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

{"title":"The Presence of Concomitant Thumb Hypoplasia in Pre-axial Polydactyly.","authors":"Soumen DAS DE","doi":"10.1142/S2424835524010033","DOIUrl":"10.1142/S2424835524010033","url":null,"abstract":"","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"601-602"},"PeriodicalIF":0.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717771","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":"Treatment of Pink Pulseless Hand Following Supracondylar Fractures of the Humerus in Children.","authors":"Man Duc Minh Phan, Quynh Nhu Tran, Nam Quang Dinh Vo, Kien Thanh Lam, Phi Duong Nguyen","doi":"10.1142/S2424835524500462","DOIUrl":"10.1142/S2424835524500462","url":null,"abstract":"<p><p><b>Background:</b> Supracondylar humerus fractures (SCHF) in children are common and can lead to serious complications, including neurovascular injury. The optimal management of children with a 'pink pulseless' hand following such a fracture is unclear. This study aimed to ascertain an appropriate therapeutic approach for children with SCHF and a pink pulseless hand. <b>Methods:</b> A retrospective analysis of medical records from paediatric patients under 16 years old with SCHF and clinically perfused but pulseless hands between 1 January 2016 and 30 June 2021 was conducted. Clinical characteristics, imaging, treatment processes and follow-up results were analysed to predict arterial injuries requiring vascular repair and determine the optimal timing for exploratory surgery. <b>Results:</b> The study included 88 patients, predominantly male (58%) with an average age of 6 years. Most fractures resulted from falls onto outstretched arms. Satisfactory outcomes, indicated by the return of the pulse following closed reduction and percutaneous pinning (CRPP) alone, were seen in 66% of patients, negating the necessity for vascular exploration. Amongst patients with a persistently absent radial pulse 72 hours after CRPP, 83% were diagnosed with brachial artery injuries, with all such patients experiencing recurrent pulse loss after surgery. <b>Conclusions:</b> Urgent reduction and CRPP are effective initial treatments for children with SCHF and a pink pulseless hand. Immediate vascular exploration is generally not necessary in these patients. Further research is needed to determine the optimal management for persistent pulselessness and recurrent pulse loss. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"554-560"},"PeriodicalIF":0.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631888","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 Treatment for Chronic Anterior Dislocation of the Radial Head.","authors":"Kee Jeong Bae, Hyun Sik Seok, Jae Min Lee, Ji Sup Hwang, Jihyeung Kim","doi":"10.1142/S2424835524500498","DOIUrl":"10.1142/S2424835524500498","url":null,"abstract":"<p><p><b>Background:</b> Surgical correction of chronic anterior dislocation of the radial head in paediatric patients is challenging, and they may experience re-dislocation or subluxation even after corrective surgery. We have been performing a radial shortening osteotomy combined with reconstruction of the annular and lateral collateral ligaments, and a corrective osteotomy of the ulna. The aim of this article is to describe our technique and outcomes at mid-term follow-up. <b>Methods:</b> This retrospective review included 10 paediatric patients with chronic anterior dislocation of the radial head that were surgically treated at our unit from January 2016 to July 2022. The dislocations were congenital in two patients, resulted from neglected Monteggia fractures in seven patients, and was idiopathic in one patient. The average age at surgery was 8.3 years. All patients underwent radial shortening osteotomy combined with reconstruction of the annular and lateral collateral ligaments, and a corrective osteotomy of the ulna. Outcomes with regards to period of follow-up, complications, arc of motion and the Kim elbow performance score were assessed. <b>Results:</b> The reduction of the radial head was maintained at the final follow-up (mean: 55 months). No acute or chronic complications occurred. The mean arc of flexion-extension improved from 124° to 140° while the arc of prono-supination decreased from 124° to 113°. The Kim elbow performance score was excellent in eight patients, fair in one and poor in one. <b>Conclusions:</b> A combination of radial shortening osteotomy, reconstruction of the annular and lateral collateral ligaments and corrective osteotomy of the ulna was able to maintain a stable reduction of the radial head with satisfactory elbow motion in the mid-term in paediatric patients with chronic anterior dislocation of the radial head regardless of the underlying cause. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"561-567"},"PeriodicalIF":0.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631709","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":"Developing a Congenital Upper Limb Difference Registry in Australia.","authors":"Daniel James Wilks, David B McCombe","doi":"10.1142/S2424835524300068","DOIUrl":"10.1142/S2424835524300068","url":null,"abstract":"<p><p>Clinical registries are increasingly common and have value in conditions such as congenital upper limb differences where collection of adequate data for scientific study can be challenging due to small numbers and clinical, surgical and psychosocial heterogeneity. This article discusses the motivation, purpose and development of the Australian Hand Differences Register before examining some of the challenges faced during its implementation and considering limitations of registry-derived data. <b>Level of Evidence:</b> Level V (Diagnostic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"486-491"},"PeriodicalIF":0.