Journal of Hand Surgery-American Volume最新文献

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Establishing the Patient Acceptable Symptoms State for the Boston Carpal Tunnel Questionnaire in a Postoperative Carpal Tunnel Surgery Population. 在腕管手术术后人群中建立波士顿腕管问卷的患者可接受症状状态。
IF 2.1 2区 医学
Journal of Hand Surgery-American Volume Pub Date : 2024-11-15 DOI: 10.1016/j.jhsa.2024.09.022
Gretchen Maughan, James Kim, Jantz Arbon, Hernan Roca, Brittany N Garcia, Nikolas H Kazmers
{"title":"Establishing the Patient Acceptable Symptoms State for the Boston Carpal Tunnel Questionnaire in a Postoperative Carpal Tunnel Surgery Population.","authors":"Gretchen Maughan, James Kim, Jantz Arbon, Hernan Roca, Brittany N Garcia, Nikolas H Kazmers","doi":"10.1016/j.jhsa.2024.09.022","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.09.022","url":null,"abstract":"<p><strong>Purpose: </strong>Threshold scores for patient acceptable symptom state (PASS) represent the score beyond which a patient considers themselves \"well.\" We aimed to determine PASS thresholds for the symptom severity scale (SSS) and functional status scale (FSS) of the Boston Carpal Tunnel Questionnaire in a sample of patients 1 year following carpal tunnel release.</p><p><strong>Methods: </strong>Adults (≥ 18 years) from a single, tertiary-care academic institution were contacted 12 ± 1 months after carpal tunnel release. The Boston Carpal Tunnel Questionnaire and two PASS anchor questions were administered via REDCap-one queried acceptability of their current symptoms, and the other queried function. Participants were classified as being in an acceptable symptom state (\"PASS(+)\") if they answered \"very satisfied\" or \"somewhat satisfied,\" whereas those responding \"neither satisfied nor dissatisfied,\" \"somewhat dissatisfied,\" or \"very dissatisfied\" were classified as \"PASS(-).\" Threshold values were calculated using three methods: (1) the mean score for PASS(+) participants, (2) the 75th percentile score for PASS(+) patients, and (3) the Youden Index determined using receiver operating curve (ROC) analysis to maximize sensitivity and specificity.</p><p><strong>Results: </strong>The 153 patients included in the study had a mean age of 60 ± 15 years and 60% (94/153) were women. At a mean follow-up of 1.0 ± 0.1 years, SSS and FSS scores were significantly lower (better) for PASS(+) than PASS(-) patients for both anchor questions. PASS estimates ranged from <1.4 to <1.8 for the SSS and from <1.3 to <1.5 for the FSS. All ROC curves produced excellent discrimination (area under the curve > 0.8).</p><p><strong>Conclusions: </strong>We propose PASS thresholds of 1.8 for the SSS and 1.5 for the FSS, derived by the Youden or ROC method, which showed excellent discrimination between PASS(+) and PASS(-) patients.</p><p><strong>Clinical relevance: </strong>These threshold values can be used to assess whether patient populations have achieved an adequate symptom and functional state.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640295","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
Comparative Computer-Aided Analysis of Three-Dimensional Carpal Alignment in Scapholunate Advanced Collapse and Healthy Wrists. 肩胛骨高级塌陷与健康腕部三维腕关节排列的计算机辅助对比分析
IF 2.1 2区 医学
Journal of Hand Surgery-American Volume Pub Date : 2024-11-14 DOI: 10.1016/j.jhsa.2024.09.021
Mikko Alanen, Samuli Aspinen, Theresa Höglund, Robert Sippo, Eero Waris
{"title":"Comparative Computer-Aided Analysis of Three-Dimensional Carpal Alignment in Scapholunate Advanced Collapse and Healthy Wrists.","authors":"Mikko Alanen, Samuli Aspinen, Theresa Höglund, Robert Sippo, Eero Waris","doi":"10.1016/j.jhsa.2024.09.021","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.09.021","url":null,"abstract":"<p><strong>Purpose: </strong>Scapholunate dissociation frequently results in malalignment and scapholunate advanced collapse (SLAC). Previous analyses have relied on visual observations of carpal angles among the scaphoid, lunate, and capitate on lateral radiographs. However, the 3-dimensional carpal alignment during SLAC progression remains unclear. The purpose of this study was to analyze 3-dimensional carpal malalignment in SLAC wrists.</p><p><strong>Methods: </strong>Using computer-aided cone-beam computed tomography analysis software based on segmentation and numerical modeling, we defined three-dimensional carpal axes and examined alignment and carpal height ratio in 18 SLAC wrists along the radial coordinate (positive in palmar and ulnar directions). These results were compared with previously reported normal alignment values obtained from 121 healthy wrists.