Journal of Hand Surgery Global Online最新文献

{"title":"Perioperative Treatment of Neuropathic Pain (Nerve SPACE 2025)","authors":"Adam Mosa MD, MSc ,&nbsp;Neill Y. Li MD ,&nbsp;Alexander Chamessian MD, PhD ,&nbsp;Lara W. Crock MD, PhD ,&nbsp;Catherine M. Curtin MD ,&nbsp;Allan Belzberg MD ,&nbsp;Sarah Buday PhD ,&nbsp;Bryan J. Loeffler MD ,&nbsp;Christopher Janney ,&nbsp;Mark A. Mahan MD ,&nbsp;Amy M. Moore MD","doi":"10.1016/j.jhsg.2025.100936","DOIUrl":"10.1016/j.jhsg.2025.100936","url":null,"abstract":"<div><div>Neuropathic pain following brachial plexus and peripheral nerve injury represents one of the most debilitating and least effectively treated sequelae of nerve trauma.</div></div><div><h3>Where are we now?</h3><div>Neuropathic pain affects a majority of patients with severe nerve injuries and is frequently more disabling than associated motor or sensory deficits. The current scientific understanding implicates maladaptive peripheral and central nervous system changes, including neuroma formation, nociceptor hyperexcitability, central sensitization, and cortical reorganization. Contemporary management relies on multimodal strategies incorporating rehabilitation, pharmacotherapy, psychological support, neuromodulation, and select surgical interventions; however, most patients experience only partial or temporary relief, underscoring the persistent gap between mechanistic insight and durable clinical benefit.</div></div><div><h3>Where do we need to go?</h3><div>There remains a critical need for more effective, durable, and patient-centered approaches to neuropathic pain. Improved stratification tools, including biologic, imaging, and electrophysiologic biomarkers, are required to guide personalized treatment selection. Existing preclinical models inadequately capture the psychosocial and functional dimensions of pain, limiting translational relevance. Future therapies must better integrate biological, technological, and psychosocial domains while prioritizing pain relief as an outcome equal in importance to motor and sensory recovery.</div></div><div><h3>How do we get there?</h3><div>Progress will depend on multidisciplinary collaboration that aligns surgical innovation, targeted pharmacologic therapies, neuromodulation technologies, and structured psychological support. One target for growth in the field will be establishing multicenter registries and consensus-built outcome measures, which will be essential to evaluate real-world effectiveness and inform best practices. Continued refinement of biologically rational surgical strategies, emerging neuromodulation platforms, and integrative rehabilitation tools offer a pathway toward care models that address both pain and function. Meaningful improvements in quality of life for patients with nerve injury–related neuropathic pain may be achieved.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 2","pages":"Article 100936"},"PeriodicalIF":0.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077553","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":"Reported Minimal Clinically Important Differences for Patient-Reported Outcome Measures in Hand and Upper-Extremity Surgery: A Systematic Review","authors":"Jenna L. Dvorsky MS ,&nbsp;Michael R. Kann BE ,&nbsp;Christopher Gonzalez BS ,&nbsp;Andrew Gordon BS ,&nbsp;James Kim BS ,&nbsp;Angela Hardi MS ,&nbsp;John Fowler MD","doi":"10.1016/j.jhsg.2025.100942","DOIUrl":"10.1016/j.jhsg.2025.100942","url":null,"abstract":"<div><h3>Purpose</h3><div>In hand and upper-extremity surgery, there are many patient-reported outcome measures (PROMs) used to quantify symptom severity and track patient progress. However, there remains variability and uncertainty regarding the true or most appropriate minimal clinically important difference (MCID) values for each. This systematic review summarized the reported MCIDs for the most commonly used outcome instruments in hand and upper-extremity surgery.</div></div><div><h3>Methods</h3><div>The published literature was searched using strategies designed by a medical librarian for the concepts of MCID; the Boston Carpal Tunnel Questionnaire; the Disabilities of the Arm, Shoulder, and Hand Score (DASH); the Michigan Hand Outcomes Questionnaire; carpel tunnel syndrome; and other hand/upper limb disorders with related synonyms. These strategies were executed in Embase, Ovid-Medline All, CINAHL Plus, Scopus, and Web of Science from database inception. Studies retrieved from the database literature search were imported to Endnote. Any duplicate citations were identified and removed. The remaining citations were imported to Covidence screening software for further screening analysis.