Journal of Hand Surgery-American Volume最新文献

{"title":"Reoperation Rate in Thumb Metacarpophalangeal Fusions Using Nitinol Compression Staples","authors":"Bergin M. Brown BS ,&nbsp;Kiera K. Balding BS ,&nbsp;Carissa C. Dock MD ,&nbsp;Rebecca Stone McGaver MS, ATC ,&nbsp;Clare K. McCarthy MD","doi":"10.1016/j.jhsa.2025.07.023","DOIUrl":"10.1016/j.jhsa.2025.07.023","url":null,"abstract":"<div><h3>Purpose</h3><div>Nitinol technology offers a low profile means of applying compression across a fracture or fusion site. The objective of this study was to evaluate the rate of reoperation and fusion using nitinol staples for metacarpophalangeal (MCP) fusions of the thumb.</div></div><div><h3>Methods</h3><div>This was a retrospective cohort study of thumb MCP fusions between March 2008 and June 2024 by a single surgeon. Fusions were performed with two nitinol staples: each beneath a collateral ligament flush with the bone. Demographic information, hand dominance, indication for surgery, length of follow-up, and reason for reoperation were collected.</div></div><div><h3>Results</h3><div>Five-hundred and ninety-nine patients (503 women and 96 men) with 697 thumbs were candidates for analysis. Eighty-two thumbs had an isolated MCP fusion with bone graft; 615 thumbs had MCP fusions in combination with a carpometacarpal arthroplasty. For patients having carpometacarpal arthroplasty, an MCP fusion was performed to increase pinch strength in those with moderate-to-severe thenar atrophy. It was also performed to address MCP hyperextension greater than 30 degrees, MCP arthritis, or chronic collateral ligament instability. The mean age at the time of surgery was 64.4 years. Nine thumbs (1.3%) returned to surgery for painful or prominent hardware, and seven thumbs (1%) had reoperation for tendon adhesions at the MCP joint. The fusion rate was determined radiographically with bone consolidation across the joint and no lucency around the staples; all patients were fused between 4 and 12 weeks after surgery. The mean time for clinical follow-up was 9.6 months, whereas for reoperation was 31.3 months for hardware removal and 9.6 months for lysis of adhesions after the initial surgery. The minimum estimate of unexpected reoperation was 2.3%.</div></div><div><h3>Conclusions</h3><div>Metacarpophalangeal fusion with nitinol continuous compression staples was associated with a 100% fusion rate and a 2.3% reoperation rate for prominent hardware or adhesions.</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 1217-1223"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979404","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":"Journal CME Questions","authors":"","doi":"10.1016/j.jhsa.2025.09.001","DOIUrl":"10.1016/j.jhsa.2025.09.001","url":null,"abstract":"","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 10","pages":"Page 1182"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145204497","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":"Amyloid Biopsy During Endoscopic Carpal Tunnel Release: A Comparison of Tenosynovial and Antebrachial Fascia Specimens","authors":"Mahmoud Mahmoud MBBS ,&nbsp;Yagiz Ozdag MD ,&nbsp;Brendan J. Carry MD ,&nbsp;Jerad M. Gardner MD ,&nbsp;C. Liam Dwyer MD ,&nbsp;Joel C. Klena MD ,&nbsp;Louis C. Grandizio DO","doi":"10.1016/j.jhsa.2025.06.009","DOIUrl":"10.1016/j.jhsa.2025.06.009","url":null,"abstract":"<div><h3>Purpose</h3><div>Indications and techniques for biopsy to detect amyloid deposition during carpal tunnel release are evolving. Despite the popularity of endoscopic carpal tunnel release (ECTR), there is concern that this technique may be less able to detect amyloid. Our purpose was to compare the incidence of amyloid deposition detected during ECTR using two different biopsy sources: tenosynovial tissue and antebrachial fascia of the distal forearm.</div></div><div><h3>Methods</h3><div>This was a single-center retrospective investigation involving two hand surgeons. All primary, elective ECTR cases in adult patients between March 2022 and September 2024 were included if they underwent isolated tenosynovial or antebrachial fascia biopsy. Baseline demographics and surgical case characteristics were recorded. The primary comparisons of interest were the incidence of amyloid deposition for the tenosynovial and antebrachial fascia groups.