</p><p><strong>Results: </strong>In the sagittal plane, mean scapholunate, lunotriquetral, lunocapitate, and capitometacarpal angles were -100° (SD, 11°); 20° (SD, 11°); 7° (SD, 12°); and 18° (SD, 8°); respectively, whereas the angles were -58° (SD, 9°); 12° (SD, 8°); -17°(SD, 11°); and 8° (SD, 6°); respectively, in healthy wrists. The sagittal scapholunate angle exhibited the highest area under the receiver operating characteristic curve (0.999), with a threshold value of ≤-76°, indicating pathology. In the coronal plane, the carpal alignment of SLAC wrists remained unchanged, excluding a minimal ulnar tilt of the capitate.</p><p><strong>Conclusions: </strong>Carpal malalignment in SLAC wrists not only affects the radio- and midcarpal joints, but also extends to the third carpometacarpal joint, with malalignment evident in both the sagittal and coronal planes. In SLAC wrists, the sagittal lunotriquetral angle increases in the positive direction, due to the lunate angulating more than the triquetrum.</p><p><strong>Clinical relevance: </strong>These findings have potential to contribute to the development of computer-aided diagnostic tools for 3-dimensional imaging technology. In the future, such tools could highlight abnormal values and minimize diagnostic errors in clinical practice.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640293","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 Pericoracoid Tissue Release in Children With Brachial Plexus Birth Injury. 臂丛神经产伤儿童的肩胛周围组织松解术
IF 2.1 2区 医学
Journal of Hand Surgery-American Volume Pub Date : 2024-11-11 DOI: 10.1016/j.jhsa.2024.10.003
Akin Uzumcugil, Kıvanç Delioğlu, Abdurrahman Yilmaz, Abdullah Serin
{"title":"The Pericoracoid Tissue Release in Children With Brachial Plexus Birth Injury.","authors":"Akin Uzumcugil, Kıvanç Delioğlu, Abdurrahman Yilmaz, Abdullah Serin","doi":"10.1016/j.jhsa.2024.10.003","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.10.003","url":null,"abstract":"<p><strong>Purpose: </strong>In brachial plexus birth injury (BPBI), children with upper trunk injuries have multidirectional movement deficits, including global abduction and hand-to-neck, hand-to-abdomen, and hand-to-spine movements. The aim of this study was to evaluate the results of pericoracoid tissue release and postoperative structured physiotherapy as a first-step intervention to reduce the multidirectional movement deficit in children with BPBI.</p><p><strong>Methods: </strong>Thirty-four children with BPBI underwent pericoracoid tissue release, including coracohumeral and coracoacromial ligament release, pectoralis minor release, and coracoid process osteotomy. Patients were followed up with regular physiotherapy and a home exercise program for 1 year after surgery. Before surgery and at 3 and 12 months after surgery, upper-extremity function was measured using the modified Mallet classification and Active Movement Scale, passive shoulder and elbow joint movements were measured using goniometry, and the difference in the distance between the treatment table and the acromion was measured.</p><p><strong>Results: </strong>There was an improvement in all movement tasks evaluated with modified Mallet classification, and there was increased shoulder flexion, abduction, and external and internal rotation movements as evaluated with Active Movement Scale. Increased passive joint movements were noted in abduction, external rotation, and internal rotation movements with the arm next to the body and with the limb in 90° abduction. There was a decrease in the distance difference between the acromion and the treatment table between both sides.</p><p><strong>Conclusions: </strong>Pericoracoid tissue release provided multidirectional improvement in shoulder joint movements in children with BPBI.</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":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632856","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
A 3-Dimensional Printed Dynamic External Fixator for the Treatment of Proximal Interphalangeal Fracture-Dislocations: A Biomechanical Study. 用于治疗近端指间骨折脱位的三维打印动态外固定器:生物力学研究。
IF 2.1 2区 医学
Journal of Hand Surgery-American Volume Pub Date : 2024-11-05 DOI: 10.1016/j.jhsa.2024.09.019
