Journal of Hand Surgery-American Volume最新文献

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A Percutaneous Triple K-Wire Fixation Technique for Nascent Malunion of Proximal Interphalangeal Joint Fracture-Dislocation: A Case Series With an Assessment of Functional Outcome. 经皮三K线固定技术治疗近端指间关节骨折-脱位的新近愈合:评估功能结果的病例系列。
IF 2.1 2区 医学
Journal of Hand Surgery-American Volume Pub Date : 2024-10-07 DOI: 10.1016/j.jhsa.2024.08.010
Anil K Bhat, Mithun Pai Gurpur, Navaneeth Panarukandy
{"title":"A Percutaneous Triple K-Wire Fixation Technique for Nascent Malunion of Proximal Interphalangeal Joint Fracture-Dislocation: A Case Series With an Assessment of Functional Outcome.","authors":"Anil K Bhat, Mithun Pai Gurpur, Navaneeth Panarukandy","doi":"10.1016/j.jhsa.2024.08.010","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.08.010","url":null,"abstract":"<p><strong>Purpose: </strong>Fracture-dislocations of the proximal interphalangeal (PIP) joint are difficult to manage. In the case of a 2- to 4-week delay in definitive treatment, a nascent malunion may result. This study aimed to evaluate the effectiveness of the percutaneous triple K-wire technique for treatment of the PIP joint nascent malunion.</p><p><strong>Methods: </strong>We treated 13 patients with nascent malunion of PIP joint fracture-dislocations using the percutaneous triple K-wire fixation technique based on the principle of soft callus manipulation to achieve congruity and reduction in the joint. The study included cases where the percentage of articular involvement exceeded 40% and in whom there was a minimum follow-up of 12 months. At the final follow-up, we measured the range of motion at the PIP joint. The Ishida and Ikuta scores were determined.</p><p><strong>Results: </strong>The mean period between injury and surgery was 17.2 days. The average follow-up time was 14.2 months. The mean active arc of motion before surgery in the PIP joint was 15 degrees and that at the final follow-up was 83 degrees. Seven patients achieved excellent outcomes according to the Ishida and Ikuta scores. The final postoperative range of motion at the PIP joint was comparable with that reported in the literature for patients who underwent different procedures.</p><p><strong>Conclusions: </strong>This procedure can be considered a viable alternative to open reduction and plating, hemihamate arthroplasty, and ligamentotaxis with distraction, particularly in the presence of nascent malunion.</p><p><strong>Type of study/level of evidence: </strong>Therapeutic IV.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382483","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}
引用次数: 0
Mid-Term Outcomes Following Trapeziectomy With Suture Suspensionplasty for Thumb Carpometacarpal Joint Osteoarthritis. 拇指掌腕关节骨关节炎的梯形切除术和缝合悬吊成形术的中期疗效。
IF 2.1 2区 医学
Journal of Hand Surgery-American Volume Pub Date : 2024-10-04 DOI: 10.1016/j.jhsa.2024.08.008
Lilah Fones, Asif M Ilyas, Alexis Kasper, Calista Stevens, Frederic E Liss, Jonas L Matzon
{"title":"Mid-Term Outcomes Following Trapeziectomy With Suture Suspensionplasty for Thumb Carpometacarpal Joint Osteoarthritis.","authors":"Lilah Fones, Asif M Ilyas, Alexis Kasper, Calista Stevens, Frederic E Liss, Jonas L Matzon","doi":"10.1016/j.jhsa.2024.08.008","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.08.008","url":null,"abstract":"<p><strong>Purpose: </strong>In the treatment of symptomatic thumb carpometacarpal joint arthritis, numerous techniques have been used to maintain the trapezial space following trapeziectomy. The purpose of this study was to report the clinical and radiographic outcomes of the suture suspensionplasty technique. The hypothesis was that suture suspensionplasty would have similar clinical and radiographic outcomes compared with other techniques aimed at maintaining the trapezial space following trapeziectomy.</p><p><strong>Methods: </strong>Data were collected on 42 patients following trapeziectomy with suture suspensionplasty for symptomatic Eaton stage II-IV carpometacarpal osteoarthritis at an average follow-up of 2.1 years. Outcomes included the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire, visual analog scale for pain, radiographic analysis of subsidence, and physical examination of lateral pinch strength and thumb opposition.