Hand Surgery & Rehabilitation最新文献

英文中文

Association Between Early Opioid Prescribing and New Persistent Use After Distal Radius Fracture: A Retrospective Cohort Study 早期阿片类药物处方与桡骨远端骨折后新的持续使用之间的关系：一项回顾性队列研究。

IF 1 4区医学 Q4 ORTHOPEDICS

Hand Surgery & Rehabilitation

Pub Date : 2026-02-01 Epub Date: 2025-11-15 DOI: 10.1016/j.hansur.2025.102535

Eve R. Glenn, Grace Q. Chen, Indeevar R. Beeram, Dawn LaPorte

Purpose

Distal radius fractures (DRFs) are common orthopaedic injuries often requiring surgical intervention. While opioids are frequently prescribed for postoperative pain, concerns regarding new persistent opioid use have emerged, particularly in opioid-naïve patients. This study examines whether early postoperative opioid prescribing increases the risk of new persistent opioid use following DRF surgery.

Methods

A retrospective cohort analysis was conducted using the TriNetX database. Opioid-naïve patients undergoing DRF surgery were stratified into opioid and no-opioid cohorts based on prescription within 30 days postoperatively. Propensity score matching was applied to adjust for confounding variables. The primary outcome was new persistent opioid use, while secondary outcomes included mortality, new mental health disorders, and persistent upper extremity pain from 90 days through one year postoperatively.

Results

Early opioid prescription was associated with a significantly higher risk of new persistent opioid use (4.2% vs. 1.4%), an increased rate of persistent forearm, hand, or finger pain (1.0% vs. 0.6%), and a higher incidence of wrist pain (5.8% vs. 3.8%) (all p < 0.01). No significant differences in mortality or new mental health disorders were observed.

Conclusions

Early opioid prescribing following DRF surgery is significantly associated with new persistent opioid use and persistent upper extremity pain. These findings may highlight the need for judicious opioid use and alternative pain management strategies to reduce the risk of prolonged opioid utilization.

Level of evidence

Therapeutic, Level III.

目的：桡骨远端骨折是一种常见的骨科损伤，通常需要手术治疗。虽然阿片类药物经常用于治疗术后疼痛，但对阿片类药物持续使用的担忧已经出现，特别是在opioid-naïve患者中。本研究探讨了术后早期阿片类药物处方是否会增加DRF手术后新的持续阿片类药物使用的风险。方法：采用TriNetX数据库进行回顾性队列分析。Opioid-naïve接受DRF手术的患者在术后30天内根据处方分为阿片类药物组和非阿片类药物组。采用倾向评分匹配来调整混杂变量。主要结局是新的持续阿片类药物使用，而次要结局包括死亡率、新的精神健康障碍和术后90天至1年的持续上肢疼痛。结果：早期阿片类药物处方与新的持续性阿片类药物使用的高风险相关（4.2%对1.4%），持续前臂、手部或手指疼痛的发生率增加（1.0%对0.6%），手腕疼痛的发生率更高（5.8%对3.8%）。在死亡率或新的精神健康障碍方面没有观察到显著差异。结论：DRF手术后早期阿片类药物处方与新的持续性阿片类药物使用和持续性上肢疼痛显著相关。这些发现可能强调需要明智地使用阿片类药物和替代疼痛管理策略，以减少长期使用阿片类药物的风险。证据等级：治疗性，III级。

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引用次数: 0

Response to the comment on: Left Hand, Right Hand: Understanding Laterality, Its Impact on Surgery, Durand S, Harder Y, Timoteo AD, Guttmann C, Mercier J, Jacques V. Hand Surg Rehabil. 2025, Oct, 44 (5), :102265. by Hafiz Abdul Mannan et al 刘建军，刘建军，刘建军，等。关于左手、右手：侧边性的认识及其对手术的影响[J] .中华手外科杂志，2015,44(5):102265。Hafiz Abdul Mannan等人。

IF 1 4区医学 Q4 ORTHOPEDICS

Hand Surgery & Rehabilitation

Pub Date : 2026-02-01 Epub Date: 2026-01-10 DOI: 10.1016/j.hansur.2026.102569

Sébastien Durand

引用次数: 0

Communicating branch between the dorsal branch of the palmar ulnar proper digital nerve and the palmar ulnar proper digital nerve of the little finger 掌尺指固有神经背支与小指掌尺指固有神经之间的交通支。

