Hand surgery & rehabilitation最新文献

{"title":"Bone grafting for scaphoid nonunion with dry arthroscopy.","authors":"Asgeir Amundsen, Istvan Zoltan Rigo, Preben Olsson Dovland, Jan-Ragnar Haugstvedt","doi":"10.1016/j.hansur.2025.102204","DOIUrl":"10.1016/j.hansur.2025.102204","url":null,"abstract":"<p><p>From the time a scaphoid fracture occurs to the successful treatment of a nonunion, months and years have often passed, and the patient frequently has reduced wrist motion, grip strength, and wrist pain. Scaphoid nonunions can be a challenge for the wrist surgeon, and operations are undertaken in several ways. Technological advancements have led surgeons to be able to do minimally invasive procedures on the wrist that were not previously attempted, sparing the soft tissue envelope from surgical trauma. Arthroscopy can be a powerful tool for diagnosis, but it has evolved over the past decades into a tool for undertaking the whole surgical procedure or parts of the procedure as hybrid wrist surgery. The purpose of this paper is to focus on the technique of dry arthroscopic bone grafting for scaphoid nonunion, aiming to produce consistent results with high union rates.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102204"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295541","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":"Combined radial closing-wedge osteotomy and ulnar shortening osteotomy for distal radius malunion.","authors":"Arnaud Walch, Sabine Pillot, Thais Galissard, Aram Gazarian, Thibault Druel","doi":"10.1016/j.hansur.2025.102207","DOIUrl":"10.1016/j.hansur.2025.102207","url":null,"abstract":"<p><strong>Purpose: </strong>Distal radius malunion alters wrist biomechanics, leading to pain, stiffness, and functional impairment. Various corrective osteotomy techniques exist. The aim of this study was to evaluate the functional outcomes of a combined radial closing-wedge osteotomy and ulnar shortening osteotomy in the treatment of distal radius malunions.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed 20 patients who underwent combined radial closing-wedge osteotomy and ulnar shortening osteotomy for symptomatic distal radius malunions. Functional outcomes, grip strength, range of motion, and radiographic parameters were analyzed.</p><p><strong>Results: </strong>Surgery significantly improved supination (20°-80°), flexion (40°-60°), extension (50°-65°), and grip strength (12 kg-22 kg). Ulnar variance correction was achieved. Complications occurred in four cases, with three requiring revision surgery.</p><p><strong>Discussion: </strong>Combined radial closing-wedge osteotomy and ulnar shortening osteotomy effectively restores wrist function while avoiding graft-related complications. This approach provides an alternative to opening-wedge osteotomies for distal radius malunions.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102207"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304097","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":"Comment on the article: Hourglass-like constriction is a hallmark of neuralgic amyotrophy (Parsonage-Turner syndrome). Hand Surg Rehabil. 2025;44(2):102090\".","authors":"Bukola A Olarewaju, Ehab Y Harahsheh, Shaymaa Shurrab, Misha B Asif, Mayowa A Osundiji","doi":"10.1016/j.hansur.2025.102200","DOIUrl":"https://doi.org/10.1016/j.hansur.2025.102200","url":null,"abstract":"","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102200"},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295542","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":"Twenty-year national trends in finger fracture epidemiology: Declining incidence, demographic disparities, and digit-specific injury patterns.","authors":"Peter V Dinh, Timothy A Reiad, Haneef A Khan, Joseph A Gil","doi":"10.1016/j.hansur.2025.102205","DOIUrl":"https://doi.org/10.1016/j.hansur.2025.102205","url":null,"abstract":"<p><strong>Background: </strong>Finger fractures are among the most common upper extremity injuries, with significant functional and socioeconomic implications. While prior studies have described the general epidemiology of finger fractures, there is limited data on longitudinal trends, digit-specific patterns, and differences in injury mechanisms by demographic groups in the United States.</p><p><strong>Methods: </strong>A retrospective analysis was performed using the National Electronic Injury Surveillance System (NEISS) database to estimate national trends in finger fracture incidence from 2004 to 2023. Cases were identified using specific diagnosis and body part codes, with narrative keyword filtering to determine the affected digit. Demographic variables, injury mechanisms, and annual incidence rates were analyzed. Trends were assessed using linear regression, and differences between groups were evaluated with Odds Ratios and Injury Proportion Ratios.</p><p><strong>Results: </strong>A total of 109,317 finger fractures were reported over the twenty-year study period, representing a nationally estimated 3,693,924 finger fractures. The average annual incidence was 59.0 per 100,000 person-years. Males accounted for 65.4% of total cases, with a male-to-female incidence ratio of approximately 2:1. The thumb (26.43%) and little finger (26.14%) were the most frequently fractured digits, followed by the ring (15.30%), middle (14.53%), and index (12.06 %) fingers. The most common causes were football (11.7 %), basketball (11.5 %), and doors (9.8 %). There was a 46% decline in emergency department finger fracture rates from 2004 to 2023 (p < .01), driven primarily by reductions in the 0-18 and 19-40 age groups. Rates in adults over 40 remained stable.</p><p><strong>Conclusion: </strong>This comprehensive, longitudinal analysis demonstrates a significant decline in emergency department finger fracture incidence in the United States over the past two decades, with notable demographic and mechanistic patterns. These findings highlight the importance of age- and activity-specific prevention strategies, continued surveillance, and targeted interventions to further reduce the burden of finger fractures, particularly among vulnerable populations such as older adults and children.