Hand surgery & rehabilitation最新文献

{"title":"Patterns of Osteoarthritis in Long Finger Joints: An Observational Cadaveric Study with Potential Biomechanical Considerations.","authors":"Raphael Israeli, Shadi Saleh, Dana Avraham, Amir Oron","doi":"10.1016/j.hansur.2024.101777","DOIUrl":"https://doi.org/10.1016/j.hansur.2024.101777","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the distribution and prevalence of osteoarthritis in metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints in long fingers in a cadaveric study, and to discuss potential biomechanical influences on these patterns.</p><p><strong>Methods: </strong>This cadaveric study evaluated 144 metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints from 12 embalmed cadaver hands. A dorsal dissection approach was used to expose the joints, which were then marked with color-coded pegs for consistent orientation during imaging. High-resolution digital images of the distal articular surfaces were captured for analysis. The images were analyzed using custom software to quantify osteoarthritic areas, distinguishing between radial and ulnar aspects. Percentage affected joint surface was calculated using pixel-based measurements. Statistical analysis was used the Student t-test and ANOVA, with the significance threshold set at p < 0.05 and 95% confidence intervals RESULTS: The ulnar side of the proximal interphalangeal joint in digits 2 and 3 showed higher prevalence of osteoarthritis (59.31% ± 15.48%) than the radial side (40.68% ± 15.48%), p = 0.007; in contrast, for digits 4 and 5, prevalence was greater on the radial (54.3% ± 10.99%) than the ulnar side (45.7% ± 10.99%), p = 0.007. No significant differences were noted in osteoarthritis distribution between the radial and ulnar aspects of the metacarpophalangeal and distal interphalangeal joints.</p><p><strong>Conclusions: </strong>This study identified distinct patterns of osteoarthritis distribution in long-finger joints, with greater prevalence in the proximal interphalangeal joints. Although there were differences between stable (digits 2 and 3) and mobile (digits 4 and 5) fingers, further research is necessary to conclusively determine the role of biomechanical forces in the development of osteoarthritis. These findings lay the groundwork for future studies of the pathophysiology of osteoarthritis in the hand, and could guide the development of preventive and therapeutic interventions.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensitivity and specificity of the sensory collapse test for nerve entrapment syndrome in the upper extremity.","authors":"Lucas Audiffret, Marie Witters, Alice Mayoly, Najib Kachouh, Sébastien Viaud-Ambrosino, Emilie Bougie, Régis Legré, Charlotte Jaloux","doi":"10.1016/j.hansur.2024.101774","DOIUrl":"https://doi.org/10.1016/j.hansur.2024.101774","url":null,"abstract":"<p><strong>Objectives: </strong>Several prospective blinded studies have found poorer sensitivity for the sensory collapse test than reported by Susan E Mackinnon's team. However, the blinded examiner had no knowledge of the patient's clinical presentation, or even of the purpose of the test. In these conditions, it seems difficult to perform the sensory collapse test correctly. The aim of the present study was to evaluate the efficacy of the sensory collapse test in the diagnosis of nerve compression in the upper extremity, using a trained, \"partially\" blinded examiner, with a minimum of clinical information in order to avoid bias due to poor execution of the test, while still unable to influence the test result.</p><p><strong>Methods: </strong>Seventy-two patients with diagnosis of nerve entrapment in the upper extremity were included prospectively. The sensory collapse test was performed by two examiners, one of whom was blinded to laterality and to the site of nerve compression, aware only of the affected nerve. Using electrodiagnosis study as reference, the sensitivity and specificity of the sensory collapse test were calculated for each examiner.</p><p><strong>Results: </strong>The unblinded examiner showed 72% sensitivity and 57% specificity, and the blinded 68% sensitivity and 57% specificity.</p><p><strong>Conclusions: </strong>The sensory collapse test is a useful for diagnosis of nerve entrapment in the upper limb, even with a blinded examiner.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Muscle activity analysis using electromyography during sensory collapse test: An experimental case report.","authors":"Vincent Martinel, Benjamin Ferembach, Karim Anani, Floris Van Rooij, Bethany Grew, Thomas Apard","doi":"10.1016/j.hansur.2024.101772","DOIUrl":"https://doi.org/10.1016/j.hansur.2024.101772","url":null,"abstract":"<p><p>A 48-year-old right-handed male surgeon complained of finger numbness, pain, cramps and weakness of 2 years' progression, without improvement after 2 carpal tunnel corticosteroid injections and splinting. The patient was diagnosed with lacertus syndrome with Hagert's triad. Sensory collapse test was positive, but the sensations during the test were not consistent with the literature. Therefore, a sensory collapse test was performed in combination with electromyography; immediately following cutaneous stimulation, partial transient collapse in muscle tone was observed, without complete interruption. Following surgical release of the ipsilateral median nerve at the lacertus fibrosus, the symptoms were resolved, and combined sensory collapse test and electromyography revealed minimal to no collapse in muscle tone following cutaneous stimulation.