Journal of Hand Surgery-American Volume最新文献

{"title":"A Longitudinal Analysis of 281 Cases of Dermofasciectomy Efficacy in Advanced Dupuytren Disease Cases: A 20-Year Perspective","authors":"Wg Cdr Ankur Pandya Eur Dip Hand Surg, FRCS(Plast) ,&nbsp;Dujanah Bhatti MRCS ,&nbsp;Oliver Manley MRCS","doi":"10.1016/j.jhsa.2025.02.007","DOIUrl":"10.1016/j.jhsa.2025.02.007","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to evaluate the long-term efficacy and outcomes of dermofasciectomy in patients with advanced Dupuytren disease over a 20-year period.</div></div><div><h3>Methods</h3><div>A longitudinal analysis was conducted on 281 cases of advanced Dupuytren disease treated with dermofasciectomy. Disease severity, surgical techniques, rates of proximal interphalangeal joint contracture recurrences, disease recurrence, wound complications, and postoperative care protocols were systematically recorded and analyzed.</div></div><div><h3>Results</h3><div>A total of 281 cases were reviewed, with patients undergoing dermofasciectomy for advanced Dupuytren disease. Full-thickness skin graft loss occurred in 1.1% of cases, with partial loss in 4.2%, primarily in diabetic patients. Junctional recurrence was observed in 3.1% of cases, with no recurrence under the graft itself. Functional outcomes were favorable, with 97% of patients reporting improved hand function. Nerve damage was minimal, with transient neuropraxia in 2.8% and only one case (0.4%) of persistent sensory loss.</div></div><div><h3>Conclusions</h3><div>Dermofasciectomy appears to be a highly effective surgical intervention for advanced Dupuytren disease, offering substantial long-term benefits in terms of function and disease control. These findings underscore the efficacy and durability of dermofasciectomy in managing advanced cases, particularly with appropriate postoperative care.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic IIb.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 6","pages":"Pages 656-662"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992390","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":"Evaluation of Test–Retest Reliability for the Patient-Reported Outcomes Measurement Information System Upper Extremity and Pain Interference Computer Adaptive Tests in a Hand Surgery Population","authors":"Hernan Roca MD ,&nbsp;Gretchen Maughan-Egbert MSPH ,&nbsp;Brittany N. Garcia MD ,&nbsp;Nikolas H. Kazmers MD, MSE","doi":"10.1016/j.jhsa.2025.03.006","DOIUrl":"10.1016/j.jhsa.2025.03.006","url":null,"abstract":"<div><h3>Purpose</h3><div>Utilization of the Patient-Reported Outcomes Measurement Information System (PROMIS) upper extremity (UE) and pain interference (PI) computer adaptive tests (CAT) has grown in the hand surgery literature. However, these instruments were derived using data from a general population rather than cohorts with UE pathology. As such, our primary purpose was to evaluate the test-retest reliability of the UE and PI CATs in a sample of hand surgery patients.</div></div><div><h3>Methods</h3><div>At a tertiary academic center, we recruited adult (≥18 years) orthopedic hand surgery patients who completed the PROMIS UE and PI CAT 1–7 days prior to their office appointment, plus a subsequent response to both instruments in clinic. Patients were included only if their upper extremity symptoms were stable between questionnaires, as assessed by an anchor question (eg, no change in scores is expected). Intraclass correlation coefficients (ICCs) were used to assess test–retest reliability. Bland–Altman Plots were created to visualize the proportion of patients whose scores differed by a value greater than the minimally clinically important difference for both instruments (4.1 for UE CAT, 4.3 for PI CAT).</div></div><div><h3>Results</h3><div>The 88 included patients had a mean age of 54 ± 18 years, and 56% (56/88) were women. There was a mean of 4 ± 2 days between surveys. The UE CAT demonstrated an ICC of 0.87 (95% confidence intervals [CI], 0.80–0.91), consistent with “good” to “excellent” reliability. The PI CAT ICC was 0.84 (95% CI, 0.76–0.89), consistent with “good” reliability. However, 34% (30/88) and 23% (20/88) of patients had UE CAT and PI CAT score differences that exceeded minimally clinically important difference thresholds.