Hand Surgery & Rehabilitation最新文献

{"title":"Curtis plasty is an effective option for correcting supple boutonnière deformity","authors":"Francis Bonte ,&nbsp;Dries Verrewaere ,&nbsp;Pieter Pierreux ,&nbsp;Hanne Vandevivere ,&nbsp;Filip Stockmans ,&nbsp;Bart Berghs","doi":"10.1016/j.hansur.2025.102126","DOIUrl":"10.1016/j.hansur.2025.102126","url":null,"abstract":"<div><div>Boutonnière deformity is characterized by flexion of the proximal interphalangeal (PIP) joint and hyperextension of the distal interphalangeal (DIP) joint, often caused by trauma or rheumatoid arthritis. When the deformity remains supple without fixed contractures, tendon reconstruction techniques such as the Curtis plasty can restore function and correct alignment.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 2","pages":"Article 102126"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627253","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":"Comparing AAOS appropriate use criteria with ChatGPT-4o recommendations on treating distal radius fractures","authors":"Kareem S. Mohamed ,&nbsp;Alexander Yu ,&nbsp;Christoph A. Schroen ,&nbsp;Akiro Duey ,&nbsp;James Hong ,&nbsp;Ryan Yu ,&nbsp;Suhas Etigunta ,&nbsp;Jamie Kator ,&nbsp;Hannah S. Rhee ,&nbsp;Michael R. Hausman","doi":"10.1016/j.hansur.2025.102122","DOIUrl":"10.1016/j.hansur.2025.102122","url":null,"abstract":"<div><h3>Introduction</h3><div>The American Academy of Orthopaedic Surgeons (AAOS) developed appropriate use criteria (AUC) to guide treatment decisions for distal radius fractures based on expert consensus. This study aims to evaluate the accuracy of Chat Generative Pre-trained Transformer-4o (ChatGPT-4o) by comparing its appropriateness scores for distal radius fracture treatment with those from the AUC.</div></div><div><h3>Methods</h3><div>The AUC patient scenarios were categorized by factors such as fracture type (AO/OTA classification), mechanism of injury, pre-injury activity level, patient health (ASA 1–4), and associated injuries. Treatment options included percutaneous pinning, spanning external fixation, volar locking plates, dorsal plates, and immobilization methods, among others. Orthopedic surgeons assigned appropriateness scores for each treatment (1–3 = “Rarely Appropriate,” 4–6 = “May Be Appropriate,” and 7–9 = “Appropriate”). ChatGPT-4o was prompted with the same patient scenarios and asked to assign scores. Differences between AAOS and ChatGPT-4o ratings were used to calculate mean error, mean absolute error, and mean squared error. Statistical significance was assessed using Spearman correlation, and appropriateness scores were grouped into categories to determine percentage overlap between the two sources.</div></div><div><h3>Results</h3><div>A total of 240 patient scenarios and 2160 paired treatment scores were analyzed. The mean error for treatment options ranged from 0.6 for volar locking plate to -2.9 for dorsal plating. Pearson correlation revealed significant positive associations for dorsal spanning bridge (0.43, P = &lt;0.001) and spanning external fixation (0.4, P = &lt;0.001). The percentage overlap between AAOS and ChatGPT-4o in the appropriateness categories varied, with 99.17% agreement for immobilization without reduction, 90.42% for volar locking plates, and only 15% for dorsal plating.</div></div><div><h3>Conclusion</h3><div>ChatGPT-4o does not consistently align with the appropriate use criteria in determining appropriate management of distal radius fractures. While there was moderate concordance in certain treatments, ChatGPT-4o tended to favor more conservative approaches, raising concerns about the reliability of AI-generated recommendations for medical advice and clinical decision-making.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 2","pages":"Article 102122"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627252","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":"Antibiotic prophylaxis and other factors influencing infection risk reduction in hand and forearm fracture surgery: A narrative review","authors":"Andrzej Żyluk","doi":"10.1016/j.hansur.2025.102152","DOIUrl":"10.1016/j.hansur.2025.102152","url":null,"abstract":"<div><div>Surgical site infection is a serious complication of fracture surgery that often requires antibiotic treatment, implant removal, and wound debridement. Antibiotic prophylaxis is one of the measures taken to reduce the risk of surgical site infection. Other factors influencing the risk of infection include leaving the ends of the K-wires protruding through the skin vs. buried under the skin, operating under full sterility vs. field sterility in the operating room, or the burden of comorbidities.</div><div>The purpose of this study was to review the current literature on antibiotic prophylaxis and other factors that influence the risk of infection during surgery for hand and distal radial fractures. We also reviewed the literature on potential adverse effects and costs of antibiotic prophylaxis.