</p><p><strong>Results: </strong>Radiographs demonstrated that 42% of the trapezial space was maintained at 2.1 years following trapeziectomy with suture suspensionplasty. Median postoperative QuickDASH scores were 3.4 (first quartile, 0; third quartile, 15.9), which is consistent with or better than normative values in the population. Median postoperative visual analog scale scores were 0 (first quartile, 0; third quartile, 0) with good postoperative thumb opposition and pinch strength.</p><p><strong>Conclusions: </strong>Patients who underwent trapeziectomy with suture suspensionplasty had similar functional and radiographic outcomes at an average of 2.1 years after surgery compared with other techniques used for treatment of symptomatic thumb carpometacarpal joint arthritis.</p><p><strong>Type of study/level of evidence: </strong>Therapeutic IV.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373595","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}
引用次数: 0
Current Concepts in Diagnosis and Management of Hand Infections. 手部感染诊断与管理的当前概念》(Current Concepts in Diagnosis and Management of Hand Infections)。
IF 2.1 2区 医学
Journal of Hand Surgery-American Volume Pub Date : 2024-10-04 DOI: 10.1016/j.jhsa.2024.09.001
Ethan Song, Jessica Seidelman, Warren Hammert, Eliana Saltzman
{"title":"Current Concepts in Diagnosis and Management of Hand Infections.","authors":"Ethan Song, Jessica Seidelman, Warren Hammert, Eliana Saltzman","doi":"10.1016/j.jhsa.2024.09.001","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.09.001","url":null,"abstract":"<p><p>Hand and upper-extremity infections span a broad spectrum of presentations for the hand surgeon, primary care provider, and emergency medicine practitioner. As many hand infections arise from penetrating trauma, knowledge of the offending pathogen, location, and mode of spread allows the clinician to determine the appropriate intervention. Along with a thorough history and physical examination, patient factors such as age, occupation, medical comorbidities, and surgical history should be noted. Timely diagnosis and appropriate management allow for optimal recovery and outcomes. In this article, we describe the ongoing debate regarding the timing and influence of preoperative antibiotics on culture yield, timing of debridement for open fractures as it relates to infection risk, and strategies for obtaining adequate cultures to guide antibiotic therapy for complex infections such as periprosthetic joint and hardware infections. Given the changing epidemiological landscape and increased rates of antibiotic resistance, it is critical to promote antibiotic stewardship. We provide updated treatment recommendations and antibiotic profiles for the treatment of common hand infections. Finally, we discuss newer technologies such as next-generation sequencing and development of promising diagnostic and treatment strategies that will enhance the hand surgeon's ability to treat complex hand infections.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373594","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}
引用次数: 0
Passive Mobilization With Place-and-Hold Versus Active Mobilization Therapy After Flexor Tendon Repair: 5-Year Minimum Follow-Up of a Randomized Controlled Trial. 屈指肌腱修复术后的放置固定被动活动疗法与主动活动疗法:随机对照试验的最短 5 年随访。
IF 2.1 2区 医学
Journal of Hand Surgery-American Volume Pub Date : 2024-10-04 DOI: 10.1016/j.jhsa.2024.08.011
Sara Chevalley, Victoria Wängberg, Martina Åhlén, Joakim Strömberg, Anders Björkman