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the exhaustion test in lacertus syndrome.","authors":"Edouard Kunegel, Rabih Kortbawi, Kevin Bruynseels, Wissam El-Kazzi, Antonia Gkotsi","doi":"10.1016/j.hansur.2024.101775","DOIUrl":"https://doi.org/10.1016/j.hansur.2024.101775","url":null,"abstract":"<p><strong>Background: </strong>Lacertus syndrome involves dynamic median nerve compression by the lacertus fibrosus, leading to sensory symptoms and loss of strength. Prevalence in the general population is unclear.</p><p><strong>Objective: </strong>This study aimed to determine the prevalence of lacertus syndrome in the Belgian population and to evaluate the effectiveness of the exhaustion test combined with the scratch collapse test.</p><p><strong>Methods: </strong>In a cross-sectional study from May 2023 to February 2024, 362 healthy individuals, aged 18 to 86 years underwent clinical examinations, including the scratch-collapse test and exhaustion test, to assess signs of lacertus syndrome.</p><p><strong>Results: </strong>11.3% of participants (95% CI: 8.2-15.1%) reported discomfort on lacertus fibrosus palpation. The scratch-collapse test at the lacertus fibrosus was positive in 7.2% of cases (95% CI: 4.8-10.4%), increasing to 25.7% (95% CI: 21.3-30.5%, p < 0.001) following the exhaustion test. There were no significant differences in gender, occupation, or hand dominance (all p > 0.05). Hagert's clinical triad and positive scratch-collapse test over the lacertus fibrosus were found in 2.21% (95% CI: 1.0-4.2%) of this general population after the exhaustion test.</p><p><strong>Conclusion: </strong>The prevalence of lacertus syndrome was 2.21% after the exhaustion test, and 0.83% before. The exhaustion test led to significant conversion of negative to positive scratch-collapse test from 7.2% to 25.7%. The exhaustion test enhanced the scratch-collapse test's diagnostic accuracy, revealing a spectrum of lacertus syndrome symptoms, from unnoticed mild cases to severe manifestations, and confirmed the importance of Hagert's clinical triad in diagnosing lacertus syndrome.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overview of French hand surgeons' practices regarding primary nerve repairs of digital nerves.","authors":"Marie Léger, Isabelle Auquit-Auckbur, Dorothée Coquerel-Beghin, Luc Meuric, Fabrice Rabarin, Octave Dhellemmes","doi":"10.1016/j.hansur.2024.101773","DOIUrl":"https://doi.org/10.1016/j.hansur.2024.101773","url":null,"abstract":"","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An unusual case of trigger finger.","authors":"Pauline Gonzalez-Espino, Gero Meyer Zu Reckendorf","doi":"10.1016/j.hansur.2024.101771","DOIUrl":"https://doi.org/10.1016/j.hansur.2024.101771","url":null,"abstract":"","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevating patient experience: Transformative strategies in hand therapy.","authors":"Jean Paul Brutus, Bianieff Tchiloemba, Anna Galstyan, Tom Lattré, Aviva Wolff, Alison Taylor","doi":"10.1016/j.hansur.2024.101764","DOIUrl":"10.1016/j.hansur.2024.101764","url":null,"abstract":"<p><p>This paper explores transformative strategies in hand therapy aimed at improving the patient experience - a critical factor linked to improved clinical outcomes and increased satisfaction for patients and therapists. The focus is on three key areas: personalized interactions, empathic communication, and sensory engagement. Personalized interactions ensure therapy is uniquely tailored to each patient' needs, fostering a sense of individual attention and care. Empathic communication involves understanding and responding effectively to patients' verbal and nonverbal cues, creating a supportive environment where patients feel genuinely heard. Sensory engagement utilizes the therapeutic environment's visual, olfactory, and auditory elements to create a calming, welcoming space conducive to healing and relaxation. Integrating these strategies aims to increase treatment effectiveness and improve therapist well-being by promoting a fulfilling and less stressful work environment. Through a comprehensive review of existing evidence, current practices and innovative approaches, this paper advocates for a holistic, patient-centered model of hand therapy that significantly improves treatment outcomes and enhances the overall therapeutic experience, ensuring it is both practical and compassionate.