IF 1 4区医学 Q4 ORTHOPEDICS

Hand Surgery & Rehabilitation

Pub Date : 2026-02-01 Epub Date: 2026-01-12 DOI: 10.1016/j.hansur.2026.102573

Yoan-Kim De Almeida, Sylvie Collon

引用次数: 0

The burden of wrist joint dislocations: A nationwide 20-year analysis and review of incidence and injury mechanism 手腕关节脱位的负担：一项20年全国范围内的发病率和损伤机制分析和回顾。

IF 1 4区医学 Q4 ORTHOPEDICS

Hand Surgery & Rehabilitation

Pub Date : 2026-02-01 Epub Date: 2026-01-21 DOI: 10.1016/j.hansur.2026.102582

Timothy A. Reiad , Peter V. Dinh , Praneeth Tummala , Jacob Glueck , Ashley Rosenberg , Carolyn Marquis , Mitchell Solano , Joseph A. Gil

Background

Wrist dislocations are rare injuries that present substantial diagnostic challenges, yet large-scale epidemiological data on injury mechanisms and trends are limited. This study characterizes wrist dislocation epidemiology using nationally representative emergency department data from 2004 to 2023.

Methods

A retrospective analysis was performed using the National Electronic Injury Surveillance System (NEISS) database to estimate national wrist dislocation trends. Cases were identified by diagnosis and body part codes. Demographics, mechanisms, and annual incidence were examined. Trends were assessed using linear regression; group differences were assessed using Odds Ratios (OR) and Injury Proportion Ratios (IPR).

Results

Among 21,237 estimated cases (3.42/1,000,000 population), males accounted for 64.2% of dislocations, with a 4.38/1,000,000 incidence vs. 2.40/1,000,000 in females (p < 0.001). Peak incidence was among ages 25–44 years (17.49 per 1,000,000 US population; male-to-female [M:F] IPR 3.59). Females demonstrated bimodal vulnerability: <5 years (IPR 1.85) and ≥65 years (IPR 1.52). Athletic dislocations (19.7%) mainly involved males in football (16.0%) and snowboarding (12.8%). Non-athletic dislocations (80.3%) disproportionately affected females (OR 3.02) and individuals ≥50 years (OR 4.68), with home environments posing elevated risks (female OR 2.22).

Conclusions

This national analysis characterizes wrist dislocation epidemiology, revealing a stable incidence despite rising sports participation. Key demographic disparities were identified, including high-risk groups of young males (15–24) and females at bimodal age peaks (<5 and ≥65 years). This descriptive epidemiological analysis provides a foundational baseline to inform future clinical research on management and outcomes within these specific populations.

背景：手腕脱臼是一种罕见的损伤，在诊断上存在很大的挑战，但关于损伤机制和趋势的大规模流行病学数据有限。本研究利用2004年至2023年具有全国代表性的急诊科数据，分析了腕部脱臼的流行病学特征。方法：使用国家电子损伤监测系统（NEISS）数据库进行回顾性分析，以估计全国腕部脱位趋势。通过诊断和身体部位编码对病例进行识别。研究了人口统计学、机制和年发病率。使用线性回归评估趋势；采用优势比（OR）和损伤比例比（IPR）评估组间差异。结果：在21,237例估计病例（342 /1,000,000人口）中，男性占脱位的64.2%，发病率为4.38/1,000,000，女性为2.40/1,000,000 (p)结论：这一全国性分析揭示了腕部脱位的流行病学特征，尽管运动参与增加，但发病率稳定。确定了关键的人口统计学差异，包括高危人群年轻男性（15-24岁）和双峰年龄高峰女性(

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引用次数: 0

Comment on: Can artificial intelligence pass the written European Board of Hand Surgery exam? Mert S, Muir L, Fuchs B, Lucksch V, Vollbach FH, Haas-Lützenberger EM, et al. Hand Surg Rehabil 2025:102197 评论：人工智能能通过欧洲手外科委员会的笔试吗？张建军，张建军，张建军，等。手外科手术治疗的临床应用[j] .中华手外科杂志，2016,25(1):1 - 7。

IF 1 4区医学 Q4 ORTHOPEDICS

Hand Surgery & Rehabilitation

Pub Date : 2026-02-01 Epub Date: 2026-01-14 DOI: 10.1016/j.hansur.2026.102575

Ismail Sivri, Furkan Mehmet Ozden, Gamze Gul, Emre Kaygin, Tuncay Colak

引用次数: 0

Functional recovery and patient-reported outcomes after total wrist arthrodesis: A decade-long follow-up 全腕关节融合术后功能恢复和患者报告的结果：长达十年的随访。

IF 1 4区医学 Q4 ORTHOPEDICS

Hand Surgery & Rehabilitation

Pub Date : 2026-02-01 Epub Date: 2025-11-14 DOI: 10.1016/j.hansur.2025.102536

Mohamad Khaled Ghannam , Victor Rutka , Louis Ducharne , Gaetan Vanpoulle , Christophe Gaillard , Laurent Mathieu , Aram Gazarian , Arnaud Walch , Thibault Druel

Introduction

Total wrist arthrodesis (TWA) is a definitive treatment for advanced wrist pathology. This study aimed to evaluate patient-reported outcomes (PROMs), persistent complaints, and quality of life after TWA at a minimal one year of follow-up.

