Journal of Hand Surgery-American Volume最新文献

{"title":"A Comparison of Tenosynovial and Transverse Carpal Ligament Biopsy for Amyloid Detection in Open Carpal Tunnel Release.","authors":"Yagiz Ozdag, Jessica L Koshinski, Brendan J Carry, Jerad M Gardner, Victoria C Garcia, C Liam Dwyer, Joel C Klena, Louis C Grandizio","doi":"10.1016/j.jhsa.2024.05.004","DOIUrl":"10.1016/j.jhsa.2024.05.004","url":null,"abstract":"<p><strong>Purpose: </strong>Our purpose was to compare differences in the incidence of amyloid deposition in tenosynovium (TS) versus transverse carpal ligament (TCL) biopsies obtained during open carpal tunnel release. We hypothesized that the incidence of amyloid would be similar between TCL and TS when obtaining both specimens from the same patient.</p><p><strong>Methods: </strong>All primary, elective open carpal tunnel release cases that underwent biopsy for amyloid between January 2022 and September 2023 were reviewed. Tenosynovial and TCL specimens were independently evaluated by a pathologist to assess for amyloid. Demographic data were collected, and incidence of amyloid deposition was compared between the two samples. Agreement statistics, sensitivity, and specificity were calculated for TCL, using TS as the reference standard.</p><p><strong>Results: </strong>A total of 196 cases met either Tier 1 (n=180) or Tier 2 (n=16) biopsy criteria. Forty-eight cases were excluded for missed biopsies or laboratory processing errors, leaving 148 cases available for analysis. Amyloid deposition was present in 31 out of 148 (21%) TS specimens and 33 out of 148 (22%) TCL specimens. Overall, the results of the TS biopsy agreed with TCL biopsy in 138 out of 148 cases (93%). In the 10 cases for which the results of the TCL and TS biopsy differed, six cases had (+) TCL and (-) TS, and four cases had amyloid deposition in TS without evidence of deposition in the TCL. Sensitivity and specificity values for the TCL specimen were 87% and 95%, respectively. Positive and negative predictive values were 82% and 97%, respectively.</p><p><strong>Conclusions: </strong>For cases of open carpal tunnel release undergoing biopsy, amyloid deposition was noted in 21% of TS specimens and 22% of TCL specimens. Results of TS and TCL biopsies obtained from the same patient agreed in 93% of cases. Single-source biopsy for amyloid represents a reasonable diagnostic approach. Future cost analyses should be performed to determine whether the addition of two biopsy sources to improve diagnostic accuracy is justified.</p><p><strong>Type of study/level of evidence: </strong>Prognostic II.</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":"141460814","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":"Comparison Study of 5-Flap Z-Plasty and Double Z-Plasty for Interdigital Pocket Web Contractures.","authors":"Chen Yang, Yong Yang, Wenyao Zhong, Bin Li, Feng Li","doi":"10.1016/j.jhsa.2022.11.011","DOIUrl":"10.1016/j.jhsa.2022.11.011","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to compare the improvement in abduction and change in web slope between 5-flap z-plasty and double z-plasty for post-burn or post-trauma interdigital pocket web contractures.</p><p><strong>Methods: </strong>We retrospectively reviewed 16 webs in 11 patients with post-burn or post-trauma interdigital pocket web contractures. Seven patients underwent 5-flap z-plasty and 4 double z-plasty. The abduction and slope angles of the affected fingers were measured before surgery and every 3 months after surgery.</p><p><strong>Results: </strong>The follow-up time ranged from 12 to 36 months. The postoperative abduction angle improved in both groups. There was an increase of 19° ± 4° in the mean abduction angle after surgery in the 5-flap z-plasty group compared with a mean of 12° ± 2° in the double z-plasty group; the postoperative decrease in the web slope angle was 30° ± 5° and 22° ± 2°, respectively. All patients were able to actively move the affected webs and fingers with no pain or other discomfort.</p><p><strong>Conclusions: </strong>Five-flap z-plasty can be considered a better alternative to double z-plasty for interdigital pocket web contractures based on the improvement in abduction angle and changes in the slope angle.</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":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10858996","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":"Does Addition of a Longer Acting Local Anesthetic Improve Postoperative Pain After Carpal Tunnel Release? A Randomized Controlled Trial.","authors":"Emily Chan, Kristi Billard, Laura Sims, Churao Yang, David Sauder","doi":"10.1016/j.jhsa.2024.05.009","DOIUrl":"10.1016/j.jhsa.2024.05.009","url":null,"abstract":"<p><strong>Purpose: </strong>Carpal tunnel release (CTR) is a simple and effective treatment for carpal tunnel syndrome in patients who have failed nonsurgical management. This surgery is often performed in the ambulatory clinic under local anesthesia, with lidocaine, a short-acting agent. Few studies have investigated the use of longer acting agents, such as bupivacaine, for outpatient CTR. Therefore, the aim of our study was to compare the postoperative pain experience after CTR with the use of either our standard lidocaine solution (control) or a mixture consisting of lidocaine and bupivacaine in equal amounts (intervention).