</div><div>Results. Three studies and one systematic review were identified for the operative treatment of closed hand and distal radius fractures, none of which supported the routine use of antibiotic prophylaxis. For leaving the ends of K-wires exposed versus burying them under the skin, two articles were found. One reported an increased risk of surgical site infection when K-wires are left exposed, and the other reported that it does not matter.</div><div>Three studies reported harmful and adverse effects of unnecessary use of antibiotic prophylaxis. Two studies reported an increased risk of surgical site infection in patients with comorbidities, compromised immunity, smoking, and alcohol use. The routine use of antibiotic prophylaxis generates significant costs that can be avoided if it is used as recommended by evidence-based medicine.</div><div>Conclusion. The authors believe that this review may have many beneficial effects for patients and the health care system, such as: preventing bacterial resistance, increasing the efficacy of antibiotics in true infections, reducing the risk of adverse reactions, and reducing health care costs.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 3","pages":"Article 102152"},"PeriodicalIF":0.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744638","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: Zobrist D, Schweizer A, Reissner L. Stability of the distal radioulnar joint before and after corrective osteotomy of the distal radius. Hand Surgery and Rehabilitation. 2025. doi: https://doi.org/10.1016/j.hansur.2025.102125","authors":"Domenico Marrella ,&nbsp;Philippe Liverneaux","doi":"10.1016/j.hansur.2025.102133","DOIUrl":"10.1016/j.hansur.2025.102133","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 3","pages":"Article 102133"},"PeriodicalIF":0.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733749","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":"A 20-year national decline in wrist fractures: Unraveling trends and persistent challenges","authors":"Peter V. Dinh ,&nbsp;Timothy A. Reiad ,&nbsp;Emilio Peveri ,&nbsp;Carolyn Marquis ,&nbsp;Joseph A. Gil","doi":"10.1016/j.hansur.2025.102151","DOIUrl":"10.1016/j.hansur.2025.102151","url":null,"abstract":"<div><h3>Background</h3><div>Wrist fractures are among the most common upper extremity injuries. Despite their prevalence and significant societal and healthcare costs, long–term epidemiological data on national wrist fracture trends remain limited.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed data from the National Electronic Injury Surveillance System (NEISS) and U.S. Census data to evaluate national trends in wrist fractures from 2004 to 2023. Utilizing weighted sampling techniques, incidence rates were calculated, and demographic patterns, causes, and differences between athletic and non–athletic injuries were assessed. Statistical analyses included regression models, chi–square tests, and injury proportion ratios (IPR).</div></div><div><h3>Results</h3><div>Over the twenty-year study period, there were a reported 106,929 wrist fractures, representing 4,040,516 cases nationwide (95% CI: 3,414,316–4,666,716). The incidence declined significantly over the study period from 78.04 per 100,000 person–years in 2004 to 60.27 in 2023 (p &lt; 0.05), representing a 22.7% decrease in overall wrist fracture incidence rates. Males aged 5–14 years showed the highest fracture rate (238.2 per 100,000), primarily driven by sports–related injuries such as bicycling, football, and skateboarding. Conversely, females aged ≥65 years had the highest risk of non–athletic fractures, often due to falls on stairs or floors. Nearly half (47.96%) of all wrist fractures were sports–related, with males three times more likely than females to sustain such injuries (OR: 3.05, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>This comprehensive analysis of wrist fracture trends over two decades reveals a significant decline in overall incidence, with notable demographic patterns. These findings underscore the importance of targeted prevention strategies, such as improving safety measures in youth sports and enhancing fall prevention programs for older adults, while highlighting the need for continued research to inform effective prevention and treatment strategies.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 3","pages":"Article 102151"},"PeriodicalIF":0.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733746","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":"Nine reasons why hand surgeons should do musculoskeletal ultrasound","authors":"Levent Özçakar ,&nbsp;Hilmi Berkan Abacıoğlu ,&nbsp;Gürsel Leblebicioğlu","doi":"10.1016/j.hansur.2025.102136","DOIUrl":"10.1016/j.hansur.2025.102136","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 3","pages":"Article 102136"},"PeriodicalIF":0.