Journal of Hand Surgery-American Volume最新文献

{"title":"A Prospective Randomized Pilot Study: One-Year Outcomes of Ligament Reconstruction Tendon Interposition Versus Suture Tape Suspensionplasty for Thumb Carpometacarpal Joint Arthritis.","authors":"Elizabeth A Graesser, Ryan P Calfee, Martin I Boyer, John C F Clohisy, Christopher J Dy, David M Brogan, Charles A Goldfarb","doi":"10.1016/j.jhsa.2024.04.012","DOIUrl":"10.1016/j.jhsa.2024.04.012","url":null,"abstract":"<p><strong>Purpose: </strong>We performed a randomized controlled trial assessing patient-reported outcome measures following trapeziectomy with ligament reconstruction and tendon interposition (LRTI) or suture tape suspensionplasty (STS) for treatment of thumb carpometacarpal joint osteoarthritis.</p><p><strong>Methods: </strong>Patients undergoing surgery for thumb carpometacarpal joint osteoarthritis were prospectively randomized to LRTI or STS. Outcome measures were collected at 2 weeks, 4 weeks, 3 months, and 1 year and included visual analog scale pain, Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity, return to work/activity, range of motion, grip/pinch strength, and complications.</p><p><strong>Results: </strong>Thirty-one patients (32 thumbs) were randomized from 51 patients offered participation over two years. One-year follow-up was 97%. Both groups had a decrease in visual analog scale pain scores at all postoperative time points. The trajectory of postoperative Patient-Reported Outcomes Measurement Information System Upper Extremity scores was similar, and both groups achieved the meaningful clinically important difference for improvement in PROMIS Upper Extremity by three months. Grip strength was substantially increased in both groups at one year. Return to work/activity and surgical complications favored the LRTI group.</p><p><strong>Conclusions: </strong>Our study did not suggest any clinically relevant differences in the postoperative patient-reported outcome measures or objective clinical measurements between LRTI and STS, although LRTI patients had a faster return to work/activity and lower complication rates.</p><p><strong>Type of study/level of evidence: </strong>Therapeutic IIB.</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":"141460815","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":"Optimizing Readability of Patient-Facing Hand Surgery Education Materials Using Chat Generative Pretrained Transformer (ChatGPT) 3.5.","authors":"Medha Vallurupalli, Nikhil D Shah, Raj M Vyas","doi":"10.1016/j.jhsa.2024.05.007","DOIUrl":"10.1016/j.jhsa.2024.05.007","url":null,"abstract":"<p><strong>Purpose: </strong>To address patient health literacy, the American Medical Association and the National Institutes of Health recommend that readability of patient education materials should not exceed an eighth grade reading level. However, patient-facing materials often remain above the recommended average reading level. Current online calculators provide readability scores; however, they lack the ability to provide text-specific feedback, which may streamline the process of simplifying patient materials. The purpose of this study was to evaluate Chat Generative Pretrained Transformer (ChatGPT) 3.5 as a tool for optimizing patient-facing hand surgery education materials through reading level analysis and simplification.</p><p><strong>Methods: </strong>The readability of 18 patient-facing hand surgery education materials was compared by a traditional online calculator for reading level and ChatGPT 3.5. The original excerpts were then entered into ChatGPT 3.5 and simplified by the artificial intelligence tool. The simplified excerpts were scored by the same calculators.</p><p><strong>Results: </strong>The readability scores for the original excerpts from the online calculator and ChatGPT 3.5 were similar. The simplified excerpts' scores were lower than the originals, with a mean of 7.28, less than the maximum recommended 8.</p><p><strong>Conclusions: </strong>The use of ChatGPT 3.5 for the purpose of simplification and readability analysis of patient-facing hand surgery materials is efficient and may help facilitate the conveyance of important health information. ChatGPT 3.5 rendered readability scores comparable with traditional readability calculators, in addition to excerpt-specific feedback. It was also able to simplify materials to the recommended grade levels.</p><p><strong>Clinical relevance: </strong>By confirming ChatGPT3.5's ability to assess and simplify patient education materials, this study offers a practical solution for potentially improving patient comprehension, engagement, and health outcomes in clinical settings.