Hand Surgery & Rehabilitation最新文献

{"title":"Ultrasound-guided trigger thumb release","authors":"Francisco Javier Ferreira Villanova ,&nbsp;Vincent Martinel ,&nbsp;Olivier Marès","doi":"10.1016/j.hansur.2025.102084","DOIUrl":"10.1016/j.hansur.2025.102084","url":null,"abstract":"<div><div>The purpose of this study was to evaluate the results of a novel retrograde ultrasound-guided A1 pulley release technique for the treatment of trigger thumb.</div><div>We conducted a retrospective, single-center study of 42 patients who underwent ultrasound-guided A1 pulley release for clinically diagnosed trigger thumb between September 2022 and December 2023. All cases were graded according to the Green classification of trigger finger severity. Inclusion criteria were patients aged &gt;18 years who failed conservative treatment (non-steroidal anti-inflammatory drugs, physical therapy, or steroid injections) for at least six weeks. Exclusion criteria were previous trigger thumb surgery, metacarpophalangeal or trapeziometacarpal arthrodesis, and documented allergy to local anesthetics. Outcome measures were pain intensity (visual analog scale, VAS), Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) scores, and complication rates.</div><div>The mean age of the patients was 37.8 years (range: 27–72). Based on Green’s classification, we treated 5 grade I, 26 grade II, 6 grade IIIA, and 5 grade IIIB cases. At one month follow-up, all patients had resolution of the triggering. The mean VAS score improved significantly from 7.2 to 1.3 and the Quick-DASH score decreased from 51 to 9.1. There were no major complications.</div><div>Open A1 pulley release for trigger thumb is effective but carries risks to the palmar radial digital nerve, especially in open surgery. Alternative methods such as ultrasound-guided and percutaneous release offer similar results with fewer complications. Recovery is faster for trigger thumb (2 weeks) compared to trigger finger (5 weeks). Some patients may experience prolonged symptoms after surgery. Open surgery has a 12% complication rate and a 2.4% revision rate. Ultrasound-guided percutaneous release is safer and allows real-time visualization during the procedure.</div><div>Retrograde ultrasound-guided A1 pulley release is an effective and safe treatment for stenosing tenosynovitis of the flexor pollicis longus. It offers advantages over traditional approaches, including improved cosmetic outcomes, the absence of sutures, and the ability for patients to resume daily activities and light work immediately postoperatively.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 ","pages":"Article 102084"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018844","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":"Anterograde ultrasound guided lacertus fibrosus release at the elbow under WALANT – Technical note","authors":"Carla Ricardo Nunes ,&nbsp;Vincent Martinel ,&nbsp;Olivier Marès","doi":"10.1016/j.hansur.2025.102086","DOIUrl":"10.1016/j.hansur.2025.102086","url":null,"abstract":"<div><div>Dynamic compression of the median nerve under the lacertus fibrosus at the elbow causes pain and weakness. It is a frequently overlooked pathology and a cause of failed recovery after carpal tunnel release.</div><div>The purpose was to present a technical note on minimally invasive ultrasound-guided lacertus syndrome surgical treatment under WALANT.</div><div>We believe the technique is indicated in patients who present with a positive Hagert's triad of pain over the median nerve at the lacertus, weakness on testing of the flexor pollicis longus, second flexor digitorum profundus, and flexor carpi radialis, and a positive sensitive collapse test. Contraindications include static median nerve compression at the elbow and allergy to lidocaine.</div><div>The technique is preceded by local anesthesia, which is completed under ultrasound guidance for deeper or more proximal structures. The entry point is calculated proximal to the lacertus and the special knife is introduced through a 0.5 cm incision. The lacertus is divided anterogradely under ultrasound guidance. Full recovery of strength is evidenced by the completion of the division.</div><div>The patient returns to full activity within days to a week after surgery.</div><div>Minimally invasive, ultrasound-guided release allows for rapid return of full-strength motion with minimal scarring.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 ","pages":"Article 102086"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018447","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 percutaneous release of the ulnar nerve at the elbow","authors":"Olivier Marès ,&nbsp;Javier Ferreira ,&nbsp;Berenice Moutinot ,&nbsp;Vincent Martinel ,&nbsp;Pascal Kouyoumdjian ,&nbsp;Thomas Apard","doi":"10.1016/j.hansur.2024.102071","DOIUrl":"10.1016/j.hansur.2024.102071","url":null,"abstract":"<div><h3>Introduction</h3><div>Surgical treatment of ulnar tunnel syndrome is controversial, with no consensus on the ideal procedure. Nevertheless, in-situ decompression seems to provide faster recovery with less morbidity than neurolysis-transposition. The aim of this retrospective study was to validate a new percutaneous technique using ultrasonography.</div></div><div><h3>Methods</h3><div>A retrospective 2-center study included 40 patients with McGowan stage 1 or 2 ulnar nerve entrapment at the elbow treated by a new limited ultrasound-guided percutaneous technique. Patients with McGowan stage 3, osteoarthritis at the elbow or instability were excluded. The study endpoint was clinical success of the percutaneous technique using ultrasonography for release of ulnar nerve entrapment at the elbow. The secondary endpoint was time to recovery.