Hand Surgery & Rehabilitation最新文献

{"title":"Comparing surgical complications and healthcare utilization after forearm nonunion/malunion repair with or without the use of autograft","authors":"Mark A. Plantz,&nbsp;Michael Kavanagh,&nbsp;Tyler Compton,&nbsp;Neha Gupta,&nbsp;Manasa Pagadala,&nbsp;John Carney,&nbsp;Erik B Gerlach,&nbsp;Peter J. Ostergaard,&nbsp;Chirag Shah","doi":"10.1016/j.hansur.2025.102220","DOIUrl":"10.1016/j.hansur.2025.102220","url":null,"abstract":"<div><h3>Introduction</h3><div>There is a lack of large sample data comparing short-term complications and healthcare utilization after forearm nonunion or malunion reconstruction with or without the use autograft. The purpose of this study is to compare short-term complications and healthcare utilization after forearm nonunion or malunion repair with or without the use of autograft.</div></div><div><h3>Methods</h3><div>All cases of radius and/or ulna nonunion/malunion repair performed between January 1, 2015 and December 31, 2020 were identified using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. Patient demographics and surgical variables were reported, including sex, age, body mass index (BMI), medical comorbidities, American Society of Anesthesiologists (ASA) classification, and operative time. Outcomes of interest included unplanned hospital readmission, reoperation, non-home discharge, mortality, inpatient hospitalization, and various surgical and medical complications within 30 days of the index procedure. Categorical variables were compared using Chi squared tests, or Fisher’s exact test, when appropriate. Continuous variables were compared using unpaired <em>t</em>-tests. Multivariate logistic regression was used to identify variables that were independently associated with the outcomes of interest.</div></div><div><h3>Results</h3><div>1327 cases were included in the final cohort (617 with autograft use; 710 without autograft). The autograft group had more male patients, less patients aged 70 years and older, and a higher rate of class III obesity (p &lt; 0.05). Otherwise, patient demographics, medical comorbidities, and ASA class were similar between groups (p &gt; 0.05). The autograft group had longer operative times (132.9 ± 69.6 min vs. 101.3 ± 55.3 min, p &lt; 0.05). The autograft group had a higher rate of inpatient hospitalization and surgical complications, largely driven by more wound complications (p &lt; 0.05). Autograft use was independently associated with inpatient hospitalization (R.R. 4.306, 95% C.I.: [2.105–8.806]) and overall surgical complications (R.R. 2.475, 95% C.I.: [1.111–5.511]) (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Forearm nonunion/malunion repair with autograft resulted in higher rates of wound complications and inpatient hospitalization compared to the non-autograft control group. Medical comorbidities, advanced age, and increased operative time were associated with various perioperative complications.</div></div><div><h3>Level of evidence</h3><div>III.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102220"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700761","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":"Lateral elbow epicondylitis recognized as an occupational disease: Evaluation of return to work after surgery in 49 patients with an average follow-up of 45.6 months","authors":"Alexis Fily,&nbsp;Julien Maximen,&nbsp;Adrien Rossetti,&nbsp;Thierry Dréano,&nbsp;Mickaël Ropars","doi":"10.1016/j.hansur.2025.102174","DOIUrl":"10.1016/j.hansur.2025.102174","url":null,"abstract":"<div><h3>Objectives</h3><div>The primary objective of this study was to evaluate the return to previous work activities following surgery for lateral epicondylitis recognized as an occupational disease. The secondary objectives were to assess the relationship between preoperative and postoperative periods of work stoppage, and to determine the influence of different factors on the ability to return to previous activity.</div></div><div><h3>Material and method</h3><div>The demographic, occupational and medical data of 49 patients were analyzed retrospectively with a mean follow-up period of 45.6 months.