Journal of Hand Surgery-American Volume最新文献

{"title":"Letter to the Editor Regarding “Revision Carpal Tunnel Release With Endoscopic Technique: Clinical Outcomes and Intraoperative Findings”","authors":"Louis C. Grandizio DO , Joel C. Klena MD","doi":"10.1016/j.jhsa.2025.06.007","DOIUrl":"10.1016/j.jhsa.2025.06.007","url":null,"abstract":"","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 9","pages":"Pages e9-e10"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter to the Editor Regarding “Revision Carpal Tunnel Release With Endoscopic Technique: Clinical Outcomes and Intraoperative Findings”","authors":"Patricia K. Wellborn MD , Alexander D. Jeffs MD , Andrew D. Allen MD , Zohair S. Zaidi MD , Gaurav A. Luther MD","doi":"10.1016/j.jhsa.2025.06.006","DOIUrl":"10.1016/j.jhsa.2025.06.006","url":null,"abstract":"","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 9","pages":"Page e11"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922552","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":"Changes in Shoulder Rotation Based on Elevation in Children With Brachial Plexus Birth Injury","authors":"Stephanie A. Russo MD, PhD ,&nbsp;R. Tyler Richardson PhD ,&nbsp;Emily M. Nice BS ,&nbsp;Ross S. Chafetz DPT, PhD ,&nbsp;Dan A. Zlotolow MD ,&nbsp;Scott H. Kozin MD","doi":"10.1016/j.jhsa.2024.06.001","DOIUrl":"10.1016/j.jhsa.2024.06.001","url":null,"abstract":"<div><h3>Purpose</h3><div><span>Lack of shoulder external rotation is common in children with brachial plexus birth injuries. Development of glenohumeral (GH) </span>dysplasia<span> is associated with progressive loss of passive external rotation. Some authors recommend measuring external rotation with the arm adducted, whereas others recommend measurement with the arm in 90° of abduction. The purpose of this study was to compare active and passive external rotation and internal rotation measured in adduction versus abduction.</span></div></div><div><h3>Methods</h3><div>Fifteen children with brachial plexus birth injuries held their affected arms in maximal external and internal rotation with the arm adducted and the arm at approximately 90° of abduction. Active and passive rotations were measured with three-dimensional motion capture. Scapulothoracic (ST) internal/external rotation and GH internal/external rotation joint angles were calculated and compared using multivariable, one-way repeated measures analyses of variance.</div></div><div><h3>Results</h3><div>There were no significant differences for active or passive ST rotation in external rotation in adduction versus abduction. Glenohumeral external rotation was significantly increased with the arm in abduction compared with adduction both actively and passively. There were no differences in ST rotation in active versus passive conditions, but all GH rotations were significantly greater passively.</div></div><div><h3>Conclusions</h3><div>Shoulder internal/external rotation in abduction and adduction is not interchangeable. Comprehensive assessment of shoulder external and internal rotation should include both adduction and abduction.</div></div><div><h3>Clinical relevance</h3><div>For children with brachial plexus birth injuries, both active and passive GH external rotations were greater in abduction. Therefore, early GH joint dysplasia may be missed if GH external rotation is measured in abduction. Additionally, consistency in arm position is important for comparison over time. The entire ST rotation capacity was used to perform maximal internal and external rotation, but the entire passive GH range of motion was not actively used. This highlights an area for potential surgical intervention to improve motion.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 9","pages":"Pages 1124.e1-1124.e6"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789897","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 Mononeuropathy and Nerve Release After Open and Arthroscopic Shoulder Surgery: A Matched Cohort Analysis","authors":"Gaston Davis BS ,&nbsp;Henson Destine BS ,&nbsp;Andres R. Perez BA ,&nbsp;Adeeb Hanna BS ,&nbsp;Nathaniel Kern BS ,&nbsp;John Dinger BS ,&nbsp;Anya T. Hall MD ,&nbsp;Jacob E. Tulipan MD ,&nbsp;Jonas L. Matzon MD ,&nbsp;Kevin B. Freedman MD ,&nbsp;Fotios P. Tjoumakaris MD","doi":"10.1016/j.jhsa.2024.09.013","DOIUrl":"10.1016/j.jhsa.2024.09.013","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to determine if patients who have undergone prior open or arthroscopic shoulder surgery and develop distal mononeuropathy (DMN) achieve the same clinical benefit after nerve release compared with those who did not have a prior shoulder procedure.</div></div><div><h3>Methods</h3><div><span>Patients were identified by Current Procedural Terminology<span> code for shoulder arthroplasty, shoulder stabilization, and </span></span>rotator cuff<span> repair and if they had an ensuing nerve release (cubital or carpal tunnel) within 2 years of shoulder surgery. Another cohort that underwent nerve release surgery for DMN with no prior history of shoulder surgery was identified and subsequently matched to the first cohort by a 3:1 (control:case) ratio. Patients were included if they were over the age of 18 years. Chart reviews and surveys stored using REDCap were used to collect demographics, surgical history, EMG/nerve conduction velocity results, postoperative symptoms, and patient-reported outcomes with a minimum 2-year follow-up.