</div></div><div><h3>Results</h3><div>A total of 195 cases were included. Eighty-seven percent were indicated for Tier 1 biopsy criteria. Of these cases, 145 (74%) underwent tenosynovial biopsy and 50 (26%) underwent antebrachial fascia biopsy. Mean age was 68 years, and 43% were women. Baseline demographics were similar between the groups, including mean age (67 vs 69 years) and the percentage of cases with diabetes (21% vs 26%). Overall, 27% of the included cases had evidence of amyloid deposition detected on biopsy performed during ECTR. Cases that had a tenosynovial biopsy had a significantly higher incidence of amyloid deposition (33%) compared with cases that underwent isolated antebrachial fascia biopsy (12%).</div></div><div><h3>Conclusions</h3><div>For primary ECTR cases, tenosynovial biopsy results in a significantly higher incidence of amyloid deposition (33%) compared with antebrachial fascia specimens (12%). Although open carpal tunnel release remains the gold standard for biopsy, if ECTR is being performed, biopsies should be obtained from the tenosynovial tissue rather than antebrachial fascia.</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 1174-1181"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805308","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":"Clinical Classification Versus MRI Patterns of Injury in Brachial Plexus Birth Injury","authors":"Caroline H. Hu MD ,&nbsp;Ann E. Van Heest MD ,&nbsp;Michelle A. James MD ,&nbsp;M. Claire Manske MD ,&nbsp;Peter Y. Shen MD ,&nbsp;Andrea S. Bauer MD","doi":"10.1016/j.jhsa.2025.06.015","DOIUrl":"10.1016/j.jhsa.2025.06.015","url":null,"abstract":"<div><h3>Purpose</h3><div>The Narakas classification describes brachial plexus birth injury (BPBI) according to nerve root injury by the pattern of motor weakness on clinical examination. However, it is unknown whether the classification truly corresponds to the described nerve roots. The distribution of nerve root injuries on magnetic resonance imaging (MRI) in infants with BPBI was compared with the clinical classification.</div></div><div><h3>Methods</h3><div>Infants with BPBI were prospectively enrolled at three children’s hospitals, and the Narakas group was determined by physical examination. Infants underwent MRI prior to age 16 weeks. Neuroradiologists determined the injury severity (intact, rupture, avulsion) at each nerve root on MRI. The nerve root findings on MRI were compared with the expected nerve root injuries, based on the clinical Narakas classification.</div></div><div><h3>Results</h3><div>Sixty-eight infants completed the MRI revealing 19 distinct patterns of nerve injury. The nerve root injury findings on MRI did not always correspond with the nerve roots involvement expected based on the Narakas classification. In Narakas 1 patients, 23% had injury to C5–C6 only, and 55% had additional injuries to C7, C8, and/or T1. In Narakas 2 patients, only 26% had an injury specifically to C5–C7 only. In the Narakas 3 and 4 groups, 43% had a C5–T1 global injury as expected by the Narakas classification. The mean number of nerve roots affected, and mean avulsions increased with higher Narakas grades. The most commonly injured and avulsed nerve roots were C6 (n = 60) and C8 (n = 15), respectively.</div></div><div><h3>Conclusions</h3><div>In 68 infants, 19 different patterns of injury were identified, suggesting that the pathoanatomy of BPBI is more nuanced than classically described. For Narakas 1 and 2 infants, the nerve root injury on MRI was often more extensive than expected based on clinical examination. Our results suggest the Narakas classification may not precisely correspond with the injury at the root level, as seen on MRI.</div></div><div><h3>Type of study/level of evidence</h3><div>Diagnostic II.