Journal of Hand Surgery-American Volume最新文献

{"title":"Conversion of Total Wrist Arthrodesis to a Total Wrist Arthroplasty: Twelve Patients Followed for 7 (2-16) Years.","authors":"Ole Reigstad, Trygve Holm-Glad, Johanne Korslund, Geir Gjelsten, Rasmus Thorkildsen, Magne Røkkum","doi":"10.1016/j.jhsa.2024.10.007","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.10.007","url":null,"abstract":"<p><strong>Purpose: </strong>Total wrist arthroplasty has become a viable alternative to arthrodesis. Wrist arthrodesis is not necessarily the final surgery for many of the patients because some patients never accept the residual pain and reduced function that accompanies a stiff wrist. The purpose of this study was to evaluate the clinical performance (pain, function, and satisfaction) of rearticulation, as well as the complications and reoperations of the procedure in a prospective unselected case series of patients.</p><p><strong>Methods: </strong>Twelve (7 men) patients with a mean age of 53 (42-67) years were converted to a total wrist arthroplasty at a mean of 8 (3-17) years after wrist arthrodesis. The patients had undergone 53 wrist surgeries prior to rearticulation.</p><p><strong>Results: </strong>One wrist with a periprosthetic fracture of the ulna and a loose distal radioulnar joint arthroplasty that had been removed during the conversion was finally fused a second time. At follow-up 7 (2-16) years after conversion, increased wrist active range of motion (0°-98°), supination (75°-85°), reduced Patient-Rated Wrist Evaluation score (56-30), and reduced visual analog scale pain scores were found. All arthroplasties were radiologically stable, well-fixed and osseointegrated. None regretted the surgery knowing the outcome.</p><p><strong>Conclusions: </strong>Conversion from total wrist arthrodesis to a modern wrist arthroplasty is feasible, yielding good functional results, significant pain relief, and stable implants.</p><p><strong>Type of study/level of evidence: </strong>Therapeutic IV.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated Compression Screw Versus Unicortical Locking Screw for Fixing the Dorsal Critical Corner in Distal Radius Fractures: A Biomechanical Study.","authors":"Pedro Bronenberg Victorica, Lauren M Shapiro, Calvin Chan, Pablo De Carli, Luis Miguel Castro Appiani, Robin N Kamal","doi":"10.1016/j.jhsa.2024.10.014","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.10.014","url":null,"abstract":"<p><strong>Purpose: </strong>Although studies have demonstrated that locked screws with a length of 75% of the radius width are sufficient for the treatment of extra-articular fractures of the distal radius, the application of this principle to intra-articular fractures is less well-understood. This study aimed to evaluate the biomechanical properties of different types of volar plate fixation constructs for the treatment of distal radius fractures in the presence of a dorsal critical corner fragment.</p><p><strong>Methods: </strong>A dorsal critical corner fracture was created in 18 synthetic distal radius models. The fragment was stabilized with one of three constructs: a posteroanterior integrated compression screw (group 1) or volar locking screws with a length of 90% or 75% of the volar/dorsal width of the radius (groups 2 and 3, respectively). For the biomechanical evaluation, a load was applied to the lunate facet. Fixation stiffness and loads to produce clinical and catastrophic failures were compared among the groups.</p><p><strong>Results: </strong>The stiffness (N/mm) was 67.8 (SD, 14.7), 64.9 (SD, 8.63), and 65.8 (SD, 36.02) for groups 1, 2, and 3, respectively. The load required to generate a catastrophic displacement was 532.9 (SD, 142.32), 307.4 (SD, 101.51), and 230.8 N (SD, 77.68) for groups 1, 2, and 3, respectively. The load required to produce a 2-mm translation of the fixed fragment was 127.9 N (SD, 28.8) for group 1, 119.7 (SD, 11.78) for group 2, and 127.6 N (SD, 46.2) for group 3.</p><p><strong>Conclusions: </strong>Significantly greater load is required for catastrophic failure after fixation of a dorsal critical corner fracture with an integrated compression screw; however, it provides similar stiffness and load to failure for 2 mm of translation.</p><p><strong>Clinical relevance: </strong>For the treatment of intra-articular distal radius fractures with dorsal critical corner fragments, an integrated compression screw may be considered for rigid fixation of the fragment to support early return to daily activities.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collagen and Vascular Changes in the Scapholunate Ligament Following Injury: An Immunohistochemical Study.","authors":"Oliver Miles, Stephen K Tham, Wayne Morrison, Eugene T Ek, Jason Palmer, David McCombe","doi":"10.1016/j.jhsa.2024.10.011","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.10.011","url":null,"abstract":"<p><strong>Purpose: </strong>The scapholunate ligament (SLL) is the most frequently injured wrist ligament. The aim of this study was to investigate cellular and extracellular changes within the SLL following injury.