Journal of Hand Surgery-American Volume最新文献_第10页

IF 2.1 2区医学

Journal of Hand Surgery-American Volume Pub Date : 2025-03-01 DOI: 10.1016/j.jhsa.2025.01.027

引用次数: 0

Treatment of Complete Brachial Plexus Injuries Using Double Free Muscle Transfer 双自由肌转移治疗完全性臂丛损伤。

IF 2.1 2区医学

Journal of Hand Surgery-American Volume Pub Date : 2025-03-01 DOI: 10.1016/j.jhsa.2023.09.005

Ryosuke Kakinoki MD, PhD , Kazuhiro Ohtani MD, PhD , Souichi Ohta MD, PhD , Ryosuke Ikeguchi MD, PhD , Masao Akagi MD, PhD , Koji Goto MD, PhD

{"title":"Treatment of Complete Brachial Plexus Injuries Using Double Free Muscle Transfer","authors":"Ryosuke Kakinoki MD, PhD , Kazuhiro Ohtani MD, PhD , Souichi Ohta MD, PhD , Ryosuke Ikeguchi MD, PhD , Masao Akagi MD, PhD , Koji Goto MD, PhD","doi":"10.1016/j.jhsa.2023.09.005","DOIUrl":"10.1016/j.jhsa.2023.09.005","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to examine the surgical outcomes of double free muscle transfer (DFMT) performed in patients with complete brachial plexus injury (BPI).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed the outcomes of DFMT for 12 patients with complete BPI who were followed up for more than 2 years after the final muscle transplantation. Their mean age was 29 years (range, 18–41). Three patients underwent contralateral C7 nerve root transfer before the DFMT. The range of motion (ROM) of the shoulder, elbow, and fingers was measured. Patient-reported outcome measures, including Disability of the Shoulder, Arm, and Hand (DASH) scores and visual analog scale (VAS) scores for pain, were also examined.</div></div><div><h3>Results</h3><div>The mean shoulder ROM against gravity was 22° ± 8° in abduction and 33° ± 5° in flexion. Seven patients underwent phrenic nerve (PhN) transfer to the suprascapular nerves, and five exhibited asymptomatic lung impairment on spirography more than 2 years after PhN transfer. The mean elbow ROM against gravity was 111° ± 9° in flexion and –32° ± 7° in extension. All patients obtained elbow flexion >90° against a 0.5-kg weight. All patients obtained touch sensation and two recognized warm and cold sensations in the affected palm. The mean total active motion of the affected fingers was 44° ± 11°. All patients exhibited hook function of the hands. The mean preoperative and postoperative DASH scores were 70.3 ± 13.4 and 51.8 ± 15.9, respectively. The mean pain VAS score was 28 ± 31 at the final follow-up.</div></div><div><h3>Conclusions</h3><div>Double free muscle transfer provided patients with complete brachial plexus palsy with good elbow flexion and hand hook functions.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic IV.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 3","pages":"Pages 382.e1-382.e10"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71429282","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

The Green Transfer—Long-Term Results 绿色转移——长期结果。

IF 2.1 2区医学

Journal of Hand Surgery-American Volume Pub Date : 2025-03-01 DOI: 10.1016/j.jhsa.2023.09.003

Douglas T. Hutchinson MD , Michelle A. James MD , Wendy A. Tomhave OTR/L , Ann Van E. Heest MD

{"title":"The Green Transfer—Long-Term Results","authors":"Douglas T. Hutchinson MD , Michelle A. James MD , Wendy A. Tomhave OTR/L , Ann Van E. Heest MD","doi":"10.1016/j.jhsa.2023.09.003","DOIUrl":"10.1016/j.jhsa.2023.09.003","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to determine the long-term results of the Green transfer (flexor carpi ulnaris to extensor carpi radialis brevis) for patient-reported outcomes, wrist position, and range of motion.</div></div><div><h3>Methods</h3><div>We re-examined 13 patients from a previous prospective study involving surgery for hemiplegia<span> that included a Green transfer. The average follow-up was 8 years with the range from 5 to 11 years. The wrist range of motion and the postoperative position of the wrists were measured. The surgical outcomes were measured via the Pediatric<span> Orthopedic Data Collection Instrument, the Shriner’s Hospital Upper Extremity Evaluation, Pediatric Quality of Life, and visual analog score for appearance from the patient and the parent.</span></span></div></div><div><h3>Results</h3><div>At this follow-up, only 7 of the 13 patients had a wrist position near neutral with the ability to flex and extend the wrist. Wrist range of motion was improved in four, decreased in four, and stayed the same in five patients. In contrast to these positional wrist results, statistically significant improvements were noted in several aspects of the Pediatric Orthopedic Data Collection Instrument, visual analog scores, and Shriner’s Hospital Upper Extremity Evaluation scores.</div></div><div><h3>Conclusions</h3><div>Long-term follow-up of the flexor carpi ulnaris to extensor carpi radialis brevis tendon transfer in hemiplegic patients reveals the results to be variable but favorable from a patient-reported outcome standpoint.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic IV.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 3","pages":"Pages 380.e1-380.e6"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138479372","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

