Journal of Hand Surgery-American Volume最新文献

{"title":"Intermediate-Term Patient-Reported Outcomes After Foveal TFCC Repair: Timing of Recovery and Successful Return to Sports or Work.","authors":"Daniel Y Hong, Karsyn N Bailey, Charles A Goldfarb","doi":"10.1016/j.jhsa.2026.06.007","DOIUrl":"https://doi.org/10.1016/j.jhsa.2026.06.007","url":null,"abstract":"<p><strong>Purpose: </strong>The triangular fibrocartilage complex (TFCC) is a critical stabilizer of the distal radioulnar and ulnocarpal joints. Recent literature has guided surgical practice in addressing deep foveal fibers that are essential for distal radioulnar joint stability. Although foveal TFCC repair has been associated with reduction in pain and improvement in patient-reported outcomes, there is limited literature on the path of the recovery process. The purpose of this retrospective study is to better understand recovery following foveal TFCC repair using the ulnar tunnel technique in both adolescents and adults.</p><p><strong>Methods: </strong>Forty-six patients treated from 2018 to 2023 by a single surgeon with a foveal TFCC repair technique were included. Pre- and post-operative Patient-Reported Outcome Measurement Instrument System (PROMIS) scores and range of motion, as well as complications were analyzed. Thirty-two patients completed follow-up questionnaires at a minimum of 2 years after surgery.</p><p><strong>Results: </strong>PROMIS pain scores at 12 weeks after surgery were significantly improved; upper extremity and physical function were not significantly improved. At an average of 32 months after surgery, PROMIS upper extremity, pain, and physical function scores were all significantly improved. The vast majority of patients regained wrist and forearm motion by 12 weeks. Complication and reoperation rates were 8.7% and 4.3%, respectively. At an average of 32 month follow-up, 77% of patients had returned to full sports and activity. The highest activity level was achieved at a median of 6 months. Of note, 45% of patients experienced a temporary setback during the recovery period.</p><p><strong>Conclusions: </strong>Ulnar tunnel repair of foveal TFCC tears is a reproducible and effective technique with good intermediate-term results. Pain and range of motion reliably improve within the first three months; return to activity and maximum functionality may not significantly improve until six months after surgery. One quarter of our cohort did not return to full activity, and many patients experienced a temporary setback during the recovery process. At intermediate-term follow-up of 32 months, patients were doing well by all subjective measures. Patients should be counseled that functional recovery following foveal TFCC repair is not linear and may require more time than expected.</p><p><strong>Type of study/level of evidence: </strong>III.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814846","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":"Through the Eyes of a Therapist: Ten Things a Hand Surgeon Should Know.","authors":"Nancy Naughton, Hannah J Gift, Brocha Z Stern","doi":"10.1016/j.jhsa.2026.06.012","DOIUrl":"https://doi.org/10.1016/j.jhsa.2026.06.012","url":null,"abstract":"","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809371","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":"Inter- and Intraobserver Reliability of Wrist Arthroscopy for TFCC Tears: An International Study.","authors":"Mikko Petteri Räisänen, Francesco Smeraglia, Martin Clementson, Robert Gvozdenovic, Kristo Kask, Charles A Goldfarb","doi":"10.1016/j.jhsa.2026.06.011","DOIUrl":"https://doi.org/10.1016/j.jhsa.2026.06.011","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the interobserver and intraobserver reliability of wrist arthroscopy for the diagnosis and classification of triangular fibrocartilage complex (TFCC) tears among experienced European hand surgeons, to assess the effect of a consensus meeting on reliability, and to determine whether reliability differs between different tears.</p><p><strong>Methods: </strong>Five hand surgeons from Europe reviewed 43 standardized wrist arthroscopy cases at two time points separated by 6 weeks. Each case included a clinical vignette, radiographs, and arthroscopy video. Surgeons assessed for the presence of a TFCC tear, classified tears using the Palmer and Atzei-Luchetti systems, and recorded treatment decisions. A consensus meeting was held between rounds. For the whole cohort, interobserver reliability was assessed using Fleiss' kappa and intraobserver reliability using Cohen's kappa. For subgroup analyses, interobserver reliability was assessed using pairwise agreement.