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 10","pages":"Pages 1183-1189"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876894","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":"Nonsurgical Treatment Versus Surgical Treatment in Displaced Metacarpal Spiral Fractures: Extended 4.5-Year Follow-Up of a Previously Randomized Controlled Trial","authors":"Fredrik Peyronson MD ,&nbsp;Cecilia Stalberg Ostwald MD ,&nbsp;Sara Edsfeldt MD, PhD ,&nbsp;Nils P. Hailer MD ,&nbsp;Grey Giddins MD ,&nbsp;Daniel Muder MD","doi":"10.1016/j.jhsa.2025.06.018","DOIUrl":"10.1016/j.jhsa.2025.06.018","url":null,"abstract":"<div><h3>Purpose</h3><div>Spiral or oblique fractures of the metacarpals of rays II−V are common and often managed nonsurgically. Surgery is typically recommended for fractures with displacement or rotational deformity. In a recent randomized controlled trial of displaced fractures, nonsurgical treatment with early unrestricted mobilization was found to be noninferior to surgical treatment at the 1-year follow-up. However, long-term outcomes comparing these approaches have not been reported. This study evaluated whether treatment differences emerge at the midterm follow-up, hypothesizing that nonsurgical treatment will remain noninferior.</div></div><div><h3>Methods</h3><div>Of 42 patients with displaced spiral/oblique metacarpal shaft fractures enrolled in our previous randomized controlled trial, 34 were analyzed at a mean of 4.5 years postinjury (range: 3.1–6.6 years). The primary outcome was grip strength of the injured hand relative to the uninjured hand, with and without adjustment for hand dominance. Secondary outcomes included the Disabilities of the Arm, Shoulder, and Hand score, range of motion, rotational deformity, complications, and patient-rated pain.</div></div><div><h3>Results</h3><div>Nonsurgical treatment remained noninferior within the predefined margin. The mean grip strength was 95% of the uninjured hand in the nonsurgical group and 95% in the surgical group. After adjusting for hand dominance, the mean grip strength was 103% of the uninjured hand in the nonsurgical group and 96% in the surgical group. Secondary outcomes were similar between the groups.</div></div><div><h3>Conclusions</h3><div>Nonsurgical treatment with early unrestricted mobilization remains noninferior to surgical treatment at the midterm follow-up. These findings support the viability of this treatment option for displaced single spiral or oblique metacarpal shaft fractures of rays II–V in patients who prefer nonsurgical treatment.</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 10","pages":"Pages 1190-1197"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979397","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":"Journal CME Instructions","authors":"","doi":"10.1016/S0363-5023(25)00493-9","DOIUrl":"10.1016/S0363-5023(25)00493-9","url":null,"abstract":"","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 10","pages":"Page A12"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145204494","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":"Sensitivity and Specificity of the Brachial Plexus Outcome Measure Activity Scale: A Retrospective Cohort Study.","authors":"Kate Kyuri Kim, Darcy Fehlings, Karen Wong, Emily S Ho","doi":"10.1016/j.jhsa.2025.07.026","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.07.026","url":null,"abstract":"<p><strong>Purpose: </strong>Upper limb impairments occur after incomplete recovery from brachial plexus birth injury (BPBI). Reconstructive surgeries are offered to address specific joint-level impairments; however, complete restoration is not possible. Thus, surgical decisions must carefully consider the goal of improving activity function within the child's life context. The Brachial Plexus Outcome Measure (BPOM) Activity scale is an outcome measure of upper limb activity limitation in children with BPBI. It measures the upper limb function on a 5-point ordinal scale, where a score of ≤3 is theoretically an indicator of surgical candidacy; however, no studies have validated this cutoff score. This study aimed to determine whether the BPOM Activity scale score of ≤3 can accurately identify children with BPBI who may benefit from reconstructive surgery.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on children with BPBI (4-18 years). Two independent researchers screened the diagnostic, surgical, and outcome data from the health records and a BPBI database. Sensitivity, specificity, and receiver operating characteristic area under the curve (AUC) of ≤3 scores for shoulder, elbow/forearm, and wrist surgeries were used to identify discriminating ability. These analyses were repeated for all scores (≤1 to ≤5) to determine the best cutoff score.