Journal of Hand Surgery-American Volume最新文献

{"title":"Perioperative Patient Experience in Office-Based Wide-Awake Hand Surgery","authors":"Shafic Sraj MD, MBA ,&nbsp;Brendan J. Farley MD ,&nbsp;John S. Taras MD ,&nbsp;Andrea B. Lese MD ,&nbsp;B. Joseph Prud’homme MD ,&nbsp;Richard Gross PhD ,&nbsp;Wing Yan Vien Cheung MA ,&nbsp;Stephanie Cox PhD","doi":"10.1016/j.jhsa.2024.10.009","DOIUrl":"10.1016/j.jhsa.2024.10.009","url":null,"abstract":"<div><h3>Purpose</h3><div>Office-based surgery, is a safe, well-tolerated option associated with high patient satisfaction. However, some patients remain hesitant due to concerns of being awake during surgery. Preoperative anxiety may be linked to poorer postoperative outcomes. The purpose of this study was to examine patients’ distress prior to, during, and following office-based hand surgery under local anesthesia and to identify patient variables associated with distress.</div></div><div><h3>Methods</h3><div>This study included 57 patients, 19 of whom had a history of anxiety and/or depression. Each patient completed the Amsterdam Preoperative Anxiety and Information Scale (APAIS) before surgery; patients completed the Subjective Units of Disturbance Scale (SUDS) before surgery, immediately after surgery, and at their first postoperative visit. They rated their SUDS with respect to the following distress domains: Being Awake During Surgery, Needlestick, Surgical Pain, and Discomfort.</div></div><div><h3>Results</h3><div>The average distress experienced was less than the patients’ preoperative expectations across all domains, and most patients rated their experiences to be equivalent to or better than expected (81 to 96% of patients, depending on the domain). Patients with elevated APAIS scores were more likely to have less distress (a better experience) than expected compared to those who were not.</div></div><div><h3>Conclusions</h3><div>Average distress levels experienced were better than expected. Patients with higher APAIS had less distress (better experiences) than they expected.</div></div><div><h3>Type of study/level of evidence</h3><div>Prognosis II.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 9","pages":"Pages 1133.e1-1133.e7"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712032","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":"Culturally Sensitive Care in Amputations: Recognition and Strategies","authors":"Tiffany Tse MD ,&nbsp;Annie Wang MD ,&nbsp;Daniel Antflek HBSc ,&nbsp;Christine Novak PhD ,&nbsp;Heather Baltzer MD","doi":"10.1016/j.jhsa.2025.04.007","DOIUrl":"10.1016/j.jhsa.2025.04.007","url":null,"abstract":"<div><div>The dignified disposal of limbs post-amputation is important to many cultural groups but is often not addressed. There is limited understanding from physicians and surgeons around the disposal process and its impact on patients, their beliefs, and their experiences within the health care system. In this overview, cultural and spiritual perspectives are reviewed and coupled with recommendations regarding the disposal and reclamation process. The current handling and management process of amputated parts is centered around hospital priorities. The beliefs and wishes of patients are not routinely considered, nor are the barriers to this adequately discussed. These implications affect groups with spiritual or cultural preferences that do not align with hospital standards, further exacerbating health inequity. This review provides information for health care providers surrounding the disposal of amputated parts to provide culturally sensitive and dignified approaches to patient care.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 9","pages":"Pages 1118-1122"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136604","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":"Comparative Computer-Aided Analysis of Three-Dimensional Carpal Alignment in Scapholunate Advanced Collapse and Healthy Wrists","authors":"Mikko Alanen MD ,&nbsp;Samuli Aspinen MD, PhD ,&nbsp;Theresa Höglund MD ,&nbsp;Robert Sippo MD ,&nbsp;Eero Waris MD, PhD","doi":"10.1016/j.jhsa.2024.09.021","DOIUrl":"10.1016/j.jhsa.2024.09.021","url":null,"abstract":"<div><h3>Purpose</h3><div>Scapholunate dissociation frequently results in malalignment and scapholunate advanced collapse (SLAC). Previous analyses have relied on visual observations of carpal angles among the scaphoid, lunate, and capitate on lateral radiographs. However, the 3-dimensional carpal alignment during SLAC progression remains unclear. The purpose of this study was to analyze 3-dimensional carpal malalignment in SLAC wrists.