</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":"141545561","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":"Management of the Spastic Elbow Deformity in Adult Patients With Upper Motor Neuron Syndrome.","authors":"Jacqueline Israel, Matthew Fahrenkopf, Peter C Rhee","doi":"10.1016/j.jhsa.2023.09.015","DOIUrl":"10.1016/j.jhsa.2023.09.015","url":null,"abstract":"<p><p>Spastic elbow deformity in patients with upper motor neuron injuries results from an imbalance of flexor and extensor forces across the ulnohumeral joint. Although not all deformities reflect the same underlying imbalances, the elbow most commonly rests in a flexed position. Patients may present with a combination of muscle spasticity, myostatic contracture, and/or joint contracture. A focused history and physical examination are essential for developing individualized surgical plans that account for variations in deformity severity and patient goals. Patients may present with or without volitional control; goals and treatment options differ depending on the degree of control present. Techniques include hyperselective neurectomy, tendon lengthening, muscle origin release, myotomy, tenotomy, periarticular soft tissue release, and skin rearrangement. This article presents a comprehensive review of the surgical approach to the volitional and nonvolitional spastic elbow deformities.</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":"141635923","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":"Prevalence and Practice Characteristics of Advanced Practice Providers in Upper-Extremity Surgery, 2013-2021.","authors":"Rishub K Das, Olivia Bittles, Wesley P Thayer, Brian C Drolet","doi":"10.1016/j.jhsa.2024.08.015","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.08.015","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated the prevalence, characteristics, and reimbursement of advanced practice providers, including nurse practitioners and physician assistants, who provide care related to the diagnosis and treatment of diseases and conditions of the hand, wrist, and upper extremities in the United States from 2013 to 2021.</p><p><strong>Methods: </strong>Our analysis was a retrospective cohort study evaluating the diagnostic, procedural, and therapeutic services provided by advanced practice providers from 2013 to 2021 using the Medicare Provider Utilization and Payment Data Public Use Files from the Centers for Medicare and Medicare Services. The reported provider type and billing codes were used to identify health care professionals providing upper-extremity care such as ordering radiographs, applying casts and splints, and performing procedures on the hand, wrist, or other anatomic regions of the upper extremity. Trends over the study period and available data about services provided were analyzed.</p><p><strong>Results: </strong>From 2013 to 2021, providers of upper-extremity care included 19,525 (64.7%) doctor of medicine or doctor of osteopathic medicine upper-extremity surgeons, 7,612 (25.2%) physician assistants, and 3,042 (10.1%) nurse practitioners. The nonsurgeon providers were more likely to be women and provide care in micropolitan areas with less than 50,000 people compared with upper-extremity surgeons. Overall, the number of advanced practice providers who billed for upper-extremity care increased by 170.9% from 1,965 in 2013 to 5,324 in 2021. Based on these trends, the growth of APPs providing upper-extremity care is expected to continue.</p><p><strong>Conclusions: </strong>There is a growing prevalence of advanced practice providers in upper-extremity care, and this trend is expected to continue.</p><p><strong>Clinical relevance: </strong>With a growing need for upper-extremity care and predicted shortages in the surgeon workforce, the scope of practice and integration of advanced practice providers merits further discussion and evaluation.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332635","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":"Outcome of Trapeziectomy and Ligament Reconstruction and Tendon Interposition for Patients Aged Less Than 56 Years: A Retrospective Study With a Minimum 5-Year Follow-Up.","authors":"Iman Hameed, Ellen Tomkinson, Omer Slevin, David McCombe, Anthony C Berger, Stephen K Tham","doi":"10.1016/j.jhsa.2024.07.024","DOIUrl":"10.1016/j.jhsa.2024.07.024","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to determine the long-term consequences of trapeziectomy and ligament reconstruction and tendon interposition (LRTI) for trapeziometacarpal osteoarthritis in patients aged less than 56 years.</p><p><strong>Methods: </strong>A retrospective study was performed to investigate the outcome of trapeziectomy and LRTI with a follow-up period of greater than 5 years in patients aged less than 56 years at the time of surgery. Patients completed the Disabilities of Arm, Shoulder, and Hand (DASH), the Patient-Rated Wrist Evaluation (PRWE), and a 10-point visual analog score for pain (VAS). Objective assessments included thumb opposition, palmar and radial abduction angles, and grip, lateral key, and thumb tip pinch strengths. Radiographic assessments of the thumb carpometacarpal joint were performed in three planes, and the trapezial space and trapezial space to metacarpal height ratios were calculated.</p><p><strong>Results: </strong>Between January 2005 and December 2017, 105 patients were treated. Forty-eight patients with 58 thumbs returned for review. The mean patient age at the time of surgery was 52.5 years, and 96% of the patients were women. The mean follow-up period from surgery was 11 years. The mean VAS score was 1. A significant association was found between younger age at the time of surgery and increased proximal migration of the metacarpal, between high VAS pain scores and high PRWE and DASH scores, weak grip, lateral key pinch and thumb tip pinch strength, and Kapandji score, and between the follow-up period and increasing VAS pain, PRWE, and DASH scores.