</span></div></div><div><h3>Results</h3><div>In total, 120 patients were included in this analysis (28 cases, 92 controls). The most common nerve release for DMN across both cohorts was open carpal tunnel release. Following nerve release, the case group had more postoperative persistent numbness/tingling than the control group. Both groups were similar with regard to postoperative pain, weakness, or patient-reported outcome measures. Residual postoperative numbness following nerve release was more likely to occur in the forearm for the case group than the control group.</div></div><div><h3>Conclusions</h3><div>Patients with a history of arthroscopic rotator cuff repair and reverse total shoulder replacement shoulder surgery before the presentation of DMN are more likely to experience persistent numbness or tingling after nerve release surgery as well as experience symptoms in the forearm than those without prior shoulder surgery.</div></div><div><h3>Type of study/level of evidence</h3><div>Symptom prevalence retrospective study III.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 9","pages":"Pages 1127.e1-1127.e7"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565378","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":"Time to Recovery of Radial Nerve Palsy After Surgically Treated Humeral Shaft Fractures","authors":"Carlos Gomez MD ,&nbsp;Alfonso Perez MD ,&nbsp;Juan Manuel Breyer MD ,&nbsp;Pamela Vergara MD","doi":"10.1016/j.jhsa.2024.11.024","DOIUrl":"10.1016/j.jhsa.2024.11.024","url":null,"abstract":"<div><h3>Purpose</h3><div><span>The purpose of this study was to report a timeframe for neurologic recovery of complete radial nerve palsies in patients with </span>humeral shaft fractures treated with internal fixation.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed the data of patients who underwent surgical treatment of a humeral shaft fracture between 2016 and 2021 at a level I trauma center. Patients with complete sensory and motor radial nerve palsy were identified. The time elapsed until detection of the first clinical signs of neurologic recovery, and then until full function (M5 according British Medical Research Council scale) was measured.</div></div><div><h3>Results</h3><div>Of 32 radial nerve palsies in 471 surgically treated humeral shaft fractures (6.8%), 17 were recorded at the time of injury and 15 were noted after surgery. Median patient age was 31.5 years (range, 19–58 years). Thirty patients recovered full motor function at a median time of 36 weeks (range, 6–83 weeks). Kaplan-Meier analyses showed that 90.6% of patients presented the first signs of nerve recovery in the initial 6 months of observation. At 12 and 18 months of follow-up, 84.3% and 94% of patients, respectively, had recovered full function of the hand and wrist.</div></div><div><h3>Conclusions</h3><div>Surgically treated humeral shaft fractures associated with radial nerve palsies are expected to show signs of neurologic recovery during the first 6 months and should recover completely after 12 months of follow-up in almost all cases.</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 1081-1087"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016641","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":"Comprehensive Examination of Upper-Extremity Spasticity","authors":"Christopher S. Crowe MD ,&nbsp;Peter C. Rhee DO ,&nbsp;Caroline Leclercq MD","doi":"10.1016/j.jhsa.2025.03.026","DOIUrl":"10.1016/j.jhsa.2025.03.026","url":null,"abstract":"<div><div><span>Spasticity is characterized by heightened muscle tone with exaggerated stretch reflexes and represents a prominent feature of upper motor neuron syndrome. This condition leads to a spectrum of upper </span>limb deformities based on underlying pathology, location and severity of the causative lesion, presence of concomitant contracture, and prior treatment. Because of the heterogeneous presentation of the spastic upper limb, a uniform approach to assessment is a critical component of caring for patients with upper motor neuron syndrome. Unfortunately, existing scientific literature lacks consistent diagnostic standards, thereby preventing effective comparison of outcomes. A minimum set of evaluation criteria should be employed to both clarify clinical communication and improve postoperative outcomes reporting. This review outlines a stepwise approach to evaluation, a guide for standardizing measurements, and explores how diagnostic findings influence surgical decision-making in upper limb spasticity.