Journal of Hand Surgery-American Volume最新文献

{"title":"A Comprehensive Surgical Approach for Congenital Clasped Thumb: Introduction of a Modified Index Finger Rotation Flap.","authors":"Papat Sriswadpong, Xiaofang Shen","doi":"10.1016/j.jhsa.2025.08.010","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.08.010","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated the outcomes of reconstructive techniques combined with a modified index finger rotation flap for complex congenital clasped thumbs, focusing on functional improvement, aesthetic results, and donor site morbidity.</p><p><strong>Methods: </strong>A retrospective review of nine patients (10 thumbs) who underwent modified index finger rotational flap reconstruction with Z-plasty donor site closure between 2022 and 2024 was conducted. Variables collected included patient demographics, preoperative first intermetacarpal angle, and postoperative outcomes, which included active radial and palmar abduction, metacarpophalangeal joint extension, donor site morbidity, and scar quality assessed using the patient and observer scar assessment scale.</p><p><strong>Results: </strong>The mean age at surgery was 6 years and 5 months (range: 15-167 months), with an average follow-up of 12.7 months (range: 6-30 months). All patients healed without complications (eg, infection, flap necrosis, or revision). The mean preoperative intermetacarpal angle was 17.5°, consistent with moderate first web space contracture. At the final follow-up, the mean active radial abduction was 49.3°, and the mean palmar abduction was 50.6°. Full metacarpophalangeal joint extension of the thumb was achieved without extensor lag. No proximal interphalangeal joint flexion contracture or extensor lag of the index finger was observed. Scar quality outcomes were favorable, with all parents reporting satisfaction with both functional and aesthetic results.</p><p><strong>Conclusions: </strong>The modified index rotation flap is an effective technique for reconstructing congenital clasped thumbs, offering improved functional and aesthetic outcomes with minimal donor site morbidity. It addresses palmar skin deficiency and first web space contracture, making it valuable for managing complex clasped thumb deformities.</p><p><strong>Type of study/level of evidence: </strong>Therapeutic V.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253734","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":"Is Scaphoid Reconstruction Still an Option for Scaphoid Nonunion With Established Arthritis? A Retrospective Study of a Group of Patients.","authors":"Wenlong Zhu, Li Zhuo, Bin Li, Yuxiao Wang, Jeffrey Yao, Yang Guo","doi":"10.1016/j.jhsa.2025.07.039","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.07.039","url":null,"abstract":"<p><strong>Purpose: </strong>Although many studies have supported salvage procedures as the best option for scaphoid nonunions with established arthritis, there remains uncertainty regarding when procedures to gain union are favored over salvage procedures. The purpose of this study was to evaluate whether the short-term results from scaphoid nonunion with established arthritis treated by scaphoid reconstruction are acceptable.</p><p><strong>Methods: </strong>We retrospectively studied the clinical outcomes of scaphoid nonunions with established arthritis treated by scaphoid reconstruction between January 2019 and December 2021. Eighteen patients with wrist arthritis beyond Vender stage II were included. The median interval between injury and surgery was 50 months (range, 12-252 months). Fifteen patients were available for a 3-year minimum follow-up. Assessments included visual analog scale scores for pain, range of motion, grip strength, as well as the Modified Mayo Wrist Score.</p><p><strong>Results: </strong>One-third of fractures healed at 8 weeks after surgery, and the rest healed before 12 weeks, as confirmed by computed tomography scan. At the 3-year minimum follow-up, average pain score, grip strength, and the Modified Mayo Wrist Score improved significantly compared with the preoperative values. The average active range of motion increased after surgery but was similar to the preoperative status. The range of motion or grip strength remained unchanged or even decreased after the surgery in three patients. At final follow-up, x-rays showed no obvious advancement of the wrist arthritis in any of the patients.</p><p><strong>Conclusions: </strong>In our group of patients with established wrist arthritis, scaphoid reconstruction resulted in acceptable short-term outcomes.</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":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253842","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":"Pediatric Finger Fractures: Preventing Big Problems After Small Fractures.","authors":"Gopal R Lalchandani, Aaron Berger, Nicole S Schroeder, Andrea S Bauer","doi":"10.1016/j.jhsa.2025.08.015","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.08.015","url":null,"abstract":"<p><p>Pediatric finger fractures are among the most common injuries of the hand. Although most can be treated nonsurgically with good results, a small subset benefits from intervention. The purpose of this review was to provide an update on potentially problematic pediatric phalanx fractures. We will review common finger fractures unique to pediatric patients, classifications, surgical indications, and treatment options for chronic presentations.