{"title":"Passive Mobilization With Place-and-Hold Versus Active Mobilization Therapy After Flexor Tendon Repair: 5-Year Minimum Follow-Up of a Randomized Controlled Trial.","authors":"Sara Chevalley, Victoria Wängberg, Martina Åhlén, Joakim Strömberg, Anders Björkman","doi":"10.1016/j.jhsa.2024.08.011","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.08.011","url":null,"abstract":"<p><strong>Purpose: </strong>There is no consensus on the optimal postoperative rehabilitation program following flexor tendon repair. Some studies suggest a faster recovery after active mobilization, whereas other studies have failed to find any differences between active and passive mobilization at 12 months. To our knowledge, no prior randomized controlled trial has compared the long-term effects of these two approaches. This randomized controlled trial compared the long-term outcomes of active mobilization with those of passive mobilization in combination with place-and-hold.</p><p><strong>Methods: </strong>Sixty-four patients with a flexor tendon injury in zones I or II were included in the study. After surgery, patients were randomized to either active mobilization or passive mobilization with place-and-hold. Forty-seven patients were available for the 5-year minimum follow-up. Assessments included range of motion, grip strength, key pinch, as well as the Disabilities of the Arm, Shoulder, and Hand (DASH) and ABILHAND questionnaires.</p><p><strong>Results: </strong>At the 5-year minimum follow-up, range of motion was significantly better in the group treated with passive mobilization with place-and-hold compared with the active mobilization group. Furthermore, there was a significant deterioration in the range of motion and an increased flexion contracture in the active mobilization group compared with 1 year after surgery. Grip strength deteriorated significantly in both groups from the 1-year to the 5-year minimum follow-up, but key pinch did not change. In both groups, DASH and ABILHAND scores improved from the 1-year to the 5-year minimum follow-up.</p><p><strong>Conclusions: </strong>Passive mobilization with place-and-hold following flexor tendon repair results in superior long-term outcomes compared with active mobilization.</p><p><strong>Type of study/level of evidence: </strong>Therapeutic I.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373596","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}
引用次数: 0
The Learning Curves of Adelaide- and Gan-Modified Lim-Tsai Flexor Tendon Repair Techniques. Adelaide 和 Gan 改良型 Lim-Tsai 屈指肌腱修复技术的学习曲线。
IF 2.1 2区 医学
Journal of Hand Surgery-American Volume Pub Date : 2024-10-03 DOI: 10.1016/j.jhsa.2024.09.004
Jaakko A E Kuronen, Benjamin Riski, Olli V Leppänen, Teemu Karjalainen, Lasse Linnanmäki
{"title":"The Learning Curves of Adelaide- and Gan-Modified Lim-Tsai Flexor Tendon Repair Techniques.","authors":"Jaakko A E Kuronen, Benjamin Riski, Olli V Leppänen, Teemu Karjalainen, Lasse Linnanmäki","doi":"10.1016/j.jhsa.2024.09.004","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.09.004","url":null,"abstract":"<p><strong>Purpose: </strong>Surgical performance that improves with experience is often depicted as representing a \"learning curve.\" Although numerous studies examine the tensile properties of various flexor tendon repairs, few compare the associated learning curves. This study aims to address this gap by comparing the learning curves of Adelaide- and Gan-modified Lim-Tsai repairs. Emphasizing the difference in learning curves is crucial because it highlights the tension between achieving biomechanically superior repairs, which may be challenging to many surgeons, and opting for possibly incrementally less strong but more feasible techniques.</p><p><strong>Methods: </strong>We organized a workshop attended by 20 medical students whose experience in surgery was limited to a few suturing exercises. Each participant repaired five porcine tendons in situ either with Adelaide- or Gan-modified Lim-Tsai, followed by a peripheral suture. We tested all tendons with linear static testing to measure ultimate and yield loads. In addition, repair times were recorded for each repair. We used a linear mixed model to compare learning between the techniques.</p><p><strong>Results: </strong>Ultimate loads increased with experience and were higher in Adelaide technique during the first two repairs, compared with Gan-modified Lim-Tsai (80 N vs 63 N and 79 N vs 66 N, respectively). Yield loads also increased with experience but did not differ between the repair techniques at any time point. Mean repair times decreased from 44 to 28 minutes and from 46 to 25 minutes with Adelaide- and Gan-modified Lim-Tsai repairs, respectively.