</div></div><div><h3>Conclusions</h3><div>For a hand surgery cohort (population level), the UE CAT demonstrated “good” to “excellent” test–retest reliability, and the PI CAT demonstrated “good” reliability. However at the patient level, score differences were clinically relevant in approximately one of three patients for UE CAT and one of four patients for the PI CAT. We conclude that these instruments are reliable at the population level, but should not be used at the level of individual hand surgery patients.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic II.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 6","pages":"Pages 648-655"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006423","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":"Letter Regarding “Short-Term Patient Outcomes After Placement of an Internal Joint Stabilizer for Terrible Triad Injuries: A Multicenter Study”","authors":"Yen-Wei Li MD ,&nbsp;Chin-Hsien Wu MD ,&nbsp;Yuan-Kun Tu MD, PhD","doi":"10.1016/j.jhsa.2025.03.024","DOIUrl":"10.1016/j.jhsa.2025.03.024","url":null,"abstract":"","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 6","pages":"Page e5"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194498","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":"Response to “Letter Regarding ‘Short-Term Patient Outcomes After Placement of an Internal Joint Stabilizer for Terrible Triad Injuries: A Multicenter Study’”","authors":"Daniel A. London MD, MS ,&nbsp;Phillip R. Ross MD ,&nbsp;Michael Wigton MD ,&nbsp;Reed W. Hoyer MD","doi":"10.1016/j.jhsa.2025.03.025","DOIUrl":"10.1016/j.jhsa.2025.03.025","url":null,"abstract":"","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 6","pages":"Page e7"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194499","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":"Microhook Nerve Connector-Assisted Polyethylene Glycol Fusion for Immediate Restoration of Axon Continuity in a Rodent Model","authors":"Geetanjali S. Bendale PhD ,&nbsp;Andrew Azdell MD ,&nbsp;Jonathan Miller MD ,&nbsp;Jonathan E. Isaacs MD","doi":"10.1016/j.jhsa.2025.03.001","DOIUrl":"10.1016/j.jhsa.2025.03.001","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of the study was to test the efficacy of polyethylene glycol (PEG) fusion in restoring axon continuity when repaired with a microhook nerve connector (MNC) coaptation aid versus conventional microsutures. Our hypothesis was that the MNC would provide precise nerve alignment and stable coaptation and would support a higher percentage of axon fusion.</div></div><div><h3>Methods</h3><div>In a rodent sciatic nerve model, transected nerves were either repaired with microsutures only (n = 12), microsutures with PEG (n = 12), or a MNC with PEG (n = 12). At initial surgery, PEG fusion was confirmed using electrophysiology. For 3 weeks, gait videos were used to calculate the sciatic function index. At the end of 3 weeks, compound muscle action potentials and muscle strength data were obtained. In a subset of animals, retrograde labeling was performed distal to the repair site and used to confirm successful axon fusion.</div></div><div><h3>Results</h3><div>Polyethylene glycol fusion was confirmed in all animals from the two PEG groups. At 3 weeks, the sciatic function index values were similar between the three groups. The microsuture-only group did not show any detectable muscle contractions or the presence of intact motor axons. Retrograde labeling demonstrated that partial motor axon continuity had been re-established via PEG fusion in all 8/8 PEG fused animals, muscle contractions were preserved in 13/16, and measurable compound muscle action potentials were recorded in 21/24. However, there were no statistically significant differences between the microsuture + PEG and the MNC + PEG groups.</div></div><div><h3>Conclusions</h3><div>In a small-diameter, direct-repair rodent model, at least some axons achieved PEG fusion. In this model, a MNC did not seem to improve PEG efficacy over suture-assisted PEG fusion.</div></div><div><h3>Clinical relevance</h3><div>Polyethylene glycol fusion either performed in conjunction with sutures or a MNC can, to a limited extent, restore axon continuity in cleanly transected, small-diameter nerves.