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733747","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":"Post-burn carpal tunnel syndrome: A systematic review","authors":"Thomas Albert ,&nbsp;Pierre Perrot ,&nbsp;Flore-Anne Lecoq ,&nbsp;Ugo Lancien","doi":"10.1016/j.hansur.2025.102134","DOIUrl":"10.1016/j.hansur.2025.102134","url":null,"abstract":"<div><h3>Objectives</h3><div>Post-burn neuropathy is a little-known pathology. However, the nerve is the most sensitive organ to burns, especially electrical burns. Carpal tunnel syndrome is the most common mononeuropathy worldwide and the most common post-burn neuropathy. The aim of this study is to evaluate, through a review of the literature, the specificities of the management of mononeuropathy of the median nerve at the wrist occurring at a distance from the burn injury.</div></div><div><h3>Methods</h3><div>A comprehensive search of the literature was conducted using the Cochrane Library, PubMed, and EMBASE. We included all articles that mentioned nerve injury associated with burns and excluded those that did not address the median nerve or in which the median nerve was the subject of early release. For each study, we compared diagnostic methods and patient management elements. We propose to associate to this review the case of a 23-year-old male victim of an electrical burn who developed a carpal tunnel at a distance from his burn. The patient underwent surgery and was evaluated 1 mo and 6 mo after surgery using grip strength, Weber’s two-point discrimination test, QuickDASH, and BCTSQ questionnaires. An electromyogram was performed preoperatively and 6 mo postoperatively.</div></div><div><h3>Results</h3><div>Thirteen articles met the inclusion criteria and were reviewed. The majority of these involved electrical and thermal burns, with TBSA ranging from 2% to 65%. The affected population was young (36.7 years) and predominantly male. The mean hospital stay was 59.1 days, compared with 137.5 days for diagnosis delay. Diagnostic electromyography was not always performed. No study used ultrasound or MRI to look for an etiology other than burns in the development of carpal tunnel syndrome. All studies that reported symptom improvement after treatment did not use a functional score. In our case, grip strength on the operated side improved moderately. Discriminative sensation was restored. QuickDASH and BCTSQ scores were initially poor and improved very modestly after surgery. Electromyography showed recovery of sensory conduction but no recovery of motor conduction.</div></div><div><h3>Conclusion</h3><div>Carpal tunnel syndrome can have significant functional consequences in burn patients because it is often overlooked and treated late. Early clinical and electromyographic diagnosis is essential to ensure surgical management before irreversible intra-neural injury occurs. Ultrasound could be useful for the early detection of signs of median nerve injury at the wrist when electromyography is not possible, and to verify the absence of another associated etiology in the development of carpal tunnel syndrome after burns. We propose a decision algorithm for the management of carpal tunnel syndrome associated with burns.</div></div><div><h3>Level of evidence</h3><div>IV.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 3","pages":"Article 102134"},"PeriodicalIF":0.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702563","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":"Total wrist arthrodesis epidemiology and prior surgeries survival","authors":"François-Gabriel Midon ,&nbsp;Lionel Athlani ,&nbsp;Martin Cholley-Roulleau ,&nbsp;Colin Piessat ,&nbsp;François Dap","doi":"10.1016/j.hansur.2025.102135","DOIUrl":"10.1016/j.hansur.2025.102135","url":null,"abstract":"<div><div>This study investigates the indications for first- and second-line total wrist arthrodesis, focusing on conversion delays following prior wrist surgeries and analyzing complications based on the underlying etiology.</div><div>We reviewed 121 patients who underwent total wrist arthrodesis over a nine-year period. First-line total arthrodesis was predominantly performed for inflammatory rheumatic conditions or spasticity, while 53% of second-line total arthrodesis were conducted for post-traumatic conditions. The procedures most frequently converted included four-corner arthrodesis (28%), proximal row carpectomy (22%), and radioscapholunate arthrodesis (20%), with mean conversion delays of 3 years, 5 years, and 1.8 years, respectively.</div><div>Four-corner arthrodesis was the most commonly converted procedure, while radioscapholunate arthrodesis showed the shortest conversion time, primarily due to pseudarthrosis.</div></div><div><h3>Level of evidence</h3><div>IV.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 3","pages":"Article 102135"},"PeriodicalIF":0.