</p><p><strong>Conclusions: </strong>Trapeziectomy and LRTI are effective procedures for patients aged less than 56 years. The benefits of surgery should be balanced against the deterioration in the outcome measures of DASH and PRWE and increasing VAS scores with increasing intervals from surgery.</p><p><strong>Type of study/level evidence: </strong>Therapeutic IV.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332634","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":"Range of Motion Following Flexor Tendon Repair: Comparing Active Flexion and Extension With Passive Flexion Using Rubber Bands Followed by Active Extension.","authors":"Markus Renberg, Jonas Svingen, Marianne Arner, Simon Farnebo","doi":"10.1016/j.jhsa.2024.08.003","DOIUrl":"10.1016/j.jhsa.2024.08.003","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare the outcome in terms of range of motion between early active flexion and extension (early active motion, [EAM]) and passive flexion using rubber bands followed by active extension (sometimes referred to as a Kleinert regimen) after flexor tendon repair in zones 1 and 2.</p><p><strong>Methods: </strong>Data were collected from the Swedish national health care registry for hand surgery (HAKIR). Rehabilitation regimens were decided by the preference of each caregiver. At 3 months, 828 digits (656 EAM and 172 passive flexion) and at 12 months, 448 digits (373 EAM and 75 passive flexion) were available for analysis. Thumbs were analyzed separately.</p><p><strong>Results: </strong>No notable difference in total active motion was found between the groups at 12 months of follow-up.</p><p><strong>Conclusions: </strong>This large registry study supports the hypothesis that EAM rehabilitation may not lead to better range of motion long-term than passive motion protocols.</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":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332636","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":"Combined Distal Interphalangeal Joint Arthrodesis With Proximal Interphalangeal Joint Arthroplasty or Arthrodesis: Technical Considerations.","authors":"Ruben Dukan, Remy Pichard, Zhi Yang Ng, Ramin Shekouhi, Harvey Chim","doi":"10.1016/j.jhsa.2024.08.006","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.08.006","url":null,"abstract":"<p><p>Combined distal interphalangeal joint (DIP) arthrodesis with proximal interphalangeal joint (PIP) arthroplasty or arthrodesis presents unique challenges. Although less common than isolated surgery for the DIP and PIP joints, with an aging population, combined DIP and PIP procedures are an increasingly encountered occurrence. Anatomical and morphological studies have provided length and width measurement standards for the middle and distal phalanges, allowing for planning to assess the compatibility of strategies. Besides reviewing anatomical studies to provide length and width guidelines for hardware placement, we will also discuss optimal hardware combinations for combined surgical intervention in the DIP and PIP joints. Conflict may exist between hardware used for the DIP arthrodesis and implants used for the PIP arthroplasty. As an example, if K-wires are used for DIP arthrodesis, any intervention in the PIP joint will be compatible. However, if headless screws are used for DIP arthrodesis, these should ideally not reach proximal to the midpoint of the middle phalanx. Other techniques, such as single or multiple oblique screws, and tension bands are compatible with PIP arthroplasty. Hence, options for management of the PIP joint are dependent on the technique used for DIP arthrodesis.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332632","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":"Validation of the Lift-Off Screw Technique in Patients Undergoing Corrective Osteotomy for Malunited Distal Radius Fractures.","authors":"Brent D Bates, Jonathan Persitz, Atefeh Noori, Andrea H W Chan, Ryan A Paul","doi":"10.1016/j.jhsa.2024.07.025","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.07.025","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to validate the clinical accuracy of the lift-off screw (LOS) technique for volar tilt correction (VTC) in patients undergoing corrective osteotomy for dorsally angulated distal radius fracture malunions.</p><p><strong>Methods: </strong>We conducted a retrospective review of 23 patients with dorsally angulated distal radius fracture malunions treated with corrective osteotomy using the LOS technique. The LOS equation L_s = [tan(T_c) ∗ L_p + C]/[cos(⍬_s)] and standardized intraoperative fluoroscopic images were used to determine and compare the calculated and clinical VTC and final volar tilt. Correlations between the LOS length and the clinical VTC were calculated, as well as between the desired VTC and the correction accuracy.</p><p><strong>Results: </strong>Preoperative volar tilt ranged from -6° to -50° (mean = -22.9° ± 10.6°). The calculated VTC was 32.7° ± 9.4°, and the clinical VTC achieved was 25.8° ± 9.3°. The difference between the clinical and calculated correction was -6.9°, with an average postoperative clinical volar tilt of 2.8° ± 5.7°, compared with a calculated volar tilt of 9.7° ± 4.4°. There was a moderately strong positive correlation between LOS screw length and clinical VTC achieved, and a moderately weak negative correlation between the desired amount of correction and the accuracy of the correction.