Pedro Bronenberg Victorica, Agustín Albani-Forneris, Fernando Holc, Lauren M Shapiro, Robin N Kamal, Jorge G Boretto
{"title":"A 3-Dimensional Printed Dynamic External Fixator for the Treatment of Proximal Interphalangeal Fracture-Dislocations: A Biomechanical Study.","authors":"Pedro Bronenberg Victorica, Agustín Albani-Forneris, Fernando Holc, Lauren M Shapiro, Robin N Kamal, Jorge G Boretto","doi":"10.1016/j.jhsa.2024.09.019","DOIUrl":"10.1016/j.jhsa.2024.09.019","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated the efficacy of a 3-dimensional printed dynamic external fixator for treating proximal interphalangeal (PIP) fracture-dislocations. The null hypothesis was that there would be no difference in maintaining PIP joint reduction between a 3-dimensional printed dynamic external fixator (3DPDEF) and the pins and rubbers traction system (PRTS).</p><p><strong>Methods: </strong>Ten cadaveric fingers underwent an oblique osteotomy at the base of the middle phalanx, recreating an unstable dorsal PIP fracture-dislocation. The percentages of compromised articular surface and middle phalanx dorsal displacement were measured. Both fixators were randomly placed on each digit and underwent 1,400 flexion-extension cycles. Efficacy, determined by joint reduction and maintenance of dorsal translation correction, was assessed using fluoroscopy before and after the cycles.</p><p><strong>Results: </strong>The mean compromised articular surface was 50.8%. After osteotomy, PIP joint subluxation occurred at 37.8° flexion. Dorsal translation after osteotomies was 2.8 mm. After applying the 3DPDEF and the PRTS, it was 0 mm and 0.1 mm, respectively. During the cycles, all the joints remained stable and reduced. Dorsal displacement after cycles was -0.1 mm for the 3DPDEF and 0 mm for the PRTS. The mean translation difference between both fixators was 0.1 and 0 mm before and after the cycles. The translation differences before and after the cycles were 0.1 mm for both dynamic fixators.</p><p><strong>Conclusions: </strong>The 3DPDEF is a suitable option for PIP fracture-dislocations, providing stability comparable to that of the PRTS while offering benefits, such as easy placement, controlled distraction, and clear visualization of the articular surface.</p><p><strong>Clinical relevance: </strong>This external fixator, characterized by its efficacy, low cost, and simplicity of application, broadens the options available to address PIP fracture-dislocations.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583560","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
Journal CME Instructions 期刊继续医学教育说明
IF 2.1 2区 医学
Journal of Hand Surgery-American Volume Pub Date : 2024-11-01 DOI: 10.1016/S0363-5023(24)00450-7
{"title":"Journal CME Instructions","authors":"","doi":"10.1016/S0363-5023(24)00450-7","DOIUrl":"10.1016/S0363-5023(24)00450-7","url":null,"abstract":"","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"49 11","pages":"Page A14"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593105","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
Artificial Intelligence-Powered Hand Surgery Consultation: GPT-4 as an Assistant in a Hand Surgery Outpatient Clinic 人工智能助力手外科会诊:GPT-4 作为手外科门诊助手。
IF 2.1 2区 医学
Journal of Hand Surgery-American Volume Pub Date : 2024-11-01 DOI: 10.1016/j.jhsa.2024.06.002
Tim Leypold MD , Benedikt Schäfer MD , Anja M. Boos MD , Justus P. Beier MD
{"title":"Artificial Intelligence-Powered Hand Surgery Consultation: GPT-4 as an Assistant in a Hand Surgery Outpatient Clinic","authors":"Tim Leypold MD ,&nbsp;Benedikt Schäfer MD ,&nbsp;Anja M. Boos MD ,&nbsp;Justus P. Beier MD","doi":"10.1016/j.jhsa.2024.06.002","DOIUrl":"10.1016/j.jhsa.2024.06.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Exploring the integration of artificial intelligence in clinical settings, this study examined the feasibility of using Generative Pretrained Transformer 4 (GPT-4), a large language model, as a consultation assistant in a hand surgery outpatient clinic.</div></div><div><h3>Methods</h3><div>The study involved 10 simulated patient scenarios with common hand conditions, where GPT-4, enhanced through specific prompt engineering techniques, conducted medical history interviews, and assisted in diagnostic processes. A panel of expert hand surgeons, each board-certified in hand surgery, evaluated GPT-4’s responses using a Likert Scale across five criteria with scores ranging from 1 (lowest) to 5 (highest).