</div></div><div><h3>Results</h3><div>At last follow-up, 26.5% of patients had returned to their previous activity. Preoperative and postoperative time off work were correlated (R = 0.331; <em>p</em> = 0.0323). Preoperative time off work of less than 12 months was significantly associated with a better ability to return to previous work (<em>p</em> = 0.017). Postoperative time off work and return to previous activity were significantly related (OR = 0.65; <em>p</em> = 0.012). The length of preoperative time off work appears to be an important factor to take into account in the context of occupational disease. The duration of postoperative time off work was consistent with French literature, but highlights significant international variability.</div></div><div><h3>Conclusion</h3><div>A quarter of patients who undergo surgery in a professional context return to their previous activity. Close collaboration among various stakeholders appears essential throughout the patient’s care pathway.</div></div><div><h3>Level of evidence</h3><div>IV. Retrospective study.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102174"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133208","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":"Complications of first rib resection for thoracic outlet syndrome – A national registry study from Finland","authors":"Markus Pääkkönen ,&nbsp;Ville Kytö ,&nbsp;Jarmo Gunn","doi":"10.1016/j.hansur.2025.102199","DOIUrl":"10.1016/j.hansur.2025.102199","url":null,"abstract":"<div><div>Many studies have described the frequency of short-term complications in patients undergoing first rib resection for thoracic outlet syndrome (TOS). The rate of long-term complications is less well known. 699 patients that had undergone first rib resection for TOS during 2004–2018 were identified from the Care Register for Healthcare in Finland. The prevalence of complications within 30 days and 1 year was analyzed. The prevalence of complications within 30 days was 9.8%, and complications occurred in 18.8% of the cases within 1 year. The rate of vascular and neural complications increased from 5.9% and 0.7% within 30 days to 10.3% and 2.7% within 1 year, respectively. Only a slight increase was seen in the rate of pneumo/chylothorax or infection. A follow-up of at least 1 year is prudent to detect all complications in patients undergoing first rib resection for TOS.</div></div><div><h3>Level of evidence</h3><div>III (Retrospective cohort study).</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102199"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251551","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":"Combined radial closing-wedge osteotomy and ulnar shortening osteotomy for distal radius malunion","authors":"Arnaud Walch ,&nbsp;Sabine Pillot ,&nbsp;Thais Galissard ,&nbsp;Aram Gazarian ,&nbsp;Thibault Druel","doi":"10.1016/j.hansur.2025.102207","DOIUrl":"10.1016/j.hansur.2025.102207","url":null,"abstract":"<div><h3>Purpose</h3><div>Distal radius malunion alters wrist biomechanics, leading to pain, stiffness, and functional impairment. Various corrective osteotomy techniques exist. The aim of this study was to evaluate the functional outcomes of a combined radial closing-wedge osteotomy and ulnar shortening osteotomy in the treatment of distal radius malunions.</div></div><div><h3>Materials and Methods</h3><div>We retrospectively reviewed 20 patients who underwent combined radial closing-wedge osteotomy and ulnar shortening osteotomy for symptomatic distal radius malunions. Functional outcomes, grip strength, range of motion, and radiographic parameters were analyzed.</div></div><div><h3>Results</h3><div>Surgery significantly improved supination (20°–80°), flexion (40°–60°), extension (50°–65°), and grip strength (12 kg–22 kg). Ulnar variance correction was achieved. Complications occurred in four cases, with three requiring revision surgery.</div></div><div><h3>Discussion</h3><div>Combined radial closing-wedge osteotomy and ulnar shortening osteotomy effectively restores wrist function while avoiding graft-related complications. This approach provides an alternative to opening-wedge osteotomies for distal radius malunions.</div></div><div><h3>Level of Evidence</h3><div>IV.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102207"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304097","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":"Surface replacing proximal interphalangeal joint arthroplasty in patients with post-traumatic versus primary osteoarthritis","authors":"Helen Richter ,&nbsp;Miriam Marks ,&nbsp;Kei Mathis ,&nbsp;Daniel B. Herren ,&nbsp;Stephan Schindele","doi":"10.1016/j.hansur.2025.102172","DOIUrl":"10.1016/j.hansur.2025.102172","url":null,"abstract":"<div><h3>Objective</h3><div>The study compared clinical and patient-reported outcomes after proximal interphalangeal (PIP) joint surface replacement in patients with post-traumatic osteoarthritis (OA) and primary OA.