Journal of Hand Surgery-American Volume最新文献

{"title":"Journal CME Questions","authors":"","doi":"10.1016/j.jhsa.2025.05.001","DOIUrl":"10.1016/j.jhsa.2025.05.001","url":null,"abstract":"","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 6","pages":"Page 731"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194610","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":"Fractional Lengthening of Forearm Flexor Tendons: A Cadaveric Biomechanical Analysis","authors":"Dang-Huy Do MD ,&nbsp;Nathan Heineman MD ,&nbsp;Jennifer L. Crook BA, BS ,&nbsp;Junho Ahn MD ,&nbsp;Douglas M. Sammer MD ,&nbsp;Daniel M. Koehler MD","doi":"10.1016/j.jhsa.2024.03.016","DOIUrl":"10.1016/j.jhsa.2024.03.016","url":null,"abstract":"<div><h3>Purpose</h3><div><span>Multiple procedures have been described for wrist and finger flexion contractures and spasticity. Fractional lengthening of forearm </span>flexor tendons<span> involves making parallel transverse tenotomies at the musculotendinous junction to elongate the muscle. Currently, there is limited literature to define the biomechanical consequences of this lengthening technique.</span></div></div><div><h3>Methods</h3><div><span>Forty-eight flexor tendons were harvested from eight paired upper limbs including flexor carpi<span> radialis, flexor carpi ulnaris, flexor pollicis longus, and flexor </span></span>digitorum<span> superficialis tendons. Each tendon that was lengthened was paired with the contralateral tendon as a control. A pair of transverse tenotomies were completed for the fractional lengthening. The first tenotomy was performed at the musculotendinous junction where the tendon narrowed to 75% of its maximal width. The second tenotomy was made 1 cm distal to the first. Tendon length was measured before and after fractional lengthening at a constant resting tension of 1 N. The maximum load at failure of each tendon and the mechanism of failure were each measured and compared with the contralateral side.</span></div></div><div><h3>Results</h3><div>After fractional lengthening, the mean increase in resting tendon length was 4 mm. When loaded to failure, the mean maximum load of fractionally lengthened tendons was 42% of the mean maximum load of intact tendons. All lengthened tendons failed at the distal tenotomy site.</div></div><div><h3>Conclusions</h3><div>Fractional lengthening resulted in an increase of 3–6 mm (mean: 4 mm) in tendon length at resting tension. There was a significant loss in tensile strength and load to failure following fractional lengthening compared with an intact musculotendinous unit.</div></div><div><h3>Clinical relevance</h3><div>The reduction in tensile strength following fractional lengthening results in loads at failure that are, in some cases, lower than the estimated forces required to perform basic tasks. Caution during the healing and rehabilitation period is warranted.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 6","pages":"Pages 756.e1-756.e7"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868260","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":"Quantifying the Burden of Unmet Upper Extremity Care Need in Low-Middle Income Countries: A Four-Country, Cluster-Randomized Study","authors":"Dattesh R. Davé MD, MSc ,&nbsp;Adam L. Kushner MD, MPH ,&nbsp;Mary C. Manske MD, MS","doi":"10.1016/j.jhsa.2024.02.008","DOIUrl":"10.1016/j.jhsa.2024.02.008","url":null,"abstract":"<div><h3>Purpose</h3><div>Currently, no nationally implementable survey exists to identify the burden of hand and upper extremity conditions at the household level in low-middle income countries (LMICs). This study describes a randomized cluster survey approach to estimating the burden of hand and upper extremity conditions in four LMICs using the Surgeons OverSeas Assessment of Surgical Need (SOSAS) survey. Additionally, this study identifies factors associated with responses of unmet surgical need at the multinational level.</div></div><div><h3>Methods</h3><div>The SOSAS instrument is a cluster-randomized, cross-sectional, countrywide survey of households administered in Nepal, Rwanda, Sierra Leone, and Uganda from 2011 to 2014. We identified nationwide trends for sociodemographic, anatomic, condition type, mechanism, prevalence, subjective disability, and barriers to care for upper extremity survey responses. A multivariable model identified factors associated with unmet upper extremity need across the four nations.