Journal of Hand Surgery-American Volume最新文献

{"title":"An Update on Osteoporosis Screening: Advances, Applications, and the Role of Hand Surgeons and Allied Health Providers","authors":"Anna Luan MD, MS ,&nbsp;Jeffrey Yao MD","doi":"10.1016/j.jhsa.2025.05.009","DOIUrl":"10.1016/j.jhsa.2025.05.009","url":null,"abstract":"<div><div><span><span>Osteoporosis and </span>osteopenia are highly prevalent and undertreated. Both are characterized by low bone mineral density and contribute to </span>fragility fractures and their subsequent morbidity and mortality. Recent advances in diagnostic modalities and pathways have demonstrated the potential to expand screening and treatment for patients with low bone mineral density. Hand surgeons will encounter patients with osteoporosis and osteopenia regardless of whether they have sustained fragility fractures and therefore must maintain an understanding of diagnostic and management considerations. This article provides an updated review on current methods of screening and the role of the hand surgeon in the evaluation and treatment of osteoporosis and osteopenia.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 10","pages":"Pages 1253-1259"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499393","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":"Integrated Compression Screw Versus Unicortical Locking Screw for Fixing the Dorsal Critical Corner in Distal Radius Fractures: A Biomechanical Study","authors":"Pedro Bronenberg Victorica MD ,&nbsp;Lauren M. Shapiro MD, MS ,&nbsp;Calvin Chan MS ,&nbsp;Pablo De Carli MD ,&nbsp;Luis Miguel Castro Appiani MD ,&nbsp;Robin N. Kamal MD, MBA","doi":"10.1016/j.jhsa.2024.10.014","DOIUrl":"10.1016/j.jhsa.2024.10.014","url":null,"abstract":"<div><h3>Purpose</h3><div><span>Although studies have demonstrated that locked screws with a length of 75% of the radius width are sufficient for the treatment of extra-articular fractures of the distal radius<span>, the application of this principle to intra-articular fractures is less well-understood. This study aimed to evaluate the biomechanical properties of different types of volar plate fixation constructs for the treatment of </span></span>distal radius fractures in the presence of a dorsal critical corner fragment.</div></div><div><h3>Methods</h3><div>A dorsal critical corner fracture was created in 18 synthetic distal radius models. The fragment was stabilized with one of three constructs: a posteroanterior integrated compression screw (group 1) or volar locking screws with a length of 90% or 75% of the volar/dorsal width of the radius (groups 2 and 3, respectively). For the biomechanical evaluation, a load was applied to the lunate facet. Fixation stiffness and loads to produce clinical and catastrophic failures were compared among the groups.</div></div><div><h3>Results</h3><div>The stiffness (N/mm) was 67.8 (SD, 14.7), 64.9 (SD, 8.63), and 65.8 (SD, 36.02) for groups 1, 2, and 3, respectively. The load required to generate a catastrophic displacement was 532.9 (SD, 142.32), 307.4 (SD, 101.51), and 230.8 N (SD, 77.68) for groups 1, 2, and 3, respectively. The load required to produce a 2-mm translation of the fixed fragment was 127.9 N (SD, 28.8) for group 1, 119.7 (SD, 11.78) for group 2, and 127.6 N (SD, 46.2) for group 3.</div></div><div><h3>Conclusions</h3><div>Significantly greater load is required for catastrophic failure after fixation of a dorsal critical corner fracture with an integrated compression screw; however, it provides similar stiffness and load to failure for 2 mm of translation.</div></div><div><h3>Clinical relevance</h3><div>For the treatment of intra-articular distal radius fractures with dorsal critical corner fragments, an integrated compression screw may be considered for rigid fixation of the fragment to support early return to daily activities.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 10","pages":"Pages 1271.e1-1271.e8"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734703","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":"Biomechanical Comparison of Suture Caliber and Number of Passes in Epitendinous Repair","authors":"David Cardenas ,&nbsp;Anca Dogaroiu ,&nbsp;Muhammad Harirah MD ,&nbsp;Andrew Y. Zhang MD ,&nbsp;Andrei Odobescu MD, PhD ,&nbsp;Douglas M. Sammer MD","doi":"10.1016/j.jhsa.2024.11.021","DOIUrl":"10.1016/j.jhsa.2024.11.021","url":null,"abstract":"<div><h3>Purpose</h3><div><span>The epitendinous suture is a critical part of </span>flexor tendon<span> repair. In addition to smoothing the repair site, it augments repair strength and increases gap resistance. This study aimed to determine whether increasing the number of passes or increasing suture caliber would improve the strength (primary outcome), 2 mm gap resistance, or stiffness of a simple running epitendinous suture.