</p><p><strong>Conclusions: </strong>The Adelaide core suture had a higher initial ultimate load capacity despite fewer suture strands, possibly indicating better tension consistency. The ultimate load of the Gan-modified Lim-Tsai repair increased between the first and fifth repair, and repeats were needed to achieve comparable results with the Adelaide repair.</p><p><strong>Clinical relevance: </strong>The results of this study suggest that both repair methods are suitable for novice surgeons, but Adelaide tends to result in higher strength from the first repair. Generalizability to other repairs should be made with caution.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373598","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}
引用次数: 0
Revision Surgery Following Primary Reconstruction for Hand Syndactyly. 手部畸形初次重建后的翻修手术
IF 2.1 2区 医学
Journal of Hand Surgery-American Volume Pub Date : 2024-10-02 DOI: 10.1016/j.jhsa.2024.08.012
Zoe E Belardo, Emily M Graham, Meagan Pehnke, Benjamin Chang, Shaun D Mendenhall, Sayaka Mori, Apurva S Shah
{"title":"Revision Surgery Following Primary Reconstruction for Hand Syndactyly.","authors":"Zoe E Belardo, Emily M Graham, Meagan Pehnke, Benjamin Chang, Shaun D Mendenhall, Sayaka Mori, Apurva S Shah","doi":"10.1016/j.jhsa.2024.08.012","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.08.012","url":null,"abstract":"<p><strong>Purpose: </strong>Web creep and scar contracture are established complications of syndactyly reconstruction; however, few reports characterize risk factors for revision surgery. The purpose of this investigation was to examine the rate and risk factors of reoperation for congenital hand syndactyly.</p><p><strong>Methods: </strong>Patients undergoing syndactyly reconstruction from 2007 to 2021 at a single children's hospital were reviewed. Cases with less than 1 year of follow-up were excluded. Demographic, surgical, and outcomes data were recorded by each web space to account for mixed treatments.</p><p><strong>Results: </strong>In total, 514 web spaces in 231 children were reviewed with a mean follow-up of 6.0 years after primary reconstruction; 66 (12.8%) web spaces in 51 (22.1%) children underwent revision. The most common procedures were web space deepening due to web creep (57.9% of cases) and digital scar contracture release (45.6%); these were augmented in a minority (17.5%) of cases by other aesthetic/functional procedures. Revisions occurred at a median of 1.7 years after primary reconstruction. First web spaces (thumb-index finger) were most frequently reoperated (33.3%). On multivariable analysis, first web space involvement, complete syndactyly, and complications after the primary reconstruction significantly increased odds of revision. Age at primary reconstruction was not a significant predictor. Following revision, 10.5% of cases had recurrent web creep, and 14.0% had recurrent scar contracture. Eight (1.6%) web spaces in seven (3.0%) children required multiple revisions.</p><p><strong>Conclusions: </strong>Approximately 13% of syndactyly reconstructions (22% of patients) require reoperation. Most revisions occur within 4 years of primary reconstruction. Complete syndactyly, complications after the primary reconstruction, and first web space involvement increase the risk of revision; age at primary reconstruction is not a risk factor. Revision outcomes mirror the index procedure, with 10% to 14% of revised web spaces experiencing recurrent web creep or contracture.</p><p><strong>Type of study/level of evidence: </strong>Therapeutic IV.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373597","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}
引用次数: 0
Etiology and Diagnostic Challenges of Ulnar Wrist Pain in Pediatric and Adolescent Patients. 小儿和青少年患者腕骨疼痛的病因和诊断难题。
IF 2.1 2区 医学
Journal of Hand Surgery-American Volume Pub Date : 2024-10-01 Epub Date: 2024-06-27 DOI: 10.1016/j.jhsa.2024.04.015
Christopher S Crowe, Andrew F Emanuels, Sanjeev Kakar, Steven L Moran
