Journal of Hand Surgery-American Volume最新文献

{"title":"Building a Positive Online Reputation in Hand Surgery: Quantitative Analysis of Factors Linked to Patient Five-Star Reviews.","authors":"Evan H Richman, Dylan R Rakowski, Benjamin R Paul, Brian W Paul, Daniel Stokes, Alexander Lauder","doi":"10.1016/j.jhsa.2025.06.012","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.06.012","url":null,"abstract":"<p><strong>Purpose: </strong>Online physician review websites have changed the health care landscape by offering patients accessible platforms to evaluate and share their experiences. Physician review websites, such as Google Reviews, Yelp, and Healthgrades, may influence patient preferences and health care delivery. This study aimed to identify both clinical and nonclinical factors associated with five-star reviews to provide actionable insights for surgeons to improve patient experience and satisfaction.</p><p><strong>Methods: </strong>Fifty fellowship-trained hand surgeons practicing in 10 major metropolitan areas were randomly selected from the American Society for Surgery of the Hand directory. Reviews from Google.com rated five stars were analyzed, with a maximum of 20 reviews per surgeon. Compliments were categorized as clinical (eg, treatment plans, diagnoses, outcomes, and pain management) or nonclinical (eg, physician/staff professionalism, wait times, scheduling, and cost) and classified as surgical or nonsurgical. Two independent reviewers analyzed the reviews, with discrepancies resolved by a third reviewer. Univariate analysis and chi-square tests were used to assess categorical variables.</p><p><strong>Results: </strong>A total of 448 five-star reviews containing 691 compliments were analyzed. Clinical compliments constituted 43.8%, whereas 56.2% were nonclinical. Common clinical compliments included clear treatment plans (21.1%) and good outcomes (19.7%). Nonclinical compliments frequently highlighted physician professionalism (51.4%) and staff professionalism (23.2%). Surgical patients were more likely to mention good outcomes (44.0% vs 5.9%) and pain control (10.4% vs 1.4%), whereas nonsurgical patients emphasized physician professionalism (55.3% vs 44.4%) and staff professionalism (26.8% vs 16.8%). Private practice surgeons received more five-star reviews than academic surgeons, although average overall ratings were similar.</p><p><strong>Conclusions: </strong>Physician interpersonal skills and staff professionalism play critical roles in positive online reviews. Clinical outcomes are key drivers for surgical patients, whereas nonsurgical patients prioritize communication and alternative care options.</p><p><strong>Clinical relevance: </strong>This study identifies key factors associated with five-star reviews in hand surgery, offering actionable insights to enhance patient satisfaction.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669020","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":"Evaluating the Safety of Limited Load Bearing for Activities of Daily Living Following Volar Locked Plating of Select Distal Radius Fractures.","authors":"Nikolas H Kazmers, Hernan Roca, Gretchen Maughan-Egbert, Miranda J Rogers","doi":"10.1016/j.jhsa.2025.05.020","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.05.020","url":null,"abstract":"<p><strong>Purpose: </strong>Distal radius fractures (DRFs) are the most common fractures worldwide. Treatment with open reduction and internal fixation (ORIF) is typically followed by a period of weight-bearing limitations. We hypothesized that (1) allowing patients to load bear for activities of daily living (ADLs) following ORIF of select fracture patterns would not lead to clinically relevant changes in radiographic alignment and (2) a low rate of complications including revision ORIF would be observed.</p><p><strong>Methods: </strong>A retrospective review of adults (≥18 years old) with DRFs treated with ORIF was identified using Current Procedural Terminology codes. A chart review was performed to identify patients permitted to load bear for ADLs and exclude patients with Arbeitsgemeinschaft für Osteosynthesenfragen classification C3 and A3 fractures (multifragmentary articular and metaphysis, respectively), volar shear fractures (Arbeitsgemeinschaft für Osteosynthesenfragen classification B1-3), volar ulnar corner fractures, and patients with polytrauma or additional ipsilateral injuries. We defined \"select patients\" as those with fracture types not listed in the exclusion criteria. Radial height, ulnar variance, radial inclination, volar tilt, and intra-articular step-off were measured by two blinded reviewers. Paired equivalence tests were conducted to evaluate differences between intraoperative and postoperative radiographic measurements (using measurement errors from the literature as upper- and lower-limit thresholds).