</p><p><strong>Methods: </strong>Fifteen SLLs were harvested, ranging between 39 days to 20 years from time of injury. These specimens were subject to immunohistochemical analysis to characterize their vascular and collagen constitution.</p><p><strong>Results: </strong>Of the 15 ligaments, 4 were harvested <3 months from injury, and 11 harvested >3 months from injury. The mean type I collagen density was 45.6% (25.2% to 55.9%) in all specimens. The mean type III collagen density was 47% (38.2% to 51.8%) of the ligament area in specimens <3 months after injury and 30.6% (13.3% to 44.1%) in those >3 months after injury. Type III collagen density was highest in the volar subunit. Type I collagen decreased only minimally in specimens taken within 2 years of injury. The increase in the type I:III collagen ratio reflected the decline in type III collagen. Blood vessels were found in 13 of 15 specimens. Mean vessel density for all specimens was 1.3% (0% to 7.1%), with the highest density of 1.8% (0% to 10%) in the volar subunit. The vessel density decreased from 2.9% (1.3% to 4.3%) to 1.6% (0% to 10%) in the volar subunit in specimens harvested >3 months after injury.</p><p><strong>Conclusions: </strong>Mean type III collagen density decreased with time, most notably within the volar subunit. Mean type I collagen density held comparatively stable in ligaments taken within 2 years from injury. Blood vessels were detected in 87% of specimens, with the highest density in the volar subunit.</p><p><strong>Clinical relevance: </strong>The SLL displays a collagen profile similar to other ligaments with favorable healing capacity. The volar subunit possessed a collagen ratio and vessel density that may suggest its acute repair and inclusion in reconstructive techniques has merit.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Patient Experience in Office-Based Wide-Awake Hand Surgery.","authors":"Shafic Sraj, Brendan J Farley, John S Taras, Andrea B Lese, B Joseph Prud'homme, Richard Gross, Wing Yan Vien Cheung, Stephanie Cox","doi":"10.1016/j.jhsa.2024.10.009","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.10.009","url":null,"abstract":"<p><strong>Purpose: </strong>Office-based surgery, is a safe, well-tolerated option associated with high patient satisfaction. However, some patients remain hesitant due to concerns of being awake during surgery. Preoperative anxiety may be linked to poorer postoperative outcomes. The purpose of this study was to examine patients' distress prior to, during, and following office-based hand surgery under local anesthesia and to identify patient variables associated with distress.</p><p><strong>Methods: </strong>This study included 57 patients, 19 of whom had a history of anxiety and/or depression. Each patient completed the Amsterdam Preoperative Anxiety and Information Scale (APAIS) before surgery; patients completed the Subjective Units of Disturbance Scale (SUDS) before surgery, immediately after surgery, and at their first postoperative visit. They rated their SUDS with respect to the following distress domains: Being Awake During Surgery, Needlestick, Surgical Pain, and Discomfort.</p><p><strong>Results: </strong>The average distress experienced was less than the patients' preoperative expectations across all domains, and most patients rated their experiences to be equivalent to or better than expected (81 to 96% of patients, depending on the domain). Patients with elevated APAIS scores were more likely to have less distress (a better experience) than expected compared to those who were not.</p><p><strong>Conclusions: </strong>Average distress levels experienced were better than expected. Patients with higher APAIS had less distress (better experiences) than they expected.</p><p><strong>Type of study/level of evidence: </strong>Prognosis II.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits of Sensory Nerve Transfers and Risks of Using the Superficial Radial Nerve as a Donor.","authors":"Yamaan S Saadeh, Martijn J Malessy","doi":"10.1016/j.jhsa.2024.09.027","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.09.027","url":null,"abstract":"<p><p>Nerve transfers have re-emerged in the past several decades as a powerful tool for restoration of neurological function and are an essential part of peripheral nerve surgical practice. There is extensive literature describing outcomes from nerve transfers for the restoration of motor nerve function and describing the complication profile. Recently, interest and use of nerve transfers for restoration of sensation has increased. In this review, we highlight the limitations of the current literature on outcomes from sensory nerve transfers and showcase potential complications from their use, particularly related to use of the superficial branch of the radial nerve as a donor sensory nerve.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Median Nerve Release in Complex Regional Pain Syndrome Type 1 of the Hand: A Prospective Case Series.","authors":"Francisco Del Piñal","doi":"10.1016/j.jhsa.2024.09.024","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.09.024","url":null,"abstract":"<p><strong>Purpose: </strong>Pain, allodynia, and stiffness in complex regional pain syndrome (CRPS) greatly affects social, vocational, and community engagement. The aim of this study was to evaluate the effect of isolated median nerve releases on the outcome of CRPS 1 of the hand.