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253859","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":"Forearm Extensor Tendon Fractional Lengthening: An Anatomic Feasibility Study.","authors":"Alex Sarosi, Diala Burjak, Peter J Taub, Eitan Melamed","doi":"10.1016/j.jhsa.2025.08.019","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.08.019","url":null,"abstract":"<p><strong>Purpose: </strong>Fractional tendon lengthening (FL) of the forearm flexors involves multiple tenotomies at the musculotendinous junction. However, the feasibility of this technique with respect to forearm extensor muscles has not been well-studied. This study sought to evaluate the anatomy of forearm extensors, analyze the extent of muscle-tendon overlap, and identify the safest area to perform FL.</p><p><strong>Methods: </strong>Nine soft-embalmed adult cadaver forearms from the midhumerus to the wrist were dissected through a dorsal longitudinal incision. For each muscle, we defined and measured the total overlapping zone with each tendon and the corrected overlapping zone. The useful zone (UZ) was recognized as the corrected overlapping zone, excluding the distal 2-6 cm, where there is minimal muscle-tendon overlap.</p><p><strong>Results: </strong>Great variability in the average UZ among extensors was noted. For wrist extensors, the UZ for extensor carpi radialis brevis and extensor carpi radialis longus were considerably shorter (0.6 and 0.1 cm, respectively) than that of extensor carpi ulnaris (5.1 cm), which still had great variability in its UZs between specimens. Finger extensors had similar UZ values. The longest UZ was for extensor pollicis longus (5 cm), followed by extensor digitorum communis (3.6 cm) and extensor digiti minimi (3.1 cm). The UZ for extensor indicis proprius was consistently short (1.7 cm).</p><p><strong>Conclusions: </strong>The area available for FL depends on the musculotendinous junction anatomy of each muscle and varies among the forearm extensors.</p><p><strong>Clinical relevance: </strong>Surgeons should consider alternative lengthening methods for extensor tendon reconstruction, as most extensor compartment muscles have limited musculotendinous junctions suitable for free lengthening.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253749","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":"Correlation and Optimal Cutoff Value of the Japanese Society for Surgery of the Hand Score for Postoperative Satisfaction in Radial Polydactyly: A Retrospective Cohort Study.","authors":"Won Sun Lee, Young Ho Shin, Jae Kwang Kim","doi":"10.1016/j.jhsa.2025.08.014","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.08.014","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to assess the correlation between the Japanese Society for Surgery of the Hand (JSSH) score and parental satisfaction in patients with radial polydactyly and to identify the optimal JSSH score that correlates with parental satisfaction.</p><p><strong>Methods: </strong>A retrospective study was conducted on 144 patients (144 thumbs) who underwent surgery for radial polydactyly between October 2017 and September 2023. Patients were classified according to the modified Wassel-Flatt classification, excluding hypoplastic types. Postoperative outcomes were evaluated using the JSSH scoring system, totaling 20 points distributed across functional, appearance, and subjective parameters. Parental satisfaction regarding function and appearance was assessed using a five-point Likert scale. Spearman's rank correlation assessed the relationship between the JSSH score and parental satisfaction, and receiver operating characteristic curve analysis was used to determine the optimal cutoff value of the JSSH score corresponding to parental satisfaction.</p><p><strong>Results: </strong>The JSSH score demonstrated a significant correlation with overall parental satisfaction. The optimal cutoff value for predicting parental satisfaction was determined to be 18.5, with an area under the receiver operating characteristic curve of 0.82. The effect size between satisfied and unsatisfied parents was 1.26. Parents reported significantly lower satisfaction with appearance outcomes compared with functional outcomes. Notably, the appearance parameter of the JSSH score showed a weak correlation with appearance satisfaction, along with limited discriminative ability and a small effect size.</p><p><strong>Conclusions: </strong>We noted a significant correlation between JSSH score and parental satisfaction in patients with radial polydactyly and established an optimal cutoff value of 18.5 points.</p><p><strong>Clinical relevance: </strong>Future development of a scoring system that better integrates both functional and aesthetic considerations (social function) could enhance the evaluation and management of patients with polydactyly.