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 6","pages":"Pages 677-684"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996559","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":"Determining the Optimal Intramedullary Screw Canal Fill Ratio in Length Unstable Metacarpal Fractures: A Biomechanical Investigation","authors":"Spencer B. Chambers MD, MSc ,&nbsp;Dan J. Thompson MS ,&nbsp;Christine V. Schaeffer MD ,&nbsp;Alexander R. Graf MD ,&nbsp;Eric Wagner MD, MSc ,&nbsp;Michael B. Gottschalk MD ,&nbsp;John G. Seiler MD ,&nbsp;Nina Suh MD, Med","doi":"10.1016/j.jhsa.2024.03.017","DOIUrl":"10.1016/j.jhsa.2024.03.017","url":null,"abstract":"<div><h3>Purpose</h3><div>Intramedullary (IM) screw fixation is gaining popularity in the treatment of metacarpal fractures. Despite its rapid adoption, there is a paucity of evidence regarding parameters to optimize effectiveness. This study aimed to quantify the relationship between stability, IM screw size, and canal fill using a cadaveric model.</div></div><div><h3>Methods</h3><div>Thirty cadaveric metacarpals (14 index, 13 middle, and three ring fingers; mean age: 58.3 years, range: 48–70) were selected to allow for canal fill ratios of 0.7–1.1 for screws sized 3.0, 3.5, and 4.5 mm. Metacarpals underwent a 45° volar–dorsal osteotomy at the midpoint before fixation with an IM screw. Specimens were subjected to 100 cycles of loading at 10 N, 20 N, and 30 N before load-to-failure testing. Correlation coefficients for angular displacement on the final cycle at each load, peak load to failure, and average stiffness were assessed.</div></div><div><h3>Results</h3><div>Correlation coefficients for the angular displacement on the 100th cycle were as follows: 10 N, R = 0.62, 20 N, R = 0.57, and 30N, R = 0.58. Correlation values for peak load to failure as a function of canal fit were as follows: 3.0 mm, R = 0.5, 3.5 mm, R = 0.17, and 4.5 mm, R = 0.44. The canal fill ratio that intersected the line-of-best fit at an angular deformity of 10° was 0.74. Average peak forces for 3.0-, 3.5-, and 4.5-mm screws were 79.5, 136.5, and 179.6 N, respectively. Average stiffness for each caliber was 14.8, 33.4, and 52.3 N/mm.</div></div><div><h3>Conclusions</h3><div>Increasing screw diameter and IM fill resulted in more stable fixation, but marginal gains were seen in ratios &gt;0.9. A minimum fill ratio of 0.74 was sufficient to withstand forces of early active motion with angular deformity &lt;10°.</div></div><div><h3>Clinical relevance</h3><div>An understanding of the relationship of IM fill ratio of metacarpal screws to fracture stability may provide a framework for clinicians to optimally size these implants.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 6","pages":"Pages 757.e1-757.e9"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617669","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":"Postoperative Psychiatric Outcomes After Upper-Extremity Amputations","authors":"Christopher M. Dussik MD ,&nbsp;Amy Phan MD ,&nbsp;Jeffrey Coombs MD ,&nbsp;Erika Chang-Sing MD ,&nbsp;Andrew Jae-Min Park MD ,&nbsp;Danielle Wilbur MD","doi":"10.1016/j.jhsa.2025.03.008","DOIUrl":"10.1016/j.jhsa.2025.03.008","url":null,"abstract":"<div><h3>Purpose</h3><div>Upper-extremity amputations alter patient form and, in cases of proximal amputation, may diminish overall function. Psychological outcomes following these procedures have been evaluated primarily on a single-institution basis. This study aimed to evaluate the incidence of psychiatric conditions following upper-extremity amputation on a population-wide basis.</div></div><div><h3>Methods</h3><div>The TriNetX database was queried for all patients treated for upper-extremity amputations between January 1, 2010, and December 31, 2022. Preoperative and date-of-surgery diagnoses were collected to identify conditions preceding amputation. The 3-year incidence of mental health conditions was evaluated based on International Classification of Diseases codes. Chi-squared analyses were used to evaluate incidence between amputation levels. Odds ratios were used to compare outcome rates relative to the general population, as well as against that of the general, upper extremity surgical population.