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702565","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":"Hamate autograft for proximal pole scaphoid fracture: A systematic review","authors":"Zac Dragan ,&nbsp;Adam R. George ,&nbsp;David J. Graham ,&nbsp;Brahman S. Sivakumar","doi":"10.1016/j.hansur.2025.102129","DOIUrl":"10.1016/j.hansur.2025.102129","url":null,"abstract":"<div><h3>Background</h3><div>Proximal pole scaphoid fracture is not uncommon and present therapeutic challenges due to impaired perfusion, with risk of secondary non-union, avascular necrosis and wrist degeneration. There is no consensus on surgical techniques for a non-salvageable proximal pole, but proximal hamate autograft to resurface the scaphoid is gaining interest. This systematic review assesses the evidence for proximal hamate autograft in resurfacing non-salvageable scaphoid proximal poles.</div></div><div><h3>Methods</h3><div>A systematic review searched the Medline, Embase, PubMed and Scopus databases for the period 2000–2024, following PRISMA guidelines. The protocol was registered with PROSPERO. Risk of bias was measured using ROBINS-I (Risk Of Bias In Non-randomized Studies - of Interventions).</div></div><div><h3>Results</h3><div>Mean duration of non-union at presentation was 50.8 months (n = 10), with a mean follow-up of 15.7 months (n = 10). Mean hamate graft length was 6.7 mm (n = 26). Radiographic union was achieved in 93.3% of patients (n = 30), at a mean 10.6 weeks (n = 26). Mean postoperative wrist flexion-extension was 89.5° (n = 10), averaging 61.4% of the arc for the contralateral hand (n = 8). Pronation and supination recovered contralateral values (n = 5). Postoperative grip strength in the affected hand was 79.8% of the contralateral value (n = 26). Postoperative QuickDASH score and VAS pain rating averaged 25 (n = 8) and 2 (n = 21), respectively. Five patients (16.7%; n = 30) experienced complications.</div></div><div><h3>Conclusions</h3><div>Hamate autografting for resurfacing non-salvageable scaphoid proximal poles demonstrated satisfactory early-to-medium-term outcomes. Although promising, more research is necessary to confirm the utility of this treatment modality.</div></div><div><h3>Level of evidence</h3><div>IV (systematic review).</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 3","pages":"Article 102129"},"PeriodicalIF":0.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675018","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":"Validity and reliability of an immersive virtual reality adaptation of the 6-minute pegboard and ring test","authors":"Çağtay Maden ,&nbsp;Demet Gözaçan Karabulut ,&nbsp;Burcu Bağcı","doi":"10.1016/j.hansur.2024.101981","DOIUrl":"10.1016/j.hansur.2024.101981","url":null,"abstract":"<div><h3>Background and Aim</h3><div>Virtual reality offers new clinical assessment and rehabilitation options that can complement or, in some cases, replace traditional methods. However, the applicability of using virtual reality tools for assessment of upper limb functional capacity has not been fully explored. We therefore developed an immersive virtual reality adaptation of the 6-Minute Pegboard and Ring Test (6PBRT-VR). The aim of the study was to test the validity and reliability of the 6PBRT-VR for the assessment of upper extremity functional capacity, and to assess the performance and feasibility of the proposed tool.</div></div><div><h3>Methods</h3><div>Thirty healthy young adults were included in the study. The participants performed the classical 6-Minute Pegboard and Ring Test first and then the 6PBRT-VR. The test-retest reliability of the 6PBRT-VR was assessed on intraclass correlation coefficient. Concurrent validity was assessed on the correlation between the 6PBRT-VR test-retest scores (number of rings moved) and the correlation between the scores from the classical 6-Minute Pegboard and Ring Test and the 6PBRT-VR. Convergent validity was assessed on correlations with handgrip strength and the total Quick Disabilities of the Arm, Shoulder, and Hand score. Cardiorespiratory responses were also measured (at baseline and after each test). Perceived arm fatigue was assessed on the Modified Borg Scale.</div></div><div><h3>Results</h3><div>The 6PBRT-VR exhibited excellent test-retest reliability, with an intraclass correlation coefficient of 0.866 (95% confidence interval 0.737−0.934). Mean 6PBRT-VR score correlated strongly with the mean score of the classical 6-Minute Pegboard and Ring Test (r = 0.817, p &lt; 0.001). A significant association was found between the 6PBRT-VR and the classical 6-Minute Pegboard and Ring Test in terms of variations in heart rate, systolic blood pressure, and Modified Borg Scale score (p &lt; 0.001). Mean 6PBRT-VR score showed moderate correlations with right (r = 0.571, p = 0.001) and left handgrip strength (r = 0.550, p = 0.002).</div></div><div><h3>Conclusion</h3><div>The 6PBRT-VR is a reliable and valid virtual tool for assessing upper-extremity functional capacity in young adults.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 1","pages":"Article 101981"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565359","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}