</div></div><div><h3>Results</h3><div>Generative Pretrained Transformer 4 achieved an average score of 4.6, reflecting good performance in documenting a medical history, as evaluated by the hand surgeons.</div></div><div><h3>Conclusions</h3><div>These findings suggest that GPT-4 can effectively document medical histories to meet the standards of hand surgeons in a simulated environment. The findings indicate potential for future application in patient care, but the actual performance of GPT-4 in real clinical settings remains to be investigated.</div></div><div><h3>Clinical relevance</h3><div>This study provides a preliminary indication that GPT-4 could be a useful consultation assistant in a hand surgery outpatient clinic, but further research is required to explore its reliability and practicality in actual practice.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"49 11","pages":"Pages 1078-1088"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effectiveness of Delayed Surgical Treatment for Distal Radius Fractures With Loss of Reduction 延迟手术治疗桡骨远端骨折并失去还原能力的效果。
IF 2.1 2区 医学
Journal of Hand Surgery-American Volume Pub Date : 2024-11-01 DOI: 10.1016/j.jhsa.2024.07.006
Tolga Keçeci MD , Bekir Karagöz MD , İsmail Ağır MD
{"title":"Effectiveness of Delayed Surgical Treatment for Distal Radius Fractures With Loss of Reduction","authors":"Tolga Keçeci MD ,&nbsp;Bekir Karagöz MD ,&nbsp;İsmail Ağır MD","doi":"10.1016/j.jhsa.2024.07.006","DOIUrl":"10.1016/j.jhsa.2024.07.006","url":null,"abstract":"<div><h3>Purpose</h3><div>This study investigated the effectiveness of volar plate surgery in patients with distal radius fractures (DRFs) initially treated nonsurgically but later experiencing reduction loss during follow-ups. Specifically, it assessed the impact of early surgery (E) (&lt;3 weeks) versus delayed surgery (D) (3–6 weeks) on wrist function in surgically treated DRFs.</div></div><div><h3>Methods</h3><div>This retrospective study included 131 patients who underwent surgery after loss of reduction. Among them, 42 patients had delayed surgery, whereas 89 received early surgical treatment. The mean follow-up duration was 18 months. The primary outcome measure was Disabilities of the Arm, Shoulder, and Hand scores. Secondary outcomes included Short Form-12 physical component summary and mental component summary scores, postoperative range of motion, and radiological measurements such as radial length, radial inclination angle, and volar tilt angle. Fracture types were categorized using Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association classification based on radiological images.</div></div><div><h3>Results</h3><div>All 131 DRFs achieved radiological union. Mean Disabilities of the Arm, Shoulder, and Hand scores were 8.0 (range, 0–78) and 10.8 (range, 0–73) for groups E and D, respectively, and the difference was not considered clinically relevant. Short Form-12 physical component summary scores (49.4 for E; 45.3 for D) and Short Form-12 mental component summary scores (52.3 for E; 53.5 for D) were similar in the two groups. Radiological measurements and range of motion were similar in the two groups. Complications, including carpal tunnel syndrome, superficial radial nerve neuropraxia, and complex regional pain syndrome, occurred in 12 (13.5%) E group patients and 9 (21.4%) D group patients.</div></div><div><h3>Conclusions</h3><div>Clinical and radiological results of early and delayed surgery after loss of reduction in secondary displaced DRF were similar. However, complication rates were higher in delayed surgery.</div></div><div><h3>Type of study/level of evidence</h3><div>Prognostic IV.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"49 11","pages":"Pages 1104-1110"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977279","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
An Analysis of Surgeon Experience, Diagnostic Testing, and Treatment Recommendation For Carpal Tunnel Syndrome 腕管综合征的外科医生经验、诊断测试和治疗建议分析。
IF 2.1 2区 医学
Journal of Hand Surgery-American Volume Pub Date : 2024-11-01 DOI: 10.1016/j.jhsa.2024.06.012
Rachel C. Hooper MD , Noelle Thompson BS , Zhaohui Fan MD , Jennifer F. Waljee MD , Erika D. Sears MD, MS