</div></div><div><h3>Results</h3><div>In total, 25 studies published from 1998 to 2025 were included in final data extraction and analysis. Among these, 9 (36.0%) reported the MCID value for BCTQ, 4 (16.0%) reported the MCID value for the MHQ and DASH, and 12 (48.0%) reported the MCID value for the Quick Disabilities of the Arm, Shoulder, and Hand.</div></div><div><h3>Conclusions</h3><div>This comprehensive systematic review summarized the reported MCIDs for the Boston Carpal Tunnel Questionnaire, DASH, Quick Disabilities of the Arm, Shoulder, and Hand, and Michigan Hand Questionnaire, all of which are commonly used hand and upper-extremity PROMs. Reported MCIDs for a given PROM can vary not only with the population or diagnosis of patients included but also with the methods used to calculate meaningful change in these patients.</div></div><div><h3>Clinical relevance</h3><div>This systematic review reports the MCIDs for common hand and upper-extremity outcome measures, providing surgeons with reference values to interpret patient-reported changes, while also demonstrating variability in MCID based on diagnosis and methodology. This can help distinguish meaningful improvement for different clinical and patient settings in addition to aid design of studies with clinically relevant end points in upper-extremity surgery.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 2","pages":"Article 100942"},"PeriodicalIF":0.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077556","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":"Ongoing Clinical Challenges in Nerve Surgery (Nerve SPACE 2025)","authors":"Katherine M. Gerull MD ,&nbsp;David M. Brogan MD, MSc ,&nbsp;Harvey Chim MD ,&nbsp;Bryan J. Loeffler MD ,&nbsp;Megan M. Jack MD ,&nbsp;Robert J. Spinner MD ,&nbsp;Macyn M. Stonner OTD","doi":"10.1016/j.jhsg.2025.100938","DOIUrl":"10.1016/j.jhsg.2025.100938","url":null,"abstract":"<div><h3>Where are we?</h3><div>There have been numerous advances over the last decade in peripheral nerve surgery and rehabilitation following nerve transfers. In particular, advances in nerve allografts, nerve wraps, peripheral nerve sheath tumor treatment, and bionic limb technology have expanded the therapeutic landscape for patients with nerve injuries, tumors, and limb loss. Rehabilitation strategies have improved significantly, largely through advances such as the Donor Activation Focused Rehabilitation Approach. Nerve allografts show promise for short digital nerve gaps, though outcomes for proximal injuries remain controversial. Nerve wraps and connectors are widely available, but their efficacy has been controversial, perhaps due to heterogeneity in materials and limited high-quality research studies. In peripheral nerve sheath tumors, molecular subtyping has improved classification, yet reliable preoperative distinction between benign and malignant tumors remains a challenge. Bionic limb reconstruction has been improved through advances in targeted reinnervation, osseointegration, and myoelectric control, although prosthetic abandonment, phantom limb pain, and high costs remain barriers.</div></div><div><h3>Where do we need to go?</h3><div>Future progress requires rigorous empirical evidence to define effective rehabilitation protocols, clarifying the role of allografts versus autografts and determining the clinical utility of nerve wraps and connectors. Improved diagnostic tools are necessary for accurate tumor characterization, and novel systemic therapies are needed for malignant tumors with poor survival outcomes. In bionic limb reconstruction, future advances should integrate intuitive prosthetic control, sensory feedback, and improve pain management while ensuring equitable access to these technologies.</div></div><div><h3>How do we get there?</h3><div>Achieving these goals will require multicenter, nonconflicted, randomized clinical trials; the development of standardized outcome measures; and investment in translational research across cellular biology, imaging, and device development. Collaborative interdisciplinary research is critical to developing evidence-based protocols and technologies. Together, these strategies can continue to accelerate our understanding of peripheral nerve injury, disease, and rehabilitation.