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 9","pages":"Pages 1097-1106"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509497","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":"Variation in Recommended Treatment Strategies Among American Surgeons for Actual Adult Traumatic Brachial Plexus Injury Cases","authors":"Michele N. Christy MD ,&nbsp;Christopher J. Dy MD, MPH ,&nbsp;R. Glenn Gaston MD ,&nbsp;Bryan J. Loeffler MD ,&nbsp;Mihir J. Desai MD ,&nbsp;Steve K. Lee MD ,&nbsp;Harvey Chim MD ,&nbsp;Jeffrey B. Friedrich MD ,&nbsp;Sameer K. Puri MD ,&nbsp;Jason H. Ko MD","doi":"10.1016/j.jhsa.2024.10.002","DOIUrl":"10.1016/j.jhsa.2024.10.002","url":null,"abstract":"<div><h3>Purpose</h3><div>The surgical management of adult traumatic brachial plexus injuries (BPI) is challenging, with no consensus on optimal strategies. This study aimed to gather preferred reconstructive strategies from BPI surgeons for actual cases from a multicenter cohort to identify areas of agreement.</div></div><div><h3>Methods</h3><div>Four case files (history, physical examination, and imaging and electrodiagnostic testing results) were distributed to eight self-designated Level IV expert BPI surgeons in the United States. Each surgeon independently reviewed the cases and provided a preferred reconstructive plan via free text response.</div></div><div><h3>Results</h3><div>For a pan-plexus case after blunt trauma (67 years old; 3 months from injury): three surgeons recommended nerve grafting upper trunk roots to distal targets. There was disagreement in shoulder reconstruction: one suggested early shoulder fusion, two preferred cranial nerve XI to suprascapular nerve (SSN) transfer, and two anticipated future salvage shoulder fusion. For elbow reconstruction, six surgeons preferred intercostal nerve to musculocutaneous nerve transfer. For an upper trunk injury from a motorcycle accident (33 years old; 6 months from injury), only one surgeon recommended nerve grafting, six preferred XI to SSN transfer, all recommended triceps-to-axillary transfer, and all but one favored a double fascicular transfer.</div></div><div><h3>Conclusions</h3><div>There is inconsistency in the use of nerve grafting for BPI patients, especially in pan-plexus injuries where options are limited. Variability exists in shoulder reconstruction and stability management, with some advocating early glenohumeral arthrodesis. Although single fascicular and triceps-to-axillary transfers are consistently favored, there is no consensus for restoring shoulder and elbow function when intraplexal transfers are unavailable.</div></div><div><h3>Clinical Relevance</h3><div>This study highlights substantial variability in surgical approaches to BPI among experts, underscoring the need for standardized treatment protocols. Understanding these diverse strategies can inform clinical decision making and help develop more uniform guidelines to improve patient outcomes.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 9","pages":"Pages 1131.e1-1131.e9"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683682","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 Z-Lengthening to Fractional Lengthening of Forearm Flexor Tendons: A Biomechanical Cadaveric Analysis","authors":"Angel A. Valencia MD ,&nbsp;Dang-Huy Do MD ,&nbsp;Nathan Heineman MD ,&nbsp;Junho Ahn MD ,&nbsp;Douglas M. Sammer MD ,&nbsp;Daniel M. Koehler MD","doi":"10.1016/j.jhsa.2025.05.005","DOIUrl":"10.1016/j.jhsa.2025.05.005","url":null,"abstract":"<div><h3>Purpose</h3><div><span>Contractures of the extrinsic forearm flexor units can be surgically treated with various procedures that lengthen the musculotendinous unit. Z-lengthening performed at the tendon level and fractional lengthening (FL) performed at the musculotendinous junction are two common interventions to address contractures. The purpose of this study was to compare the biomechanical properties of </span>flexor tendons undergoing Z-lengthening versus FL.</div></div><div><h3>Methods</h3><div><span>Seventy-two flexor tendons were harvested from 12 paired upper extremities, including flexor carpi<span> radialis, flexor carpi ulnaris, flexor pollicis longus, and flexor </span></span>digitorum<span><span> superficialis tendons. Tendons for each set of paired upper-extremities were subjected to either FL or Z-lengthening, so that each type of tendon in an upper extremity pair received a different lengthening procedure. Z-lengthened tendons were lengthened 20 mm and repaired with a pair of 2-0 horizontal mattress sutures. For fractionally lengthened tendons, a transverse tenotomy was made at the musculotendinous junction at the level corresponding to 75% of its maximal width, followed by a second tenotomy 1 cm distal to the first. The maximum load at failure and excursion at failure for each tendon type were measured and compared with the </span>contralateral side.</span></div></div><div><h3>Results</h3><div>Z-lengthened tendons demonstrated a significantly greater load to failure compared with the fractionally lengthened tendons (24.1 N vs 17.3 N). Maximum tendon excursion at failure was also significantly greater for Z-lengthening compared with FL. Among Z-lengthened tendons, 91% (32/35) failed because of suture pullout.</div></div><div><h3>Conclusions</h3><div>Z-lengthened forearm flexor tendons had greater overall tensile strength and excursion at failure compared with fractionally lengthened tendons.