Benefits of Sensory Nerve Transfers and Risks of Using the Superficial Radial Nerve as a Donor 感觉神经移植的益处和使用桡侧浅神经作为供体的风险

IF 2.1 2区医学

Journal of Hand Surgery-American Volume Pub Date : 2025-03-01 DOI: 10.1016/j.jhsa.2024.09.027

Yamaan S. Saadeh MD , Martijn J. Malessy PhD, MD

引用次数: 0

Claims Database Research in Hand Surgery: From Data to Bedside 手外科索赔数据库研究：从数据到床边

IF 2.1 2区医学

Journal of Hand Surgery-American Volume Pub Date : 2025-03-01 DOI: 10.1016/j.jhsa.2024.10.004

Thompson Zhuang MD, MBA , Lauren M. Shapiro MD, MS , Robin N. Kamal MD, MBA, MS

引用次数: 0

Total Wrist Arthroplasty With a New Design: 20 Cases With 8-Year Follow-Up 新设计全腕关节置换术20例，随访8年

IF 2.1 2区医学

Journal of Hand Surgery-American Volume Pub Date : 2025-03-01 DOI: 10.1016/j.jhsa.2023.08.004

Daniel Reiser MD, PhD , Per Fischer MD, PhD , Kurt Pettersson MD, PhD , Per Wretenberg MD, PhD , Marcus Sagerfors MD, PhD

{"title":"Total Wrist Arthroplasty With a New Design: 20 Cases With 8-Year Follow-Up","authors":"Daniel Reiser MD, PhD , Per Fischer MD, PhD , Kurt Pettersson MD, PhD , Per Wretenberg MD, PhD , Marcus Sagerfors MD, PhD","doi":"10.1016/j.jhsa.2023.08.004","DOIUrl":"10.1016/j.jhsa.2023.08.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Total wrist arthroplasty (TWA) is an established motion-preserving alternative to arthrodesis in the treatment of wrist arthritis, but post-TWA complications requiring additional surgery remain an issue. A new TWA design has been proposed. The purpose of this study was to report the outcome of a cohort study of 20 patients who underwent surgery using the new TWA design.</div></div><div><h3>Methods</h3><div>Patients were assessed before surgery and at 1, 2, and 8 years after surgery for visual analog scale (VAS) pain scores, wrist range of motion, hand grip strength, and patient-reported outcome measures (PROMs). Radiographic examination was conducted for evidence of prosthetic loosening. Reasons for revision were analyzed.</div></div><div><h3>Results</h3><div>In total, 24 reoperations were performed, including 12 revisions in 6 patients. Patient-reported outcome measures improved significantly at the 2-year follow-up compared with preoperative values. Hand grip strength, wrist extension, and VAS pain scores improved significantly at the 2-year follow-up. No radiographic loosening of the components was observed, but backing out of the carpal screws was noted in 16 of the 20 cases.</div></div><div><h3>Conclusions</h3><div>The new TWA resulted in improved VAS pain scores, PROMs, wrist extension, and hand grip strength. The high frequency of reoperation is a concern, and modification of the implant is needed.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic IV.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 3","pages":"Pages 377.e1-377.e8"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10635164","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

The Effect of Area-Level Deprivation on the Severity of Cubital Tunnel Syndrome on Presentation to a Hand Surgeon 区域水平剥夺对手外科医生肘管综合征严重程度的影响。

IF 2.1 2区医学

Journal of Hand Surgery-American Volume Pub Date : 2025-03-01 DOI: 10.1016/j.jhsa.2024.11.007

