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

{"title":"Biomechanical Evaluation of a Novel Six Strands, Non-locking Flexor Tendon Repair Technique.","authors":"Bin Shahri Naufal, Fang Li, Jie Rei Wee, Jiayi Li, Yoke-Rung Wong","doi":"10.1142/S242483552650013X","DOIUrl":"10.1142/S242483552650013X","url":null,"abstract":"<p><p><b>Background:</b> We designed a new non-locking six-strand suture technique (Li-Wee) as an evolution of our previous work. The aim of this study is to biomechanically compare repairs using this technique with FiberWire^® 4-0 versus Prolene^® 4-0. <b>Methods:</b> Thirty porcine flexor tendons were harvested for the experiments. A transverse cut was made in the middle of the tendons to allow for tendon repair. Repairs were made equally by using the Li-Wee technique with FiberWire^® 4-0 and Prolene^® 4-0. The ultimate tensile strength (UTS), load to 2 mm gap force, stiffness and repair times were measured under static testing. Furthermore, cyclic testing was performed on five specimens with the circumferential epitendinous suture from each repair group to evaluate their gap formation under cyclic loadings and final UTS. <b>Results:</b> The mean UTS of repairs using FiberWire^® was 81.3 ± 10.3 N while repairs done with Prolene^® was 66.7 ± 8.3 N under static testing, and 98.7 ± 4.9 N for repairs using FiberWire^® and 68.3 ± 10.4 N for repairs using Prolene^® under cyclic testing. Comparing FiberWire^® and Prolene^® repairs, the load to 2 mm gap force was 37.6 ± 8.4 N and 31.0 ± 10.9 N; stiffness was 6.5 ± 0.9 N/m and 8.1 ± 1.0 N/m; repair times were 466 ± 45 s and 465 ± 62 s, respectively. A statistically significant difference was found between groups for UTS under both static and cyclic testing, as well as stiffness. <b>Conclusions:</b> This study has shown that six-strand non-locking Li-Wee flexor tendon repair using FiberWire^® offers satisfactory repair strength, adequate stiffness and 2 mm gap force.</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"107-112"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936078","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":"Trapeziectomy versus Total Joint Arthroplasty: A Comparison of Health Utility Outcomes Collected by the UK Hand Registry.","authors":"George J M Hourston, Will N Matthews, Rumina Begum, Adrian J Chojnowski","doi":"10.1142/S2424835526500062","DOIUrl":"10.1142/S2424835526500062","url":null,"abstract":"<p><p><b>Background:</b> We aimed to evaluate the difference in health utility outcome measures between trapeziectomy and total joint arthroplasty (TJA) in the surgical management of basal thumb osteoarthritis (BTOA). <b>Methods:</b> Data obtained from the UK Hand Registry for all trapeziectomies (± ligament reconstruction and tendon interposition) and total joint arthroplasties for BTOA, including patient-reported outcome measures (PROMs) EQ5D and PEM part 2 scores, at baseline, 3 months, 6 months, 1 year and 2 years postoperatively. EQ5D scores were converted to index values, and PEM part 2 scores were calculated to allow comparison with baseline scores and to generate delta values at each time point. Mann-Whitney <i>U</i> tests were used to determine statistical differences. <b>Results:</b> A total of 948 procedures identified (710 trapeziectomy; 238 TJA), 76% female. More PROMs were collected for trapeziectomy patients at all timepoints (267 EQ5D and 262 PEM-2 at baseline; 27 EQ5D and 26 PEM-2 at 2 years) than for TJA patients (98 EQ5D and 111 PEM-2 at baseline; 8 EQ5D and 18 PEM-2 at 2 years). PEM-2 was significantly improved in the TJA group at 3 months (<i>p</i> = 0.047) and 6 months (<i>p</i> = 0.012); there was no significant difference at subsequent follow-up (1 year, <i>p</i> = 0.611; 2 years, <i>p</i> = 0.438). There was no significant difference in EQ5D identified between trapeziectomy and TJA at any time point (3 months, <i>p</i> = 0.056; 6 months, <i>p</i> = 0.059; 1 year, <i>p</i> = 0.222; 2 years, <i>p</i> = 0.250). <b>Conclusions:</b> TJA appears to offer a faster return of hand function, as measured by PEM-2, when compared with trapeziectomy, though this clinical improvement is not sustained beyond 6 months from this registry data. We identified no significant difference in EQ5D between the two procedures at any time point, though both groups improved from baseline. Greater engagement with the UKHR from surgeons and patients might help to reduce attrition and improve longer-term outcomes reporting. <b>Level of Evidence:</b> Level III (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"49-55"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936083","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":"Autologous Fat Grafting for Trapeziometacarpal Joint Osteoarthritis: A Systematic Review of Effectiveness