</span></div></div><div><h3>Methods</h3><div>A total of 30 flexor pollicis longus (FPL), flexor digitorum<span> profundus (FDP), and flexor digitorum<span> superficialis (FDS) tendons were harvested from three cadavers, and transverse tendon lacerations were produced. Tendons were repaired with only an epitendinous suture (no core suture) in three groups: 6-0 Prolene<span> with six passes, 5-0 Prolene with six passes, or 5-0 Prolene with six passes. Epitendinous repair strength was tested using a materials testing machine.</span></span></span></div></div><div><h3>Results</h3><div>The use of eight passes had significantly greater ultimate tensile strength<span> than six passes (21 +/− 7 N vs 14 +/− 5 N). Although 5-0 suture had a higher average ultimate tensile strength than 6-0 suture, this difference was not statistically significant (14 N +/− 5 vs 10 N +/− 3). Failure mode for all groups was most often suture tear-through.</span></div></div><div><h3>Conclusions</h3><div>A simple epitendinous suture using eight passes provides almost 50% more epitendinous repair strength and greater 2 mm gap resistance than six passes when using 5-0 Prolene.</div></div><div><h3>Clinical relevance</h3><div>When performing a simple running epitendinous repair to augment a core flexor tendon repair, the surgeon should consider the additional strength and gap resistance provided by eight passes compared to six.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 10","pages":"Pages 1278.e1-1278.e6"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190318","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 Cadaveric Anatomy Study of the Shape-Modified Radial Forearm Flap","authors":"Octave Charvillat MD ,&nbsp;Rodolphe Chartier MD ,&nbsp;Raphael Sinna MD, PhD ,&nbsp;Vladimir Rotari MD ,&nbsp;Emmanuel David MD ,&nbsp;Céline Klein MD, PhD","doi":"10.1016/j.jhsa.2025.07.008","DOIUrl":"10.1016/j.jhsa.2025.07.008","url":null,"abstract":"<div><h3>Purpose</h3><div>Mateev developed a shape-modified radial forearm flap (SMRFF), the use of which is not widespread. This study aimed to analyze hand subunit defects and combinations thereof that can be reconstructed using the SMRFF.</div></div><div><h3>Methods</h3><div>An anatomical study of 10 injected cadavers was conducted to investigate the subunits and combinations reachable with SMRFF. The radial pedicle length, the number and locations of radial artery perforators, the skin flap’s dimensions and surface area, and the number, dimension, and surface area of skin paddles were recorded.</div></div><div><h3>Results</h3><div>In all 10 cadavers, the dorsum, the palm, all combinations of palmar subunits, and both sides of the first webspace could be covered. Two dorsal proximal phalanges could be covered only when adjacent. The mean radial pedicle length was 19.3 cm. All perforators (diameter &gt; 0.5 mm) were septocutaneous, ranging from 3 to 9 per artery (mean: 6.3). On average, there were two perforators in the proximal third of the forearm, 2.3 in the middle third, and two in the distal third. At the proximal third of the forearm, the mean distance between the lateral epicondyle and the perforator was 6.6 cm. At the middle third of the forearm, this distance was 11.8 cm. At the distal third of the forearm, the mean distance between the perforator and the radial styloid process was 4.3 cm. The mean flap surface area was 98.4 cm², with 34.4 cm² for proximal paddles, 28.2 cm² for middle paddles, and 22.8 cm² for distal paddles.</div></div><div><h3>Conclusions</h3><div>The SMRFF can effectively reach various hand subunit defects, offering versatile coverage for palmar and dorsal regions, with detailed perforator and flaps measurements.</div></div><div><h3>Clinical relevance</h3><div>This study investigates the anatomical feasibility of the SMRFF and demonstrates its adaptability, making it a potentially valuable tool in hand surgery.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 10","pages":"Pages 1207-1216"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979327","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":"Relative Metacarpal Shortening as a Radiographic Measure of Fourth and Fifth Carpometacarpal Fracture Dislocation.","authors":"Lilah Fones, Daniel Nemirov, Meysam Fathi Choghadeh, Pedro K Beredjiklian","doi":"10.1016/j.jhsa.2025.08.011","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.08.011","url":null,"abstract":"<p><strong>Purpose: </strong>Fourth and fifth carpometacarpal fracture dislocations may be missed on plain x-ray. The purpose of this study was to describe a radiographic measurement, the relative metacarpal shortening (RMS), to evaluate for fourth and fifth carpometacarpal fracture dislocations on posteroanterior radiographs. We hypothesize that the RMS will increase in patients with fourth and fifth carpometacarpal fracture dislocations relative to controls.