</div></div><div><h3>Methods</h3><div><span>Data from a prospective registry of patients who underwent surface replacing PIP joint arthroplasty (CapFlex-PIP, KLS Martin, Germany) were analysed. The primary outcome was active range of motion (ROM) measured before surgery and at several times up to five years after surgery. Grip strength, the brief Michigan Hand Outcomes Questionnaire (MHQ) and pain during daily activities were also assessed. Using </span>propensity score matching, 22 patients with post-traumatic OA were matched to 110 patients with primary OA based on their preoperative (baseline) ROM. Between-group differences were analysed using the Mann-Whitney U test or Fisher’s exact test.</div></div><div><h3>Results</h3><div>After matching, the mean baseline ROM of 34° (95% confidence interval [CI]: 22 to 46) for post-traumatic OA patients and 38° (CI: 34 to 42) for primary OA patients were comparable. By one year, ROM improved significantly after PIP arthroplasty to 53° (CI: 45 to 61) and 59° (CI: 55 to 63) for post-traumatic and primary OA patients respectively, and there was no significant difference between groups (p = 0.103). Thereafter, ROM declined in a similar manner for both groups over the 5-year follow-up period. The brief MHQ score and grip strength at baseline and the 1-year follow-up were significantly higher in the post-traumatic OA group. Complications occurred in five post-traumatic OA patients (23%) and in 15 patients (14%) with primary OA (p = 0.327).</div></div><div><h3>Conclusion</h3><div>Proximal interphalangeal joint surface replacement arthroplasty for post-traumatic osteoarthritis significantly improved range of motion, and this trend was similar to that achieved for patients with primary osteoarthritis. As clinical and patient-reported outcomes also improved, we recommend this procedure for patients with post-traumatic osteoarthritis, but the potentially higher risk of complications and reoperations for post-traumatic osteoarthritis patients should be considered.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102172"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061034","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":"Limited palmar fasciectomy combined with Z-plasty for Dupuytren’s disease: A 56 cases review","authors":"Nathan Guez ,&nbsp;Octave Dhellemmes ,&nbsp;Alexandre Bazeli ,&nbsp;Francesco Monti ,&nbsp;Isabelle Auquit-Auckbur","doi":"10.1016/j.hansur.2025.102206","DOIUrl":"10.1016/j.hansur.2025.102206","url":null,"abstract":"<div><h3>Introduction</h3><div><span>Fasciectomy is the gold standard for treating palmodigital cords in Dupuytren's disease. When </span>flexion contracture predominates at the metacarpophalangeal (MCP) joint, a segmental aponeurectomy in the palm combined with a Z-plasty can be performed.</div><div>The primary objective of this study was to evaluate the improvement in MCP extension achieved by this limited procedure. The secondary objectives were to assess long-term complications and recurrence rates.</div></div><div><h3>Materials and methods</h3><div>A retrospective study was conducted on patients who underwent pure palmar segmental fasciectomy with Z-plasty between 2014 and 2023. Palmar fasciectomy was performed on patients with exclusive or predominant MCP Dupuytren's contracture. This local fasciectomy procedure achieved full MCP joint extension. One or more Z-plasties enabled tension-free wound closure. Patients were reviewed, and extension deficit, complications, and recurrence were noted.</div></div><div><h3>Results</h3><div>46 patients (56 operated rays) were reviewed, with a mean follow-up period of 26 months (range 10–60 months). The mean preoperative MCP extension deficit was 48.4°. At the final follow-up, the mean MCP contracture was 6.1°, representing an improvement rate of 87%. Eleven patients experienced recurrence, five developed complex regional pain syndrome<span> after surgery and one had neurapraxia that resolved spontaneously.</span></div></div><div><h3>Discussion</h3><div><span>Segmental palmar fasciectomy and Z-plasty demonstrated substantial improvement in MCP extension. Complications appear to be fewer than with extended palmo-digital fasciectomy, and the recurrence rate is lower than with collagenase or </span>fasciotomy.