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102205"},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295543","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":"QuickDASH: Reliability in the assessment of carpal tunnel syndrome.","authors":"Ophélie Simon, Alexandre Petit, Émilie Marteau, Nicolas Bigorre","doi":"10.1016/j.hansur.2025.102202","DOIUrl":"10.1016/j.hansur.2025.102202","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, along with its shortened version QuickDASH, are widely used self-assessment tools for evaluating upper limb function across various acute and chronic conditions. These tools aim to standardise outcome measures globally, contingent upon certified versions and adherence to calculation guidelines. While overall reliability of the QuickDASH is established, question-by-question reproducibility and methodology have not been rigorously assessed. Carpal tunnel syndrome was chosen for testing the reliability of the QuickDASH. This study aimed to evaluate the question-by-question reliability of the QuickDASH in carpal tunnel syndrome patients. Additionally, we surveyed members of the French Society of Hand Surgery regarding their QuickDASH usage practices and examined patients' functional expectations to correlate them with the questionnaire items. Our hypothesis suggested that response reliability might be affected by patient and practitioner factors or data collection methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A non-interventional, single-center study was conducted from July 2023 to June 2024, including patients whose carpal tunnel syndrome was confirmed by clinical and electrophysiological tests. Patients completed the QuickDASH three times on consecutive days. Demographic, clinical, and paraclinical data were collected, including pain medication, ease of completion, age, sex, body mass index, profession, occupational health status, smoking, diabetes, thoracic outlet syndrome, and electroneuromyogram data. In October 2023, an online survey queried SFCM members on their QuickDASH application methods, response management, and knowledge of guidelines. Finally, A separate group of patients was interviewed preoperatively to describe their symptoms openly and symptoms were then compiled for analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The QuickDASH was found easy to complete by 93.3% of patients. The intraclass correlation scores indicated strong reliability for the overall QuickDASH, with 93% pre-operatively, 87% post-operatively and 92% in the overall population. However, question-specific intra-class correlations revealed less consistency, particularly for certain items post-operatively. Among surveyed practitioners, 65.5% reported that patients completed the QuickDASH autonomously, and 63.2% provided direct clarification when needed. While 58.1% of practitioners indicated the QuickDASH did not affect therapeutic decisions, 41.9% acknowledged its potential impact. Word clouds created from open-ended patient responses highlighted pain, tingling, and nocturnal symptoms as primary concerns pre-operatively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The QuickDASH questionnaire demonstrated high reliability for measuring upper limb function in carpal tunnel syndrome patients, though some questions showed variability in their responses. Despite its widespread us","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102202"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144277054","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":"Fractal geometry in wrist biomechanics: A preliminary study with implications for arthroplasty and surgery.","authors":"Lauren Gorelick, Amir Oron, Gil Gannot, Raphael Israeli","doi":"10.1016/j.hansur.2025.102203","DOIUrl":"10.1016/j.hansur.2025.102203","url":null,"abstract":"<p><strong>Background: </strong>Traditional biomechanical theories of wrist motion-such as row, column, and link joint models-offer limited explanations for the complex, multidirectional kinematics observed clinically. Emerging perspectives suggest fractal geometry, represented by the Golden Ratio (φ = 1.618), might underlie wrist biomechanics, providing a more comprehensive and clinically relevant framework.</p><p><strong>Objectives: </strong>This preliminary radiographic study aims to investigate whether wrist anthropometric ratios align significantly with fractal geometry principles, specifically evaluating their consistency with the Golden Ratio. Additionally, the study explores potential implications for wrist arthroplasty design and surgical practice.</p><p><strong>Methods: </strong>A cross-sectional radiographic analysis was conducted on 210 healthy adult wrist radiographs. Anthropometric measurements included ratios between ulnar styloid, radial styloid, and the capitate bone, defined as A/B and (A + B)/C, and were statistically compared to the Golden Ratio. Statistical analyses incorporated tolerance intervals calculated under both normal and log-normal distribution assumptions, with a significance level set at P < 0.05.</p><p><strong>Results: </strong>Mean anthropometric ratios closely matched the Golden Ratio, with an A/B mean of 1.615 (95% CI: 1.503-1.735) and an (A + B)/C mean of 1.620 (95% CI: 1.503-1.735). Tolerance intervals indicated that 95% of the study population fell within the fractal range (1.503-1.735), irrespective of age, gender, or laterality. High interobserver reliability (ICC = 0.91) further validated the consistency of these measurements.</p><p><strong>Conclusion: </strong>The findings support the hypothesis that wrist biomechanics may be fundamentally organized by fractal geometry. These preliminary results challenge existing biomechanical paradigms and highlight potential applications in designing more biomechanically accurate wrist prostheses and enhancing surgical precision. Future research should assess clinical outcomes related to fractal-based prosthetic designs and explore fractal deviations as early indicators of wrist pathology.