared to impact the likelihood of undergoing surgical management. Clinicians must be cognisant of potential demographic biases when making treatment decisions. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"175-181"},"PeriodicalIF":0.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500666","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 and Tendon Transfers for Upper Extremity Reconstruction in Spinal Cord Injury Patients: A Systematic Review.","authors":"Ramin Shekouhi, Hassan Darabi, Xizhao Chen, Kuan-I Lee, Maryam Sohooli, Harel G Schwartzberg, Mark A Maier, Harvey Chim","doi":"10.1142/S2424835526500232","DOIUrl":"10.1142/S2424835526500232","url":null,"abstract":"<p><p><b>Background:</b> Spinal cord injury (SCI) often results in upper extremity paralysis, significantly limiting independence and quality of life. Surgical interventions, including nerve and tendon transfers, offer the potential to restore critical functions such as hand grasp and elbow extension. However, the utilisation of these techniques remains limited despite promising outcomes. As such, this study aimed to systematically review the literature on the clinical outcomes of nerve and tendon transfers for upper extremity reconstruction in patients with cervical SCI. <b>Methods:</b> A systematic search was conducted in PubMed/Medline, Scopus, Embase and Web of Science following PRISMA guidelines. Studies reporting quantitative outcomes following nerve or tendon transfer in SCI patients were included. Risk of bias was assessed using the Newcastle-Ottawa Scale, and descriptive synthesis was performed due to heterogeneity. <b>Results:</b> Thirty studies met the inclusion criteria: 15 focussed on nerve transfers (208 patients, 319 limbs) and 15 on tendon transfers (360 patients, 447 limbs). The most common nerve transfers were brachialis to the anterior interosseous nerve (AIN) and supinator to the posterior interosseous nerve (PIN). Tendon transfers most frequently included extensor carpi radialis longus (ECRL) to flexor digitorum profundus (FDP) and brachioradialis (BR) to flexor pollicis longus (FPL). Both techniques demonstrated significant functional gains, with nerve transfers associated with more natural biomechanics and tendon transfers with greater strength. Early rehabilitation appeared to enhance outcomes. <b>Conclusions:</b> Both nerve and tendon transfer techniques can substantially improve upper limb function in patients with cervical SCI. <b>Level of Evidence:</b> Level III (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"202-216"},"PeriodicalIF":0.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312381","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":"Outcomes of Static External Fixation in Delayed Presentations of Dorsal PIPJ Subluxation.","authors":"Srinivasan Rajappa, Venu Babu","doi":"10.1142/S2424835526500165","DOIUrl":"10.1142/S2424835526500165","url":null,"abstract":"<p><p><b>Background:</b> Neglected dorsal subluxation of the proximal interphalangeal joint (PIPJ) results in significant compromise of hand function. Operations like volar plate arthroplasty, hemihamate arthroplasty and joint fusions have been described to treat them. However, all are open procedures and technically demanding. Dynamic external fixation has been used as a treatment for acute injuries. There is a paucity of literature on the use of static external fixation in the treatment of neglected PIPJ fracture subluxations. We describe the outcomes of the use of static external fixation followed by splinting and therapy for this injury. <b>Methods:</b> Six adults who had chronic dorsal subluxations of the PIPJ with a minimum chronicity of 5 weeks from the injury were included in the study. All of them underwent application of joint-spanning external fixation followed by acute single-step intraoperative distraction. The apparatus was removed at 5 weeks, followed by splinting and therapy. Outcomes recorded were pain scores, total active motion (TAM) and Quick DASH score. <b>Results:</b> The mean age of patients was 30 years. The mean time from injury to surgery was 4.2 months. The mean preoperative VAS was 3.66, and the postoperative VAS was 1.83. The mean TAM improved from 131.6° to 253°. The mean Q-DASH score was 6.41. <b>Conclusions:</b> Static PIPJ distraction using an external fixator followed by splinting and therapy gives good results in neglected dorsal PIPJ fracture subluxations. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"190-195"},"PeriodicalIF":0.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500691","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":"Ultrasound-Guided Percutaneous Fractional Tendon Lengthening for an Isolated FDS Contracture: A Case Report.","authors":"Ian Jason Magtoto","doi":"10.1142/S2424835526970039","DOIUrl":"10.1142/S2424835526970039","url":null,"abstract":"<p><p>Fractional tendon lengthening (FTL) is a technique to release certain contractures of various musculotendinous units of the upper and lower limb. It is traditionally done as an open procedure in the operating room under varying types of anaesthesia. A 19-year-old female with an isolated middle finger flexor digitorum superficialis (FDS) contracture who underwent ultrasound-guided percutaneous FTL under wide awake local anaesthesia, without a tourniquet, is presented. This alternative FTL technique allows for a percutaneous approach, which can be done in the clinic under local anaesthesia with possibly comparable outcomes to the standard open approach. <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"237-241"},"PeriodicalIF":0.