</div></div><div><h3>Results</h3><div>A total of 25,091 patients underwent 25,415 amputations during our period of analysis. This group consisted of 23,416 transmetacarpal or digital amputations, 956 transforearm or wrist disarticulations, and 1,043 transhumerus or shoulder disarticulations. Traumatic etiologies were the most common across all levels. Increases in the rate of depression, general anxiety disorder, psychosis, mood disorders, alcohol or opioid abuse, post-traumatic stress disorder, and suicidality were observed in amputations at and proximal to the wrist compared to those isolated within the hand. Except for general anxiety disorder, the incidence of all psychiatric outcomes was higher relative to the general population. Compared to patients undergoing nonamputation upper extremity surgical procedures, matched analyses revealed increased odds of psychiatric illness at all amputation levels proximal to the phalanges.</div></div><div><h3>Conclusions</h3><div>Approximately one in six patients who undergo an upper extremity amputation develop a psychiatric condition within 3 years, at an increased rate compared to the general population. Patients with more proximal amputations face a greater burden of psychiatric illness compared to those with more distal amputations.</div></div><div><h3>Type of study/level of evidence</h3><div>Prognosis IIc.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 6","pages":"Pages 703-710"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034420","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 Contribution of the Distal Oblique Band to Distal Radioulnar Joint Stability","authors":"Jorge L. Orbay MD ,&nbsp;Brandon Gardner MD, PhD ,&nbsp;John J. Heifner MD ,&nbsp;Anthony Martin MD ,&nbsp;Deana M. Mercer MD","doi":"10.1016/j.jhsa.2024.03.001","DOIUrl":"10.1016/j.jhsa.2024.03.001","url":null,"abstract":"<div><h3>Purpose</h3><div>The distal radioulnar joint (DRUJ) is supported by an array of dynamic and static stabilizers, of which the triangular fibrocartilage complex (TFCC) is the most important, and the distal interosseous ligament is next in importance. The distal oblique band (DOB) is an identifiable component of the distal interosseous ligament, found in a subset of the population. Our objective was to determine the contribution of the DOB to DRUJ stability in the presence of a disrupted TFCC.</div></div><div><h3>Methods</h3><div>Twenty-three above-elbow specimens were prepared by removing the TFCC and the DRUJ joint capsule, preserving the distal interosseous ligament and the pronator quadratus. Cadavers were stratified into two groups—those with, and those without a DOB. A bone plate and screws were attached to the ulna; then, a transverse load was applied to failure, creating a diastasis between the radius and ulna.</div></div><div><h3>Results</h3><div>The group with a DOB had a mean load at failure of 160.7 ± 46.5 N. The group without a DOB had a mean load at failure of 148.0 ± 26.3 N. Stiffness prior to failure was 16.9 N/mm in the group with a DOB and 12.4 N/mm in the group without a DOB.</div></div><div><h3>Conclusions</h3><div>The current results indicate that the DOB may not substantially contribute to DRUJ stability in the presence of a disrupted TFCC.</div></div><div><h3>Clinical relevance</h3><div>Stability of the DRUJ after TFCC injury may not be substantially improved by the presence of a DOB. Thus, the clinical importance of DOB reconstruction remains unclear.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 6","pages":"Pages 753.e1-753.e5"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140781850","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 Impact of a Computer-Based Interactive Informed Consent for Surgery on Decision Conflict","authors":"Sina Ramtin MD ,&nbsp;Floor Davids BSc ,&nbsp;Amir Reza Farhoud MD ,&nbsp;Raul Tejada BSA ,&nbsp;David Ring MD, PhD","doi":"10.1016/j.jhsa.2024.03.011","DOIUrl":"10.1016/j.jhsa.2024.03.011","url":null,"abstract":"<div><h3>Purpose</h3><div>Informed consent for surgery can address the legal aspects of care while also being simple, informative, and empathic. We developed interactive informed consents and compared them with standard printed informed consents asking: (1) are there any factors associated with lower decision conflict or greater patient-rated clinician empathy including consent format? (2) Are there any factors associated with rating the consent process as informative, comfortable, and satisfying including consent format?