</p><p><strong>Methods: </strong>A retrospective review identified posteroanterior hand radiographs of skeletally mature patients with fourth and/or fifth carpometacarpal fracture dislocations. Comparisons were made of normal radiographs identified from patients presenting to the outpatient orthopedic hand clinic for complaints other than fracture or dislocation. Three independent reviewers performed measurements, with two of these reviewers measuring the RMS for each patient radiograph. The fourth and fifth RMS were calculated by dividing the length from the fourth/fifth distal metacarpal head to a tangential line to the third metacarpal head by the third metacarpal length. Measures were compared between the two cohorts. Agreement was assessed by intraclass correlation coefficients between reviewers.</p><p><strong>Results: </strong>In total, 42 controls and 41 fractures were included. The fracture group included 18 patients (43.9%) with isolated fifth metacarpal involvement and 23 patients (56.1%) with both fourth and fifth metacarpal involvement. Fractures were more commonly right-sided, younger, and men relative to controls. The fourth and fifth RMS were higher for fractures (0.16 and 0.31) than for controls (0.12 and 0.26), respectively. The intraclass correlation coefficient agreement test was almost perfect for all measurements (range: 0.82-0.94).</p><p><strong>Conclusions: </strong>The RMS is a radiographic measurement with almost perfect agreement between reviewers and is increased in fourth and fifth carpometacarpal fracture dislocations. Fourth RMS >0.13 and fifth RMS >0.28 should increase the index of suspicion for carpometacarpal fracture dislocation in a patient with corresponding ulnar hand pain.</p><p><strong>Type of study/level of evidence: </strong>Diagnostic IV.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207820","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":"Motion-preserving procedures in the treatment of scapholunate advanced collapse wrist: Proximal row carpectomy versus four-corner arthrodesis","authors":"John D. Wyrick MD,&nbsp;Peter J. Stern MD,&nbsp;Thomas R. Kiefhaber MD","doi":"10.1016/j.jhsa.2025.07.014","DOIUrl":"10.1016/j.jhsa.2025.07.014","url":null,"abstract":"<div><div>Seventeen patients were treated with scaphoid excision and four-corner arthrodesis (lunate, capitate, hamate, triquetrum) for scapholunate advanced collapse wrist and followed for a mean of 27 months. Eleven wrists in 10 patients had a proximal row carpectomy for scapholunate advanced collapse wrist and were followed for a mean of 37 months. The total arc of motion averaged 95° in the four-corner arthrodesis patients and 115° in the proximal row carpectomy patients, which was 47% and 64%, respectively, of the range of motion of the opposite wrist. Grip strength averaged 74% of the opposite wrist in the four-corner arthrodesis group and 94% in the proximal row carpectomy group. Three wrists in the four-corner arthrodesis group failed and were successfully converted to a total wrist fusion; two additional patients are awaiting arthrodesis. There were no failures in the proximal row carpectomy group. Proximal row carpectomy showed a high degree of patient satisfaction and is our motion-preserving procedure of choice except in those wrists with advanced capitolunate arthritis.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 10","pages":"Pages 1232-1237"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145204442","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 Esmarch Bandage in Hand Surgery: Historical Overview, Clinical Utility, and Associated Risks","authors":"Naomi Kelley MD ,&nbsp;Nathan T. Morrell MD","doi":"10.1016/j.jhsa.2025.04.009","DOIUrl":"10.1016/j.jhsa.2025.04.009","url":null,"abstract":"<div><div>There is no debating the impact of tourniquets on the field of hand surgery. Tourniquets provide considerable utility for surgeons, allowing improved tissue visualization and reduced intraoperative blood loss. Although there are a number of limb exsanguination<span><span> techniques, the most common is the use of a thin, wide elastic bandage, commonly referred to as the “Esmarch bandage.” Described in 1873, the original “Esmarch bandage” exsanguinated the operative limb with a woven rubber bandage before application of a hollow rubber tube on the proximal limb to provide a bloodless surgical field. Johann Friedrich August von Esmarch’s contribution was primarily the manner in which he maintained </span>limb ischemia<span> as the bandage used for exsanguination had been previously developed by others. von Esmarch’s impact has nevertheless been memorialized by the use of thin, elastic bandage, despite the fact that the current “Esmarch bandage” bears little resemblance to his 19th century rubber tube. In this manuscript, we summarize the history, utility, complications, and current recommendations associated with the modern Esmarch bandage within the context of hand surgery.