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 2","pages":"Article 100938"},"PeriodicalIF":0.0,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077558","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":"Localizing Nerve Injury, Defining Injury Severity, and Estimating Prognosis (Nerve SPACE 2025)","authors":"John Fowler MD ,&nbsp;David Wright MD ,&nbsp;David Cholok MD ,&nbsp;Sandip Biswal MD ,&nbsp;Summer Gibbs PhD ,&nbsp;Sameer Shah MD ,&nbsp;Tom Quick MD ,&nbsp;Ek Tsoon Tan PhD ,&nbsp;Ryckie Wade PhD ,&nbsp;O. Kenny Nwawka MD ,&nbsp;Jonathan Winograd MD","doi":"10.1016/j.jhsg.2025.100940","DOIUrl":"10.1016/j.jhsg.2025.100940","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Localizing nerve injury, defining injury severity, and estimating prognosis are critical factors in surgical decision-making when indicating patients for operative intervention following traumatic nerve injury.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Where are we now?&lt;/h3&gt;&lt;div&gt;Current methods for localizing nerve injury and determining severity of injury include physical examination, electrodiagnostic studies, imaging including ultrasound and magnetic resonance imaging, and surgical exploration. However, these methods remain suboptimal, especially in cases of segmental or multilevel injury as is often seen in blunt force trauma as well as in cases of partial (axonotmetic) injury. A period of observation is often required to determine if spontaneous recovery will occur. In neurotmetic injuries, it is challenging to accurately determine the zone of injury intraoperatively to ensure that reconstruction is performed using healthy, viable nerve. As a result of these shortcomings, it has been difficult to accurately and consistently classify nerve injury according to location and severity which has resulted in difficulty estimating the prognosis for many injuries.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Where do we need to go?&lt;/h3&gt;&lt;div&gt;Better diagnostic methods are needed to be able to accurately determine the location of nerve injury to direct surgical intervention and determine prognosis, especially in blunt, ballistic, multilevel, or segmental injuries. Additionally, improved methods are needed to evaluate partial axonotmetic injuries in which the epineurium remains grossly intact on inspection intraoperatively, but with varying degrees of axonotmetic injury within the nerve. This includes a need for both noninvasive preoperative imaging and biomarkers as well as intraoperative modalities to more accurately determine the degree of intraneural damage and assist in preoperative indications and intraoperative decision-making. Improving these diagnostic modalities will allow classification of injuries by location and severity on a more consistent and accurate basis, leading to improved ability to estimate prognosis, surgical indications, and intraoperative decision-making.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;How do we get there?&lt;/h3&gt;&lt;div&gt;Emerging diagnostic modalities, including simultaneous positron emission tomography and magnetic resonance imaging, nerve-specific fluorescence imaging, quantitative ultrasound and magnetic resonance imaging, peripheral nerve diffusion tensor imaging, magnetic resonance neurography, polarization-sensitive optical coherence tomography, and serum biomarkers for peripheral nerve injury, offer promising advances that may help better localize and define injury severity in peripheral nerve injury. More research and funding are needed to better understand how best to apply each of these modalities for traumatic nerve injury, leading to broader adoption, more accurate classification and consistent reporting of data that can be linked to patient outcomes ","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 2","pages":"Article 100940"},"PeriodicalIF":0.0,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077671","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":"Current Gaps and Future Directions in Brachial Plexus, Upper-Extremity and Lower-Extremity Nerve Injuries (Nerve SPACE 2025)","authors":"Ethan Blum MEng ,&nbsp;David J. Wright MD ,&nbsp;Yusha Katie Liu MD, PhD ,&nbsp;Christopher J. Dy MD, MPH.","doi":"10.1016/j.jhsg.2025.100935","DOIUrl":"10.1016/j.jhsg.2025.100935","url":null,"abstract":"<div><h3>Background</h3><div>Treatment of peripheral nerve injury remains one of the most challenging aspects of reconstructive surgery. Functional outcomes remain inconsistent, high-quality evidence is limited, and major knowledge gaps persist.</div></div><div><h3>Where are we now?