Methods

A multicenter retrospective cohort of 28 patients who underwent dorsal plate TWA between 2009 and 2022 was analyzed. The primary outcome was the Overall Subjective Self-Assessment (OSSA) including a specific analysis of patients’ complaints. Secondary outcomes included QuickDASH, PRWE, VAS, SF-36, grip strength, and satisfaction.

Results

Mean follow-up was 116 months. OSSA averaged 5/10, with reduced mobility as the main complaint. Patients reported low pain levels (mean VAS 2). Grip strength was 55% of the contralateral side. Despite functional limitations (mean QuickDASH and PRWE: 42), satisfaction was high (mean 8/10). The SF-36 physical score was lower than the general population, but mental health was preserved, regardless of the etiology for TWA.

Conclusion

While OSSA revealed moderate score due to immobility, overall acceptance and adaptation post-TWA were high. Preoperative counseling is essential to align expectations with outcomes.

Level of evidence

IV.

简介：全腕部关节融合术（TWA）是晚期腕部病理的最终治疗方法。本研究旨在评估患者报告的结果（PROMs），持续的投诉和TWA后至少一年的随访生活质量。方法：对2009年至2022年间接受背板TWA的28例患者进行多中心回顾性队列分析。主要结果是总体主观自我评估（OSSA），包括对患者投诉的具体分析。次要结果包括QuickDASH、PRWE、VAS、SF-36、握力和满意度。结果：平均随访116个月。OSSA平均为5/10，主要抱怨是活动能力降低。患者报告疼痛水平低（平均VAS 2）。对侧握力为55%。尽管功能受限（平均QuickDASH和PRWE: 42），但满意度很高（平均8/10）。SF-36生理评分低于一般人群，但无论TWA的病因如何，心理健康状况都得到了保留。结论：手术后OSSA评分中等，但整体接受度和适应度较高。术前咨询对于使预期与结果保持一致至关重要。证据等级：四级。

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引用次数: 0

Corrective osteotomy of a malunion of the distal radius using a spanning plate in an older patient 用跨越钢板矫正桡骨远端畸形愈合1例。

IF 1 4区医学 Q4 ORTHOPEDICS

Hand Surgery & Rehabilitation

Pub Date : 2026-02-01 Epub Date: 2025-11-21 DOI: 10.1016/j.hansur.2025.102537

Alienor De Bue , Lucas Audiffret , Najib Kachouh , Jean-Baptiste de Villeneuve Bargemon

Introduction

Distal radius malunions in older patients represent a therapeutic challenge due to osteoporotic bone quality and the need to preserve autonomy. Spanning plates, which are widely used in complex distal radius fractures, allow immediate weight-bearing, but their use in corrective osteotomies has not been reported.

Case report

We report the case of a 77-year-old right-handed female patient, dependent on a cane, who presented with a distal radius malunion 3 months after conservative management of a displaced fracture. The deformity resulted in severe functional impairment and loss of independence. Considering her frailty and scheduled tibiotalar arthrodesis, a corrective osteotomy of the distal radius with an autologous bone graft and fixation using a dorsal spanning plate was performed during the same procedure. This strategy allowed for the patients to use a cane immediately after the procedure. Rehabilitation was initiated early, leading to full recovery of finger flexion within 11 days. Five months after plate removal, the patient presented 50 ° flexion, 50 ° extension, and a grip strength of 12 kg; showed complete pain resolution; and had a QuickDASH score of 18.18.

Conclusion

This case highlights the potential use of spanning plates as a temporary fixation method for distal radius corrective osteotomy in frail older patients. This technique allows weight-bearing immediately after surgery, thus preserving autonomy while providing satisfactory functional and radiological outcomes.