</p><p><strong>Results: </strong>Interobserver agreement for TFCC tear presence was fair in both rounds, with modest improvement after the consensus meeting. Agreement for TFCC classification was slight-to-fair, and agreement for treatment decisions was low. Intraobserver agreement was consistently higher than interobserver agreement and generally moderate. Subgroup analyses showed higher interobserver agreement for central tears than peripheral tears in assessing TFCC tear presence/absence (central: 94.3% in both rounds versus peripheral: 80.0% and 85.0%). In contrast, for Palmer classification, agreement was higher for peripheral tears, particularly in Round 2 (peripheral: 61.3% versus central: 38.6%). Similar patterns were observed when combined tears were included. The consensus meeting did not meaningfully increase agreement within subgroups between rounds.</p><p><strong>Conclusions: </strong>Arthroscopy demonstrated only moderate reliability for the assessment of TFCC pathology in this study, even among experienced hand surgeons. Although tear presence is commonly recognized, substantial variability persists in classification and decision making for treatment.</p><p><strong>Clinical relevance: </strong>These findings highlight limitations of current arthroscopic classification systems and underscore the need for improved education and classification optimization to enhance diagnostic reproducibility.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809416","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":"Can Large Language Models Preserve Diagnostic Accuracy Despite Patient Self-Diagnosis and Framing Bias in Hypothetical Upper-Extremity Scenarios?","authors":"Emily H Jaarsma, David Ring, John Wickman, Alexander Drost","doi":"10.1016/j.jhsa.2026.07.014","DOIUrl":"https://doi.org/10.1016/j.jhsa.2026.07.014","url":null,"abstract":"<p><strong>Purpose: </strong>Online health queries are often addressed by large language models (LLMs) embedded in search engines. It is possible that LLMs, like human clinicians, might be misdirected by vague symptom descriptions or inaccurate self-diagnoses. We examined patient and scenario factors associated with an LLM's ability to identify intended upper-extremity musculoskeletal diagnoses and its tendency to deviate from patient self-diagnoses in structured clinical vignettes.</p><p><strong>Methods: </strong>ChatGPT (GPT-5) evaluated 180 randomized hypothetical clinical vignettes depicting five common upper-extremity conditions: de Quervain tendinopathy, rotator cuff tendinopathy, lateral epicondylitis, trigger digit, and trapeziometacarpal arthritis. Each vignette included randomized patient characteristics, characteristic or vague symptom descriptions, and a patient self-diagnosis (categorized as correct, a plausible alternative, or a common misconception diagnosis). The LLM was prompted to select the single most likely diagnosis. Multivariable logistic regression identified independent predictors of diagnostic accuracy and deviation.</p><p><strong>Results: </strong>The LLM correctly identified the intended diagnosis in 165 of 180 scenarios (92%). Accuracy was unaffected by the patient's self-diagnosis, was higher for characteristic than vague symptom, and was lower for de Quervain tendinopathy relative to other conditions. The model deviated from the patient's proposed diagnosis in 117 scenarios (65%), of which 104 deviations (89%) appropriately aligned with the intended diagnosis. The LLM was more likely to disregard patient-provided diagnoses that did not match the intended diagnosis, regardless of whether they represented plausible alternatives or common misconceptions.</p><p><strong>Conclusions: </strong>In this experimental setting, an LLM identified simulated upper extremity conditions regardless of patient self-diagnosis, suggesting limited susceptibility to the anchoring, confirmation, and acquiescence biases known to affect human diagnostic reasoning. LLMs may therefore support debiasing and patient guidance by helping address unhealthy misconceptions and aligning tests and treatment choices with patient values.</p><p><strong>Type of study/level of evidence: </strong>V (Experimental Vignette Diagnostic Accuracy Study).</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814805","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 Efficacy of Transosseous Foveal Repair Combined With Dorsal Reinforcement in the Treatment of Chronic Triangular Fibrocartilage Complex Injury With Severe Distal Radioulnar Joint Instability.","authors":"Wen Zhang, Tianyi Wu, Chunyang Wang, Pak-Cheong Ho, Luyuan Sun, Peng Hou","doi":"10.1016/j.jhsa.2026.07.007","DOIUrl":"https://doi.org/10.1016/j.jhsa.2026.07.007","url":null,"abstract":"<p><strong>Purpose: </strong>Mere triangular fibrocartilage complex (TFCC) foveal repair might not be sufficient to yield a favorable prognosis in severe distal radioulnar (DRU) joint instability. In this study, we aimed to evaluate the efficacy of allogeneic tendon graft reinforcement for dorsal structure repair following arthroscopically assisted transosseous foveal reconstruction.