</div></div><div><h3>Results</h3><div>Across the four countries, 13,763 individuals participated in the survey, with 883 conditions of the upper extremity identified (7.4% of all surgical conditions surveyed). Fractures accompanied many of the injuries (32.3%). Although most conditions were acquired, congenital conditions comprised 11% of all etiologies. Overall, open fire/explosion was the most common mechanism (22.9%). Rwandans had the highest proportion of individuals seeking care (91.0%) and receiving care (88.6%). Sierra Leone indicated the fewest seeking and receiving care (71% and 63%, respectively). Chronic injuries were significantly associated with receiving care, whereas illiteracy and worsening subjective disability were barriers to receiving care.</div></div><div><h3>Conclusions</h3><div>In this survey of upper extremity conditions from four LMICs, upper extremity conditions primarily resulted from fire/explosions, and many reported sustaining a fracture. Illiteracy and more disabling conditions decreased the odds of receiving care by 30% to 40%, respectively.</div></div><div><h3>Clinical relevance</h3><div>The SOSAS survey may provide a reproducible means to evaluate the unmet need for upper extremity care across similar LMICs.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 6","pages":"Pages 750.e1-750.e12"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141328157","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":"Supination Peak Tourque After Inlay Versus Onlay Distal Biceps Reinsertion: A Randomized Controlled Trial","authors":"Ivan Pichierri MD ,&nbsp;Valeria Vismara MD ,&nbsp;Simone Cassin MD ,&nbsp;Francesco Luceri MD ,&nbsp;Pietro Simone Randelli MD ,&nbsp;Paolo Arrigoni MD","doi":"10.1016/j.jhsa.2025.02.018","DOIUrl":"10.1016/j.jhsa.2025.02.018","url":null,"abstract":"<div><h3>Purpose</h3><div>Distal biceps brachii tendon (DBBT) rupture causes elbow weakness in forearm supination and flexion movements. Surgical treatment is indicated for young patients with high functional demands. This study aimed to evaluate forearm supination strength recovery after surgical repair with two different fixation techniques, onlay fixation with suture anchors and inlay with a bicortical button.</div></div><div><h3>Methods</h3><div>This was a single-center, prospective, randomized, controlled, study. A total of 40 patients with complete DBBT rupture were enrolled and allocated through block randomization before surgery to either receive onlay fixation (group A) or inlay fixation (group B). A single anterior incision approach was used for both groups. The forearm supination strength was measured using a digital dynamometer before surgery and at least 6 months postsurgery. Supination strength was evaluated on both forearms, with the tested elbow in 45°, 90°, and 120° degrees of flexion, and the forearm in a neutral position (0°).</div></div><div><h3>Results</h3><div>There was no statistically significant difference between the treatment groups in peak strength gained after surgery. No significant difference was found when the elbow was tested in the three different degrees of flexion. There was a decrease in supination peak torque of more than 50% compared to the control limb before surgery and a strength increase of ≥100% at follow-up after surgery was observed for both groups.</div></div><div><h3>Conclusions</h3><div>Onlay and inlay fixation techniques for surgical repair of DBBT rupture do not show significant differences in supination strength recovery and allow for excellent elbow function.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic I.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 6","pages":"Pages 670-676"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782092","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":"Gender Differences in Salary Compensation for Academic Hand Surgery Faculty at US Medical Schools","authors":"Jason Silvestre MD ,&nbsp;Dawn M. LaPorte MD ,&nbsp;Dane N. Daley MD ,&nbsp;Charles A. Daly MD ,&nbsp;Ann Van Heest MD","doi":"10.1016/j.jhsa.2025.02.014","DOIUrl":"10.1016/j.jhsa.2025.02.014","url":null,"abstract":"<div><h3>Purpose</h3><div>This study investigated gender differences in salary compensation for hand surgery faculty at US medical schools.</div></div><div><h3>Methods</h3><div>Salary compensation benchmarks were analyzed from 154 US medical schools in the 2023 American Association of Medical Colleges Faculty Salary Survey. Median salaries were extracted for assistant professors, associate professors, and full professors. Net present value (NPV) calculations were used to determine the impact of gender on total salary compensation assuming different academic scenarios including promotion timelines and career longevity.