</div></div><div><h3>Results</h3><div>All 40 patients showed clinical improvement, with the resolution of acroparesthesia symptoms. No recurrences were observed at 13 months’ follow-up. There were no cases of neurological complications, ulnar nerve instability or infection.</div><div>Patients were able to return to work rapidly, with an average absence of 3.5 weeks.</div></div><div><h3>Discussion</h3><div>Numerous studies questioned the value of ulnar nerve transposition associated with release in the early stages. No significant difference was found between in-situ decompression and transposition; however, more complications were observed in patients with transposition.</div></div><div><h3>Conclusion</h3><div>Overall, this new ultrasound-guided percutaneous technique for ulnar nerve entrapment was safe. It allowed rapid recovery with effective symptom relief while limiting the risk of complications and time off work.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 ","pages":"Article 102071"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904652","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":"Neurotization of the axillary nerve using a motor branch of the triceps brachii: Outcomes after a 3-to-15-year follow-up","authors":"Safire Ballet ,&nbsp;Thibault Druel ,&nbsp;Thomas Jalaguier ,&nbsp;Arthémon Heitz ,&nbsp;Victor Rutka ,&nbsp;Laurent Mathieu ,&nbsp;Aram Gazarian ,&nbsp;Arnaud Walch","doi":"10.1016/j.hansur.2025.102162","DOIUrl":"10.1016/j.hansur.2025.102162","url":null,"abstract":"<div><h3>Purpose</h3><div>Axillary nerve neurotization using a motor branch of the triceps brachii has become a therapeutic option in the management of deltoid paralysis. The purpose of this study was to report the medium to long-term outcomes of this procedure.</div></div><div><h3>Material and methods</h3><div>Twenty patients with a median age of 31 years (interquartile range – IQR, 29–53) were included in a single-operator retrospective study. A clinical evaluation was conducted, including the assessment of deltoid muscle strength using the British Medical Research Council grading system and a dynamometer with comparisons made between preoperative and postoperative outcomes.</div></div><div><h3>Results</h3><div>The median follow-up period was 6 years (IQR, 5–11). At last follow-up, the median active abduction was 160° (IQR 60–160), and 85% of patients recovered at least M3 abduction force. No donor site deficits were identified.</div></div><div><h3>Discussion</h3><div>The medium to long-term outcomes of the neurotization of a triceps brachii motor branch on the axillary nerve are comparable to the short-term outcomes.</div></div><div><h3>Level of evidence</h3><div>IV.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 3","pages":"Article 102162"},"PeriodicalIF":0.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065428","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":"Arthroscopic treatment of scaphoid nonunion with distal radius bone graft: A retrospective series of 31 cases","authors":"Alexandra M. Stein ,&nbsp;Violaine Beauthier ,&nbsp;Charles Schlur ,&nbsp;Marc Juvenspan ,&nbsp;Emmanuel Dahan","doi":"10.1016/j.hansur.2025.102163","DOIUrl":"10.1016/j.hansur.2025.102163","url":null,"abstract":"<div><div>The objective of this study was to evaluate the clinical outcomes of arthroscopic bone grafting for the treatment of scaphoid nonunion. This was a retrospective, multicenter study involving 31 patients with scaphoid nonunion, all treated arthroscopically. The procedure included harvesting of a cancellous bone graft from the distal radius, arthroscopic debridement of the nonunion site, injection of the bone graft under arthroscopic control, and retrograde percutaneous fixation.</div><div>At an average follow-up of 11.7 months, 90.3% of the fractures had consolidated at a mean time of 12.2 weeks. The Visual Analog Scale for pain decreased from 4.9 to 1.3, and strength increased from 24.2 kg to 32.3 kg. The Mayo Wrist Score improved from 53.9 to 79, and the Quick Disability of Arm Shoulder and Hand score improved from 40.5 to 10.3.</div><div>This is a minimally invasive technique that preserves scaphoid vascularization, with results comparable to other techniques.</div></div><div><h3>Level of evidence</h3><div>III.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 3","pages":"Article 102163"},"PeriodicalIF":0.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056090","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":"Comment on the article: Recurrence of a giant-cell tumor of the wrist with malignant transformation and pulmonary metastases treated with a custom-made prosthesis. Fulchignoni C, Pataia E, Ziranu A, Vitiello R, Pietramala S, El Motassime A, et al. Hand Surg Rehabil. 2025;44(February (1)):102076","authors":"Domenico Marrella ,&nbsp;Philippe Liverneaux","doi":"10.1016/j.hansur.2025.102161","DOIUrl":"10.1016/j.hansur.2025.102161","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 3","pages":"Article 102161"},"PeriodicalIF":0.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060807","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":"Iliac crest graft reconstruction for giant cell tumour of the distal phalanx: A case report","authors":"Brahman S. Sivakumar ,&nbsp;Amoussou S.C.R. Houegban ,&nbsp;Caroline Leclercq","doi":"10.1016/j.hansur.2025.102160","DOIUrl":"10.1016/j.hansur.2025.102160","url":null,"abstract":"<div><div>Giant cell tumours of bone are exceedingly rare in the distal phalanx of the thumb and pose therapeutic challenges when found in this location. We present a case of a giant cell tumour in this region, and a novel method of reconstruction to maintain length and function.