{"title":"Etiology and Diagnostic Challenges of Ulnar Wrist Pain in Pediatric and Adolescent Patients.","authors":"Christopher S Crowe, Andrew F Emanuels, Sanjeev Kakar, Steven L Moran","doi":"10.1016/j.jhsa.2024.04.015","DOIUrl":"10.1016/j.jhsa.2024.04.015","url":null,"abstract":"<p><strong>Purpose: </strong>Diagnosing the cause of ulnar-sided wrist pain can be difficult in the pediatric and adolescent age group. While frequently used, the diagnostic accuracy of magnetic resonance image (MRI), as compared with intraoperative arthroscopic findings, is not well-described in this population. This study aimed to determine concordance rates between magnetic resonance and arthroscopic findings depending on the specific ulnar wrist pathology.</p><p><strong>Methods: </strong>A retrospective review was performed to identify pediatric and adolescent patients who underwent operative treatment of ulnar wrist pain between 2004 and 2021. Patients were included in the analysis if they were <18 years of age, complained of ulnar-sided wrist pain, underwent MRI of the affected wrist with an available report interpreted by a consultant radiologist, and had a diagnostic arthroscopy procedure within one year of imaging. Ulnar pathologies analyzed included triangular fibrocartilage (TFCC) tears, ulnotriquetral (UT) ligament tears, lunotriquetral ligament abnormalities, and ulnocarpal impaction.</p><p><strong>Results: </strong>A total of 40 patients with a mean age of 15-years-old (range 11 to 17) were included in the analysis. Twenty-four were female, and approximately half had their dominant extremity affected. Most had a history of antecedent trauma (n = 34, 85%), but only 15/40 (38%) had a history of fracture. The mean duration of symptoms prior to presentation was six months (standard deviation, 7). The most common etiologies were Palmer 1B TFCC tears (n = 27, 68%) followed by UT split tears (n = 11, 28%). MRI overall demonstrated high specificity (82% to 94%), but low sensitivity (14% to 71%) for ulnar-sided wrist conditions. Accuracy varied between 70% and 83% depending on the specific injury.</p><p><strong>Conclusion: </strong>While MRI is a useful adjunct for determining the cause of ulnar wrist pathologies, findings are often discordant when compared with diagnostic arthroscopy. Surgeons should have a high degree of suspicion for TFCC-related pathology in the setting of positive provocative clinical examination despite negative MRI findings in young patients.</p><p><strong>Type of study/level of evidence: </strong>Diagnostic IIb.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460820","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}
引用次数: 0
Early Results of 3-Dimensional Planning and Customized Cutting Guides for the Treatment of Severe Madelung Deformity. 三维规划和定制切割导板治疗严重马德龙缺损的早期结果。
IF 2.1 2区 医学
Journal of Hand Surgery-American Volume Pub Date : 2024-10-01 Epub Date: 2023-02-09 DOI: 10.1016/j.jhsa.2022.12.011
Manon Bachy, Madeline Tadley, Scott H Kozin, Samir K Trehan, Aaron Daluiski, Dan A Zlotolow
{"title":"Early Results of 3-Dimensional Planning and Customized Cutting Guides for the Treatment of Severe Madelung Deformity.","authors":"Manon Bachy, Madeline Tadley, Scott H Kozin, Samir K Trehan, Aaron Daluiski, Dan A Zlotolow","doi":"10.1016/j.jhsa.2022.12.011","DOIUrl":"10.1016/j.jhsa.2022.12.011","url":null,"abstract":"<p><strong>Purpose: </strong>Surgical treatment of Madelung deformity can present challenges due to a need for multiplanar correction. Developing customized cutting guides for osteotomies may improve surgical outcomes by enhancing the surgeon's understanding and surgical correction.</p><p><strong>Methods: </strong>All patients who underwent forearm osteotomies for Madelung deformity using computed tomography planning with 3-dimensional-printed customized cutting guides were retrospectively reviewed (n = 8). Seven patients underwent a double osteotomy of the radius, and 1 underwent a single osteotomy.</p><p><strong>Results: </strong>Ulnar tilt was improved in all cases. Correction of deformity was significant on anteroposterior but not on lateral views. The mean preoperative and postoperative radial bow was measured in 2 planes, with an average preoperative bow of 32° (± 21°) on anteroposterior radiographs and 36° (± 17°) on lateral radiographs, and an average bow of 10° (± 6°) on anteroposterior radiographs and 7° (± 6°) on lateral films after surgery. The predicted radial bow was calculated to be 9.1° (± 8°).