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, radiological and dynamic CT results of scapholunate intercarpal ligamentoplasty for scapholunate dissociation.","authors":"Lionel Athlani, Émeline Luc, Nicolas Pauchard, Alain Blum, Gilles Dautel, Pedro Augusto Gondim Teixeira","doi":"10.1016/j.hansur.2024.101762","DOIUrl":"10.1016/j.hansur.2024.101762","url":null,"abstract":"<p><p>A clinical, radiological and four-dimensional computed tomography (4DCT) assessment of the outcomes of scapholunate intercarpal ligamentoplasty (SLICL) was done with a minimum follow-up of 2 years. Twenty-nine patients (23 men and 6 women) with a mean age of 40 years (22-57) who had chronic scapholunate dissociation were treated with the SLICL procedure. There were 18 cases of dynamic instability and 11 of static instability. The patients were evaluated with a mean follow-up of 61 months (24-94). SLICL significantly reduced pain and increased grip strength and wrist function. On radiographs, the mean static and dynamic scapholunate gaps as well as the scapholunate and radiolunate angles improved significantly. The dorsal scaphoid displacement was always corrected. 4DCT after surgery provided a more precise analysis of the SLICL's effectiveness at restoring intracarpal alignment. Correction of the DISI deformity and dorsal scaphoid displacement was confirmed. SLICL restored a normal variation in the scapholunate gap (range value) during radioulnar deviation movement without systematically reducing the distance between the bones (mean and maximum values) which remained pathological in wrists with static instability but not in those with dynamic instability. At the final follow-up, no patients had signs of osteoarthritis due to ScaphoLunate Advanced Collapse. LEVEL OF EVIDENCE: III.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-based Measurement of the Intra-scaphoid angle.","authors":"Mauro Maniglio, Bérénice Moutinot, Sébastien Durand","doi":"10.1016/j.hansur.2024.101755","DOIUrl":"10.1016/j.hansur.2024.101755","url":null,"abstract":"<p><strong>Introduction: </strong>Ultrasound is gaining popularity for diagnosing scaphoid fractures. However, it hasn't been used to assess fracture displacement, such as humpback deformity. We propose a sonographic method to measure the intra-scaphoid angle, potentially serving as an alternative to CT scans for detecting fragment malposition after a scaphoid fracture.</p><p><strong>Methods: </strong>We recruited 11 healthy adult volunteers without wrist pathology and performed bilateral wrist ultrasounds, totaling 22 examinations. Each wrist was splinted at 50 ° extension and fully supinated. Two hand surgeons independently performed the ultrasounds. All images were then evaluated separately by two evaluators. The following measurements were taken: 1. Inter-poles distance (IPD): Distance between the summits of the two scaphoid poles on the palmar cortex. 2. Palmar cortical intra-scaphoid angle (PCISA): Angle between the two summits and the deepest point of the waist on the palmar cortex. Measurements were compared for inter-investigator and inter-evaluator reliability using the intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>The study included four males and seven females, with an average age of 35 years (range 21-56). The mean PCISA was 142 ° (SD 10 °) and the mean IPD was 16.3 mm (SD 2.1 mm). Differences in IPD measurements averaged 0.3 mm (range 0-5.2 mm) among investigators and 1.0 mm (range 0.1-3.8 mm) among evaluators. For PCISA, the differences averaged 4 ° (range 0-17 °) among investigators and 6 ° (range 0-15 °) among evaluators. The ICC for IPD was 0.804 (investigators) and 0.572 (evaluators); for PCISA, it was 0.704 (investigators) and 0.602 (evaluators).</p><p><strong>Conclusion: </strong>This study presents a cost-effective and accessible sonographic technique to measure the intra-scaphoid angle. Further research is required to assess its effectiveness in scaphoid fractures and compare it to CT-based measurements like the H/L ratio, LISA, and DCA.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ChatGPT: A concise Google alternative for people seeking accurate and comprehensive carpal tunnel syndrome information.","authors":"Jack C Casey, Myles Dworkin, Julia Winschel, Janine Molino, Mohammad Daher, Julia A Katarincic, Joseph A Gil, Edward Akelman","doi":"10.1016/j.hansur.2024.101757","DOIUrl":"10.1016/j.hansur.2024.101757","url":null,"abstract":"<p><p>Popular artificial intelligence systems, like ChatGPT, may be used by anyone to generate humanlike answers to questions. This study assessed whether ChatGPT version 3.5 (ChatGPTv3.5) or the first five results from a Google search provide more accurate, complete, and concise answers to the most common questions patients have about carpal tunnel syndrome. Three orthopedic hand surgeons blindly graded the answers using Likert scales to assess accuracy, completeness, and conciseness. ChatGPTv3.5 and the first five Google results provide answers to carpal tunnel syndrome questions that are similar in accuracy and completeness, but ChatGPTv3.5 answers are more concise. ChatGPTv3.5, being freely accessible to the public, is therefore a good resource for patients seeking concise, Google-equivalent answers to specific medical questions regarding carpal tunnel syndrome. ChatGPTv3.5, given its lack of updated sourcing and risk of presenting false information, should not replace frequently updated academic websites as the primary online medical resource for patients.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141895016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}