</p><p><strong>Results: </strong>Of the 66 included patients, mean age was 51 ± 19 years, and 68% (45/66) were women. One patient underwent bilateral ORIF, resulting in 67 cases, of which 17 (25%) were extra-articular, 16 (24%) were two-fragment intra-articular, and 34 (51%) had three intra-articular fragments. No immediate postoperative complications (including implant failure/migration or revision ORIF) were observed within 5 weeks of early load bearing for ADLs.</p><p><strong>Conclusions: </strong>Limited load bearing for ADLs following ORIF of DRFs with select fracture patterns did not lead to clinically relevant changes in radiographic alignment, loss of reduction, or the need for revision ORIF.</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":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661092","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":"Arthroscopic Resection of the Proximal Capitate With Tendon Interposition for Isolated Capitolunate Osteoarthritis: A Retrospective Series of Six Cases.","authors":"Alexandre Quemener-Tanguy, Axel Koehly, Grégoire Van Straaten, Antoine Martins, Michel Levadoux, Jean-Baptiste de Villeneuve Bargemon","doi":"10.1016/j.jhsa.2025.06.004","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.06.004","url":null,"abstract":"<p><strong>Purpose: </strong>Isolated capitolunate joint osteoarthritis is a rare condition with a poorly understood pathophysiology. To avoid midcarpal arthrodesis in active patients, we propose arthroscopic resection of the proximal pole of the capitate with tendon interposition (arthroscopic capitolunate tendinous interposition [ACLTI]). This study aimed to present the outcomes of patients after undergoing ACLTI.</p><p><strong>Methods: </strong>This retrospective, single-center study included six patients with isolated capitolunate osteoarthritis who underwent capitate resection combined with ACLTI. The mean follow-up period was 89.3 months. Assessments included the visual analog scale score for pain, joint range of motion, grip strength, Patient-Rated Wrist Evaluation (PRWE) score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score. A descriptive and comparative preoperative and postoperative analysis was conducted.</p><p><strong>Results: </strong>The postoperative results showed substantial improvement in the median pain scores, with a visual analog scale score of 0/10 compared with 5/10 before surgery. The mean PRWE score improved to 17.2 ± 14.2, QuickDASH score to 21.5 ± 6.5, extension to 74.2° ± 11.1°, flexion to 70° ± 13.8°, and grip strength to 25 ± 9.5 kg. No complications were reported.</p><p><strong>Conclusions: </strong>Arthroscopic resection of the proximal capitate with tendon interposition appears to be an effective therapeutic option for active patients with isolated capitolunate osteoarthritis. This approach does not preclude the possibility of secondary arthrodesis in case of failure.</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":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610324","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":"Transfer of Middle and Posterior Deltoid Extended by the Lateral Intermuscular Septum for Elbow Extension Reconstruction.","authors":"Jayme A Bertelli, Leonardo D Lanzarin, Dashiel Cañizares, Fernando Levaro, Mohammed Tahir, Francisco Soldado","doi":"10.1016/j.jhsa.2025.06.003","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.06.003","url":null,"abstract":"<p><strong>Purpose: </strong>Restoring elbow extension in tetraplegia and brachial plexus injuries is critical for improving hand function. In chronic lesions, the traditional method is based on the transfer of the posterior deltoid elongated by a tendon graft to the triceps. Tendon grafts need a prolonged immobilization period to avoid stretching at the muscle-tendon junction. To avoid the use of tendon grafts, we propose harvesting the middle and posterior deltoid muscle along with the entire length of the lateral intermuscular septum, facilitating direct suturing to the triceps tendon.</p><p><strong>Methods: </strong>Before surgery, the feasibility of this technique was analyzed in six fresh cadavers. From March 2021 to July 2024, we performed this muscle transfer on 12 upper limbs from 10 patients with spinal cord injury (C6), brachial plexus trauma, or brachial plexus birth injury. After surgery, the elbow was immobilized in extension for 3 weeks, with no restrictions on elbow flexion following cast removal. After surgery, evaluation focused on active elbow extension, with a median follow-up of 6 months.