Hand Surgery & Rehabilitation最新文献

{"title":"Five-to-8-year prospective follow-up of 61 Touch® trapeziometacarpal prostheses","authors":"Cyril Falaise,&nbsp;Sandrine Boulat","doi":"10.1016/j.hansur.2025.102167","DOIUrl":"10.1016/j.hansur.2025.102167","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to evaluate the clinical and radiologic outcomes of the first patients who received a dual-mobility trapeziometacarpal prosthesis in our centre, for first carpometacarpal joint osteoarthritis, with a minimum 5-year follow-up.</div></div><div><h3>Patients and methods</h3><div>Fifty-seven patients received a total trapeziometacarpal ball-and-socket arthroplasty with the Touch® prosthesis for severe arthritis and one for significant laxity. Four patients underwent bilateral surgery. One was lost of follow-up and three died during the study. Function was assessed before surgery and at one, 3, 5 and 10-years follow-up visits. Visual analog scale for pain, active thumb range of motion, including Kapandji’s score, key-pinch grip strength and patients’ satisfaction outcomes were recorded by an independent observer. Standardized radiographs were obtained to assess osteolysis, loosening, and subsidence.</div></div><div><h3>Results</h3><div>Patients were followed for an average of 6.5 years (5–8.8). Pain decreased from 7.3 to 0.4, range of motion increased, and key grip strength improved from 67% to 102% of the contralateral side. Metacarpophalangeal hyperextension was present in 26 thumbs (46%) before surgery (5 severe, more than 30°), and in 19 thumbs (33%) at follow-up. Z-deformity was reported in 13 cases (23%) preoperatively and in 2 cases (4%) postoperatively. At maximum follow-up, radiographs showed minor osteolysis in 4 cases (7%) around the trapezium component and in 7 cases (12%) around the metacarpal component. One revision (2%) was required for cup loosening 7 years after surgery. All patients were satisfied or very satisfied with the treatment.</div></div><div><h3>Conclusions</h3><div>This prospective study of 61 Touch® dual mobility prostheses confirms that this implant is a safe and effective treatment option for trapeziometacarpal osteoarthritis in the short and medium term. Continued follow-up is necessary to assess the long-term outcomes of this arthroplasty.</div></div><div><h3>Level of evidence</h3><div>II.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 3","pages":"Article 102167"},"PeriodicalIF":0.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided trigger finger release with a minimally invasive knife: A retrospective analysis of 297 releases","authors":"Michiel Cromheecke ,&nbsp;Sebastiaan Bogaert ,&nbsp;Mathieu Dejonghe ,&nbsp;Pieter-Bastiaan De Keyzer ,&nbsp;Olivier Mares ,&nbsp;Jean Goubau ,&nbsp;Jean-Michel Cognet","doi":"10.1016/j.hansur.2025.102081","DOIUrl":"10.1016/j.hansur.2025.102081","url":null,"abstract":"<div><div>Trigger finger, or stenosing tenovaginitis, is a common condition characterized by impaired flexor tendon sliding due to thickening of the A1 pulley. While open surgical release remains the gold standard for the treatment of persistent trigger finger, there is increasing interest in minimally invasive ultrasound-guided techniques to improve precision and outcomes.</div><div>The purpose of this study is to evaluate the outcomes, safety, and complications associated with ultrasound-guided trigger finger release using a minimally invasive surgical knife.</div><div>We performed a retrospective analysis of 297 trigger finger releases performed on 238 patients between April 2021 and December 2023. All procedures were performed on the long fingers, excluding the thumb, using ultrasound guidance under WALANT or regional anesthesia. Patients were evaluated at 6 weeks and 3 months postoperatively for symptom resolution, complications, and functional recovery.</div><div>The procedure achieved a 100% success rate for complete release of the A1 pulley with no major complications or iatrogenic damage such as tendon or neurovascular injury. Minor complications, such as temporary postoperative loss of motion or localized pain, occurred in 33 cases (11.1%) and all resolved with conservative management by the three-month follow-up. Importantly, only one procedure required conversion to open surgery due to intraoperative uncertainty, where full release was confirmed.</div><div>Ultrasound-guided minimally invasive trigger finger release is a safe and effective technique. It provides precise release with a low risk of complications or iatrogenic damage. As ultrasound technology advances and availability increases, this technique has the potential to become a reliable and patient-friendly alternative to classic open methods.