{"title":"An Analysis of Surgeon Experience, Diagnostic Testing, and Treatment Recommendation For Carpal Tunnel Syndrome","authors":"Rachel C. Hooper MD ,&nbsp;Noelle Thompson BS ,&nbsp;Zhaohui Fan MD ,&nbsp;Jennifer F. Waljee MD ,&nbsp;Erika D. Sears MD, MS","doi":"10.1016/j.jhsa.2024.06.012","DOIUrl":"10.1016/j.jhsa.2024.06.012","url":null,"abstract":"<div><h3>Purpose</h3><div>The diagnosis of carpal tunnel syndrome (CTS) can be made clinically using the Carpal Tunnel Syndrome-6 (CTS-6) criteria. The role of electrodiagnostic studies (EDS) is controversial. We examined differences in the utilization of CTS-6 and EDS based on surgeon experience and practice setting.</div></div><div><h3>Methods</h3><div>Members of the American Society for Surgery of the Hand were emailed an anonymous web-based link to participate. The survey included an assessment of hypothetical CTS scenarios with varying clinical severity. We collected surgeon demographic attributes, years in practice, practice setting, and frequency of CTS-6 and EDS utilization. A comparison was made of years of experience with surgeon-reported utilization of CTS-6 and EDS as well as treatment recommendation.</div></div><div><h3>Results</h3><div>We received 771 responses (25% response rate). Surgeons recommended carpal tunnel release (CTR) for patients without EDS (16%), normal EDS (33%), and abnormal EDS (90%). Fifty-three percent of surgeons with &lt;15 years in practice reported often/always using CTS-6 criteria in their practice compared to 30% and 29% of surgeons with 16–30 years and &gt; 30 years in practice, respectively. Surgeons with 16–30 and &gt;30 years in practice had significantly lower odds of reporting often/almost always using CTS-6 relative to surgeons with 1–15 years in practice (OR 0.35 and 0.31, respectively). A greater proportion of surgeons with 16–30 years (68%) and &gt;30 years (65.5%) in practice responded often/almost always applying EDS compared to surgeons with &lt;15 years (56%) in practice. In addition, surgeons with 16–30 years and &gt;30 years in practice had a higher odds of often/always using EDS (ORs 1.74 and 1.98, respectively) compared to surgeons with 1–15 years in practice (<em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>Utilization of CTS-6 and EDS varied based on years in practice. This difference may reflect changing guidelines, the growing evidence regarding clinical assessment tools, and the emergence of other diagnostic modalities.</div></div><div><h3>Clinical relevance</h3><div>Given the expense and invasiveness of EDS, opportunities to integrate clinical assessment tools readily into the diagnostic algorithm may shift the role of EDS toward selective utilization for complex clinical scenarios rather than for routine use.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"49 11","pages":"Pages 1061-1067"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977278","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
Impact of Possible Sarcopenia and Nutritional Status on Postoperative Quick Disabilities of the Arm, Shoulder, and Hand Score in Geriatric Women With Distal Radius Fracture 桡骨远端骨折老年女性术后手臂、肩部和手部快速残疾评分中可能存在的肌少症和营养状况的影响。
IF 2.1 2区 医学
Journal of Hand Surgery-American Volume Pub Date : 2024-11-01 DOI: 10.1016/j.jhsa.2024.07.007
Takafumi Hosokawa MD, PhD , Tsuyoshi Tajika MD, PhD , Morimichi Suto MD , Akira Honda MD, PhD , Hirotaka Chikuda MD, PhD
{"title":"Impact of Possible Sarcopenia and Nutritional Status on Postoperative Quick Disabilities of the Arm, Shoulder, and Hand Score in Geriatric Women With Distal Radius Fracture","authors":"Takafumi Hosokawa MD, PhD ,&nbsp;Tsuyoshi Tajika MD, PhD ,&nbsp;Morimichi Suto MD ,&nbsp;Akira Honda MD, PhD ,&nbsp;Hirotaka Chikuda MD, PhD","doi":"10.1016/j.jhsa.2024.07.007","DOIUrl":"10.1016/j.jhsa.2024.07.007","url":null,"abstract":"<div><h3>Purpose</h3><div>Distal radius fracture (DRF), sarcopenia, and malnutrition have been reported to be interrelated. However, there are few reports on the effects of sarcopenia and malnutrition on DRF patients’ postoperative outcomes. This study examined the healthy-side grip strength and preoperative blood tests to determine the presence of possible sarcopenia (PS) and malnutrition in geriatric women with DRF and their impact on postoperative functional outcomes.