</p><p><strong>Methods: </strong>Patients undergoing CTR were randomized into control or intervention groups. Postoperative pain severity and numbness were recorded at several timepoints within the first 72 hours. The timing and quantity of postoperative analgesic use (acetaminophen and/or ibuprofen) was also documented. Both patients and assessor were blinded to allocation.</p><p><strong>Results: </strong>Our study cohort included 139 patients: 67 in the control group and 72 in the intervention group. Postoperative pain scores were significantly lower in the intervention group at 6 hours (2.3 vs 3.2) and 8 hours (2.9 vs 3.9). Additionally, patients in the intervention group reported longer time to first analgesic use than those in the control group (5.2 hours vs 3.7 hours). A greater proportion of patients in the intervention group reported postoperative numbness at nearly all time points, compared to the control group.</p><p><strong>Conclusions: </strong>Our study shows that a mixture of bupivacaine and lidocaine improves early postoperative pain but causes prolonged finger numbness when compared to lidocaine alone. As both medications are effective and feasible for outpatient CTR, surgeon and patient preference should guide local anesthetic choice.</p><p><strong>Type of study/level of evidence: </strong>Therapeutic Ib.</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":"141494329","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":"Complications Following Intramedullary Screw Fixation for Metacarpal Fractures: A Systematic Review.","authors":"Chibuzo C Anene, Terence L Thomas, Jonas L Matzon, Christopher M Jones","doi":"10.1016/j.jhsa.2023.01.012","DOIUrl":"10.1016/j.jhsa.2023.01.012","url":null,"abstract":"<p><strong>Purpose: </strong>There has been a recent increase in the use of intramedullary screws (IMS) for the surgical treatment of metacarpal fractures. While IMS fixation has been shown to produce excellent functional outcomes, postoperative complications have yet to be fully explored in a comprehensive way. This systematic review quantified the incidence, treatment, and results of complications following IMS fixation for metacarpal fractures.</p><p><strong>Methods: </strong>A systematic review was performed using PubMed, Cochrane Central, EBSCO, and EMBASE databases. All clinical studies that documented IMS complications following metacarpal fracture fixation were included. Descriptive statistics were analyzed for all available data.</p><p><strong>Results: </strong>Twenty-six studies were included: 2 randomized trials, 4 cohort studies, 19 case series, and 1 case report. Among the 1,014 fractures studied, 47 complications were reported across all studies (4.6%). Stiffness was the most common, followed by extension lag, loss of reduction, shortening, and complex regional pain syndrome. Other complications included screw fracture, bending, and migration; early-onset arthrosis; infection; tendon adhesion; hypertrophic scar; hematoma; and nickel allergy. Eighteen of the 47 (38%) patients with complications underwent revision surgery.</p><p><strong>Conclusions: </strong>Complications following IMS fixation of metacarpal fractures are relatively uncommon.</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":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10846501","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":"Shared Decision Making in Hand Surgery.","authors":"Gopal R Lalchandani, Lauren M Shapiro, Nicole S Schroeder","doi":"10.1016/j.jhsa.2024.04.013","DOIUrl":"10.1016/j.jhsa.2024.04.013","url":null,"abstract":"<p><p>Shared decision-making (SDM) is a collaborative effort between a physician and a patient to make an informed clinical decision, as defined by each patient's preferences and values. Shared decision-making is particularly used in areas of clinical equipoise or preference-sensitive conditions, which are common in hand surgery. Although there is increased interest in SDM across health care, hand surgeons receive little formal training on SDM. In this review, we explore existing barriers to SDM in hand surgery and provide a framework for participating in SDM discussions.</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":"141735724","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":"Supplementary Fixation Improves Stability of Intra-Articular Distal Radius Fractures Managed With a Spanning Plate.","authors":"Jacob M Modest, Jeremy E Raducha, Rachel M Schilkowsky, Janine Molino, Christopher J Got, Julia A Katarincic, Joseph A Gil","doi":"10.1016/j.jhsa.2023.01.002","DOIUrl":"10.1016/j.jhsa.2023.01.002","url":null,"abstract":"<p><strong>Purpose: </strong>Previous studies evaluating weight bearing of distal radius fractures treated through dorsal spanning bridge plates used extra-articular fracture models, and have not evaluated the role of supplementary fixation. We hypothesized that supplementary fixation with a spanning dorsal bridge plate for an intra-articular wrist fracture would decrease the displacement of individual articular pieces with cyclic axial loading and allow for walker or crutch weight bearing.</p><p><strong>Methods: </strong>Thirty cadaveric forearms were matched into 3 cohorts, controlling for age, sex, and bone mineral density. An intra-articular fracture model was fixed with the following 3 techniques: (1) cohort A with a dorsal bridge plate, (2) cohort B with a dorsal bridge plate and two 1.6-mm k-wires, and (3) cohort C with a dorsal bridge plate and a radial pin plate. Specimens were axially loaded cyclically with escalating weights consistent with walker and crutch weight-bearing with failure defined as 2-mm displacement.