</p><p><strong>Results: </strong>Of the 502 patients screened, 251 were included. The sensitivity and specificity of ≤3 scores had acceptable to excellent discriminating ability for shoulder (90%, 72%, 0.81 AUC), elbow/forearm (89%, 90%, 0.89 AUC), and wrist (80%, 93%, 0.86 AUC) surgeries. Sensitivity, specificity, and AUC were the highest at the ≤3 score compared with other cutoff scores.</p><p><strong>Conclusions: </strong>The BPOM Activity scale ≤3 cutoff score was able to identify children with BPBI who may benefit from upper limb reconstructive surgery.</p><p><strong>Clinical relevance: </strong>These findings indicate that the BPOM Activity scale can help support shared decision-making for interventions to optimize upper limb function after BPBI.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202093","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":"Association of Nontobacco Nicotine Dependence with Postoperative Complications After Distal Radius ORIF: A Retrospective Analysis.","authors":"Umar Ghilzai, Jad J Lawand, Abdullah Ghali, Krishna Chandra, Eileen Phan, Adil Shahzad Ahmed","doi":"10.1016/j.jhsa.2025.08.003","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.08.003","url":null,"abstract":"<p><strong>Purpose: </strong>Distal radius fractures are common, with management varying by age, activity level, and fracture characteristics. Although operative treatment can improve early recovery, it may be associated with complications. Nontobacco nicotine dependence (NTND), through products like e-cigarettes, has increased, but its impact on postoperative outcomes remains underexplored. This study investigated the effect of NTND on complications following distal radius fracture open reduction and internal fixation (ORIF).</p><p><strong>Methods: </strong>A retrospective cohort study using the TriNetX database categorized adult patients undergoing distal radius ORIF into NTND and non-NTND cohorts. Propensity score matching accounted for demographic and comorbidity differences. Outcomes assessed included 90-day complications (skin infection; sepsis, defined as systemic infection; wrist stiffness; wound disruption; deep vein thrombosis; acute kidney disease; stroke; myocardial infarction; pulmonary embolism; and chronic regional pain syndrome) and 2-year complications (loosening of ORIF hardware, wrist stiffness, nonunion, nerve injury, and tendon injury).</p><p><strong>Results: </strong>After propensity matching, 3,034 patients were matched to each cohort. At 90 days, NTND patients had significantly higher risks of skin infection (OR, 2.48; 95% CI, 1.58-3.89) and lower risk of postoperative stiffness (OR, 0.77; 95% CI, 0.66-0.91). At 2 years, NTND patients exhibited increased risks of loosening of ORIF hardware (OR, 1.66; 95% CI, 1.07-2.60) and nonunion (OR, 2.35; 95% CI, 2.37-4.13), a lower risk of wrist stiffness (OR, 0.78; 95% CI, 0.67-0.91). No statistically significant differences were observed for malunion, tendon ruptures, or nerve injury.</p><p><strong>Conclusions: </strong>The NTND is associated with significantly higher risk of postoperative complications following distal radius ORIF, including infection, loosening of ORIF hardware, and nonunion but a lower risk of wrist stiffness. These findings suggest that NTND is an important risk factor and highlights the need for further research and targeted perioperative management strategies to mitigate risks in this population.</p><p><strong>Type of study/level of evidence: </strong>Prognostic II.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139565","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":"Outcomes of Upper-Extremity Revascularization Following Acute Limb Ischemia.","authors":"Diane Jo, Fuad Abbas, Christopher Jou, Riley Marlar, Rommy Obeid, Ryan Khalaf, Mazen Al-Malak, Ying Ku, R'ay Fodor, Sean Lyden, Antonio Rampazzo, Bahar Bassiri Gharb","doi":"10.1016/j.jhsa.2025.08.005","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.08.005","url":null,"abstract":"<p><strong>Purpose: </strong>Acute limb ischemia (ALI) is a vascular emergency that demands prompt diagnosis and surgical intervention. This study investigated the incidence, clinical presentation, and outcomes of upper-extremity ALI and examined the impact of patient risk factors on these outcomes.