</div></div><div><h3>Results</h3><div>Compensation data were available for 157 full-time academic hand surgeons, and 34 were women (22%). There were 70 assistant professors (45%), 49 associate professors (31%), and 38 full professors (24%). Most faculty were men across academic ranks (range, 70% to 88%). Gender differences in annual salary compensation were greatest at the assistant professor level. Women hand surgeons earned less than men hand surgeons at each academic rank including at assistant professor ($432,500, 74% of salaries of men), associate professor ($587,439, 89% of salaries of men), and full professor ($567,230, 82% of salaries of men). Gender differences in annual salary translated to a NPV difference of $2.0 to $2.6 million in lifetime salary compensation.</div></div><div><h3>Conclusions</h3><div>Gender differences in salary exist across academic ranks for hand surgery faculty at US medical schools. These differences are highest among assistant professors. More investigation is needed to determine reasons for these differences and create strategies that promote gender equity in academic hand surgery.</div></div><div><h3>Clinical relevance</h3><div>Promoting gender diversity, inclusion, and equity is a strategic imperative held by multiple professional societies in academic surgery. Understanding reasons for gender differences in salary compensation may lead to strategies that promote gender equity in hand surgery.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 6","pages":"Pages 663-669"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Radial Longitudinal Deficiency on Long-Term Use of the Thumb in Pediatric Patients Following Index Pollicization","authors":"Paula A. Pino MD ,&nbsp;Aida K. Sarcon MD ,&nbsp;Rou Wan MD ,&nbsp;Wendy Tomhave BA ,&nbsp;Ann E. Van Heest ,&nbsp;Steven L. Moran MD","doi":"10.1016/j.jhsa.2024.02.010","DOIUrl":"10.1016/j.jhsa.2024.02.010","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the effect of radial longitudinal deficiency on the function of pollicized digits as determined by the Thumb Grasp and Pinch (T-GAP) assessment.</div></div><div><h3>Methods</h3><div><span>We retrospectively evaluated 25 hands with thumb hypoplasia that underwent </span>index finger pollicization. Patients were followed for an average of 10.4 years. Hands were divided by severity into two groups: no or mild radial longitudinal deficiency (RLD) (Group 1 = 16) and moderate to severe RLD (Group 2 = 9). We collected demographic information and completed physical examination measures, including hand strength, elbow, wrist, and hand range of motion, the Kapandji opposition score, active grasp span, and T-GAP total score.</div></div><div><h3>Results</h3><div>Patients with moderate to severe forms of RLD had stiffer long fingers, lower Kapandji opposition scores, and limited active and passive range of motion for elbow flexion<span><span>, wrist ulnar deviation, and pollicized thumb interphalangeal flexion. They had shorter forearms, decreased active grasp span, and fewer thumb creases at the interphalangeal thumb joint. In addition, the T-GAP total score was significantly lower when comparing the two groups. Children with mild </span>dysplasia were able to achieve 32% of age-matched normal grasp strength. Patients with more severe radial dysplasia averaged 17% less grasp strength compared with children with mild dysplasia. Patients with moderate to severe RLD also had lower T-GAP total scores and strength measurements if they had limited wrist ulnar deviation.</span></div></div><div><h3>Conclusions</h3><div>Individuals with moderate to severe RLD have unique anatomical factors that affect outcomes after pollicization. These individuals use their thumbs for fewer activities, have weaker grasp, and retain more primitive grasp patterns compared with those who have milder forms of RLD.</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":"50 6","pages":"Pages 751.e1-751.e9"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140766097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping Origins of Tendons on the Medial Epicondyle to Improve Treatment of Medial Epicondylitis: Anatomical Study","authors":"Marko V. Dragisic BS ,&nbsp;Mollie K. Hanlon MS ,&nbsp;Gregory A. Merrell MD","doi":"10.1016/j.jhsa.2024.04.008","DOIUrl":"10.1016/j.jhsa.2024.04.008","url":null,"abstract":"<div><h3>Purpose</h3><div><span><span>Medial epicondylitis is a </span>tendinosis found commonly in throwing and golfing athletes. Although there are choices for nonsurgical treatments, when these fail, surgical intervention can be considered. When surgical treatment is performed, the objective is to debride the diseased tissue from the </span>epicondyle<span>. The purpose of this study was to clarify the locations and size of the common flexor tendons<span> and medial collateral ligament (MCL) relative to each other and to the posterior ridge of the medial epicondyle.</span></span></div></div><div><h3>Methods</h3><div>The common flexor tendons and MCL were dissected and reflected their origin on the medial epicondyle in six cadaver elbows. Measurements were taken from the posterior and distal ridges of the medial epicondyle with respect to the humerus. Each origin was also measured for its height and width.