</div></div><div><h3>Methods</h3><div>Using computer-aided cone-beam computed tomography analysis software based on segmentation and numerical modeling, we defined three-dimensional carpal axes and examined alignment and carpal height ratio in 18 SLAC wrists along the radial coordinate (positive in palmar and ulnar directions). These results were compared with previously reported normal alignment values obtained from 121 healthy wrists.</div></div><div><h3>Results</h3><div>In the sagittal plane, mean scapholunate, lunotriquetral, lunocapitate, and capitometacarpal angles were –100° (SD, 11°); 20° (SD, 11°); 7° (SD, 12°); and 18° (SD, 8°); respectively, whereas the angles were –58° (SD, 9°); 12° (SD, 8°); –17°(SD, 11°); and 8° (SD, 6°); respectively, in healthy wrists. The sagittal scapholunate angle exhibited the highest area under the receiver operating characteristic curve (0.999), with a threshold value of ≤–76°, indicating pathology. In the coronal plane, the carpal alignment of SLAC wrists remained unchanged, excluding a minimal ulnar tilt of the capitate.</div></div><div><h3>Conclusions</h3><div>Carpal malalignment in SLAC wrists not only affects the radio- and midcarpal joints, but also extends to the third carpometacarpal joint, with malalignment evident in both the sagittal and coronal planes. In SLAC wrists, the sagittal lunotriquetral angle increases in the positive direction, due to the lunate angulating more than the triquetrum.</div></div><div><h3>Clinical relevance</h3><div>These findings have potential to contribute to the development of computer-aided diagnostic tools for 3-dimensional imaging technology. In the future, such tools could highlight abnormal values and minimize diagnostic errors in clinical practice.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 9","pages":"Pages 1130.e1-1130.e9"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640293","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 Suture Method for Collateral Ligaments of the Finger Proximal Interphalangeal Joint: A Cadaver Study","authors":"Kenji Kubota MD ,&nbsp;Takane Suzuki PhD ,&nbsp;Yusuke Matsuura PhD ,&nbsp;Takahiro Yamazaki MD ,&nbsp;Seiji Ohtori PhD","doi":"10.1016/j.jhsa.2024.09.020","DOIUrl":"10.1016/j.jhsa.2024.09.020","url":null,"abstract":"<div><h3>Purpose</h3><div><span><span><span>In a cadaveric model, a comparison was made of the strength of a </span>suture method for </span>collateral ligaments (the N method) with that of simple sutures using suture anchors for the repair of collateral ligaments in the proximal interphalangeal </span>joint.</div></div><div><h3>Methods</h3><div><span>We obtained 72 fingers from 18 upper limbs of fresh-frozen cadavers and compared the left and right sides of the same specimens. In experiment 1, we examined the rupture strength and rupture sites of intact collateral ligaments in 24 fingers. In experiment 2, we compared the rupture strength and failure modes of the N method (three locking sutures) with those of simple sutures (S group) on 32 fingers. In experiment 3, we examined the rupture strength and failure modes between the N method with three locking sutures (N3 group) and the N method with two locking sutures (N2 group) on 16 fingers. All the experiments involved mechanical testing by applying </span>lateral stress to the collateral ligaments at a rate of 1 mm/s using testing equipment.</div></div><div><h3>Results</h3><div>In Experiment 1, the mean rupture strength of intact collateral ligaments was 80.6 ± 27.5 N. Proximal tears were the most common rupture sites. In Experiment 2, the mean rupture strength was significantly higher in the N group (46.3 ± 19.2 N) than in the S group (24.1 ± 12.7 N). In the N group, suture breakage occurred more frequently than in the S group, whereas in the S group, there was a higher incidence of suture cut out. In Experiment 3, the N3 and N2 groups exhibited nearly identical rupture strength values.</div></div><div><h3>Conclusions</h3><div>This study showed that the N method had better rupture strength than the simple suture method following finger collateral ligament repair.</div></div><div><h3>Clinical relevance</h3><div>The outcome provides useful information for informing the choice of suture method in clinical practice.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 9","pages":"Pages 1129.e1-1129.e7"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640287","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 and Upper-Extremity Surgeons Are Poised to Lead Efforts in Promoting Sustainability in the Operating Room","authors":"Brittany N. Garcia MD ,&nbsp;Paige M. Fox MD, PhD ,&nbsp;Donald H. Lalonde MD ,&nbsp;Laura L. Bellaire MD","doi":"10.1016/j.jhsa.2025.04.024","DOIUrl":"10.1016/j.jhsa.2025.04.024","url":null,"abstract":"<div><div><span>Health care spending comprises almost 20% of the US economy, averaging over $13,000 per person in 2022. Similarly, health care systems are responsible for a considerable portion of greenhouse gas emissions