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 ","pages":"Article 102081"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"De Quervain’s disease: Ultrasound-guided release","authors":"Francisco Javier Ferreira Villanova ,&nbsp;Vincent Martinel ,&nbsp;Olivier Marès","doi":"10.1016/j.hansur.2025.102087","DOIUrl":"10.1016/j.hansur.2025.102087","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to evaluate the outcomes of a novel antegrade, ultrasound-guided release of the first extensor tendon compartment for treating De Quervain’s disease.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, single-center study of 34 patients who underwent ultrasound-guided release of the first extensor compartment for clinically diagnosed De Quervain’s disease between June 2022 and December 2023. Inclusion criteria included age &gt;18 years and failure of conservative treatment (e.g., NSAIDs, physiotherapy, and steroid injection) for more than six weeks. Exclusion criteria were prior trigger thumb surgery and documented allergy to local anesthetics. Outcomes were assessed using pain intensity (visual analog scale, VAS), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores, and complication rates.</div></div><div><h3>Results</h3><div>The mean VAS for pain improved from 7.4 to 1.1, and the QuickDASH score improved from 55 to 9.4 at the final follow-up. We recorded three minor complications and no major complications.</div></div><div><h3>Conclusion</h3><div>Ultrasound-guided surgical release of the first extensor compartment for De Quervain’s disease is a minimally invasive, technologically advanced, and effective treatment option.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 ","pages":"Article 102087"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radial nerve at Frohse's arcade: a new technique of release under total ultrasound guidance. First experience","authors":"Olivier Marès ,&nbsp;Javier Ferreira ,&nbsp;Sarah Pradel ,&nbsp;Vincent Martinel ,&nbsp;Camillo Chaves ,&nbsp;Thomas Apard","doi":"10.1016/j.hansur.2025.102089","DOIUrl":"10.1016/j.hansur.2025.102089","url":null,"abstract":"<div><div>Radial nerve compression at the arcade of Frohse is a rare but significant condition that typically presents with pain primarily after exertion and at night on the dorsal side of the forearm, more distally than tennis elbow pain, and weakness of the wrist extensors and the long fingers and thumb extensors. Traditional treatment often involves open surgery, resulting in significant scarring.</div><div>This study introduces a novel percutaneous radial nerve release technique under complete ultrasound guidance and highlights its efficacy and safety. The procedure involves identifying the entry point, lateral of the radial nerve, allowing for targeted release of the superficial fascia surrounding the supinator muscle without damaging nearby vascular or nerve structures.</div><div>A cadaveric study was performed on ten fresh-frozen specimens to validate the entry point and route, which successfully demonstrated complete fascial release without complications.</div><div>Preliminary clinical results from five patients showed complete resolution of symptoms associated with radial tunnel syndrome with no reported complications. The technique results in a significantly smaller incision (&lt;1 cm) compared to traditional methods (up to 10 cm) and can be performed under WALANT anesthesia, making it suitable for the outpatient setting.</div><div>This approach offers a minimally invasive alternative for patients with isolated posterior interosseous nerve compression and highlights the importance of ultrasound guidance in achieving optimal results. Because the technique requires a learning curve, it is recommended for surgeons with experience in ultrasound-guided procedures.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 ","pages":"Article 102089"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous ultrasound guided retrograde lacertus fibrosus release","authors":"Thomas Apard ,&nbsp;Vincent Martinel","doi":"10.1016/j.hansur.2025.102130","DOIUrl":"10.1016/j.hansur.2025.102130","url":null,"abstract":"<div><div>The purpose of this technical note is to present a microinvasive percutaneous ultrasound-guided release of the lacertus fibrosus of the biceps brachii for lacertus syndrome, i.e., median nerve entrapment at the elbow.