Level of evidence

导言：老年患者桡骨远端畸形愈合由于骨质疏松性骨质量和保持自主性的需要，对治疗提出了挑战。跨越钢板广泛用于复杂的桡骨远端骨折，可立即承重，但在矫正性截骨术中的应用尚未见报道。病例报告：我们报告一例77岁的右撇子女性患者，依赖拐杖，在保守治疗移位性骨折3个月后出现桡骨远端畸形愈合。畸形导致严重的功能损伤和独立性丧失。考虑到她的身体虚弱和预定的胫距关节融合术，在同一手术中进行了桡骨远端自体骨移植和背侧跨越钢板固定的矫正截骨术。这种策略允许患者在手术后立即使用手杖。早期开始康复治疗，11天内手指屈曲完全恢复。钢板取出后5个月，患者屈曲50°，伸直50°，握力12 kg；疼痛完全消退；QuickDASH得分为18.18。结论：本病例强调了跨越钢板作为桡骨远端矫正截骨术的临时固定方法在虚弱老年患者中的潜在应用。该技术允许术后立即负重，从而在保持自主性的同时提供令人满意的功能和放射学结果。证据等级：4；

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引用次数: 0

IF 1 4区医学 Q4 ORTHOPEDICS

Hand Surgery & Rehabilitation

Pub Date : 2026-02-01 Epub Date: 2026-01-21 DOI: 10.1016/j.hansur.2026.102579

Nicolas Dreant

引用次数: 0

Ultrasound imaging/guidance for dactylitis in a writer 作者中指炎的超声成像/指导。

IF 1 4区医学 Q4 ORTHOPEDICS

Hand Surgery & Rehabilitation

Pub Date : 2026-02-01 Epub Date: 2025-11-04 DOI: 10.1016/j.hansur.2025.102532

Abdullah Emre Uğur , Beytullah Yazar , Levent Özçakar

引用次数: 0

Modified Camitz versus flexor digitorum superficialis of the fourth finger opponensplasty in severe carpal tunnel syndrome: A systematic review 改良Camitz与指浅屈肌四指对手成形术治疗严重腕管综合征：系统回顾。

IF 1 4区医学 Q4 ORTHOPEDICS

Hand Surgery & Rehabilitation

Pub Date : 2026-02-01 Epub Date: 2025-11-21 DOI: 10.1016/j.hansur.2025.102540

Tomoyuki Kuroiwa , Ausberto Velasquez Garcia , Naoya Iida , Kai-lan Hsu , Omar Selim

Background

Several opponensplasty techniques have been employed to address thenar muscle atrophy associated with severe carpal tunnel syndrome (CTS). Although modified Camitz opponensplasty (MCO) using the palmaris longus (PL) tendon is widely used by hand surgeons, alternative tendon transfer donors have been proposed, such as opponensplasty using the flexor digitorum superficialis of the ring finger (OF4). However, it is unclear which surgical technique provides superior outcomes. Hence, this systematic review aims to examine the difference in functional outcomes between MCO and OF4 for restoring thumb opposition in advanced CTS.

Methods

A systematic search using PubMed, MEDLINE, Embase, and Scopus was performed. English-language articles reporting outcomes of opponensplasty for carpal tunnel syndrome were only included. The Mann-Whitney U test was used to compare differences in clinical outcomes.

Results

301 studies were identified and only 8 eligible studies were collected and reviewed. In both groups, the postoperative outcomes were better than the preoperative ones. Among the outcomes that could be directly compared between groups, no clear differences were found.

Conclusion

Although both surgeries can provide good thumb opposition, the choice of opponensplasty technique should be based on the surgeon’s experience and preference unless being performed on a patient with congenital PL tendon deficiency.

背景：几种对手成形术已被用于治疗严重腕管综合征（CTS）相关的大鱼际肌萎缩。尽管使用掌长肌腱的改良Camitz对手成形术（MCO）被手外科医生广泛使用，但也有人提出了其他肌腱移植供体，如使用无名指指浅屈肌的对手成形术（OF4）。然而，目前尚不清楚哪种手术技术能提供更好的治疗效果。因此，本系统综述旨在研究MCO和OF4在晚期CTS中恢复拇指对位功能结果的差异。方法：采用PubMed、MEDLINE、Embase、Scopus进行系统检索。仅纳入报道腕管综合征对手成形术结果的英文文章。Mann-Whitney U检验用于比较临床结果的差异。结果：301项研究被确定，只有8项符合条件的研究被收集和回顾。两组患者术后预后均优于术前。在两组间可直接比较的结果中，未发现明显差异。结论：尽管两种术式均可提供良好的拇指对指效果，但除非是先天性前腱缺陷患者，否则应根据术者的经验和喜好选择对指成形术。

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