Rimel N. Mwamba BA , Jeffrey G. Stepan MD, MSc

{"title":"The Effect of Area-Level Deprivation on the Severity of Cubital Tunnel Syndrome on Presentation to a Hand Surgeon","authors":"Rimel N. Mwamba BA , Jeffrey G. Stepan MD, MSc","doi":"10.1016/j.jhsa.2024.11.007","DOIUrl":"10.1016/j.jhsa.2024.11.007","url":null,"abstract":"<div><h3>Purpose</h3><div>Cubital tunnel syndrome (CuTS) is the second most common upper-extremity neuropathy and can cause debilitating symptoms. Patients presenting to care with severe CuTS can be left with permanent weakness and numbness despite treatment. The aim of this study was to examine the relationship between area-level deprivation and the severity of CuTS on presentation to a hand surgeon.</div></div><div><h3>Methods</h3><div>We retrospectively identified 369 patients who were diagnosed with CuTS at a new patient visit between January 2017 and December 2021. We queried the electronic health record to assess the severity of CuTS using the McGowan grade. We used patient addresses to determine the national percentile of area-level deprivation for each patient. Bivariate analyses were used to determine if sociodemographic factors were associated with CuTS severity on presentation or rates of surgical intervention.</div></div><div><h3>Results</h3><div>In bivariate analysis, patients with higher levels of area-level deprivation had more severe CuTS. Those who were older, were men, and had public insurance were also found to have more severe CuTS. Secondary analysis revealed that patients with higher levels of deprivation were more likely to receive nerve conduction testing. No sociodemographic factors were associated with whether patients received surgical intervention or in time from presentation to surgery.</div></div><div><h3>Conclusions</h3><div>Patients from marginalized backgrounds present to hand surgeons with more severe CuTS disease.</div></div><div><h3>Clinical relevance</h3><div>Delayed presentation can lead to worse outcomes in CuTS. Understanding barriers to earlier presentation in more deprived locations and certain patient populations can help develop solutions to address these disparities.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 3","pages":"Pages 292-298"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830844","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 日刊CME指南

IF 2.1 2区医学

Journal of Hand Surgery-American Volume Pub Date : 2025-03-01 DOI: 10.1016/S0363-5023(25)00052-8

引用次数: 0

Journal CME Questions 期刊CME问题

IF 2.1 2区医学

Journal of Hand Surgery-American Volume Pub Date : 2025-03-01 DOI: 10.1016/j.jhsa.2025.01.026

引用次数: 0

Comparative Outcomes of Anterior and Posterior Plating for Distal-Third Humerus Shaft Fractures 前路与后路钢板治疗肱骨远端-第三骨干骨折的疗效比较

IF 2.1 2区医学

Journal of Hand Surgery-American Volume Pub Date : 2025-03-01 DOI: 10.1016/j.jhsa.2023.07.014

Yuya Shimamoto MD , Katsuhiro Tokutake MD, PhD , Yasuhiko Takegami MD, PhD , Yuta Asami MD , Ken Sato MD , Hiroki Ueno MD , Takahiko Nakano MD , Sei Fujii MD , Nobuyuki Okui MD, PhD , Shiro Imagama MD, PhD

{"title":"Comparative Outcomes of Anterior and Posterior Plating for Distal-Third Humerus Shaft Fractures","authors":"Yuya Shimamoto MD , Katsuhiro Tokutake MD, PhD , Yasuhiko Takegami MD, PhD , Yuta Asami MD , Ken Sato MD , Hiroki Ueno MD , Takahiko Nakano MD , Sei Fujii MD , Nobuyuki Okui MD, PhD , Shiro Imagama MD, PhD","doi":"10.1016/j.jhsa.2023.07.014","DOIUrl":"10.1016/j.jhsa.2023.07.014","url":null,"abstract":"<div><h3>Purpose</h3><div>When treating distal-third humerus shaft fractures<span> (HSFs) surgically, the optimal approach for plating is controversial. We conducted a retrospective multicenter study to investigate and compare the clinical outcomes of anterior and posterior plating in distal-third HSFs and the incidence of complications including iatrogenic radial nerve palsy.</span></div></div><div><h3>Methods</h3><div>We identified 116 patients from our multicenter trauma database who were diagnosed as having distal-third HSFs and who underwent surgical treatment, including intramedullary nailing<span> between 2011 and 2020. We analyzed 50 cases treated in one of two ways: open reduction internal fixation with anterior plating (group A: 20 cases) and open reduction internal fixation with posterior plating (group P: 30 cases).</span></div></div><div><h3>Results</h3><div>The findings were similar in terms of operation time, estimated bleeding, and clinical and radiographic outcomes between the groups. Postoperative radial nerve palsy occurred only in group P (4 cases) and never in group A.</div></div><div><h3>Conclusions</h3><div>The results of this study suggest that the anterior approach is a safe and effective method for treating distal-third HSFs with satisfactory outcomes.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic IV.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 3","pages":"Pages 375.e1-375.e8"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10161829","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