</div></div><div><h3>Level of evidence</h3><div>5.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 3","pages":"Article 102160"},"PeriodicalIF":0.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059182","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":"Clinical and psychosocial characteristics of persistent finger post-traumatic segmentary exclusion syndrome: A descriptive study","authors":"Louis Tremblais ,&nbsp;Anne-Lise Garel ,&nbsp;Philippe Pernot ,&nbsp;Aurélie Brie ,&nbsp;Aram Gazarian ,&nbsp;Arnaud Walch ,&nbsp;Thibault Druel","doi":"10.1016/j.hansur.2025.102159","DOIUrl":"10.1016/j.hansur.2025.102159","url":null,"abstract":"<div><h3>Purpose</h3><div>Segmentary exclusion syndrome is a motor behavior disorder characterized by non-use or underuse of a limb segment, typically following local inflammation after trauma. Despite its significant impact on hand function and quality of life, segmentary exclusion syndrome is underrecognized and often diagnosed late. This study describes the population, and the symptoms associated with persistent finger segmentary exclusion syndrome.</div></div><div><h3>Materials and methods</h3><div>A retrospective analysis was conducted in a specialized hand surgery center. Twenty-one adult patients diagnosed with segmentary exclusion syndrome persisting &gt;3 mo post-trauma were included. Data collected included demographics, injury mechanisms, somatosensory disorders, flexion active range of motion, pain during movement, psychosocial flags, and sleep disturbances.</div></div><div><h3>Results</h3><div>Somatosensory disorders were present in 81% of patients, with allodynia (76%) and hyperesthesia (18%) as the most common subtypes. Flexion active range of motion limitations were observed in 52% of patients, often co-occurring with sensory disturbances or pain. Pain was reported in 29% of patients but was rarely an isolated symptom. Psychosocial factors were prevalent, with yellow flags in 71%, black flags in 62%, and blue flags in 29%. Sleep disturbances were reported in 52% of cases.</div></div><div><h3>Discussion</h3><div>Persistent finger segmentary exclusion syndrome is primarily associated with somatosensory disturbances, particularly allodynia and hyperesthesia, which appear central to its chronicization. Psychosocial factors and sleep disturbances were highly prevalent. Early recognition and a holistic, multidisciplinary approach seem therefore essential to improve outcomes in affected patients.</div></div><div><h3>Level of evidence</h3><div>IV.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 3","pages":"Article 102159"},"PeriodicalIF":0.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061277","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 minimally invasive release of the pectoralis minor: Initial experience in cadaveric specimens","authors":"Jeffrey Michaud ,&nbsp;Lolita Micicoi ,&nbsp;Remy Coulomb ,&nbsp;Jules Cavailhes ,&nbsp;Martin Bertrand ,&nbsp;Vincent Martinel ,&nbsp;Pascal Kouyoumdjian ,&nbsp;Olivier Mares","doi":"10.1016/j.hansur.2025.102158","DOIUrl":"10.1016/j.hansur.2025.102158","url":null,"abstract":"<div><h3>Introduction</h3><div>Pectoralis minor syndrome results from excessive contraction or shortening of the pectoralis minor muscle, causing scapular dyskinesis, shoulder dysfunction, and potential neurovascular compression. Existing surgical treatments, including open and arthroscopic pectoralis minor releases, lack minimally invasive options.</div></div><div><h3>Objective</h3><div>To evaluate the feasibility, safety and efficiency of ultrasound-guided release of the pectoralis minor coracoid insertion in a cadaveric model.</div></div><div><h3>Methods</h3><div>A single-operator study was conducted on eight shoulders from four fresh cadavers. Under ultrasound guidance, the coracoid insertion of the pectoralis minor was visualized, and a minimally invasive release was performed using a specialized KEMIS© knife. The completeness of the tendon release was validated by open dissection. Operative times and potential injury to adjacent structures were recorded.</div></div><div><h3>Results</h3><div>Complete tendon sectioning was achieved in all specimens without injury to the brachial plexus, subclavian artery, or vein. Minor damage to anterior deltoid fibres (&lt;10%) was noted in some shoulders. Localization times improved significantly (from 75 to 35 s), and tendon cutting times were consistently less than 20 s after the second procedure.</div></div><div><h3>Conclusion</h3><div>Ultrasound-guided pectoralis minor muscle release is a safe, efficient, minimally invasive technique with a short learning curve. These findings warrant further studies to investigate its clinical applicability and long-term outcomes.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 3","pages":"Article 102158"},"PeriodicalIF":0.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056445","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":"Comment on the article: Radiographic evaluation of trapeziometacarpal total joint arthroplasty: Why and how? Joris Duerinckx and Kjell Van Royen","authors":"Raj Pradhan ,&nbsp;Chris Jump ,&nbsp;Sumedh Talwalkar","doi":"10.1016/j.hansur.2025.102157","DOIUrl":"10.1016/j.hansur.2025.102157","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 3","pages":"Article 102157"},"PeriodicalIF":0.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055244","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}