</p><p><strong>Results: </strong>The cadaveric study demonstrated the feasibility of creating a resistant junction between the deltoid muscle and the lateral intermuscular septum. All but one patient showed strength against manual resistance in elbow extension below the horizontal plane, and 10 of 12 limbs were capable of maintaining elbow extension with the shoulder at 90° abduction, a function that was not attainable before surgery. Two patients achieved active elbow extension with the arm overhead. The technique resulted in improved elbow extension with no notable complications or loss of active shoulder abduction.</p><p><strong>Conclusions: </strong>This technique offers a promising approach to restoring elbow extension in patients with upper limb paralysis. By avoiding tendon grafts and reducing postoperative immobilization, it provides a functional and efficient alternative to the traditional method.</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":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610325","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":"Clinical and Imaging Findings of Wrist Tuberculosis: A Study of 47 Patients.","authors":"Jia-Lu Wei, Yan Bi, Xu-Wen Fu, Min Qi, Ying Pu, Fang Xiao, Xiang Li, Xin-Hua Cun","doi":"10.1016/j.jhsa.2025.05.015","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.05.015","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to describe the clinical and imaging features of patients with wrist tuberculosis (TB) and to explore the importance of magnetic resonance imaging (MRI) in the evaluation and treatment of wrist TB.</p><p><strong>Methods: </strong>The clinical and imaging data of 47 patients with wrist TB, diagnosed through a combination of pathological (microbiological culture, polymerase chain reaction, and histopathological examination) and clinical methods, were retrospectively analyzed. The demographic characteristics, clinical symptoms, laboratory tests, and imaging findings of these patients were recorded.</p><p><strong>Results: </strong>The mean age of the patients was 53.9 ± 15.3 years, and the time from the onset of the patient's symptoms to the diagnosis of wrist TB was 16.2 ± 25.6 months. The main clinical manifestations included wrist pain (100%), wrist swelling (97.9%), and limited wrist joint movement (89.4%). According to the X-ray findings, wrist TB was classified into the synovitis stage (stage I, n = 22; 46.8%) and the bone erosion/destruction stage (stage II, n = 25; 53.2%). The MRI manifestations included bone destruction (87.2%) and synovitis (100%), and other manifestations included joint space narrowing (44.7%), tendon sheath involvement (66.0%), abscess formation (42.6%), and rice body formation (12.8%). Early bone destruction, not seen on plain radiographs (46.8%), was detected by MRI examination. There was an increase in the proportions of dorsal soft tissue abscesses and distal radioulnar joint abscesses detected by MRI examination in stage II patients compared with stage I patients.</p><p><strong>Conclusions: </strong>MRI can serve as an important adjunct in the diagnosis of wrist TB, offering valuable insights into bone, joint, and soft tissue involvement that may not be visible on plain radiographs.</p><p><strong>Type of study/level of evidence: </strong>Diagnostic IV.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592972","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 Optimal Osteotomy Angles for Kienböck and Preiser Disease Using Finite Element Analysis: Stress Changes in the Lunate and Scaphoid Bones Associated With Closing Radial Wedge Osteotomy.","authors":"Atsushi Hojo, Yusuke Matsuura, Takahiro Yamazaki, Takane Suzuki, Seiji Ohtori","doi":"10.1016/j.jhsa.2025.05.014","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.05.014","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the biomechanical effects of varying closing radial wedge osteotomy (CRWO) angles on the scaphoid and lunate using finite element analysis (FEA) and to identify the optimal osteotomy angle for treating Kienböck and Preiser diseases.</p><p><strong>Methods: </strong>Eight fresh-frozen cadaveric upper extremities (5 men, 3 women; mean age, 89.4 years) were analyzed. Specimen-specific computed tomography-based FEA models were developed to simulate carpal alignment changes in neutral and ulnar-deviated wrist positions with simulated CRWO angles of 5°, 10°, 15°, and 20°. A physiological load of 102 N was applied to the metacarpal heads. Stress distribution was analyzed across 3 scaphoid regions (proximal, body, distal) and 2 lunate regions (radial, ulnar). Changes in equivalent stress and minimum principal stress were compared with pre-osteotomy levels.</p><p><strong>Results: </strong>A 20° osteotomy resulted in a reduction of minimum principal stress in the lunate (-29.9%) and a decrease in the scaphoid (-9.2%). With increasing osteotomy angles, stress distribution changed with measured stress values shifting in the proximal regions of the scaphoid and radial potion of the lunate. The triquetrum exhibited varying responses, with stress measurements showing changes from +8.6% to -9.1% at lower osteotomy angles (5° to 10°) and reductions at higher angles (15° to 20°).