and Outcomes.","authors":"Lin Oo, Samson Turner, Bryan Lim, Roberto Cuomo, Ishith Seth, Warren M Rozen","doi":"10.1142/S2424835526500050","DOIUrl":"10.1142/S2424835526500050","url":null,"abstract":"<p><p><b>Background:</b> Carpometacarpal-1 joint osteoarthritis (CMC-1 OA) is a common degenerative hand condition that significantly impairs hand function and quality of life, with autologous fat grafting (AFG) emerging as a promising treatment option. This study aims to conduct a systematic review of the outcomes of the use of AFG for CMC-1 OA. <b>Methods:</b> A comprehensive literature search was conducted across various databases. Ten relevant studies were identified, analysed and assessed for risk of bias (ROB) using the Cochrane Systematic Review RCT ROB assessment tool, Evidence Project ROB tool and the Joanna Briggs Institute Critical Appraisal Checklist. <b>Results:</b> The review included one RCT, two prospective comparative studies, four prospective non-comparator studies and three case series. Post-AFG, pain decreased by an average of 4.5 points on the visual analogue scale. Patient-reported outcomes improved by 60% in Arm, Shoulder and Hand Disability scores. Pinch grip and grip strength results varied, with only two studies showing significant improvements. Patient satisfaction was high: 83% would recommend the treatment, and 73% would undergo it again. Surgical revision rates fluctuated, peaking at 38.7% over 5 years. <b>Conclusions:</b> AFG shows promise as a lasting treatment for CMC-1 OA, providing significant pain relief and improved hand function. However, more studies on objective outcomes are necessary to establish its efficacy. <b>Level of Evidence:</b> Level III (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"38-48"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936064","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":"First Metacarpal Extension Osteotomy by Use of a New Anatomical Shamoji Plate for Base of Thumb Arthritis: Short-Term Results.","authors":"Keiichi Muramatsu, Ian Jason Magtoto, Genuino Karissa A Flores, Masaya Ueda, Yo Morita","doi":"10.1142/S2424835526500086","DOIUrl":"10.1142/S2424835526500086","url":null,"abstract":"<p><p><b>Background:</b> The first metacarpal extension osteotomy (FMEO) is an effective surgical procedure for thumb carpometacarpal (CMC) arthritis, but a dedicated fixation implant was not yet available. The Shamoji plate is a newly developed anatomical locking implant for FMEO. We report the short-term postoperative results of FMEO using the Shamoji plate in patients with early to moderate stage of CMC arthritis of the thumb. <b>Methods:</b> We reviewed 17 thumbs in 17 patients who underwent FMEO using the Shamoji plate. At the initial time of diagnosis, all cases were classified as Eaton stage 2 of CMC joint arthritis. The postoperative follow-up period ranged from 5 to 18 months, with an average of 10.1 months. An L-sized Shamoji plate (30 mm, six locking screws and one cortical screw) with a 30° bend was used most. Postoperatively, active range-of-motion exercises started the following day after surgery. Clinical outcomes and realignment of CMC joint on plain radiograph and computed tomography were evaluated. <b>Results:</b> An average operation time was 52 minutes. Plain radiographs showed early bone union in all patients with an average time of 3.3 months. Visual analogue scale, tip pinch strength and Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score were significantly improved postoperatively. The flexion angle of the metacarpophalangeal joint decreased approximately 10°. The metacarpals were dorsally realigned 23°-25° after FMEO. The dorsal subluxation angle and % subluxation were significantly improved, indicating a significant improvement in malalignment of the CMC joint. <b>Conclusions:</b> The Shamoji plate is a sufficient internal fixation implant with good short-term results in terms of osteotomy angle, bone healing, pain relief, functional recovery and realignment of the CMC joint. FMEO by use of Shamoji plate is expected to provide reliable clinical outcomes for patients with the CMC joint arthritis in Eaton stage 2. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"65-71"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936100","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":"Role of Alpha-Lipoic Acid as a Co-adjuvant Treatment with Surgical Decompression of Carpal Tunnel Syndrome: A Retrospective Study.","authors":"Sergi Barrera-Ochoa, Jose Antonio Prieto-Meré, Ester Mora, Julio Adrían Martinez-Garza, Gerardo Méndez, Gustavo Sosa","doi":"10.1142/S2424835526500104","DOIUrl":"10.1142/S2424835526500104","url":null,"abstract":"<p><p><b>Introduction:</b> Surgical decompression remains the gold standard for managing severe carpal tunnel syndrome (CTS). However, perioperative pain and incomplete symptom resolution persist in some patients. Alpha-lipoic acid (ALA), a neuroprotective antioxidant, has shown potential benefits in neuropathic conditions. This retrospective study evaluates the clinical and electrophysiological effects of ALA as an adjunctive therapy in CTS management. <b>Methods:</b> We retrospectively analysed 164 patients with electrodiagnostically confirmed CTS who underwent open surgical decompression. Patients were divided into three groups: Group A (surgery only), Group B (surgery plus postoperative ALA) and Group C (pre- and postoperative ALA). Outcomes were assessed using the visual analogue scale (VAS), Boston Carpal Tunnel Questionnaire (BCTQ), analgesic consumption and nerve conduction studies, with follow-up at 6 weeks, 6 months and 12 months. <b>Results:</b> ALA-treated patients showed statistically significant improvements in VAS scores, BCTQ subscales and analgesic consumption compared to controls. Only the group receiving both pre- and postoperative ALA achieved clinically meaningful improvements, exceeding the established MCID thresholds for both symptom severity (0.76 points) and functional status (0.32 points). Electrophysiological parameters, such as motor conduction velocity, also improved more in ALA-treated groups. <b>Conclusions:</b> Adjunctive use of ALA in CTS surgery was associated with statistically significant, yet clinically modest, improvements in pain, function and electrophysiology. These findings support further investigation of ALA as a low-risk, potentially beneficial coadjuvant in CTS treatment protocols. <b>Level of Evidence:</b> Level III (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"81-89"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936092","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 Novel Palmar Approach for Arthroplasty of the Distal Interphalangeal Joint.","authors":"Takeyasu Toyama, Yoshitaka Minamikawa, Yoshitaka Hamada, Takanori Saito","doi":"10.1142/S2424835526970027","DOIUrl":"10.1142/S2424835526970027","url":null,"abstract":"<p><p>Degenerative changes of the distal interphalangeal (DIP) joint are often managed surgically with arthrodesis or silicone implant arthroplasty when conservative treatments fail. Conventional approaches for silicone implant arthroplasty require division of the extensor tendon, leading to prolonged immobilisation and potential extension lag. We introduce a novel palmar flexor tendon splitting approach. This approach allows silicone implant arthroplasty while preserving the extensor mechanism, eliminating the need for post-surgical immobilisation and permitting early range of motion exercise. We performed silicone implant arthroplasty using this approach on 16 fingers in 12 patients and followed up for more than 3 months. There was no flexor tendon rupture or nerve injury, and the mean DIP range of motion was 28.3°, with an extension lag of 11°. Postoperative wound healing was excellent in this approach, with no delayed healing or maceration. This approach is simple and eliminates postoperative immobilisation and has the potential to reduce extension lag. <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"118-122"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936104","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 Second and Third Carpometacarpal Joint Instability in Elite Boxers.","authors":"Yuzuru Iijima, Koichi Kusunose","doi":"10.1142/S2424835526500074","DOIUrl":"10.1142/S2424835526500074","url":null,"abstract":"<p><p><b>Background:</b> Instability of the second and third carpometacarpal joints (CMCJs) is a rare disorder. This study aimed to present treatment outcomes of CMCJ instability in elite boxers. <b>Methods:</b> Combat-sport athletes with second and third CMCJ instability treated at our hospital between 2011 and 2023 were included. Diagnosis and severity were assessed using lateral stress radiographs (Iijima-Kusunose [IK] classification). Treatment was based on the IK classification. Patients requiring surgery underwent arthrodesis using a single headless compression screw. Data collected included age, sex, symptom duration, type and level of sport, hand involved, number of CMCJs involved, IK grade, treatment type and follow-up period. The lead and rear hands were defined by boxing stance, independent of hand dominance. Outcome measures were pain (visual analogue score [VAS]), postoperative stability and complications. <b>Results:</b> Twenty athletes (19 male, 1 female; mean age: 24.7 years) were included. All had unilateral injuries, involving the lead hand in 2 and the rear hand in 18. There were 5 patients with grade 1, 3 with grade 2 and 12 with grade 3. Seven were treated conservatively and 13 surgically. Mean symptom duration was 15.8 weeks in conservatively treated and 1.7 years in surgically treated patients. All returned to their pre-injury competition level and were pain-free without residual instability. The mean follow-up was 6.7 years (range: 1.8-11.7 years). Three surgical patients had complications (one screw fracture, one metacarpal base fracture and one loosening), all resolving without sequelae. <b>Conclusions:</b> The IK classification-based strategy and a simplified single-screw arthrodesis provide an effective framework for diagnosing and treating CMCJ instability in elite combat-sport athletes. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"56-64"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936157","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":"Upper Limb Amputations in End-Stage Renal Failure Patients: A Single Institution's Prospective Cohort Study on Risk Factors and Survival Analysis.","authors":"Zhi Xuan Low, Ethel Shu Mei Chow, Dawn Sinn Yii Chia","doi":"10.1142/S2424835526500128","DOIUrl":"10.1142/S2424835526500128","url":null,"abstract":"<p><p><b>Background:</b> Patients with end-stage renal failure (ESRF) are prone to vascular complications that may result in limb ischaemia and gangrene. While lower limb amputation (LLA) outcomes in this population are well-documented, data on upper limb involvement remain limited. This study aimed to characterise the types of hand conditions leading to hand specialist referrals amongst ESRF patients, identify risk factors associated with upper limb amputation (ULA) and assess post-amputation survival outcomes. <b>Methods:</b> ESRF patients referred to a single hand surgery unit were recruited over 5 years. Data on demographics, comorbidities, referral diagnosis and treatment were obtained. Univariate analysis and Kaplan-Meier survival analysis were performed using STATA. <b>Results:</b> Of the 76 included patients, 50% were referred for infection and the rest for trauma, digit ischaemia and gout in decreasing order of incidence. A total of 22 patients, accounting for 29% of the cohort, required ULA. All but one patient (96%) underwent a ULA due to an infection. Significant risk factors identified are having an ipsilateral arteriovenous fistula (<i>p</i> = 0.024), peripheral neuropathy (<i>p</i> = 0.031), peripheral arterial disease (PAD; <i>p</i> = 0.00010), hyperlipidaemia (<i>p</i> = 0.013), the history of previous surgery for a soft tissue infection (<i>p</i> < 0.0001) and previous amputation in any limb (<i>p</i> = 0.013). Survival rates at 1, 2 and 5 years post-ULA were 82%, 59% and 14%, respectively. The time to mortality after index amputation was 2.42 years. <b>Conclusions:</b> Infections were the most common referral diagnosis and the primary indication for ULA in ESRF patients. Identified risk factors - including PAD, previous soft tissue infection, prior LLA and the presence of an ipsilateral AV fistula - put patients at increased risk for ULA. Post-amputation survival was poor, with high mortality within 5 years. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"98-106"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936131","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/S2424835526100016","DOIUrl":"https://doi.org/10.1142/S2424835526100016","url":null,"abstract":"","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":"31 1","pages":"126-128"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151236","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 New Arthroscopic One-Needle-One-Suture Repair Technique for Scapholunate Instability.","authors":"Chaoming Zhang, Rebecca Q R Lim, Lucian Lior Marcovici, Bo Liu","doi":"10.1142/S2424835526970015","DOIUrl":"10.1142/S2424835526970015","url":null,"abstract":"<p><p>Scapholunate instability (SLI) is the most frequent cause of carpal instability. There is a plethora of repair methods with a trend towards minimally invasive techniques, with the general principles aimed at restoring the integrity of the ligament and physiological carpal kinematics. We introduce a novel, all-arthroscopic one-needle-one-suture repair technique as a potential repair technique for SLI. Utilising a single 0 FiberWire suture threaded through an 18-gauge (18-G) needle, this technique allows for precise suture placement within the scapholunate ligament complex. The suture is secured with an arthroscopic gliding knot. This method reduces the need for multiple punctures and complex suture manoeuvres, thereby streamlining the surgical procedure and providing a simpler, minimally invasive alternative for certain patients with SLI. <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"113-117"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935962","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}