</div><div>Using the Walant technique (wide awake local anesthesia and no tourniquet), the entry point is made with a 19G needle to introduce the hook distally from the distal border of the lacertus fibrosus. The hook is then slid along the pronator teres fascia to the proximal border of the lacertus fibrosus. The cut is ultrasound-guided from proximal to distal. The cut is effective when the back of the force is observed in the 3 targeted muscles (flexor carpi radialis, flexor pollicis longus and flexor digitorum profundus).</div><div>This minimally invasive surgical procedure is efficient in terms of lacertus fibrosus sectioning. Real-time ultrasound monitoring may improve safety. The technique could be considered as a new ultrasound-guided alternative to open surgery.</div><div>When performed superficially to the pronator teres muscle under WALANT anesthesia and percutaneously, ultrasound-guided lacertus fibrosus release may be an effective treatment for lacertus syndrome in the interventional ultrasound unit.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 ","pages":"Article 102130"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transverse ultrasound-guided fasciotomy in lateral epicondylitis","authors":"Vincent Martinel ,&nbsp;Franck Lapègue ,&nbsp;Aymeric Andre ,&nbsp;Olivier Marès","doi":"10.1016/j.hansur.2024.102075","DOIUrl":"10.1016/j.hansur.2024.102075","url":null,"abstract":"<div><div>Lateral epicondylitis is a very common form of tendinosis that may heal spontaneously. Diagnosis is mainly clinical. Treatment is usually non-operative. However, if conservative treatment fails, open or arthroscopic tenotomy of the epicondylar muscles may be an option. Ultrasound-guided percutaneous tenotomy may now be performed on the common epicondylar tendon close to the enthesis, with a success rate close to that of conventional surgery. For several years now, we have used a slightly different technique, involving ultrasound-guided fasciotomy of the extensor digitorum communis and extensor carpi radialis brevis muscles at the level of the radiohumeral joint. It may be performed under local anesthesia in the office. Ultrasound-guided hydro-dissection of the fascia is essential to facilitate the procedure and easily visualize the various anatomical structures. Fasciotomy can be performed with an ophthalmology scalpel, surgical knife or curved needle. This procedure is similar to arthroscopic techniques, but is significantly less expensive and with lower carbon footprint. It is safe and effective when a surgeon with experience in ultrasound-guided procedures performs it.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 ","pages":"Article 102075"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound guided Carpal tunnel release: The retrograde technique","authors":"Thomas Apard ,&nbsp;Jules Descamps ,&nbsp;Vincent Martinel","doi":"10.1016/j.hansur.2025.102132","DOIUrl":"10.1016/j.hansur.2025.102132","url":null,"abstract":"<div><div>Ultrasound-guided surgery is a new trend resulting from the introduction of high-frequency linear probes and higher-quality screens. Surgical treatment of carpal tunnel syndrome is increasingly being performed under ultrasound guidance. Knowledge of musculoskeletal ultrasound is, of course, essential. Several types of cutting instruments (miniature knife, Gigli saw or hook) and surgical approaches (wrist or palm) have been described. Ultrasonography allows the use of the wide awake and local anesthesia with no tourniquet (WALANT) technique in the outpatient setting. The purpose of this article is to report our experience with retrograde percutaneous ultrasound-guided techniques.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 ","pages":"Article 102132"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided radial nerve release for lateral intermuscular septum syndrome","authors":"Thomas Apard ,&nbsp;Vincent Martinel","doi":"10.1016/j.hansur.2025.102131","DOIUrl":"10.1016/j.hansur.2025.102131","url":null,"abstract":"<div><div>Radial nerve entrapment at the lateral intermuscular septum in the distal upper arm can cause debilitating pain and functional impairment. The nerve passes from the dorsal to the volar compartment through the LIS, approximately 8–10 cm proximal to the lateral epicondyle, making it susceptible to compression. Clinical signs include wrist drop, localized pain, and weakness in wrist and finger extension, often seen in manual laborers and athletes.</div><div>A minimally invasive, ultrasound-guided, percutaneous technique using local anesthesia and no tourniquet allows precise nerve decompression while preserving function. Hydrodissection under Doppler ultrasound ensures safety and avoids complications such as nerve palsy. This approach minimizes tissue disruption compared to traditional open decompression. Despite promising results, the technique remains under-researched, with no large-scale clinical trials available. Prospective studies with long-term follow-up are essential to establish the efficacy of this innovative, patient-centered technique.