</div></div><div><h3>Methods</h3><div>Ninety-four adult patients accepted an offer of surgery from one of three hand surgeons to address one of six common hand surgery diagnoses: carpal tunnel release, cubital tunnel release, trigger finger release, plate and screw fixation of a distal radius fracture<span>, removal of a benign mass, including a ganglion cyst<span>, and Dupuytren contracture release. Fifty-three patients were randomized to complete an interactive consent, and 41, a standard written consent. Symptoms of anxiety, depression, and unhelpful thoughts were measured. Patients completed the Decision Conflict Scale and the Jefferson Scale of Patient’s Perceptions of Physician Empathy and rated the consent as informative, comfortable, and satisfactory on a scale of 0–10.</span></span></div></div><div><h3>Results</h3><div>Greater decisional conflict was slightly associated with greater patient unhelpful thoughts about symptoms and was not associated with consent format. A higher rating of comfort with the consent process was slightly associated with patient choice to proceed with surgical treatment, but not with consent format. Accounting for potential confounding in multivariable analysis, a higher rating of the consent process as informative was slightly associated with patient preference for surgical over nonsurgical treatment,</div></div><div><h3>Conclusions</h3><div>The observation that an interactive consent form was not related to decision conflict or other aspects of patient experience suggests that such tools may not have much weight relative to the interaction between patient and clinician.</div></div><div><h3>Clinical relevance</h3><div>Efforts to improve informed consent may need to focus on the dialog between patient and surgeon rather than how information is presented.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 6","pages":"Pages 755.e1-755.e10"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913387","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":"Open Versus Endoscopic Carpal Tunnel Release: A Decision Tool Guided by Multi-Criteria Decision Analysis Incorporating Patient-Reported Outcomes, Complications, and Cost.","authors":"Casey Imbergamo, Gongliang Zhang, Gabriel Yohe, Kyle Sanniec, Allan Fong, Aviram M Giladi","doi":"10.1016/j.jhsa.2025.04.016","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.04.016","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this work was to develop a multi-criteria decision analysis model guided in part by early postoperative patient-reported data to compare open (OCTR) and endoscopic carpal tunnel release (ECTR) and create an interactive platform in the shared decision-making process. Our null hypothesis was that there would be no difference in patient-reported outcomes following OCTR or ECTR, and with all variables weighted equally, OCTR would be the preferred procedure, owing primarily to its lesser cost.</p><p><strong>Methods: </strong>Data from patients who underwent OCTR or ECTR at an institution from 2018 to 2023 were collected. Patient-reported outcome data used in this study to reflect early postoperative experiences/value were collected in real time at the 2-week postoperative time point. Institutional financial data were collected. Complication data were pulled from the existing literature. Multi-criteria decision analysis modeling was then used to create an interface whereby patients and providers can manually adjust weights for each variable based on individual priorities.</p><p><strong>Results: </strong>Nine hundred and eight patient encounters were included for data set modeling. When preferentially weighting transient nerve injury, recurrence, or patient cost as variables of importance, OCTR is the preferred procedure. When weighing permanent nerve injury, infection, or early improvement in pain/function, ECTR is the preferred procedure. The Curtis National Hand Center Carpal Tunnel Decision Matrix was subsequently created to provide real time results as the weight of each variable is adjusted.</p><p><strong>Conclusions: </strong>This study presents a model guided by patient-reported outcome data as a reflection of the patient experience surrounding carpal tunnel release surgery. This decision aid tool is intended to be used for individual patient-level knowledge and decision-making as a reflection of patient attitudes.</p><p><strong>Level of evidence/type of study: </strong>Decision analysis IV.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163858","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}