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102203"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251552","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":"Complications of first rib resection for thoracic outlet syndrome - A national registry study from Finland.","authors":"Markus Pääkkönen, Ville Kytö, Jarmo Gunn","doi":"10.1016/j.hansur.2025.102199","DOIUrl":"10.1016/j.hansur.2025.102199","url":null,"abstract":"<p><p>Many studies have described the frequency of short-term complications in patients undergoing first rib resection for thoracic outlet syndrome (TOS). The rate of long-term complications is less well known. 699 patients that had undergone first rib resection for TOS during 2004-2018 were identified from the Care Register for Healthcare in Finland. The prevalence of complications within 30 days and 1 year was analyzed. The prevalence of complications within 30 days was 9.8%, and complications occurred in 18.8% of the cases within 1 year. The rate of vascular and neural complications increased from 5.9% and 0.7% within 30 days to 10.3% and 2.7% within 1 year, respectively. Only a slight increase was seen in the rate of pneumo/chylothorax or infection. A follow-up of at least 1 year is prudent to detect all complications in patients undergoing first rib resection for TOS. LEVEL OF EVIDENCE: III (Retrospective cohort study).</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102199"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251551","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":"Can artificial intelligence pass the written European Board of Hand Surgery exam?","authors":"Sinan Mert, Lindsay Muir, Benedikt Fuchs, Vanessa Lucksch, Felix H Vollbach, Elisabeth M Haas-Lützenberger, Riccardo E Giunta, Nikolaus Thierfelder, Wolfram Demmer","doi":"10.1016/j.hansur.2025.102197","DOIUrl":"10.1016/j.hansur.2025.102197","url":null,"abstract":"<p><p>Various artificial intelligence-based applications have emerged as transformative tools across numerous domains. Among these, ChatGPT has earned global recognition with its capacity for dynamic user interaction and holds significant potential in the medical sector. However, the subject-specific accuracy of ChatGPT remains a matter of debate. This study assesses the capabilities and knowledge of different artificial intelligence chatbots (ChatGPT, Google Gemini, and Claude) in the domain of hand surgery. Each chatbot conducted a full written EBHS exam. The test results were analyzed according to the EBHS-guidelines, focused on the total scores and the ratio of correct to incorrect responses for each artificial intelligence model. Findings revealed that three out of the four chatbots achieved passing scores on the exam. Notably, ChatGPT-4o1 demonstrated significantly superior performance. This study highlights the subject-specific expertise of different artificial intelligence programs within the specialized field of hand surgery while also underscoring their variability and limitations.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102197"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188719","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":"Lateral elbow epicondylitis recognized as an occupational disease: Evaluation of return to work after surgery in 49 patients with an average follow-up of 45.6 months.","authors":"Alexis Fily, Julien Maximen, Adrien Rossetti, Thierry Dréano, Mickaël Ropars","doi":"10.1016/j.hansur.2025.102174","DOIUrl":"10.1016/j.hansur.2025.102174","url":null,"abstract":"<p><strong>Objectives: </strong>The primary objective of this study was to evaluate the return to previous work activities following surgery for lateral epicondylitis recognized as an occupational disease. The secondary objectives were to assess the relationship between preoperative and postoperative periods of work stoppage, and to determine the influence of different factors on the ability to return to previous activity.</p><p><strong>Material and method: </strong>The demographic, occupational and medical data of 49 patients were analyzed retrospectively with a mean follow-up period of 45.6 months.</p><p><strong>Results: </strong>At last follow-up, 26.5% of patients had returned to their previous activity. Preoperative and postoperative time off work were correlated (R = 0.331; p = 0.0323). Preoperative time off work of less than 12 months was significantly associated with a better ability to return to previous work (p = 0.017). Postoperative time off work and return to previous activity were significantly related (OR = 0.65; p = 0.012). The length of preoperative time off work appears to be an important factor to take into account in the context of occupational disease. The duration of postoperative time off work was consistent with French literature, but highlights significant international variability.</p><p><strong>Conclusion: </strong>A quarter of patients who undergo surgery in a professional context return to their previous activity. Close collaboration among various stakeholders appears essential throughout the patient's care pathway.</p><p><strong>Level of evidence: </strong>IV. Retrospective study.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102174"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133208","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":"Comment on the article: Rein S, Hagert E. Nerve transfer of the median flexor pollicis brevis branch to the deep branch of the ulnar nerve for ulnar nerve palsy: a cadaveric feasibility study. Hand Surg Rehabil. 2025;44 (April (2)):102083.","authors":"Alfio Luca Costa, Bruno Battiston, Paolo Titolo, Mariarosaria Galeano, Michele Rosario Colonna","doi":"10.1016/j.hansur.2025.102170","DOIUrl":"10.1016/j.hansur.2025.102170","url":null,"abstract":"","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102170"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096558","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}