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240264","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":"Magnetic Resonance Imaging Assessment of Radial Wrist Pain: A Practical Guide for Surgeons.","authors":"Christopher S Crowe, Gavin A McKenzie, Sanjeev Kakar","doi":"10.1016/j.jhsa.2025.08.007","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.08.007","url":null,"abstract":"<p><p>Radial-sided wrist pain is a frequent clinical complaint. Although a thorough history and physical examination often suffice for identifying the causative pathology, overlapping or subtle findings can complicate the diagnostic process. In such cases, magnetic resonance imaging may serve as a useful adjunct diagnostic tool. This review highlights the clinically relevant structures and radiographic features of the radial wrist and outlines a systematic approach for interpreting magnetic resonance imaging for patients presenting with radial-sided wrist pain.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240248","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":"Amyloidosis and Biopsy During Carpal Tunnel Release: A Survey of American Society for Surgery of the Hand Members.","authors":"Andrew Cross, Yagiz Ozdag, Mahmoud Mahmoud, Joel C Klena, Louis C Grandizio","doi":"10.1016/j.jhsa.2025.08.020","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.08.020","url":null,"abstract":"<p><strong>Purpose: </strong>Our purpose was to assess the current surgical practices of hand surgeons with respect to carpal tunnel release (CTR) and biopsy for amyloidosis. In addition, we aimed to determine whether surgeon demographic factors were associated with higher rates of biopsy during CTR.</p><p><strong>Methods: </strong>An anonymous, multiple-choice survey was distributed to all active American Society for Surgery of the Hand members, which included baseline demographic questions. Using a five-point Likert scale, the respondents were asked how frequently they obtain biopsies during CTR cases meeting tier 1 and tier 2 criteria. Questions related to biopsy techniques, CTR techniques, referral patterns, and billing practices were also administered. Bivariate comparisons were made to assess the relationship between surgeon demographics and the likelihood of having ever performed a biopsy.</p><p><strong>Results: </strong>Of the 3,903 distributed surveys, 643 (16%) responded. Thirty-nine percent stated that they \"never\" perform a biopsy for tier 1 criteria, 32% responded \"rarely,\" and 8% responded \"always.\" Forty-six percent of the surgeons performed endoscopic carpal tunnel release; however, only 53% of surgeons using endoscopic carpal tunnel release did so to obtain biopsies. Fifty-nine percent of respondents stated that they \"always\" refer patients with evidence of amyloid deposition on biopsy to a cardiologist. Surgeons in academic practice models were significantly more likely to have ever performed biopsies on patients with tier 1 criteria compared with nonacademic surgeons (70% vs 59%). However, years in practice, residency training, and practice location were not associated with a higher likelihood of having ever performed a biopsy.</p><p><strong>Conclusions: </strong>The frequency of biopsy for amyloid during CTR appears low among the American Society for Surgery of the Hand members. Although surgeons in academic settings were more likely to perform a biopsy during CTR, no other demographic factors were associated with higher biopsy rates.</p><p><strong>Clinical relevance: </strong>Understanding current practice patterns may aid in devising screening strategies and can inform both evidence-based management guidelines and care pathways.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240293","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":"Glucagon-like peptide-1 Agonists and Common Hand Procedures: Perioperative and Postoperative Risks and Complications.","authors":"Troy B Amen, Lina I Ibrahim, Stephen M Gillinov, Kaveh A Torabian, Michael C Dean, Adriana Liimakka, Steve K Lee","doi":"10.1016/j.jhsa.2025.08.004","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.08.004","url":null,"abstract":"<p><strong>Purpose: </strong>Glucagon-like peptide-1 (GLP-1) receptor agonists have recently become a cornerstone in managing type 2 diabetes mellitus and obesity given their ability to improve glycemic control and promote weight loss. However, the postoperative safety profile of these medications in patients undergoing common hand procedures remains poorly studied. The purpose of this study was to evaluate the effects of preoperative GLP-1 agonists use on postoperative complications, readmission, and reoperation following several commonly performed hand procedures.</p><p><strong>Methods: </strong>A retrospective study using a large insurance claims database was performed from 2015 to 2022. Patients undergoing six common hand procedures were queried. Individuals taking GLP-1 agonists at the time of surgery were propensity score-matched to those not taking the medications in a 1:4 fashion controlling for numerous clinical variables. Postoperative complications, 90-day readmission, 90-day reoperation for infection, and 2-year all-cause revision rates were then calculated between both groups using multivariable logistic regression.</p><p><strong>Results: </strong>Patients taking GLP-1 agonists had equal or lower odds of postoperative infections including lower rates of surgical site infections and equal rates of wound dehiscence. These patients also had lower risk of postoperative pneumonia, acute kidney injury, hematoma, pulmonary embolism, and deep vein thrombosis. Risk of all-cause 90-day readmission was significantly lower for patients taking GLP-1 agonists. Rates of 90-day reoperation for infection and 2-year all-cause revision were equal between both cohorts.