</p><p><strong>Results: </strong>No specimens failed at 2- or 5-kg weights, but cohort A had significantly more displacement at these weights compared with cohort B. Cohort A had significantly more failure than cohort C. Both cohort A and cohort B had significantly more displacement at crutch weight bearing compared with cohort C. The supplementary fixation group had significantly lower displacement at crutch weight-bearing compared with cohort A in all gaps. Survival curves demonstrated the fixation cohort to survive higher loads than the nonfixation group.</p><p><strong>Conclusion: </strong>There was significantly less displacement and less failure of intra-articular distal radius fractures treated with a spanning dorsal bridge plate and supplementary fixation. Our model showed that either type of fixation was superior to the nonfixation group.</p><p><strong>Clinical significance: </strong>When considering early weight-bearing for intra-articular distal radius fractures treated with a spanning dorsal bridge plate, supplementary fixation may be considered as an augmentation to prevent fracture displacement.</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":"9281753","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 Role of Mentorship in Career Advancement: A Survey of Women in Academic Hand Surgery.","authors":"Banafsheh Sharif-Askary, Salma A Abdou, Karina Charipova, Erika D Sears, Aviram M Giladi","doi":"10.1016/j.jhsa.2022.12.015","DOIUrl":"10.1016/j.jhsa.2022.12.015","url":null,"abstract":"<p><strong>Purpose: </strong>Despite the increasing percentage of women within the American Society for Surgery of the Hand, women remain underrepresented within leadership in academic hand surgery. Although this disparity in leadership representation may be improving, we aimed to investigate the role mentorship plays in advancing women in academic hand surgery.</p><p><strong>Methods: </strong>This is a survey-based, mixed-methods study. A written survey assessing themes in personal and professional experiences with mentorship was sent to hand fellowship-trained women. Inclusion criteria were the completion of a hand fellowship and current affiliation with an academic institution. An evolved grounded theory framework was used to evaluate the responses. Themes were identified based on common responses.</p><p><strong>Results: </strong>Of 186 eligible participants, 144 (85.2%) received the survey. The response rate was 48.6%. Respondents indicated that residency was the stage at which mentorship was most impactful (n = 25, 37%), and half of the respondents identified their desire to work in academic hand surgery during residency (n = 35, 50%). Obstacles to finding a mentor included lack of availability (n = 46, 67.7%), hesitance in searching for a mentor (n = 16, 23.5%), and searching for a mentor within an environment that was not conducive to success for trainees (n = 7, 10.3%). Most (84%) cited instances were the ones having the advice of a woman mentor was more impactful than that of a mentor who is a man. The reported need for same-sex mentorship fell into three categories: (1) insight into shared experiences, (2) assistance with conflict/bias management, and (3) support during career navigation.</p><p><strong>Conclusions: </strong>The findings of this study demonstrate the need for high-quality mentorship during the residency with a specific emphasis on same-sex mentorship.</p><p><strong>Clinical relevance: </strong>Our findings provide clear objectives related to improving access to and quality of mentorship. This foundational understanding will enrich mentor-mentee relationships, allowing for greater personal and professional success and satisfaction for both parties.</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":"9336778","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":"Does Preservation of Metacarpophalangeal Joint Vascularity Protect Against Physeal Arrest in Index Finger Pollicization?","authors":"Meera Reghunathan, Katharine Hinchcliff, Courtney Schneidau, Chris Stutz, Marybeth Ezaki, Scott N Oishi","doi":"10.1016/j.jhsa.2024.05.010","DOIUrl":"10.1016/j.jhsa.2024.05.010","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether preservation of blood supply to the index metacarpophalangeal joint decreases the rate of physeal arrest.</p><p><strong>Methods: </strong>A retrospective review of 41 pollicized digits in 35 patients with 2-year minimum radiographic follow-up was conducted at a single institution. Other complications evaluated included nonunion at the pollicized digit base and clinical instability at the new carpometacarpal joint. Findings were compared to historical controls, which were performed by our group prior to routine identification and sparing of the metacarpophalangeal joint blood supply. No other modifications to surgical technique were made between the previous and current patient cohorts.</p><p><strong>Results: </strong>Two pollicized digits in two different patients had radiographic evidence of physeal arrest, one of which was partial and the other complete, for an arrest rate of 4.9%. This was significantly less than the arrest rate in our historical cohort of 24.7% (21 of 85 patients). Five patients did not have radiographic bony union at the base of the index metacarpal, but only one patient had clinical instability at the new carpometacarpal joint.