both nationally and globally. Operating rooms are resource-intensive and account for large portions of hospital waste. Hand and upper-extremity surgery is unique among surgical specialties given its high-volume and ability to use different surgical environments, such as office-based surgery or procedure rooms, along with wide-awake surgery with </span>local anesthesia. As such, hand surgeons are positioned to be leaders in initiatives aimed at ameliorating waste and promoting sustainability in surgery. Minimizing our environmental impact and addressing surgical contributions to climate change are priorities of several hand surgical societies and organizations. Hand surgeons around the globe are taking a deeper look into where scalable, efficient, and valuable impacts can be made. While important efforts have been implemented, ongoing work in this space is imperative. Best practices should be created, scaled, and shared for clinical care, auditing methods, and reporting standards.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 9","pages":"Pages 1108-1116"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318758","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":"Revision A1 Pulley Release: An Analysis of Risk Factors Using a National Database","authors":"Douglas J. Weaver MD ,&nbsp;Jennifer Lewis BS ,&nbsp;Walaa Abdelfadeel MD ,&nbsp;Jason A. Strelzow MD ,&nbsp;Jennifer Moriatis Wolf MD, PhD","doi":"10.1016/j.jhsa.2024.09.016","DOIUrl":"10.1016/j.jhsa.2024.09.016","url":null,"abstract":"<div><h3>Purpose</h3><div>Trigger finger release (TFR) is a commonly performed procedure in hand surgery. Trigger finger release has a high success rate, but recurrence can occur. Data on revision TFR (rTFR) are sparse, with little known regarding factors associated with the need for revision surgery. Our purpose was to analyze risk factors associated with rTFR procedures.</div></div><div><h3>Methods</h3><div><span>Using a national database (PearlDiver Research Program), patients who underwent TFR between 2015 and 2022 were identified using Current Procedural Terminology and </span>International Classification of Diseases<span> (ICD)-10 codes. Patients were included if they received an ICD-10 diagnosis of trigger finger on the same day as their release or within 2 weeks of their procedure. Patients who underwent rTFR were determined through identification of a secondary procedure completed in the same digit on the ipsilateral hand performed after the index procedure. Revision rates at 1, 3, and 5 years were recorded. Demographics and comorbidities were categorically examined via univariate and multivariable logistic regression analyses.</span></div></div><div><h3>Results</h3><div><span>A total of 46,613 patients meeting inclusion criteria were identified after TFR with 1,793 (3.85%) undergoing revision release. Multivariable analysis demonstrated that diabetes, ischemic heart disease, and male sex were associated with statistically significantly increased odds of revision procedures at 1, 3, and 5 years from the initial operation. Age &gt;65 years and hypertension were associated with an increased odds of revision surgery at 3 and 5 years, and </span>carpal tunnel syndrome as a risk factor at 1 and 3 years only. Hypothyroidism was associated with a decreased revision rate at all time points and tobacco use at 5 years only.</div></div><div><h3>Conclusions</h3><div>These data demonstrate that male sex, diabetes, and heart disease are risk factors for requiring revision TFR in the short and medium terms. This information can add to preoperative counseling with patients undergoing surgical treatment of trigger digits.</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 9","pages":"Pages 1033-1042"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549000","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.2025.07.034","DOIUrl":"10.1016/j.jhsa.2025.07.034","url":null,"abstract":"","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 9","pages":"Pages 1116-1117"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922606","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.2025.07.033","DOIUrl":"10.1016/j.jhsa.2025.07.033","url":null,"abstract":"","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 9","pages":"Pages 1106-1107"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922080","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 Percutaneous Triple K-Wire Fixation Technique for Nascent Malunion of Proximal Interphalangeal Joint Fracture-Dislocation: A Case Series With an Assessment of Functional Outcome","authors":"Anil K. Bhat MS (Ortho), DNB (Ortho) ,&nbsp;Mithun Pai Gurpur MS (Ortho), FNB (Hand & Microsurgery) ,&nbsp;Navaneeth Panarukandy MS (Ortho)","doi":"10.1016/j.jhsa.2024.08.010","DOIUrl":"10.1016/j.jhsa.2024.08.010","url":null,"abstract":"<div><h3>Purpose</h3><div>Fracture-dislocations of the proximal interphalangeal (PIP) joint are difficult to manage. In the case of a 2- to 4-week delay in definitive treatment, a nascent malunion may result. This study aimed to evaluate the effectiveness of the percutaneous triple K-wire technique for treatment of the PIP joint nascent malunion.