</p><p><strong>Conclusions: </strong>FEA-based analysis showed stress reductions in the lunate at osteotomy angles between 10° and 20°, with measurements indicating that a 20° angle resulted in the greatest measured stress reduction in both the lunate and scaphoid.</p><p><strong>Clinical relevance: </strong>This study provides biomechanical evidence supporting CRWO for Kienböck and Preiser diseases and offers guidance on selecting osteotomy angles for improved clinical outcomes.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592973","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":"The Subdermal Approach for Harvesting Superficial Circumflex Iliac Artery-Based Pure Skin Perforator Flaps in Hand and Wrist Reconstruction.","authors":"Xuwei Zhu, Shi Li, Ya Lv, Jingquan Yang, Feiya Zhou, Tinggang Chu, Kailiang Zhou, Jian Ding, Yiheng Chen","doi":"10.1016/j.jhsa.2025.05.008","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.05.008","url":null,"abstract":"<p><strong>Purpose: </strong>The pure skin perforator (PSP) flap technique offers a reliable solution for aesthetic limb reconstruction by reducing flap thickness to approximately 2 mm while preserving blood supply. The subdermal approach simplifies flap harvesting, reducing surgical time and donor site morbidity. This study aimed to evaluate the clinical outcomes and feasibility of using the subdermal approach for harvesting superficial circumflex iliac artery (SCIA)-based PSP flaps in reconstructing hand and wrist defects.</p><p><strong>Methods: </strong>This retrospective study included 11 patients with hand or wrist skin defects, who underwent SCIA-PSP flap reconstruction using the subdermal approach between March 2022 and February 2024. Flap design and harvesting were guided by preoperative high-frequency ultrasonography, with dissection at the subdermal plane using a surgical microscope. Postoperative care included monitoring flap viability and assessing aesthetic outcomes at 6 months using a five-point Likert scale.</p><p><strong>Results: </strong>A total of 13 flaps were harvested, with two flaps harvested in cases 5 and 6, respectively. The flap sizes ranged from 11 to 98 cm² (mean: 47.5 cm²). Harvest times ranged from 37 to 140 minutes (mean: 70.1 minutes). Twelve flaps were successfully transferred, with one experiencing partial necrosis. Aesthetic outcomes at 6 months showed favorable results, with mean scores of 4.5 for overall aesthetic outcome and 4.7 for contour and texture match.</p><p><strong>Conclusions: </strong>The subdermal approach for harvesting SCIA-PSP flaps is a feasible and effective technique for hand and wrist reconstruction, yielding excellent aesthetic results. Further research is needed to confirm its broader clinical applications.</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":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592974","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":"Nonsurgical Treatment Versus Intramedullary Fixation of Displaced Metacarpal Shaft Fractures.","authors":"Alexander D Jeffs, Andrew D Allen, Zohair S Zaidi, Stephen M Himmelberg, Nicholas C Bank, Sarah C Conlon, Nathaniel C Adams, Patricia K Wellborn, Charles A Baumann, G Aman Luther","doi":"10.1016/j.jhsa.2025.05.012","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.05.012","url":null,"abstract":"<p><strong>Purpose: </strong>Retrograde intramedullary headless compression screw (IMHS) fixation offers potential advantages over traditional surgical treatment of metacarpal shaft fractures. The purpose of this study was to compare the rates of recovery of short-term functional outcomes for displaced metacarpal shaft fractures treated nonsurgically and those treated using a minimally invasive intramedullary screw technique. We hypothesized that IMHS fixation would lead to earlier return of function with equivalent outcomes at final follow-up.</p><p><strong>Methods: </strong>We identified patients between 2017 and 2022 with a displaced metacarpal shaft fracture treated nonsurgically or with IMHS. We included patients aged 18-65 years with a minimum 12 week follow up. We excluded open fractures and those presenting >1 week from injury. We documented radiographic displacement, grip strength, visual analog scale pain scores, total active motion (TAM), return to work (RTW), time to union, complications, and treatment cost. We performed a linear regression analysis to compare outcomes over time and survival curves for RTW.</p><p><strong>Results: </strong>Ninety-nine patients with 109 fractures were included. Intramedullary headless compression screw fixation demonstrated less radiographic shortening (2.4 vs 5.1 mm) and angulation at 12 weeks (2° vs 30°) compared with nonsurgical management. There was significantly faster normalization of grip strength in the IMHS group during the first 6 weeks. At 12 weeks, there was no significant difference between the IMHS and nonsurgical groups in TAM, pain, or grip strength. The IMHS group had faster return to light (1.2 vs 2.1 weeks) and heavy-duty work (3.1 vs 6.1 weeks). Average direct cost was $1,413 and $2,452 for nonsurgical and IMHS patients, respectively.