</div></div><div><h3>Results</h3><div>The flexor carpi<span> ulnaris origin starts at a mean of 4.2 mm from the posterior ridge of the medial epicondyle and extends anteriorly an average of 4.8 mm. The flexor carpi radialis starts at a mean of 4.2 mm from the posterior ridge and extends anteriorly an average of 7.4 mm. The pronator teres begins at a mean of 4.6 mm from the posterior ridge and extends an average of 5.7 mm anteriorly. The MCL starts at an average of 10.4 mm from the posterior ridge and extends 5.2 mm anteriorly.</span></div></div><div><h3>Conclusions</h3><div>The measurements found have allowed the creation of a map of the specific common flexor tendon origins and their sizes on the medial epicondyle, as well as their position relative to the MCL.</div></div><div><h3>Clinical relevance</h3><div>A surgeon may debride 1 cm anteriorly from the posterior ridge of the medial epicondyle to safely address the affected tissues and ensure the safety and integrity of the MCL.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 6","pages":"Pages 759.e1-759.e5"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460838","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":"Upper-Extremity Nerve Transfers for Sensation: A Systematic Review","authors":"Nicholas A. Orlando MSc ,&nbsp;Cecil S. Qiu MD ,&nbsp;Emma K. Rowley BS ,&nbsp;Ahmed Sabit MA ,&nbsp;Ala Elhelali PhD ,&nbsp;Sami H. Tuffaha MD","doi":"10.1016/j.jhsa.2024.03.020","DOIUrl":"10.1016/j.jhsa.2024.03.020","url":null,"abstract":"<div><h3>Purpose</h3><div>Sensory nerve transfers may be performed to restore protective sensation and tactile perception after peripheral nerve injury in the upper extremity. There is a paucity of literature on the available donor–recipient configurations for sensory nerve transfers. This article presents a systematic review of reported sensory nerve transfers in the upper extremity.</div></div><div><h3>Methods</h3><div>Original articles published between 1982 and 2022 were searched in MEDLINE and EMBASE. Articles describing a sensory nerve transfer were included if patient sensory outcomes were reported. Outcomes were categorized according to the modified British Medical Research Council scale, with an outcome of S3 or better defined as satisfactory.</div></div><div><h3>Results</h3><div>Of 1,049 articles, 39 met inclusion and quality criteria. Twenty-seven articles were primary research studies reporting on 197 patients who underwent 11 unique nondigital sensory donor nerve transfers and 24 unique digital donor nerve transfer procedures. The most reliable recipient nerve for restoring sensation to the ulnar border of the small finger was proper ulnar digital nerve of the small finger (38 patients, 89% satisfactory sensory outcome). The best available donors for transfer into the proper ulnar digital nerve of the small finger were proper ulnar digital nerve of the long finger (16 patients, 87.5% good sensory outcome) and palmar cutaneous branch of the median nerve (15 patients, 100% good sensory outcome). To restore sensation along the ulnar border of the thumb and radial aspect of the index finger, the best available donor was the superficial branch of the radial nerve, regardless of transfer into common digital nerve 1 (38 patients, success rate 63%) or directly to proper ulnar digital nerve of the thumb or proper radial digital nerve of the index finger (nine patients, success rates 67%).</div></div><div><h3>Conclusions</h3><div>Outcomes after sensory nerve transfers are generally good. Surgeons should transfer into a digital nerve recipient when attempting to reconstruct sensation.</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 6","pages":"Pages 758.e1-758.e10"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789899","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":"A Comparison of Patient Characteristics and Outcomes Between Patients Receiving Flexor Digitorum Superficialis Slip Excision or Isolated A1 Pulley Release for Trigger Finger","authors":"Margaret M. Fisher MS ,&nbsp;Andrew D. Allen MD ,&nbsp;Alexander D. Jeffs MD ,&nbsp;Patricia K. Wellborn MD ,&nbsp;Di Hu MS ,&nbsp;J. Megan M. Patterson MD ,&nbsp;Reid W. Draeger MD","doi":"10.1016/j.jhsa.2024.02.003","DOIUrl":"10.1016/j.jhsa.2024.02.003","url":null,"abstract":"<div><h3>Purpose</h3><div>Resection of the radial or ulnar slip of the flexor digitorum superficialis (FDS) tendon is a known treatment option for persistent trigger finger. Risk factors for undergoing FDS slip excision are unclear. We hypothesized that patients who underwent A1 pulley release with FDS slip excision secondary to persistent triggering would have a higher comorbidity burden compared to those receiving A1 pulley release alone.