</p><p><strong>Methods: </strong>A total of 21 patients were enrolled in the study, and the mean follow-up duration was 44.5 months. Clinical outcomes were evaluated using multiple assessment tools, including the visual analog scale pain score, grip strength, modified Mayo wrist score, and patient-rated wrist evaluation (PRWE) score.</p><p><strong>Results: </strong>All patients had a notable reduction of wrist pain at the final follow-up with the mean visual analog scale pain score decreased from 5.5 to 0.7. The grip strength increased from 75.1% to 86.6% compared with the unaffected side. The modified Mayo wrist score increased from 68.9 to 90.3 and the PRWE score decreased from 50.4 to 8.9. Using a PRWE score decrease of 24 points or more as the criterion, all patients showed clinically meaningful improvements.</p><p><strong>Conclusions: </strong>In this uncontrolled case series, transosseous TFCC foveal repair combined with dorsal DRU joint reinforcement was associated with favorable clinical outcomes in patients with chronic TFCC injury and severe DRU joint instability. Comparative studies are required to determine whether the addition of dorsal reinforcement is superior to isolated foveal repair.</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":2.4,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801874","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":"Medial and Lateral Ligament Bracing in Severe Elbow Instability After Acute Elbow Dislocation.","authors":"Marvin Stryga, Juliane Aden, Freya Reeh, Stephan Sehmisch, Helmut Lill, Alexander Ellwein","doi":"10.1016/j.jhsa.2026.06.008","DOIUrl":"https://doi.org/10.1016/j.jhsa.2026.06.008","url":null,"abstract":"<p><strong>Purpose: </strong>Augmentation of the medial and lateral collateral ligaments using additional ligament bracing has been shown to improve primary stability in biomechanical studies considerably. However, the general indication for ligament bracing remains a topic of discussion. This study aimed to present clinical outcomes in the treatment of severe medial and lateral elbow instability using ligament bracing.</p><p><strong>Methods: </strong>This retrospective study included patients treated for severe medial and lateral elbow instability with ligament bracing. Inclusion criteria were rupture of the medial and lateral ligaments. Severe instability was defined as recurrent dislocation during motion testing after reduction or as decentration on computed tomography or magnetic resonance imaging. Surgical treatment involved repair of the medial and lateral capsule ligament complex with additional ligament bracing. Clinical outcomes were evaluated based on range of motion, Disabilities of the Arm, Shoulder, and Hand score, and subjective satisfaction. Revisions were analyzed.</p><p><strong>Results: </strong>Thirty-three patients with a mean age of 49 years and a mean follow-up of 30 months were included. The Disabilities of the Arm, Shoulder, and Hand score was 15 (range 0-71), and patient satisfaction was 80% (range 20% to 100%). The mean range of motion in extension/flexion was 117° (range 45° to 160°), and pronation/supination was 172° (range 150° to 180°). Overall, 5 revisions (15.2%) were performed, including 1 for recurrent instability 8 days after surgery.</p><p><strong>Conclusions: </strong>Ligament bracing in the treatment of severe medial and lateral elbow instabilities could restore elbow stability and show good clinical results with a low complication rate. The main reason for the revisions is elbow stiffness. It remains unclear to what extent these are a consequence of the rigid implant or significant trauma.</p><p><strong>Type of study/level of evidence: </strong>Therapeutic III.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801883","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":"Distal Radius Articular Surface Visualization: Comparison of Ligament-Sparing Volar and Dorsal Radiocarpal Arthrotomies for Distal Radius Fracture Reduction.","authors":"Dylan R Rakowski, Evan H Richman, Riley Kahan, Kacy J Peek, Thomas J France, Hunter Swartwout, Michael Rogers, Fraser J Leversedge, Alexander Lauder","doi":"10.1016/j.jhsa.2026.06.004","DOIUrl":"https://doi.org/10.1016/j.jhsa.2026.06.004","url":null,"abstract":"<p><strong>Purpose: </strong>Direct articular surface visualization may improve reduction accuracy in intra-articular distal radius fractures. A ligament-sparing volar radiocarpal arthrotomy has been described to complement the standard volar approach, but the articular surface area (SA) visualized has not been compared to the traditional dorsal radiocarpal arthrotomy. This study quantified and compared articular SA visualization through volar and dorsal ligament-sparing radiocarpal arthrotomies in a cadaveric model.