</p><p><strong>Methods: </strong>In this prospective case series, people of any age diagnosed with and treated for CRPS 1 of the upper limb attending the author's practice were consecutively recruited. All were self-referrals dissatisfied with the treatment provided previously. Only patients who had been treated with nerve release to control their symptoms were included. Primary outcome measures were pain and Disabilities of the Arm, Shoulder, and Hand score. A secondary outcome was withdrawal from pain medication. Full resolution was defined as 0 pain, on a scale of 0-10, and total withdrawal from pain medication at the latest follow-up.</p><p><strong>Results: </strong>Between January 2018 and December 2022, 82 participants with CRPS 1 of the hand for an average of 20 months were evaluated. Eighty-five nerve releases were performed. As per protocol, carpal tunnel release was performed in all, and three patients also received an endoscopic pronator release. Minor procedures unrelated to the pain were carried out concomitantly in 17 patients. Significant improvements were observed in pain score (mean 8.9 ± 1.2 at baseline vs 0.6 ± 1.8 at 35 months) and in Disabilities of the Arm, Shoulder, and Hand score (82 ± 13 vs 13 ± 20) for the same period. Five patients (6%) were considered failures. In contrast, 65 patients (79%) had full resolution of their symptoms.</p><p><strong>Conclusions: </strong>This study demonstrates that a large percentage of patients diagnosed with and treated for CRPS type 1 can have full resolution of their symptoms with carpal tunnel release. Future research is needed to understand the pathophysiology and the failures.</p><p><strong>Type of study/level of evidence: </strong>Therapeutic II.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Claims Database Research in Hand Surgery: From Data to Bedside.","authors":"Thompson Zhuang, Lauren M Shapiro, Robin N Kamal","doi":"10.1016/j.jhsa.2024.10.004","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.10.004","url":null,"abstract":"<p><p>The widespread availability of administrative claims data has unlocked opportunities to answer challenging clinical questions in hand surgery, overcoming the limitations of traditional data sets. Researchers are taking advantage of claims data sets to obtain samples from broader segments of the population and achieve statistical power that was previously unattainable. Therefore, a basic understanding of claims database research is quickly becoming an invaluable tool in the surgeon's toolkit, enabling the performance of ground-breaking research and the critical evaluation of data-driven results to inform clinical practice. We provide an overview of methodological approaches to claims data analysis for hand surgery and a roadmap for analyzing and interpreting these studies in clinical practice.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Effect of Triamcinolone Local Injection on Clinical Outcomes of Patients With Radial Tunnel Syndrome: A Placebo-Controlled Clinical Trial.","authors":"Fariba Estaji, Mahla Daliri, Shahryar Hashemi, Ali Moradi","doi":"10.1016/j.jhsa.2024.09.023","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.09.023","url":null,"abstract":"<p><strong>Purpose: </strong>The role of corticosteroid injection for radial tunnel syndrome (RTS) has not been studied in a placebo-controlled clinical trial. The present clinical trial aimed to evaluate the effect of local triamcinolone injection on pain intensity, upper-extremity disability, and elbow function of patients with RTS.</p><p><strong>Methods: </strong>Forty-nine patients clinically diagnosed with RTS were randomized into the intervention and placebo groups. The diagnosis of RTS was made based on the following criteria: activity-related pain, maximal tenderness 3 to 5 cm distal to the lateral epicondyle, pain that worsens with forearm supination, pain radiating to the dorsoradial aspect of the forearm, and a positive Lister test. To confirm RTS, patients needed to exhibit at least four of these five criteria, with the requirement that one of the criteria be the tenderness located 3-5 cm distal to the lateral epicondyle. Patients in the intervention group received local injection of a single dose of corticosteroid (0.25 mL lidocaine 1% and 1 mL triamcinolone 40 mg/mL), and the placebo group received injection of single dose of normal saline (0.25 mL lidocaine 1% and 1 mL normal saline). The clinical outcomes, including QuickDASH (Disabilities of the Arm, Shoulder, and Hand), visual analog scale for pain, and Oxford Elbow Score, were evaluated before treatment, as well as 2 weeks and 3 months after the injection.</p><p><strong>Results: </strong>Visual analog scale pain score, QuickDASH score, and Oxford Elbow Scores were similar between the intervention and placebo groups at 2 weeks and 3 months of follow-up. However, reduction in visual analog scale pain, QuickDASH score, and Oxford Elbow Scores were statistically significant over time among both groups.