</div></div><div><h3>Methods</h3><div>We treated 13 patients with nascent malunion of PIP joint fracture-dislocations using the percutaneous triple K-wire fixation technique based on the principle of soft callus manipulation to achieve congruity and reduction in the joint. The study included cases where the percentage of articular involvement exceeded 40% and in whom there was a minimum follow-up of 12 months. At the final follow-up, we measured the range of motion at the PIP joint. The Ishida and Ikuta scores were determined.</div></div><div><h3>Results</h3><div>The mean period between injury and surgery was 17.2 days. The average follow-up time was 14.2 months. The mean active arc of motion before surgery in the PIP joint was 15 degrees and that at the final follow-up was 83 degrees. Seven patients achieved excellent outcomes according to the Ishida and Ikuta scores. The final postoperative range of motion at the PIP joint was comparable with that reported in the literature for patients who underwent different procedures.</div></div><div><h3>Conclusions</h3><div>This procedure can be considered a viable alternative to open reduction<span> and plating, hemihamate arthroplasty<span>, and ligamentotaxis with distraction, particularly in the presence of nascent malunion.</span></span></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 9","pages":"Pages 1125.e1-1125.e9"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382483","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":"National Trends of Surgical Interventions for Thumb Carpometacarpal Arthritis From 2010 to 2022","authors":"Wesley Day BS ,&nbsp;Albert Rancu BS ,&nbsp;Andrea Halim MD ,&nbsp;Michael J. Gouzoulis BS ,&nbsp;Peter Y. Joo MD, MPH ,&nbsp;Jonathan N. Grauer MD","doi":"10.1016/j.jhsa.2025.03.014","DOIUrl":"10.1016/j.jhsa.2025.03.014","url":null,"abstract":"<div><h3>Purpose</h3><div>Thumb carpometacarpal arthritis is a common condition for which several surgical options are used: trapeziectomy with ligament reconstruction<span> and tendon interposition (LRTI), other nonprosthetic arthroplasties<span><span> without tendon transfer (eg, suture button suspensionplasty), trapeziectomy alone, </span>arthrodesis, and prosthetic arthroplasty. The current study used a large, national, multi-insurance database to characterize utilization and factors associated with these surgical options over the years.</span></span></div></div><div><h3>Methods</h3><div><span><span>All adult patients who underwent one of the above-noted procedures were identified from 2010 to October 2022 using PearlDiver database. Patient characteristics were abstracted including clinical (age, sex, Elixhauser Comorbidity Index) and nonclinical (insurance plan, and geographic region) variables. Characteristics were compared with multivariable </span>logistic regression to assess whether each influenced the odds of undergoing one procedure versus the others. Relative utilization of the different surgeries was assessed over the years of the study and changes in patient characteristics over time were compared with univariate </span>linear regression.</div></div><div><h3>Results</h3><div>Of 160,387 patients identified, LRTI was performed for 97,595 (60.8%), other nonprosthetic arthroplasty for 46,371 (28.9%), trapeziectomy alone for 11,353 (7.1%), arthrodesis for 3,245 (2.0%), and prosthetic arthroplasty for 1,823 (1.1%). Various clinical and nonclinical variables were independently predictive of the surgery performed, the strongest being geographic region in which the surgery was performed. From 2010 to 2022, relative utilization, when compared with all other cohorts, only increased for nonprosthetic non-LRTI arthroplasty (from 27.1% to 35.7%, an absolute increase of 31.5%). Fewer cases of LRTI, trapeziectomy, arthrodesis, and prosthetic arthroplasty were performed (absolute decreases of 8.2%, 16.8%, 52.0%, and 44.9%, respectively).</div></div><div><h3>Conclusions</h3><div>Of surgical options to address thumb carpometacarpal arthritis, LRTI still predominates, but nonprosthetic arthroplasty was the only cohort increasing in utilization over the years. Both patient clinical and nonclinical factors were associated with receiving one surgical modality over the others.</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 9","pages":"Pages 1088-1096"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060142","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}