</h3><div>When evaluating patients for peripheral nerve injury, the treating physician must ascertain several critical factors to help inform decision-making, including the timing, mechanism, localization, and severity of the injury. Current algorithms rely on history, physical examination, electrodiagnostic studies, imaging, and occasionally operative exploration to establish a diagnosis. The surgeon must decide if the injury will recover spontaneously or if further operative intervention is indicated to achieve the best possible functional outcome. Accurate prognostication remains challenging secondary to the difficulty grouping patients into homogenous cohorts based on patient and injury characteristics, as well as heterogenous outcome measures. Intraoperatively, determining both the severity and zone of injury remains challenging. Surgical treatment strategies include neurolysis, primary repair, nerve grafting, nerve transfer, or tendon transfers. Functional outcomes assessment is currently performed using Medical Research Council muscle grading, range of motion measures, and various sensory measures, which remain subjective with inconsistent intraobserver and interobserver reliability. Nerve-specific patient reported outcomes measures remain limited.</div></div><div><h3>Where do we need to go?</h3><div>Diagnostic improvements are needed to more quickly and accurately define injury severity and determine which patients will benefit from surgical intervention. Intraoperatively, accurate determination of both the zone of injury and the functional status of the proximal nerve is also needed. Reproducible outcome measures that can be easily adopted across multiple institutions are needed to facilitate high-quality evidence that can help guide treatment decisions.</div></div><div><h3>How do we get there?</h3><div>Multicenter collaborative efforts are needed to focus clinical research priorities using reproducible diagnostic criteria to accurately define injury severity, establish consistency in surgical techniques and treatment algorithms, and accurately and reproducibly measure outcomes. Further translational efforts in imaging, biomaterials, and basic science research are also needed. By aligning research priorities with patient-centered outcomes, the field can begin to close the gap between surgical innovation and functional recovery.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 2","pages":"Article 100935"},"PeriodicalIF":0.0,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077543","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":"Impact on Families of Upper Extremity Surgical Treatment for Children with Cerebral Palsy","authors":"Sarah Romans MD ,&nbsp;Adam Mosa MD ,&nbsp;Lindley B. Wall MD, MSc","doi":"10.1016/j.jhsg.2025.100943","DOIUrl":"10.1016/j.jhsg.2025.100943","url":null,"abstract":"<div><h3>Purpose</h3><div>Upper-extremity surgery for children with cerebral palsy (CP) aims to address spasticity, improve function, and enhance quality of life. Although previous research has focused on functional outcomes, limited data exist regarding the broader impact of these surgeries on families. This study examines the psychosocial, functional, and familial impacts of upper-extremity surgery in CP patients, which in turn would to inform preoperative education and postoperative support strategies.</div></div><div><h3>Methods</h3><div>Parents/guardians of children with CP who underwent upper-extremity surgery at least 6 months prior were recruited. Participants completed the validated Impact on Family Scale survey and participated in semistructured interviews exploring family experiences. Thematic analysis of interview transcripts was performed, with intercoder reliability achieved through independent coding. Survey data were analyzed to identify common family impacts.</div></div><div><h3>Results</h3><div>Thirteen interviews were conducted (11 parents, two patients). Thematic analysis identified six overarching themes: (1) functional and mobility improvements, including range of motion; (2) independence in activities of daily living; (3) positive cosmetic impacts; (4) patient psychosocial outcomes, such as increased confidence and social engagement; (5) family-level psychosocial outcomes, including stress during recovery and the importance of external family support systems; and (6) interactions with the care team. Impact on Family Scale survey results had a mean score of 55.1 and revealed that psychosocial and financial burdens varied, with the highest agreement for statements emphasizing normalization of the child’s condition.</div></div><div><h3>Conclusions</h3><div>Upper-extremity surgery for CP has profound physical and psychosocial impacts on both patients and their families. Improvements in functional independence, confidence, and aesthetics were commonly observed; however, emotional challenges during recovery were notable. The findings underscore the importance of setting realistic expectations, providing robust preoperative education, and ensuring access to psychosocial support systems. Future studies should investigate longitudinal outcomes and interventions to better support families during the surgical journey.