</div></div><div><h3>Clinical relevance</h3><div>Surgeons should consider performing Z-lengthening as an alternative method for tendons that are susceptible to failure with FL.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 9","pages":"Pages 1050-1055"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509496","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":"Complications and Outcomes of Bone-Anchored Prostheses of the Hand: A Systematic Review","authors":"Taylor Bates MD ,&nbsp;Liana J. Tedesco MD ,&nbsp;Janos Barrera MD ,&nbsp;Adam Margalit ,&nbsp;Michael Fitzgerald ,&nbsp;Jacques Hacquebord MD ,&nbsp;Omri Ayalon MD","doi":"10.1016/j.jhsa.2024.09.017","DOIUrl":"10.1016/j.jhsa.2024.09.017","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to conduct a systematic review<span> evaluating the reported complications and outcomes of bone-anchored prostheses in digit and partial hand amputees.</span></div></div><div><h3>Methods</h3><div>A literature review of primary research articles on osseointegration and bone-anchored prostheses for digit and partial amputees was performed. The Medline, Embase, Scopus, and Cochrane Library databases were queried. Inclusion criteria were journal articles that evaluated osseointegration and bone-anchored prostheses in digit and partial hand amputees. The main outcome measures were reported complications and the need for revision surgery. Secondary outcomes included all reported outcome assessments.</div></div><div><h3>Results</h3><div>Fifteen articles were included with publication dates ranging from 1996 to 2022. The sample sizes ranged from single-patient case reports to a 13-patient retrospective study. Overall, 33 men and 16 women were reported with a mean age of 33.6 years (range: 12–68) and a total of 71 amputated digits. The median follow-up was 2.1 years (IQR: 1.1–6.8 years). A total of 24 complications were reported in 14 digits (19.7%). Complications included superficial infection in 6 digits (8.5%), abutment loosening or failure in 5 (7%), fixture aseptic loosening in 4 (5.6%), deep infection in 1 (1.4%), and soft tissue instability in 1 (1.4%). Sixteen revision surgeries or component changes were reported.</div></div><div><h3>Conclusions</h3><div>Bone-anchored prostheses using osseointegrated implants in the hand are associated with favorable outcomes in the limited number of low-quality studies available for review. Superficial infections and implant-related failures were the most frequently reported complications.</div></div><div><h3>Type of study/level of evidence</h3><div>Systematic review IV.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 9","pages":"Pages 1128.e1-1128.e9"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683626","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":"Increasing Severity of Radial Longitudinal Deficiency Correlates With the Degree of Proximal Ulnar Hypoplasia","authors":"Felicity G. Fishman MD, MJ ,&nbsp;Alicia M. January PhD","doi":"10.1016/j.jhsa.2024.04.014","DOIUrl":"10.1016/j.jhsa.2024.04.014","url":null,"abstract":"<div><h3>Purpose</h3><div>Classification systems and treatment for children with radial longitudinal deficiency are classically focused on the hand and wrist. However, the elbow can affect the function of these patients secondary to stiffness or instability. The objective of this study was to determine if a correlation exists between severity of radial longitudinal deficiency (RLD) and degree of proximal ulnar hypoplasia.</div></div><div><h3>Methods</h3><div>A single-institution retrospective review was performed at a pediatric<span><span> hospital. One hundred elbows were identified in 72 patients who met the inclusion criteria. Measurements such as the coronoid height, olecranon coronoid angle (OCA), and the anterior coverage index were obtained from lateral radiographs of children with RLD. Ten elbows had posterior </span>subluxation<span> of the ulnohumeral joint radiographically. Eleven patients had thrombocytopenia absent radius (TAR) syndrome.</span></span></div></div><div><h3>Results</h3><div>There was a significant mean difference for OCA between RLD types. Type 4 RLD (mean [M] = 17.9; standard deviation [SD] = 11.3) had a significantly lower OCA than type 0 (M = 26.4; SD = 5.9) and type 1 (M = 31.0; SD = 5.0). A subanalysis of the 58 elbows with type 4 RLD demonstrated that those with TAR (<em>n</em> = 11) had significantly higher anterior coverage index total scores (M <em>=</em> 1.7; SD = 0.3) than those with type 4 without TAR (M <em>=</em> 1.5; SD = 0.2).</div></div><div><h3>Conclusions</h3><div>The degree of proximal ulnar hypoplasia is correlated with increasing severity of RLD, with significantly lower OCA and coronoid height observed in the elbow radiographs of patients with type 4 RLD compared with type 0 and type 1. Children with TAR have less proximal ulnar dysplasia and higher anterior coverage index than children with type 4 RLD without associated TAR.</div></div><div><h3>Type of study/level of evidence</h3><div>Prognostic IV.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 9","pages":"Pages 1123.e1-1123.e6"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141545560","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}