</div></div><div><h3>Methods</h3><div>Fifty-five woman older than 60 years treated with volar-locking plate fixation for low-energy DRF from standing-level falls were retrospectively studied. Based on the criteria of The Asian Working Group for Sarcopenia 2019, patients with a healthy-side grip strength &lt;18 kg were defined as PS. Nutritional assessment was performed using Onodera’s Prognostic Nutritional Index (PNI) before surgery, with a value &lt;50 defined as malnutrition. The Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) was used for functional assessment at 1 year after surgery. Patients were divided into two groups according to PS, and patient demographic data and postoperative outcomes were compared. Multiple regression analysis was performed to estimate the regression coefficient and 95% confidence intervals for 1-year QuickDASH after surgery with adjustment for age, PS, and malnutrition.</div></div><div><h3>Results</h3><div>Possible sarcopenia was present in 10 patients (18.2%), and malnutrition in 24 patients (43.6%). Possible sarcopenia patients were older, had lower PNI, serum albumin, and both sides grip strength, and worse QuickDASH compared with non-PS patients. In multiple regression analysis, age, PS, and malnutrition were significant predictors of QuickDASH (standardized coefficient β, 0.35, 0.34, and 0.24; 95% confidence interval, 0.22–1.02, 3.52–16.49, and 0.50–10.78).</div></div><div><h3>Conclusions</h3><div>Possible sarcopenia with a healthy-side grip strength &lt;18 kg and malnutrition with a PNI &lt;50 were associated with worse 1-year QuickDASH after surgery in women DRF patients over 60 years.</div></div><div><h3>Type of study/level of evidence</h3><div>Prognostic Ⅳ.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"49 11","pages":"Pages 1112-1118"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977281","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
Harms Reporting in Randomized Controlled Trials Underpinning the American Academy of Orthopaedic Surgeons Clinical Practice Guidelines for Distal Radius Fractures 美国矫形外科医师学会桡骨远端骨折临床实践指南》所依据的随机对照试验中的危害报告。
IF 2.1 2区 医学
Journal of Hand Surgery-American Volume Pub Date : 2024-11-01 DOI: 10.1016/j.jhsa.2023.03.008
{"title":"Harms Reporting in Randomized Controlled Trials Underpinning the American Academy of Orthopaedic Surgeons Clinical Practice Guidelines for Distal Radius Fractures","authors":"","doi":"10.1016/j.jhsa.2023.03.008","DOIUrl":"10.1016/j.jhsa.2023.03.008","url":null,"abstract":"<div><h3>Purpose</h3><div><span>The purpose of this study was to measure the harms-related reporting among randomized controlled trials (RCTs) cited as supporting evidence for the American Academy of Orthopaedic Surgeons clinical practice guidelines regarding the management of </span>distal radius fractures.</div></div><div><h3>Methods</h3><div><span><span>We adhered to the guidance for reporting metaresearch and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines throughout the course of this investigation. We used the American Academy of Orthopaedic Surgeons clinical practice guidelines for </span>distal radius fractures available on </span><span><span>Orthoguidelines.org</span><svg><path></path></svg></span><span>. A linear regression analysis was conducted to model the relationship between the year of publication and the total Consolidated Standards of Reporting Trials percentage adherence over time.</span></div></div><div><h3>Results</h3><div>Thirty-five RCTs were included in the final sample. The average number of Consolidated Standards of Reporting Trials Extension for Harms items adequately reported across all included RCTs was 9.2 (9.2/18, 50.9%). None of the included trials adequately reported all 18 items. Ten items had a compliance of more than 50% (10/18, 55.6%), 4 items had a compliance of 20%–50% (4/18, 22.2%), and 4 items had a compliance of less than 20% (4/18, 22.2%). The results of the linear regression model showed no significant improvement in Consolidated Standards of Reporting Trials Harms reporting over time.</div></div><div><h3>Conclusions</h3><div>Adverse events are incompletely reported among RCTs cited as supporting evidence for American Academy of Orthopaedic Surgeons clinical practice guidelines for the management of distal radius fractures.</div></div><div><h3>Clinical relevance</h3><div>Given our findings, specific attention should be paid to improving the standardization of the classification of adverse events to facilitate ease in the reporting process.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"49 11","pages":"Pages 1145.e1-1145.e9"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9344155","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}
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