</p><p><strong>Conclusions: </strong>The LOS technique is a reproducible method to plan the amount of sagittal plane correction during corrective osteotomy surgery for dorsally angulated distal radius fracture malunions. We demonstrate that this technique underestimates the clinical correction achieved by an average of 7°, with larger deformities experiencing greater undercorrection. Undercorrection of volar tilt during corrective osteotomy should be anticipated by surgeons and considered in future implant and cutting guide designs.</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":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332640","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 of Early Versus Late Debridement Outcomes in the Management of Open Distal Radius Fractures.","authors":"Daniel Nemirov, Gleb Medvedev, Myles Dworkin, Michael Rivlin, Pedro K Beredjiklian, Rick Tosti","doi":"10.1016/j.jhsa.2024.08.007","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.08.007","url":null,"abstract":"<p><strong>Purpose: </strong>The optimal timing for surgical treatment of open distal radius fractures remains an area of debate. The purpose of this study was to examine the outcomes of open distal radius fractures treated surgically before or after 24 hours.</p><p><strong>Methods: </strong>A multicenter retrospective review was performed on all open distal radius fractures treated over 11 years. Patient demographics, injury mechanism, and initial treatment were recorded. Fracture severity was graded by the Gustilo-Anderson classification. Comparisons were made between those treated surgically within and after 24 hours. Outcomes examined included infection, revision surgery, osteomyelitis, and nonunion.</p><p><strong>Results: </strong>A total of 230 cases met the inclusion criteria. The cohorts of early and delayed surgical intervention were similar with regard to preoperative demographics. The most common mechanism of injury was motor vehicle accident. Approximately 40% of cases were graded as type I, 40% as type II, and 20% as type III. Mean time to debridement in the group treated after 24 hours was 5 days. A mean postoperative follow-up of greater than 6 months was obtained in both cohorts. Similar outcomes were found between cohorts with respect to postoperative infection, revision surgery, osteomyelitis, and nonunion.</p><p><strong>Conclusions: </strong>Similar outcomes with regards to infection, revision, osteomyelitis, and nonunion were found between open distal radius fractures treated emergently versus those managed in a delayed fashion. Patient- and injury-specific factors are important in dictating care.</p><p><strong>Type of study/level of evidence: </strong>Prognostic IIB.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332633","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":"Use of Prophylactic Antibiotics in Hand Surgeries in Colombia.","authors":"Luis Fernando Valladales-Restrepo, María Camila Oyuela-Gutiérrez, Ana Camila Delgado-Araujo, Alejandra Sabogal-Ortiz, Jorge Enrique Machado-Alba","doi":"10.1016/j.jhsa.2024.08.004","DOIUrl":"https://doi.org/10.1016/j.jhsa.2024.08.004","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the investigation was to determine the rate of prophylactic antibiotic use in hand surgeries and the factors related to their use in a group of Colombian patients.</p><p><strong>Methods: </strong>This was a descriptive study of patients undergoing hand surgery between January 2021 and December 2022. Sociodemographic, clinical, and pharmacological variables were analyzed. The use of prophylactic antibiotics in clean wounds was considered inappropriate except in those who needed placement of an internal fixation implant. Variables related to inappropriate use of prophylactic antibiotics were analyzed.</p><p><strong>Results: </strong>A total of 523 patients were reviewed, with an average age of 44.3 years; 51.2% were men. Most of the patients had a diagnosis of hand fracture (28.7%), trigger finger (24.5%), or ganglion (18.5%). The surgical wound was considered clean in 79.0% of cases. A total of 91.0% received prophylactic antibiotics, mostly cefazolin (63.3%). Some 55.7% were considered inappropriate by our criteria. Women (odds ratio [OR], 3.19; 95% confidence interval [CI], 1.85-5.47), middle-low to high socioeconomic status (OR, 1.88; 95% CI, 1.05-3.38), treatment in clinic #1 (OR, 9.67; 95% CI, 4.81-19.43), history of diabetes mellitus (OR, 2.90; 95% CI, 1.07-7.86), and diagnosis of trigger finger (OR, 19.92; 95% CI, 9.95-39.88), ganglion (OR, 24.53; 95% CI, 11.72-51.34), or tenosynovitis (OR, 19.61; 95% CI, 6.78-56.73) were associated with receiving inappropriate prophylactic antibiotics. At hospital discharge, 60.6% received prophylactic antibiotics.</p><p><strong>Conclusions: </strong>In a low-middle income country, the use of inappropriate antibiotics in hand surgical procedures is as common as in higher-income countries. The causes appear multifactorial, including the characteristics of the health systems, doctors, and patients.</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":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332639","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}