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689413","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":"Factors Affecting Appearance after Thumb Polydactyly Reconstruction - A Caregiver's Perspective in an Asian Population.","authors":"Min Kai Chang, Lauren Hui Ling Kwang, Ashley Hsi Yin Chua, Nicole Kim Luan Lee, Ee Ming Chew","doi":"10.1142/S2424835524500486","DOIUrl":"10.1142/S2424835524500486","url":null,"abstract":"<p><p><b>Background:</b> Current research on thumb polydactyly reconstruction focusses primarily on clinical evaluations. Details on aesthetic outcomes are relatively lacking. This study aims to address this gap by: (1) investigating the effectiveness of surgical treatment in achieving symmetrical thumb size, length and girth; (2) assessing aesthetic outcomes from a caregiver's perspective and (3) identifying key factors that influence aesthetic outcomes to inform strategies to improve surgical reconstruction. <b>Methods:</b> Patients who underwent thumb polydactyly reconstruction were recalled for assessment. Objective measurements of both the reconstructed and unaffected thumbs were taken. Surgical scars were evaluated by measuring their length and using the Vancouver Scar Scale (VSS). To assess the appearance of the reconstructed thumbs, we used the Visual Analogue Scale (VAS) through surveys completed by the primary caregiver of each patient. Caregivers also provided reasons for any unsatisfactory appearance outcomes and we correlated these with objective factors. <b>Results:</b> This study included 26 paediatric patients with 29 reconstructed thumbs. The mean VAS score for overall thumb appearance was 7.8 ± 2.2. While surgical treatment achieved symmetry in most anthropometric measures, reconstructed thumbs had smaller nail plates and greater joint angulation. Caregiver assessment of thumb width was closely related to the objective interphalangeal joint (IPJ) girth measurements, and perceived excessive angulation was related to the IPJ angle. Symmetry was not associated with nail fold width or scar location. However, perceived scar prominence was linked to VSS score and scar location. <b>Conclusions:</b> Thumb polydactyly reconstruction achieves symmetry in size, length and girth, but nail plate size and joint angulation remain significant challenges. Despite this, caregivers are generally satisfied with the overall appearance. Attention should be focussed on improving thumb IPJ girth, IPJ angulation and scar location to enhance overall aesthetic outcomes. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"568-578"},"PeriodicalIF":0.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631702","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 Application of a Cross-Shaped Advancement Flap in Polysyndactyly of the Fifth Toe.","authors":"Xiaofang Shen, Yu Chen, Guang Yang","doi":"10.1142/S2424835524970014","DOIUrl":"10.1142/S2424835524970014","url":null,"abstract":"<p><p>Polysyndactyly of the foot is a common congenital malformation of the lower extremity. We introduce our surgical technique for reconstruction of polysyndactyly of the fifth toe fused with the fourth toe. The technique includes the removal of the medial hypoplastic ray, web-space reconstruction using a dorsal cross-shaped advancement flap and closure of the lateral incisions of the separated toes with a tongue-shaped flap and zigzag triangular flaps. This technique is advantageous to prevent postoperative web creep, reduce the tension of the dorsal incision closure and it is relatively easy to grasp for the inexperienced surgeon. <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"589-593"},"PeriodicalIF":0.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689460","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":"Editorial.","authors":"Renita Sirisena, Soumen DAS DE","doi":"10.1142/S2424835524010045","DOIUrl":"10.1142/S2424835524010045","url":null,"abstract":"","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"485"},"PeriodicalIF":0.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717768","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":"Camptodactyly.","authors":"Takehiko Takagi","doi":"10.1142/S2424835524300032","DOIUrl":"10.1142/S2424835524300032","url":null,"abstract":"<p><p>Camptodactyly is a congenital difference with flexion contracture of the proximal interphalangeal (PIP) joint. Camptodactyly limited to one finger is believed to be due to an anomaly of the lumbrical muscle that inserts into the flexor digitorum superficialis (FDS) tendon instead of the extensor expansion, whereas multiple finger camptodactyly is believed to be a result of shortage of soft tissues on the flexor surface of the fingers. It is important to differentiate camptodactyly from other causes of extension lag at the PIP joint. It is difficult to obtain good results after the release of flexion contractures in camptodactyly. The main goal of surgery is to prevent progressive contracture with appropriate postoperative therapy using night splinting and stretching. We should strive for a considered approach based on a thorough understanding of the pathophysiology of camptodactyly. <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"547-553"},"PeriodicalIF":0.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631593","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 Considerations in the Management of Constriction Ring Syndrome.","authors":"S Raja Sabapathy, Monusha Mohan","doi":"10.1142/S2424835524300044","DOIUrl":"10.1142/S2424835524300044","url":null,"abstract":"<p><p>Surgical management of constriction ring syndrome (CRS) is individualised due to the heterogenic presentation of the condition. CRS includes constriction rings, acrosyndactyly, nubbins and short digits. Involvement of more than one limb is common and children often need multiple surgeries. Each limb may need staged surgeries. If the child has vascular or lymphatic compromise secondary to a constriction ring, the ring needs to be excised and released in the first few days of life. The rings are released using multiple big Z-plasties in one or two stages. Nerve palsy associated with the rings need early intervention. Tendon transfers may be advised when nerve procedures like neurolysis and nerve reconstruction fail. Acrosyndactyly can be corrected with separation of the fused fingertips. At times, the web is more distal than usual and requires web deepening using partial syndactyly separation techniques and may need full thickness skin grafting. Complex type of acrosyndactyly is difficult to treat as it needs proper planning and staged surgical correction to achieve a five-digit hand. Separation of the syndactyly with web deepening gives more functional length and independence to the digits. The short fingers, especially the thumb, need reconstruction. Non-vascularised toe phalangeal transfer or a microvascular toe transfer can reconstruct a missing digit. <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"537-546"},"PeriodicalIF":0.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631729","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":"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}