</div></div><div><h3>Conclusion</h3><div>Limited palmar fasciectomy combined with Z-plasty is a simple, safe and effective treatment option for patients with MCP flexion contracture as the predominant or exclusive manifestation of Dupuytren’s disease.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102206"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487499","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":"High-resolution ultrasonography for extensor digiti minimi tendinopathy diagnosis","authors":"Hilmi Berkan Abacıoğlu,&nbsp;Berkay Yalçınkaya,&nbsp;Ahmet Furkan Çolak,&nbsp;Levent Özçakar","doi":"10.1016/j.hansur.2025.102209","DOIUrl":"10.1016/j.hansur.2025.102209","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102209"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512859","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 progressive learning strategy for flexor tendon repair for young surgeons","authors":"Nicolas Bigorre ,&nbsp;Thomas Daoulas","doi":"10.1016/j.hansur.2025.102173","DOIUrl":"10.1016/j.hansur.2025.102173","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102173"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096534","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":"Transfer of the long head of triceps branch to the anterior division of the axillary nerve for deltoid reanimation: Anterior or posterior approach? An anatomical study","authors":"Jean-Noël Goubier ,&nbsp;Tanguy Perraudin ,&nbsp;Camille Echalier","doi":"10.1016/j.hansur.2025.102211","DOIUrl":"10.1016/j.hansur.2025.102211","url":null,"abstract":"<div><div>Transferring the long head of the triceps nerve to the axillary nerve<span><span> is a widely used technique for restoring abduction and elevation of the shoulder in adults with partial brachial plexus lesions<span>. This procedure can be performed using either an anterior (axillary) or a posterior approach. This anatomical study aimed to compare the distance between the microsurgical<span> suture of the nerve transfer and the axillary nerve's entry into the middle and anterior deltoid, to determine which approach provides the shortest nerve </span></span></span>regrowth path.</span></div><div>The anatomical study was carried out on 12 subjects (i.e. 24 shoulders). For each subject, the transfer of the long portion of the triceps nerve to the anterior division of the axillary nerve was simulated. The microsurgical suture area was marked on the axillary nerve using stitches or clips. The nerve was then dissected and released until it entered the middle and anterior bundles of the deltoid via a lateral trans-deltoid route. The nerve was then cut flush with the muscle and recovered via the axillary route on ten shoulders (five right, five left) and via the posterior route on ten shoulders (five right, five left). The distance between the marker and the end of the axillary nerve was measured. The time taken to locate the teres minor branch after locating the axillary nerve through the anterior and posterior approaches was also noted.</div><div>On average, the distance between the suture and the nerve's entry into the deltoid was 74 mm for the anterior approach (ranging from 65 to 80 mm), and 62.4 mm for the posterior approach (ranging from 38 to 69 mm). There was a significant difference in length between the two approaches. The teres minor branch was located more quickly with the anterior approach (average time: 4 min, range 2−6 min) than with the posterior approach (average time: 18.1 min, range 16−21 min). This difference was significant (p &lt; 0.05).</div><div>In a nerve transfer, the distance between the suture and the recipient muscle affects the time taken for reinnervation<span><span> and therefore the outcome, given the progressive degradation of the motor end plates from the initial lesion. This study shows that the distance is significantly shorter via the posterior route. Reinnervation of the </span>deltoid muscle should therefore be faster and of better quality via this route. These results must be confirmed by a clinical study.</span></div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102211"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531960","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":"What long-term prospects for hand surgery education?","authors":"Nicolas Bigorre,&nbsp;Thomas Daoulas,&nbsp;Stéphane Guero","doi":"10.1016/j.hansur.2025.102218","DOIUrl":"10.1016/j.hansur.2025.102218","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102218"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621554","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}