</p><p><strong>Conclusions: </strong>Three-dimensional planning allows predictable deformity correction across multiple but not all parameters. Future studies comparing clinical and radiographic outcomes of guided versus nonguided osteotomies are required to justify the additional expense and preoperative planning efforts.</p><p><strong>Type of study/level of evidence: </strong>Therapeutic V.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10690266","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}
引用次数: 0
The Effect of Anticoagulant and Antiplatelet Medications on Wide-Awake Hand Surgery: An Analysis of 2,162 Cases. 抗凝药物和抗血小板药物对宽醒手外科手术的影响:对 2,162 个病例的分析。
IF 2.1 2区 医学
Journal of Hand Surgery-American Volume Pub Date : 2024-10-01 Epub Date: 2024-07-17 DOI: 10.1016/j.jhsa.2024.04.010
Kyle J Plusch, Chaim Miller, Kelsey Wood, Samuel Alfonsi, Amir R Kachooei, Jonas L Matzon, Asif M Ilyas
{"title":"The Effect of Anticoagulant and Antiplatelet Medications on Wide-Awake Hand Surgery: An Analysis of 2,162 Cases.","authors":"Kyle J Plusch, Chaim Miller, Kelsey Wood, Samuel Alfonsi, Amir R Kachooei, Jonas L Matzon, Asif M Ilyas","doi":"10.1016/j.jhsa.2024.04.010","DOIUrl":"10.1016/j.jhsa.2024.04.010","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the study was to determine if perioperative prescription anticoagulant (AC) or antiplatelet (AP) medication use increases the rate of revision surgeries or complications following wide-awake hand surgery performed under local anesthesia.</p><p><strong>Methods: </strong>All patients who underwent outpatient wide-awake hand surgery under local anesthesia without a tourniquet by two fellowship-trained orthopedic hand surgeons at a single academic practice over a 3-year period were included. Prescription history was reviewed to determine if any prescriptions were filled for an AC/AP drug within 90 days of surgery. All cases requiring revision were identified. Office notes were reviewed to determine postoperative complications and/or postoperative antibiotics prescribed for infection concerns. The number of revisions, complications, and postoperative antibiotic prescriptions were compared between patients who did, and did not, use perioperative AC/AP drugs.</p><p><strong>Results: </strong>A total of 2,162 wide-awake local anesthesia surgeries were included, and there were 128 cases (5.9%) with perioperative AC/AP use. Of the 2,162 cases, 19 cases required revision surgery (18 without AC/AP use and one with AC/AP use). Postoperative wound complications occurred in 42 patients (38 without AC/AP use and four with AC/AP use). Of the wound complications, four were related to postoperative bleeding, one case of incisional bleeding, and three cases of incisional hematomas (three without AC/AP use and one with AC/AP use). None of these patients required additional intervention; their incisional bleeding or hematoma was resolved by their subsequent office visit. Sixty-five patients received postoperative antibiotics for infection concerns (59 without AC/AP use and six with AC/AP use).</p><p><strong>Conclusions: </strong>Prescription AC/AP medication use in the perioperative period for wide-awake hand surgery performed under local anesthesia was not associated with an increased risk for revision surgery or postoperative wound complications. This study demonstrates the safety of continuing patients' prescribed AC/AP medications during wide-awake hand surgery.</p><p><strong>Type of study/level of evidence: </strong>Prognosis IV.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635924","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}
引用次数: 0
Midcarpal Impaction Syndromes as a Rare Cause of Ulnar-Sided Wrist Pain: A Review. 中掌嵌顿综合征是造成尺侧腕部疼痛的罕见原因:综述》(Midcarpal Impaction Syndromes as a Rare Cause of Ulnar-Sided Wrist Pain: A Review.
IF 2.1 2区 医学
Journal of Hand Surgery-American Volume Pub Date : 2024-10-01 DOI: 10.1016/j.jhsa.2024.07.016
Steven Kyriacou, Ramon Tahmassebi
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