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 ","pages":"Article 102131"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided release of carpal tunnel syndrome — Anterograde technique","authors":"Carla Ricardo Nunes ,&nbsp;Olivier Marès ,&nbsp;Vincent Martinel","doi":"10.1016/j.hansur.2025.102091","DOIUrl":"10.1016/j.hansur.2025.102091","url":null,"abstract":"<div><div>Compression of the median nerve in the carpal tunnel is a frequent pathology with severe functional impact. An ultrasound-guided technique was developed to preserve structures, diminish scar fibrosis and enable fast return to full activity. Its advantages are safety and low additional cost.</div><div>Ultrasound-guided carpal tunnel release is indicated in moderate and severe carpal tunnel syndrome persisting after conservative treatment. A preoperative ultrasound scan is recommended to evaluate anatomy. Recurrent carpal tunnel syndrome, secondary carpal tunnel syndrome and anatomic variants compromising the safety of transverse carpal ligament division are contraindications.</div><div>The procedure is performed under local anesthesia without tourniquet. The entry point is a short transverse incision proximal to the wrist crease. The transverse carpal ligament is divided anterogradely, using a dedicated blade under ultrasound control, making sure no nerves, tendons or blood vessels are injured. The final step is to check that the division is complete. Early return to use of the hand is permitted.</div><div>Reports of similar techniques demonstrated early symptomatic relieve, favorable patient-reported outcome measures from within 1 week after surgery to 2 years’ follow-up, with early return to normal daily activity and work. The complications rate is low: many series showed no complications. Comparative studies between ultrasound-guided carpal tunnel release and the mini-open technique reported similar or greater and quicker symptom relief, less scar pain and better strength. Final functional results tend to be similar.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 ","pages":"Article 102091"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic exertional compartment syndrome in the forearm: Ultrasound-guided surgical technique","authors":"Jean Michel Cognet ,&nbsp;Jean Baptiste Facon ,&nbsp;Alexandre Faure ,&nbsp;Olivier Mares","doi":"10.1016/j.hansur.2025.102094","DOIUrl":"10.1016/j.hansur.2025.102094","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic exertional compartment syndrome of the forearm is most commonly associated with exercise. It presents as cramping after a few minutes of activity, requiring cessation of exercise. We describe an ultrasound-guided surgical technique for the treatment of forearm chronic exertional compartment syndrome.</div></div><div><h3>Anatomy and Pathophysiology</h3><div>The forearm consists of three compartments: the anterior, lateral, and dorsal compartments. These compartments are formed by the muscles of the forearm and are surrounded by a fibroelastic membrane composed of connective tissue. Repetitive activity in the forearm leads to an increase in muscle volume within a non-extensible compartment. This increase in pressure causes pain and cramping, forcing the individual to stop the activity. Diagnosis is based on measurement of intramuscular compartment pressures.</div></div><div><h3>Surgical Technique</h3><div>Surgical treatment involves performing a fasciotomy. This can be done through an incision along the length of the forearm or through a minimally invasive approach using endoscopic or ultrasound guidance. The ultrasound-guided technique uses two small entry points and a specialized knife. No post-operative immobilization is required, allowing patients to quickly resume their activities.</div></div><div><h3>Discussion</h3><div>Chronic exertional compartment syndrome of the forearm is a condition that is particularly common among motorcyclists. Diagnosis is based on a combination of a suggestive clinical presentation and pathological intramuscular pressure. Treatment may be conservative or surgical (fasciotomy). Fasciotomy can be performed using an open approach or a minimally invasive ultrasound-guided technique. Published studies on ultrasound-guided treatment report excellent results with a rapid return to sports activities after surgery.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 ","pages":"Article 102094"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}