</div></div><div><h3>Methods</h3><div>We identified all adult patients who underwent A1 pulley release with FDS slip excision because of persistent triggering either intraoperatively or postoperatively from 2018 to 2023. We selected a 3:1 age- and sex-matched control group who underwent isolated A1 pulley release. Charts were retrospectively reviewed for demographics, selected comorbidities, trigger finger history, and postoperative course. We performed multivariable logistic regression to assess the probability of FDS slip excision after adjusting for several variables that were significant in bivariate comparisons.</div></div><div><h3>Results</h3><div>We identified 48 patients who underwent A1 pulley release with FDS slip excision and 144 controls. Our multivariable model showed that patients with additional trigger fingers and a preoperative proximal interphalangeal (PIP) joint contracture were significantly more likely to undergo FDS slip excision.</div></div><div><h3>Conclusions</h3><div>Patients who underwent A1 pulley release with FDS slip excision were significantly more likely to have multiple trigger fingers or a preoperative PIP joint contracture. Clinicians should counsel patients with these risk factors regarding the potential for FDS slip excision in addition to A1 pulley release to alleviate triggering of the affected digit.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic III.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 6","pages":"Pages 748.e1-748.e7"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177799","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":"Establishing a Murine Model of Muscle Changes in Chronic Nerve Compression","authors":"Jordan Burgess BA ,&nbsp;Jagmeet Arora BS ,&nbsp;Allen Green BS ,&nbsp;Amar Singh PhD ,&nbsp;Evan Jarman BS ,&nbsp;Augustine Kang BS, PhD ,&nbsp;Kate Hayashigatani ,&nbsp;Yusha Katie Liu MD, PhD ,&nbsp;Raymond Sobel MD ,&nbsp;Paige M. Fox MD, PhD","doi":"10.1016/j.jhsa.2025.03.003","DOIUrl":"10.1016/j.jhsa.2025.03.003","url":null,"abstract":"<div><h3>Purpose</h3><div>We aimed to build upon a previously validated model of early chronic nerve compression (CNC) by evaluating changes in gross muscle weight, muscle gene expression, and muscle function, and correlating the mechanism and timing of muscle- and nerve related changes.</div></div><div><h3>Methods</h3><div>Chronic nerve compression was induced by placing a Silastic tube around the sciatic nerve with the contralateral limb as control. At 6, 8, and 12 weeks of compression, gait analysis, muscle force measurements, and electrodiagnostics (EDX) were performed, and the sciatic nerve, tibialis anterior (TA), extensor digitorum longus (EDL), and gastrocnemius were harvested. Muscle weight (MW), cross-sectional area (CSA), g-ratio, axon area, and axon density were measured. Reverse transcripton polymerase chain reaction of TA+EDL muscle was performed. Genes assayed included atrogenes (<em>Foxo-3</em>, <em>Atrogin-1</em>, and <em>MuRF1</em>), markers of myogenesis (<em>MyoD</em> and <em>MyoG</em>), fatty acid synthase, type-I collagen (Col1a1), and inflammatory markers (tumor necrosis factor-α and interleukin-1β).</div></div><div><h3>Results</h3><div>At 6 weeks, we observed a maximum 30.8% decrease in nerve conduction speed. G-ratio was increased 14.4% at 8 weeks, and at all time points, we observed a 25%–26% decrease in axon area. At 12 weeks, we observed a 10.4% decrease in TA+EDL MW, and at 8 weeks, CSA was reduced 13.9%. At 8 weeks, expression of atrogenes was increased 2–3-fold implying ongoing atrophy. <em>MyoD</em>/<em>MyoG</em> expression was reduced 0.3 times, and fatty acid synthase, type-1 collagen, and inflammatory marker expression was increased 1.3-, 1.4-, and &gt;2-fold, respectively. There were no clinically important differences in gait analysis or muscle force measurement between compressed and control limbs at any time-point.</div></div><div><h3>Conclusions</h3><div>The murine model of muscle changes in CNC demonstrates reduced nerve conduction speed, demyelination, and a shift in axon size consistent with early CNC. Changes in MW, CSA, and gene expression occur in the absence of significant differences in muscle function.</div></div><div><h3>Clinical relevance</h3><div>These findings establish a mouse model of early muscle changes in CNC that can be used to investigate interventions to reduce or delay muscle changes in compression neuropathies.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 6","pages":"Pages 685-696"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043150","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}