</span></span></div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 10","pages":"Pages 1260-1263"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235915","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":"Hand Surgeons and Accountable Care Organizations: Increasing Reimbursement Through Value","authors":"Claudius D. Jarrett MD ,&nbsp;Jeffry James MBA ,&nbsp;David Ring MD, PhD","doi":"10.1016/j.jhsa.2025.06.020","DOIUrl":"10.1016/j.jhsa.2025.06.020","url":null,"abstract":"<div><div>Alternative payment models have become an important aspect of health care reimbursement reform. The Center for Medicare and Medicaid Services is attempting to decrease the percentage of traditional fee-for-service secondary to its misaligned incentives and unsustainable financial viability. Accountable care organizations (ACOs), by facilitating alternative payment models, have shown potential to improve the quality and decrease the cost of health care, resulting in a higher net profit for participating practices. As a result, ACOs are anticipated to grow substantially in a number of attributable lives and in the financial responsibility of those lives. Relying on traditional means of reimbursement may impact the financial stability of some hand and upper-extremity practices. Collaborating with ACOs provides another means for hand surgeons to participate in alternative payment models, recognize the high quality of care we provide, and share in the rewards received through cost savings.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 10","pages":"Pages 1264-1268"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876895","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":"Mental and Physical Health Disparities in Patients With Carpal Tunnel Syndrome Living With High Levels of Social Deprivation","authors":"Melissa A. Wright MD ,&nbsp;Casey M. Beleckas BS ,&nbsp;Ryan P. Calfee MD, MSc","doi":"10.1016/j.jhsa.2025.07.016","DOIUrl":"10.1016/j.jhsa.2025.07.016","url":null,"abstract":"<div><h3>Purpose</h3><div>Social, mental, and physical health have a complex interrelationship with each influencing individuals’ overall health experience. Social circumstances have been shown to influence symptom intensity and magnitude of disability for a variety of medical conditions. We tested the null hypothesis that social deprivation would not impact Patient-Reported Outcomes Measurement Information System (PROMIS) scores or objective health factors in patients presenting for treatment of carpal tunnel syndrome (CTS).</div></div><div><h3>Methods</h3><div>This cross-sectional study analyzed data from 367 patients who presented for evaluation of CTS to 1 of 6 hand surgeons at a tertiary academic center between August 1, 2016, and June 30, 2017. Patients completed PROMIS Physical Function—v1.2, Pain Interference—v1.1, Depression—v1.0, and Anxiety—v1.0 Computer Adaptive Tests. The Area Deprivation Index was used to quantify social deprivation. Medical record review determined duration of symptoms, tobacco and opioid use, and the Charlson Comorbidity Index (CCI) for each patient. Sample demographics, PROMIS scores, and objective health measures were compared in groups defined by national quartiles of social deprivation.</div></div><div><h3>Results</h3><div>Patients with CTS living in the most deprived quartile had worse mean scores across all 4 PROMIS domains compared with those living in the least deprived quartile. A higher proportion of individuals from the most deprived quartile had a heightened level of anxiety than those in the least deprived quartile (37.3% vs 12.6%). The mean CCI was higher in the most deprived quartile, as was the proportion of individuals using tobacco. There were no differences in opioid use or symptom duration between patients from each deprivation quartile.</div></div><div><h3>Conclusions</h3><div>Social deprivation is associated with worse patient-reported health measures in patients with CTS. Compared with those from the least deprived areas, patients from the most deprived areas also have a greater comorbidity burden and higher rates of tobacco use at presentation to a hand surgeon.</div></div><div><h3>Type of study/level of evidence</h3><div>Prognostic II.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 10","pages":"Pages 1241-1249"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145204443","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 Pericoracoid Tissue Release in Children With Brachial Plexus Birth Injury","authors":"Akin Uzumcugil MD ,&nbsp;Kıvanç Delioğlu PT, PhD ,&nbsp;Abdurrahman Yilmaz MD ,&nbsp;Abdullah Serin MD","doi":"10.1016/j.jhsa.2024.10.003","DOIUrl":"10.1016/j.jhsa.2024.10.003","url":null,"abstract":"<div><h3>Purpose</h3><div>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.</div></div><div><h3>Methods</h3><div><span>Thirty-four children with BPBI underwent pericoracoid tissue release, including coracohumeral and coracoacromial ligament release, pectoralis minor release, and coracoid process </span>osteotomy<span><span>. 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 </span>acromion was measured.</span></div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>Pericoracoid tissue release provided multidirectional improvement in shoulder joint movements in children with BPBI.</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 10","pages":"Pages 1270.e1-1270.e11"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","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}