</p><p><strong>Methods: </strong>Twenty-four fresh-frozen cadaveric specimens (12 matched pairs) underwent either a volar or dorsal ligament-sparing radiocarpal arthrotomy; one wrist from each pair was randomized to each approach. Visible articular SA was calculated using photogrammetric three-dimensional models created using postarthrotomy images. Radiocarpal disarticulation was performed to calculate total articular SA. Total SA percentage was compared using paired t tests. Regional articular visualization was characterized for each approach by overlay mapping.</p><p><strong>Results: </strong>Mean percentage of SA visualization was 63.7% (range, 43.9% to 90.7%) via volar radiocarpal arthrotomy and 77.3% (range, 53.1% to 90.9%) via dorsal radiocarpal arthrotomy; the dorsal arthrotomy provided a mean increase in visualization of 13.5% (P = .008). Based on overlay mapping, the volar arthrotomy improved visualization of the volar rim, whereas dorsal arthrotomy improved visualization of the dorsal rim, dorsal-radial scaphoid facet, and dorsal-ulnar lunate facet. There was similar visualization of the central third of the radius, volar-radial scaphoid facet, and volar-ulnar lunate facet.</p><p><strong>Conclusions: </strong>Both volar and dorsal arthrotomies provide excellent visualization of the distal radius articular surface, although dorsal arthrotomy provided greater overall visualization. Volar arthrotomy improved exposure of the volar rim, a region commonly involved in volar rim marginal fractures and volar shear intra-articular fractures. The dorsal arthrotomy allowed regional visualization of fracture patterns involving the dorsal-radial styloid, dorsal-ulnar lunate facet, or dorsal rim articular comminution.</p><p><strong>Clinical relevance: </strong>Radiocarpal arthrotomies provide a practical direct assessment of the distal radius articular surface without additional incisions or arthroscopic resources.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801842","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":"Nerve Transfers to Rebalance the Spastic Wrist: An Anatomical Feasibility Study.","authors":"Kitty Y Wu, Trina Stephens, Reza Shahriarirad, Peter C Rhee","doi":"10.1016/j.jhsa.2026.07.004","DOIUrl":"https://doi.org/10.1016/j.jhsa.2026.07.004","url":null,"abstract":"<p><strong>Purpose: </strong>Spastic wrist flexion deformities result from an imbalance between spastic wrist flexors and weak or paralyzed wrist extensors. Nerve transfers offer the potential to restore this balance by combining neurotomy of the spastic donor nerve with reinnervation of the paralyzed recipient muscle. This study evaluated the anatomic feasibility of addressing the spastic wrist flexion deformity by transferring a motor branch from the flexor carpi ulnaris (FCU) to the extensor carpi radialis brevis (ECRB) and/or longus extensor carpi radialis (ECRL).</p><p><strong>Methods: </strong>Ten fresh-frozen cadaveric upper-extremity specimens were dissected. Motor branches to the FCU were identified through an incision between its two heads. The radial nerve branches to the ECRL and ECRB were exposed via a separate curvilinear incision within the antecubital fossa. The number of motor branches, muscle entry points, and length available for nerve transfer was recorded for each motor branch relative to the interepicondylar line (IEL).</p><p><strong>Results: </strong>The ECRL received one to three motor branches, entering the muscle at a median distance 1.6 cm distal to the IEL (range: 4 cm proximal to 6.4 cm distal). The median branch length available for transfer was 3.8 cm (range: 1.5-7.0 cm). The ECRB received one to three motor branches, entering the muscle at a median of 2.7 cm distal to the IEL (range: 1.7-8.0 cm distal). The median maximal branch length was 5.5 cm (range: 4.0-9.0 cm). The FCU had two to three motor branches, median muscle entry point 2.5 cm distal to the IEL (range 0 to 8.0 cm distal), and median maximal branch length of 3.3 cm (range: 1.6-5.2 cm). Direct, tension-free coaptation of the FCU to ECRB motor nerve was feasible in 90% specimens and the FCU to ECRL motor nerve in 50% of specimens.</p><p><strong>Conclusions: </strong>FCU to ECRB nerve transfer was anatomically feasible in the majority specimens and may offer a possible surgical option to rebalance resting wrist posture and function in patients with spastic wrist flexion deformities.