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic IV.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 2","pages":"Article 100943"},"PeriodicalIF":0.0,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077552","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":"Challenges in Clinical Research for Nerve Injuries (Nerve SPACE 2025)","authors":"Eliana B. Saltzman MD ,&nbsp;Daniel Y. Hong MD ,&nbsp;Roger Cornwall MD ,&nbsp;Heather L. Baltzer MD, MSc ,&nbsp;Thomas J. Wilson MD ,&nbsp;Jenny M. Dorich PhD, CHT ,&nbsp;Caroline Miller ,&nbsp;Avi M. Giladi MD, MS ,&nbsp;Paige M. Fox MD, PhD","doi":"10.1016/j.jhsg.2025.100939","DOIUrl":"10.1016/j.jhsg.2025.100939","url":null,"abstract":"<div><div>Because of the relative infancy of peripheral nerve injury research, there is a lack of standardization of nomenclature and language. The lack of consistency among researchers and publications leads to difficulties assessing outcomes and comparing across patients, surgeons, and interventions.</div></div><div><h3>Where Are We Now?</h3><div>Current efforts in nerve research are focused on determining appropriate-study outcomes and the validation of these for both physicians and patients to reflect the goals of care. Siloed efforts across multiple institutions and specialties limit progress.</div></div><div><h3>Where Do We Need to Go?</h3><div>Future efforts in peripheral nerve injury clinical research should focus on aligning multiple core outcome sets in a reproducible fashion across similar conditions while integrating the patient experience. As outcomes are being implemented, there is a need to measure them accurately using group consensus and technology to limit bias.</div></div><div><h3>How Do We Get There?</h3><div>Collaboration between experts through individual surgeons and societal efforts to align on a minimal core set of outcomes is paramount. Integration into the electronic medical record will increase the feasibility of surgeons to use these outcomes as both research and clinical tools.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 2","pages":"Article 100939"},"PeriodicalIF":0.0,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022675","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":"Out-Of-Pocket Expenses of Carpal Tunnel Release","authors":"Derrick W. Williams MD, MBA ,&nbsp;Philip Blazar MD ,&nbsp;Kyra A. Benavent BS ,&nbsp;Laura Byrne BS ,&nbsp;Brandon E. Earp MD ,&nbsp;Dafang Zhang MD","doi":"10.1016/j.jhsg.2025.100846","DOIUrl":"10.1016/j.jhsg.2025.100846","url":null,"abstract":"<div><h3>Purpose</h3><div>Out-of-pocket charges (OOPCs) are growing faster than the total cost of care. Carpal tunnel release (CTR) is performed in variable surgical settings under different anesthetic protocols. OOPC of CTR may impact patient choice and patient perception of the value of their insurance. The primary objective of this study was to identify factors associated with OOPC after CTR.</div></div><div><h3>Methods</h3><div>We retrospectively identified patients who underwent CTR between January 1, 2019, and November 4, 2022 by three hand surgeons at a tertiary referral center in the Northeast United States. The final cohort comprised 808 patients. OOPC was defined as surgical and anesthesia fees billed to the patient for CTR surgery following primary and secondary insurance payment. Multivariable logistic regression analysis was performed to identify explanatory variables independently associated with our response variables.</div></div><div><h3>Results</h3><div>The mean age of the final cohort was 61.7 years, with 66% women, 79% White, and 100% insured. The multivariable logistic regression analysis showed protective factors against OOPC after CTR included Hispanic ethnicity and diabetes mellitus. Risk factors for having OOPC included no secondary insurance, procedure in a minor procedure room, and out-of-state residence.</div></div><div><h3>Conclusions</h3><div>As overall health care costs balloon, patients are bearing more financial responsibility for care. Our results may aid surgeons in shared decision-making discussions about modifiable surgical choices such as surgical setting and anesthesia choice.</div><div><em>Type of study/level of evidence</em>: Economic Analysis IV.