</p><p><strong>Conclusion: </strong>This study found that patients taking GLP-1 agonists were at no higher risk for 90-day postoperative infections including surgical site infections and wound dehiscence. Furthermore, these patients demonstrated equal or lower rates of overall perioperative complications, reoperation, and readmission compared to their matched controls.</p><p><strong>Type of study/level of evidence: </strong>Prognostic IIc.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240298","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":"Mortality Associated With Upper Extremity Amputations in Vasculopathic Patients: A Matched Cohort Analysis of 9,904 Individuals.","authors":"Nicholas C Bank, Seong-Won Kim, Bradley J Lauck, Alexander D Jeffs, Megan M Patterson, Rebecca J Cleveland, Reid W Draeger","doi":"10.1016/j.jhsa.2025.08.016","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.08.016","url":null,"abstract":"<p><strong>Purpose: </strong>Peripheral vascular disease (PVD) is a well-established risk factor for lower-extremity amputations and is associated with poor outcomes and increased mortality for patients undergoing these procedures. However, the outcomes and mortality risks for vasculopathic patients undergoing upper-extremity amputations (UEA), particularly of the hand, are less understood. This study aimed to elucidate the mortality risks associated with UEA in patients with PVD.</p><p><strong>Methods: </strong>The TriNetX database was retrospectively queried using International Classification of Diseases-10th Clinical Modification and Current Procedural Terminology coding to identify patients with and without PVD who underwent UEA procedures. Patients were split into the following two cohorts: (1) UEA without PVD (no PVD), and (2) UEA with PVD (PVD). Cohorts were matched 1:1 using propensity scoring based on age, sex, body mass index, diabetes, and tobacco use. Relative risks, hazard ratios of mortality, and Kaplan-Meier survival analyses were performed to determine mortality rates at 6 months, 1 year, 5 years, and 10 years after initial UEA.</p><p><strong>Results: </strong>This study identified 36,368 patients, with 6,750 patients in the UEA with PVD cohort, and 29,213 patients in the UEA with no PVD cohort. Each matched cohort consisted of 4,952 patients. Patients without a history of PVD undergoing UEA were considerably less likely to die at each time point. Furthermore, the risk of mortality was lower for the no PVD cohort, and mortality rates were higher for the PVD group at each time point.</p><p><strong>Conclusions: </strong>These findings showed increased mortality risk for UEA patients with PVD compared with patients without PVD.</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":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240330","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":"Expansion of Hand Trauma Transfers at a Level 1 Trauma Center Following Integration with the ASSH Hand Trauma Center Network.","authors":"William Delahoussaye, Madeline Gautreaux, Patrick A Palines, Ramin Shekouhi, Kelly L Babineaux","doi":"10.1016/j.jhsa.2025.08.002","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.08.002","url":null,"abstract":"<p><strong>Purpose: </strong>This study sought to evaluate how joining the National Hand Trauma Center Network (NHTCN) affected the volume, demographics, and severity of hand trauma transfers to our institution.</p><p><strong>Methods: </strong>Data for this study were collected retrospectively over a 6-year period from 2016 to 2021 from our institutional trauma registry. Patients were selected based on the criterion of being transferred to our facility because of isolated hand trauma. Analyses of transfer rates, transfer distance, sending facilities, injury patterns, insurance type, path of care, and hospital charges prior to and after joining the NHTCN were performed.</p><p><strong>Results: </strong>There was a total of 39 transfers with isolated hand trauma over 3 years prior to joining the NHTCN, and 114 over 3 years after. The average number of hand transfers per year increased by 25, with an increase in both in-state and out-of-state transfers. This included an increase in transfers of serious injuries including complete amputations, open devascularization injuries, and open fractures. The average distance traveled by transfers increased by 22.6 miles. The demographics and insurance coverage of transfers were similar. The overall average charge per person increased from $23,885 to $33,663. Admissions of transfers decreased by 27.3%. The percentage of transfers undergoing surgery or receiving specialized hand care in the ED increased from 66.7% to 91.2%.</p><p><strong>Conclusions: </strong>Integration into the NHTCN increased our institution's volume of hand trauma transfers, with patients transferred from additional referring facilities, some of which were further from our center.</p><p><strong>Clinical relevance: </strong>These findings suggest that joining the NHTCN increased regional patient access to specialized hand surgical care. There was an overall increase in the quantity of severe injuries treated; however, there were only small shifts in the overall composition of transfers.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226403","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}