</p><p><strong>Conclusions: </strong>The IMHS group demonstrated earlier return of grip strength and RTW compared with nonsurgical treatment. Intramedullary headless compression screw fixation improved radiographic parameters at 12 weeks without a difference in TAM, grip strength, or visual analog scale pain scores. The direct cost was higher by $1,039 with IMHS fixation.</p><p><strong>Level of evidence: </strong>Therapeutic IV.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585652","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":"Mapping Origins of Tendons on the Lateral Epicondyle.","authors":"Connor Kacena-Merrell, Simon Ngo, Ian Chow","doi":"10.1016/j.jhsa.2025.05.016","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.05.016","url":null,"abstract":"<p><strong>Purpose: </strong>To map the dimensions of key structures in the lateral elbow, focusing on the relationships between the extensor carpi radialis brevis (ECRB), extensor digitorum communis (EDC), joint capsule, and lateral collateral ligament (LCL).</p><p><strong>Methods: </strong>Six cadaveric arms were dissected to measure the lateral elbow structures: extensor carpi radialis longus (ECRL), ECRB, EDC, LCL, extensor carpi ulnaris, and anconeus. Each structure was isolated, and then, the origin dimensions were recorded in height, width, and distance from the lateral epicondylar prominence and joint capsule. Mean measurements and two standard errors for each tendon were calculated.</p><p><strong>Results: </strong>The ECRB was, on average, observed to be 8.3 ± 0.8 mm proximal to distal and 7.6 ± 0.3 mm anterior to posterior. The ECRB was 0 mm from the joint capsule. The EDC was observed to have average lengths of 5.1 ± 0.6 mm proximal to distal and 7.3 ± 0.9 mm anterior to posterior. The EDC, on its distal-most edge, touches the LCL's proximal edge. The mean distance from the LCL to the epicondyle was observed to be 10.3 ± 1.5 mm.</p><p><strong>Conclusions: </strong>Avoiding dissection more than 1 cm distal to the lateral epicondylar prominence and 1 cm posterior to the capitellum will avoid injury to the LCL and will allow for debridement of both the ECRB and EDC.</p><p><strong>Clinical relevance: </strong>These findings provide anatomical benchmarks to help surgeons avoid inadvertent damage to the LCL and joint capsule in lateral epicondylitis surgeries.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576987","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":"Dry Needle Arthroscopy of the Wrist in an Office Setting: 15 Cases.","authors":"Mattias Hedspång, Marcus Sagerfors, Sanjeev Kakar, Linda Ryen, Peter Asklöf, Daniel Reiser","doi":"10.1016/j.jhsa.2025.01.015","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.01.015","url":null,"abstract":"<p><strong>Purpose: </strong>Arthroscopy remains the gold standard to diagnose ligamentous lesions in the wrist. The coronavirus disease (COVID)-19 pandemic put a strain on resources, prompting an increase in procedures performed under local anesthesia. Dry needle arthroscopy of the wrist has previously been used in the operating room. The purpose of this study was to assess the results and patient satisfaction of wrist arthroscopy under local anesthesia in an office setting.</p><p><strong>Methods: </strong>A prospective series of 15 patients presenting with wrist trauma and a suspected ligamentous injury to the wrist were included. All patients underwent radiography and magnetic resonance imaging (MRI) before the procedure. Dry needle arthroscopy was performed by a surgeon with a nurse assistant, in the office under local anesthesia, using a traction device for distraction of the wrist. Patient satisfaction was assessed with the Picker Patient Experience-15 (PPE-15) questionnaire.</p><p><strong>Results: </strong>The patient's mean age was 34 years (range: 18-51). There were no intraoperative complications or postoperative infections. The median PPE-15 score was 90 of 100. Visualization of the intraarticular structures was excellent.</p><p><strong>Conclusions: </strong>Dry needle arthroscopy of the wrist under local anesthesia in an office setting seems to be a feasible method to diagnose ligament injuries of the wrist. Patient satisfaction with the procedure was high.</p><p><strong>Clinical relevance: </strong>Dry needle arthroscopy of the wrist under local anesthesia in-office could facilitate and expedite diagnosis of wrist injuries.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568083","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}