</p><p><strong>Methods: </strong>A retrospective review of patients who underwent upper-extremity revascularization for ALI at a single health care system from 2003 to 2023 was conducted. Patients with ischemia duration under 14 days were included. Data on demographics, hypercoagulability risk factors, ischemia duration, clinical presentation, etiology, hospitalization length, and complications were analyzed.</p><p><strong>Results: </strong>Three hundred sixty-six patients underwent revascularization for ALI during the study period. The average age of the patients was 65.0 ± 17.0 years, and 69.7% were women. Common etiologies included embolism from atrial fibrillation (21.5%) and iatrogenic injury (29.3%). The brachial artery was the most common occlusion site (89%). The median ischemia time was 12.0 hours (IQR = 29.2). Pain and paresthesia at initial presentation were considerably associated with increased duration of ischemia. Eighty patients (21.9%) experienced complications. Eleven patients (3%) who received prophylactic fasciotomy had a median ischemia duration of 22 (13-76) hours, which was similar to patients without prophylactic fasciotomy (14 [7-35] hours). Prophylactic fasciotomy was also associated with increased complications.</p><p><strong>Conclusions: </strong>Upper-extremity ALI revascularization has a high complication rate. Although longer ischemia duration may intensify symptoms, it does not predict complications or hospital stay. Prophylactic fasciotomy, lacking clear benefit, may increase risks, and calls into question its routine use in upper-extremity ALI cases.</p><p><strong>Type of study/level of evidence: </strong>Prognostic IV.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132571","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":"Buttress Plating for Type 3-4-5 Jersey Finger Fractures: Without Bone Fragment Disruption and With a Challenging Rate of Hardware Removal-A Case Series.","authors":"Ömer F Kümbüloğlu, Yusuf Altuntas, İsmail Demirkale","doi":"10.1016/j.jhsa.2025.07.038","DOIUrl":"https://doi.org/10.1016/j.jhsa.2025.07.038","url":null,"abstract":"<p><strong>Purpose: </strong>The use of plates in the treatment of Leddy-Packer type 3-5 flexor digitorum profundus tendon avulsion injuries is becoming increasingly prevalent; however, potential complications, including disruption of the avulsed bone fragment and damage to the flexor digitorum profundus tendon, may be encountered. The objective of this study was to ascertain whether the buttress plate technique, without screw placement in the avulsed fragment, can be employed as a treatment option for patients with type 3, 4, and 5 flexor digitorum profundus tendon avulsion injuries.</p><p><strong>Methods: </strong>Type 3, 4, and 5 flexor digitorum profundus tendon avulsion injuries treated with the buttress plate technique were evaluated retrospectively. The Disabilities of the Arm, Shoulder, and Hand score, range of motion of the distal interphalangeal joint, and visual analog scale score for pain were assessed.</p><p><strong>Results: </strong>The study included 12 patients with types 3-5 flexor digitorum profundus tendon avulsion injury. The follow-up period averaged 21 months (range, 15-32 months). All patients achieved union. The mean active range of flexion motion obtained in the distal interphalangeal joint was 74° (SD, 19°). Patients with type 3 and 5 injuries exhibited a functional distal interphalangeal joint range of motion. The plate was removed in nine patients with plate-related tenderness in the finger.</p><p><strong>Conclusions: </strong>The buttress plate technique may be considered as a treatment option for type 3 and type 5 injuries.</p><p><strong>Type of study/level of evidence: </strong>Therapeutic IV.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092909","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}