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 2","pages":"Article 100846"},"PeriodicalIF":0.0,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077554","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":"Perineural Lipoma of the Ulnar Nerve Within the Cubital Tunnel: A Brief Review of the Literature","authors":"J.J.E. Delahaije MSc ,&nbsp;J. van Boxtel MSc ,&nbsp;S.F.A. Raupp MSc ,&nbsp;E.L.W.G. van Haren MSc","doi":"10.1016/j.jhsg.2025.100889","DOIUrl":"10.1016/j.jhsg.2025.100889","url":null,"abstract":"<div><div>This study presents a case of a patient with a 6-month history of progressively worsening paresthesia, numbness, weakness, and shooting pain in the ulnar nerve distribution of the left hand. Ultrasound measurements showed an enlarged cross-sectional area of the ulnar nerve, confirming the diagnosis, and an isoechogenic and homogenous mass alongside the ulnar nerve. An open cubital tunnel release was performed for ulnar nerve decompression. Intraoperatively, a perineural lipoma was identified within the cubital tunnel and subsequently confirmed by histopathological analysis. Soft tissue lipomas rarely cause symptomatic compressive neuropathy. Although other space-occupying lesions within the cubital tunnel are well-documented in the literature, a perineural lipoma causing extrinsic ulnar nerve compression has not been previously reported. After surgery, shooting pain resolved, sensation normalized in digits four and five, and hand strength gradually improved. Therefore, we report the first case of a perineural lipoma extrinsically causing ulnar nerve compression in the cubital tunnel.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 2","pages":"Article 100889"},"PeriodicalIF":0.0,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022673","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":"Personality and Perception: A Qualitative Investigation of Factors That Shape Mentorship Satisfaction Among Hand Surgery Fellows","authors":"Colby Newson MD ,&nbsp;Steven Kozusko MD ,&nbsp;Ava Chappell MD ,&nbsp;Kacy J. Peek MD ,&nbsp;A. Bobby Chhabra MD ,&nbsp;Brent R. DeGeorge Jr. MD, PhD","doi":"10.1016/j.jhsg.2025.100922","DOIUrl":"10.1016/j.jhsg.2025.100922","url":null,"abstract":"<div><h3>Purpose</h3><div>Mentorship is critical to the professional and personal development of surgical trainees, influencing clinical competence and career advancement. Although mentorship during residency has been widely studied, little is known about mentorship experiences during hand surgery fellowship, a brief and high stakes training period requiring rapid relationship formation. This study explored mentorship experiences and satisfaction among hand surgery fellows and to assess how personality traits, demographics, and program factors influence mentorship quality.</div></div><div><h3>Methods</h3><div>A mixed-methods study was conducted across 10 US hand surgery fellowship programs with Institutional Review Board approval. Participants completed an online questionnaire assessing demographics, fellowship characteristics, mentorship satisfaction, and personality traits. Semistructured interviews were conducted, transcribed, and analyzed using inductive content analysis to identify common themes. Quantitative data were analyzed using descriptive statistics, Pearson correlations, and analysis of variance with significance set at <em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>A total of 10 fellows from 10 programs participated. Fellows valued personal mentor attributes (eg, altruism, honesty, patience) over relational and professional qualities and rated shared demographics as least important. Mentorship satisfaction showed nonsignificant trends: higher satisfaction among fellows who rated themselves as more emotionally stable and lower satisfaction among those scoring higher in openness to experience. Program structure showed similar trends, with greater satisfaction reported by fellows with more mentors and fewer cofellows. Qualitative analysis identified seven themes: (1) ideal mentor qualities, (2) organic relationship building, (3) mutual investment and communication, (4) diverse mentor expertise, (5) demographics and representation, (6) sponsorship beyond mentorship, and (7) dealing with time and other challenges.</div></div><div><h3>Conclusions</h3><div>Hand surgery fellows reported overall positive mentorship experiences and emphasized personal qualities over demographic similarity. Although quantitative associations were limited by sample size, trends suggest that personality traits and program structure may influence mentorship satisfaction. Recognizing these dynamics may help fellowship directors identify trainees at risk for poor mentorship alignment and implement early, targeted support within the 1-year fellowship’s limited timeframe.</div></div><div><h3>Type of study/level of evidence</h3><div>Differential diagnosis/symptom prevalence study IV.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 2","pages":"Article 100922"},"PeriodicalIF":0.0,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023227","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}