</p><p><strong>Conclusions: </strong>Significantly fewer patients who underwent index finger pollicization with preservation of the metacarpophalangeal joint blood supply went on to develop physeal arrest when compared to patients who underwent pollicization prior to adoption of this technique. This finding suggests that sparing of the physeal blood supply is preventative against proximal phalanx physeal arrest.</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":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141545559","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":"Risk Factors for Requiring Ulnar Superficialis Slip Resection During Trigger Finger Release.","authors":"Stephanie A Kwan, Matthew B Sherman, Daniel Fletcher, Jonas L Matzon","doi":"10.1016/j.jhsa.2024.08.013","DOIUrl":"10.1016/j.jhsa.2024.08.013","url":null,"abstract":"<p><strong>Purpose: </strong>Ulnar superficialis slip resection (USSR) has been described to address persistent postoperative triggering following trigger finger release (TFR). The primary purpose of our study was to evaluate the results of simultaneous TFR and USSR under wide-awake local anesthesia no tourniquet (WALANT). The secondary purpose was to identify patient characteristics and risk factors associated with persistent triggering following A1 pulley release requiring USSR.</p><p><strong>Method: </strong>We retrospectively identified 1,005 patients who underwent TFR at one institution by a single fellowship-trained, hand surgeon under WALANT from 2015 to 2023. Nine hundred ninety-two patients were treated with TFR alone. Twelve patients (1.2%) underwent USSR because of persistent triggering that was identified in the operating room after release of the A1 pulley. An age-, sex-, and body mass index-matched cohort of 28 patients who underwent TFR alone was created. Medical records were reviewed for demographics and complications.</p><p><strong>Results: </strong>A total of 12 patients (14 digits) underwent TFR with USSR. The long finger was the most commonly affected finger (6, 42%). Patients in the USSR group had more average lifetime trigger fingers compared with the control group (4 vs 1). Additionally, the percentage of patients who had previously undergone TFRs for other fingers was higher in the USSR group (100%) compared with the control group (36%). After surgery, 6 patients (4 USSR and 2 control) underwent formal hand therapy for postoperative stiffness with USSR patients receiving therapy more often than controls.</p><p><strong>Conclusions: </strong>Although uncommon, some patients (1.2%) who undergo TFR require USSR for persistent triggering following A1 pulley release. Patients who have had more lifetime trigger fingers and/or who have previously undergone TFR for other fingers are more likely to need USSR. No serious complications were incurred by patients who underwent USSR, but these patients may benefit from hand therapy compared to those undergoing isolated TFR.</p><p><strong>Type of study/level of evidence: </strong>Therapeutic III.</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":"142332637","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":"Tendon Lengthening Surgery for Elbow Flexion Contractures in Brachial Plexus Birth Palsy.","authors":"Javier Gutierrez-Pereira, Antonio Garcia-Lopez","doi":"10.1016/j.jhsa.2024.07.026","DOIUrl":"10.1016/j.jhsa.2024.07.026","url":null,"abstract":"<p><strong>Purpose: </strong>Flexion contracture of the elbow is a common deformity associated with brachial plexus birth palsy and is often managed with preventive night orthoses. For severe cases, however, surgical interventions may become necessary. This study evaluated the effectiveness of surgically releasing elbow flexion contractures exceeding 30° through partial tenotomy of the brachialis and biceps brachii muscles, along with a division of the lacertus fibrosus.</p><p><strong>Methods: </strong>We performed 36 anterior elbow releases on patients with injury to the upper trunk (C5-C6) of the brachial plexus and elbow flexion contractures between 30° and 80°. All releases involved lacertus fibrosus section and partial lengthening of the distal portion of the brachialis tendon. In severe cases, biceps brachii tenotomy was also performed. All participants had a minimum follow-up of 12 months and preoperative elbow flexion strength of at least grade 4 on the British Medical Research Council scale, with no deformities in the shape of the ulnohumeral joint or radial head subluxation.</p><p><strong>Results: </strong>Following a mean follow-up of 41 months, the average extension gain was 31° (range, 10°-50°). All patients maintained their flexion strength. Except for two participants with weaker triceps, the mean elbow extension gain was sustained throughout the follow-up period. There were no major or minor complications or reinterventions in the study.</p><p><strong>Conclusions: </strong>Partial tenotomy of the brachialis and biceps brachii muscles, coupled with lacertus fibrosus section, is an effective treatment for elbow contractures exceeding 30° flexion. This method is successful in individuals with a functioning triceps brachii and elbow extension strength of at least grade 3 on the British Medical Research Council scale.</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":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332638","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}