</p><p><strong>Conclusions: </strong>Triamcinolone injection does not have any superior effect on the clinical outcomes of patients with RTS, compared with placebo.</p><p><strong>Type of study/level of evidence: </strong>Therapeutic II.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications and Outcomes of Bone-Anchored Prostheses of the Hand: A Systematic Review.","authors":"Taylor Bates, Liana J Tedesco, Janos Barrera, Adam Margalit, Michael Fitzgerald, Jacques Hacquebord, Omri Ayalon","doi":"10.1016/j.jhsa.2024.09.017","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.09.017","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to conduct a systematic review evaluating the reported complications and outcomes of bone-anchored prostheses in digit and partial hand amputees.</p><p><strong>Methods: </strong>A literature review of primary research articles on osseointegration and bone-anchored prostheses for digit and partial amputees was performed. The Medline, Embase, Scopus, and Cochrane Library databases were queried. Inclusion criteria were journal articles that evaluated osseointegration and bone-anchored prostheses in digit and partial hand amputees. The main outcome measures were reported complications and the need for revision surgery. Secondary outcomes included all reported outcome assessments.</p><p><strong>Results: </strong>Fifteen articles were included with publication dates ranging from 1996 to 2022. The sample sizes ranged from single-patient case reports to a 13-patient retrospective study. Overall, 33 men and 16 women were reported with a mean age of 33.6 years (range: 12-68) and a total of 71 amputated digits. The median follow-up was 2.1 years (IQR: 1.1-6.8 years). A total of 24 complications were reported in 14 digits (19.7%). Complications included superficial infection in 6 digits (8.5%), abutment loosening or failure in 5 (7%), fixture aseptic loosening in 4 (5.6%), deep infection in 1 (1.4%), and soft tissue instability in 1 (1.4%). Sixteen revision surgeries or component changes were reported.</p><p><strong>Conclusions: </strong>Bone-anchored prostheses using osseointegrated implants in the hand are associated with favorable outcomes in the limited number of low-quality studies available for review. Superficial infections and implant-related failures were the most frequently reported complications.</p><p><strong>Type of study/level of evidence: </strong>Systematic review IV.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Description of Specific Portals for Extensor Carpi Ulnaris Tenoscopy: Anatomical Safety Study.","authors":"Elisa de Torres-de Torres, Fernando Corella, Ricardo Kaempf de Oliveira, Montserrat Ocampos Hernández, Miguel Ángel Corella, María Teresa Vázquez-Osorio","doi":"10.1016/j.jhsa.2024.10.005","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.10.005","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this study was to describe potential working portals positioned directly over the extensor carpi ulnaris (ECU) tendon and assess their safety in relation to the dorsal branch of the ulnar nerve (DBUN).</p><p><strong>Methods: </strong>A descriptive anatomical study was conducted on 15 fresh human cadaver upper limbs. Five distinct portals over the ECU were examined, and the shortest distances from these portals to the DBUN were measured. Additionally, three distances from two portals and the ulnar styloid to the point where the DBUN crosses the ECU tendon were assessed.</p><p><strong>Results: </strong>The measurements of the distance to the DBUN from the portal at the level of the ulnocarpal joint (UCJ) from the proximal ECU (PECU) portal and from the portals located two and three centimeters proximal to the PECU indicate that no distances fell within the high-risk category (less than 3.5 mm). Measuring from the portal at the level of the UCJ to the DBUN, only one specimen fell within the medium-risk range (3.5-4.5 mm). However, in the rest of the previously described portals, all measurements corresponded to a low-risk range (more than 4.5 mm). The measurements from the distal ECU (DECU) portal to the DBUN revealed that 4 of 15 specimens had a distance less than 3.5 mm (high-risk range), whereas 2 of 15 fell within the medium-risk range.</p><p><strong>Conclusions: </strong>Proximal portals are safer and present a lower risk of nerve injury. Three distinct zones have been defined along the ECU based on their safety characteristics. The \"green zone\" is the safest area, situated 1 cm proximal to the 6R portal. The \"yellow zone\" encompasses the area extending from 1 cm proximal to 0.5 cm distal to the 6R portal. Finally, the \"red zone\" is located 0.5 cm distal to the 6R portal.</p><p><strong>Clinical relevance: </strong>For arthroscopic procedures involving the ECU, additional portals may be necessary. This anatomical study may be valuable in developing and implementing surgical techniques tailored for ECU pathology.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}