</p><p><strong>Type of study/level of evidence: </strong>Diagnostic, IV.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801910","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":"Adams-Berger Reconstruction for Chronic Distal Radioulnar Joint Instability: Prospective 12-Month Outcomes.","authors":"Himadri Dhabal, Mainak Chandra, Sunny Kumar Mallick, Sanjay Kumar","doi":"10.1016/j.jhsa.2026.07.008","DOIUrl":"https://doi.org/10.1016/j.jhsa.2026.07.008","url":null,"abstract":"<p><strong>Purpose: </strong>To prospectively evaluate stability restoration and functional outcomes following Adams-Berger ligament reconstruction for chronic distal radioulnar joint instability at 12 months.</p><p><strong>Methods: </strong>Thirty consecutive patients with symptomatic chronic distal radioulnar joint instability refractory to nonsurgical management underwent Adams-Berger ligament reconstruction using an autologous tendon graft. Patients with advanced arthritis, fixed bony deformity, or infection were excluded. Clinical evaluation included distal radioulnar joint stress testing, forearm pronation-supination range of motion, grip strength, Modified Mayo Wrist Score, Patient-Rated Wrist Evaluation, and Disabilities of the Arm, Shoulder and Hand score. Assessments were performed before surgery and at scheduled intervals through 12 months after surgery.</p><p><strong>Results: </strong>At 12 months, substantial improvement in distal radioulnar joint stability was observed, with restoration of a firm end point and minimal residual translation in most patients. Grip strength increased compared with preoperative values. Forearm rotation was preserved within functional limits. Patient-reported outcome measures demonstrated marked reduction in pain and disability with corresponding improvement in overall upper-extremity function. Most patients achieved good to excellent clinical outcomes. No graft failures or revision procedures were recorded during the follow-up period.</p><p><strong>Conclusions: </strong>Adams-Berger ligament reconstruction demonstrated favorable short-term restoration of distal radioulnar joint stability with clinically meaningful improvement in strength and patient-reported outcomes at 12 months. Functional forearm rotation was preserved in this prospective cohort.</p><p><strong>Type of study/level of evidence: </strong>Prospective Cohort Study II.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801919","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":"Observer-Blinded Comparison of Virtual and Manual Finger ROM in AI-Based 3-Dimensional Hand Models.","authors":"Yusuf İslam Değerli, Sedanur Güngör, Deran Oskay, Çiğdem Öksüz","doi":"10.1016/j.jhsa.2026.06.009","DOIUrl":"https://doi.org/10.1016/j.jhsa.2026.06.009","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the validity, agreement, and intra- and inter-rater reliability of an artificial intelligence (AI)-based 3-dimensional hand modeling system with virtual goniometry for assessing finger joint range of motion (ROM) in individuals with postinjury movement limitations.</p><p><strong>Methods: </strong>This cross-sectional, observer-blinded validation study included individuals with persistent finger ROM limitations following hand injury. Finger joint ROM was assessed using both manual goniometry and AI-based 3-dimensional hand modeling with virtual goniometry. Measurements were obtained for the metacarpophalangeal (MCP), proximal interphalangeal (PIP), distal interphalangeal (DIP), and thumb interphalangeal (IP) joints. The agreement between measurement methods and the consistency of repeated measurements across and within raters were evaluated.</p><p><strong>Results: </strong>Measurements obtained using AI-based 3-dimensional hand modeling demonstrated strong consistency with manual goniometry for MCP, PIP, and DIP joint flexion. Agreement among methods showed no systematic bias for these joints. Intra- and inter-rater reliability were high for finger joint flexion measurements. Greater variability was observed in thumb IP flexion and total finger extension measurements compared with other joint motions.</p><p><strong>Conclusions: </strong>AI-based 3-dimensional hand modeling with virtual goniometry provides valid and reliable measurements for assessing MCP, PIP, and DIP joint flexion following hand injury. The increased variability observed in thumb IP flexion and finger extension measurements indicates that these outcomes should be interpreted with caution when used in remote or technology-assisted clinical assessments.</p><p><strong>Type of study/level of evidence: </strong>Diagnostic IIb.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801913","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}