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500693","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":"Reference Values for Normal Wrist Parameters in the Thai Population.","authors":"Sirisak Chaitantipongse, Sutee Thaveepunsan, Sitthiphong Suwannaphisit, Theephop Teeragananan","doi":"10.1142/S2424835526500037","DOIUrl":"10.1142/S2424835526500037","url":null,"abstract":"<p><p><b>Background:</b> Radiological wrist parameters are used to evaluate the treatment of distal radius fractures. Accurately restoring the distal radius is essential for good functional outcomes, but the reference values used for the Thai population are based on Western databases. This study aims to determine the reference values for normal wrist parameters in the Thai population. <b>Methods:</b> Two orthopaedic hand surgeons analysed 200 posteroanterior (PA) and lateral wrist radiographs, measuring radial height, radial inclination, ulnar variance and volar tilt using the central reference point (CRP) as a reference, with comparisons between sex and wrist side. Interobserver reliability was assessed using the intraclass correlation coefficient (ICC). <b>Results:</b> The mean values of wrist parameters were as follows: radial height, 10.7 ± 1.3 mm; radial inclination, 22.8° ± 2.4°; ulnar variance, -0.2 ± 1.2 mm and volar tilt, 13.5° ± 3.0°. All parameters had significant sex-based differences, with higher radial height in males and higher radial inclination, ulnar variance and volar tilt in females. No significant differences were found between the wrist sides. The interobserver reliability was excellent for radial inclination (ICC = 0.92) and ulnar variance (ICC = 0.93) and good for radial height (ICC = 0.90) and volar tilt (ICC = 0.79). <b>Conclusions:</b> Reference values were established for normal wrist parameters in the Thai population, with notable sex-based differences. The values are comparable to Western references except for volar tilt, which is higher in Thais. These findings can be applied in the treatment of distal radius fractures, the design of implants and the development of research or artificial intelligence databases. <b>Level of Evidence:</b> Level IV (Diagnostic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"20-27"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936154","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":"Considerations in Rerouting Extensor Pollicis Longus.","authors":"Praveen Bhardwaj","doi":"10.1142/S2424835526010010","DOIUrl":"10.1142/S2424835526010010","url":null,"abstract":"","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"123-125"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114935","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":"Efforts Towards Enhancing the Peripheral Nerve Regeneration: Current Update.","authors":"Hiroyuki Tanaka, Toru Iwahashi, Kunihiro Oka","doi":"10.1142/S242483552630001X","DOIUrl":"10.1142/S242483552630001X","url":null,"abstract":"<p><p>Peripheral nerve injuries remain a significant clinical challenge due to suboptimal functional recovery, even with surgical intervention. This article critically reviews current adjunctive strategies aimed at enhancing outcomes after peripheral nerve repair. The modalities discussed include electrical stimulation, erythropoietin, tacrolimus, methylcobalamin, gene therapy and stem cell-based interventions. For each modality, we examine proposed mechanisms of action, quality of evidence and translational relevance. Special attention is given to differentiating findings from animal models and their applicability to clinical practice. Rather than highlighting speculative biological mechanisms, this review focusses on evaluating the clinical utility and limitations of each approach to guide evidence-based therapeutic decisions. <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"1-6"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936071","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 Effect of Mental Illness on Reoperation Rates and Follow-Up after Surgical Fixation of Distal Radius Fractures.","authors":"Maximilian A Meyer, Stijn D Nelen, Kyra Benavent, R Marijn Houwert, Falco Hietbrink, Dafang Zhang","doi":"10.1142/S2424835526500025","DOIUrl":"10.1142/S2424835526500025","url":null,"abstract":"<p><p><b>Background:</b> This study aimed to assess whether the presence of psychiatric co-morbidity impacts reoperation rates or the ability to complete routine follow-up after open reduction and internal fixation (ORIF) of distal radius fractures. <b>Methods:</b> A retrospective cohort study was performed of all patients who underwent distal radius ORIF with a volar locking plate between January 2012 and December 2016 at two Level I trauma centres. Presence of a psychiatric diagnosis at the time of injury was recorded. Bivariate analysis was utilised to compare patient characteristics, injury characteristics, reoperation rates and length of follow-up between those with and without psychiatric co-morbidity. Multivariable regression analysis was performed to identify whether psychiatric co-morbidity was predictive of reoperation or the ability to complete routine post-operative follow-up. <b>Results:</b> A total of 1,071 patients sustaining 1,110 distal radius fractures (39 bilateral injuries) met the inclusion criteria, of whom 338 patients (30.5%) had a psychiatric diagnosis at the time of injury. Bivariate analysis revealed a higher proportion of females in the psychiatric co-morbidity cohort (79% vs. 66%). There was no difference in reoperation rates (18% vs. 13%, <i>p</i> = 0.10) nor length of follow-up (12.8 months vs. 14.3 months, <i>p</i> = 0.67) between the psychiatric co-morbidity and control cohorts. Multivariable logistic regression revealed that the presence of psychiatric co-morbidity did not independently predict reoperation rate nor length of follow-up. <b>Conclusions:</b> The presence of psychiatric co-morbidity does not affect post-operative follow-up or need for revision surgery after distal radius ORIF. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"13-19"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936089","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 Effect of Psychosocial Factors on Nonoperatively and Operatively Treated Adult Distal Radius Fractures.","authors":"Daniel Y Hong, S Dillon Powell, Bryanna K Geiger, Alaka Gorur, Robert J Strauch","doi":"10.1142/S2424835526500013","DOIUrl":"10.1142/S2424835526500013","url":null,"abstract":"<p><p><b>Background:</b> Psychosocial factors may play a role in the management of distal radius fractures (DRF). The purpose of this study was to explore how psychiatric history and socioeconomic status affect access to care, patient-reported outcomes (PROs) and complications after adult DRF. <b>Methods:</b> A retrospective cohort study of adult patients from 2005 to 2015 with a DRF was conducted. PROs were collected via DASH and VAS questionnaires. Socioeconomic status was inferred through insurance status and Area Deprivation Index (ADI) based upon the patient's ZIP code of residence. Complications and reoperations were collected. Statistical analysis consisted of generalised estimating equations (GEE) with a logistic link to account for repeated measures of individual subjects. <b>Results:</b> A total of 316 patients were studied. Psychiatric history was associated with increased time from injury to first clinic visit with a hand surgeon by a mean of 3.3 days, while time to surgery was increased with higher ADI percentile by a mean of 0.08 days per ADI percentile. Psychiatric history and higher ADI percentiles were associated with higher DASH scores by a mean of 8.9 points and 0.22 points per ADI percentile, respectively. VAS scores and complication or reoperation rates were not statistically affected by psychiatric history, insurance or ADI. <b>Conclusions:</b> Patients with a psychiatric history or those residing in a more socioeconomically disadvantaged neighbourhood have increased time to follow-up and surgery as well as worse DASH scores following DRF. <b>Level of Evidence:</b> Level III (Diagnostic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"7-12"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936077","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":"Clinical Applications of Autologous Fat Grafting in Pathological Hand Conditions.","authors":"Arjuna Thakker, Navid Mohamadzade, Jabez Gnany, Aniketh Venkataram, Mohamed Abdelrahman","doi":"10.1142/S2424835526500098","DOIUrl":"10.1142/S2424835526500098","url":null,"abstract":"<p><p><b>Background:</b> Autologous fat grafting (AFG) is increasingly explored beyond cosmetic applications, with interest in its regenerative potential for hand conditions such as cutaneous systemic sclerosis, thumb base osteoarthritis, Dupuytren contracture, burn scars, trauma and congenital hand deformities. This systematic review evaluates the therapeutic efficacy, techniques and outcomes associated with AFG across pathological hand conditions. <b>Methods:</b> A systematic literature search was conducted in July 2023 using PubMed, Ovid MEDLINE, Embase and Web of Science. Studies were included if they involved autologous fat or stromal vascular fraction (SVF) grafting for therapeutic purposes in hand conditions. Risk of bias (RoB) was assessed using RoB 2.0 for randomised controlled trials (RCTs) and the MINORS tool for non-RCTs. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed throughout. <b>Results:</b> Twenty-five studies were included (8 RCTs, 17 non-RCTs), involving a total of 909 patients. Conditions studied included systemic sclerosis (<i>n</i> = 7 studies), thumb base osteoarthritis (<i>n</i> = 7), Dupuytren contracture (<i>n</i> = 6), burn-related scars (<i>n</i> = 2), hand trauma (<i>n</i> = 2) and congenital deformities (<i>n</i> = 2). AFG was most consistently associated with improvements in pain (visual analogue scale [VAS]), joint mobility (range of motion) and functional scores such as the Cochin Hand Function Scale (CHFS), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Michigan Hand Questionnaire (MHQ), particularly in systemic sclerosis and thumb base osteoarthritis. Findings in Dupuytren's contracture were mixed, with observational studies reporting early improvements but RCTs showing higher recurrence rates. Outcomes for burn scars, trauma and congenital deformities were less consistent. Techniques for fat harvesting, processing and injection varied widely. <b>Conclusions:</b> AFG shows therapeutic potential across several hand conditions, with the strongest current evidence supporting its use in systemic sclerosis and thumb base osteoarthritis. However, significant methodological heterogeneity and limited high-level evidence remain. Further robust, standardised RCTs are needed to clarify indications, optimise techniques and assess long-term outcomes. <b>Level of Evidence:</b> Level III (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"72-80"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936084","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}