Journal of Hand Surgery-American Volume最新文献

{"title":"The Journal of Hand Surgery in 2026 and Beyond: It Takes a Village","authors":"Gregory A. Merrell MD","doi":"10.1016/j.jhsa.2025.11.001","DOIUrl":"10.1016/j.jhsa.2025.11.001","url":null,"abstract":"","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"51 1","pages":"Pages 1-2"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145895853","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":"A Survey-Based Assessment of Treatment Preferences for Distal Radius Fractures in Participants Aged 65 Years and Older","authors":"Zayd Al Rawi BS ,&nbsp;Elizabeth Graesser MD ,&nbsp;Lindley B. Wall MD, MSc","doi":"10.1016/j.jhsa.2025.09.017","DOIUrl":"10.1016/j.jhsa.2025.09.017","url":null,"abstract":"<div><h3>Purpose</h3><div>The management of distal radius fractures (DRF) in patients aged ≥65 years is debated because there is evidence that operative and nonsurgical treatment yield similar outcomes 1 year after injury. When more than one reasonable treatment option exists, shared decision-making between the patient and physician should be used. This study elicited preferences for the treatment of DRF using a survey of participants aged ≥65 years.</div></div><div><h3>Methods</h3><div>A survey for participants ≥65 years was administered using Amazon Mechanical Turk. Participants were presented with a theoretical scenario in which they sustained a DRF, followed by two treatment options (surgery or casting) and evidence-based information on benefits, risks, and outcomes. Participants then responded to a series of 12 statements regarding the treatment options, rating their level of agreement on a Likert scale. At the end of the survey, they were asked to select their preferred treatment option.</div></div><div><h3>Results</h3><div>There were 393 respondents that met inclusion criteria, and 74% were men. Fifty-three percent reported a prior history of a wrist fracture, with 84% of those participants undergoing surgery. Thirty-nine percent strongly agreed that avoiding surgical risks is an important part of their decision, and 36% strongly agreed that they were willing to accept a longer time in a cast. Despite this, 82% of participants selected surgery as their preferred treatment for a theoretical DRF.</div></div><div><h3>Conclusions</h3><div>Although most participants selected surgery as their preferred treatment, many responses regarding individual treatment factors aligned with nonsurgical treatment. This may be attributed to participants’ belief that surgery leads to better outcomes or may highlight a disconnect between participants’ values and their treatment choice.</div></div><div><h3>Clinical relevance</h3><div>The results of this study can be used to facilitate shared decision-making conversations regarding the treatment of DRF in this patient population.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"51 1","pages":"Pages 33-41"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145531010","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":"Journal CME Questions","authors":"","doi":"10.1016/j.jhsa.2025.12.003","DOIUrl":"10.1016/j.jhsa.2025.12.003","url":null,"abstract":"","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"51 1","pages":"Page 113"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145895851","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":"Objective Evaluation of the “Scratch Collapse Test” for the Diagnosis of Cubital Tunnel Syndrome Using Dynamometer","authors":"Navapong Anantavorasakul MD ,&nbsp;Isarapong Duangmee MD ,&nbsp;Sineenart Honglertkawin MD ,&nbsp;Sopinan Siripoonyothai MD ,&nbsp;Piyabuth Kittithamvongs MD, MSc ,&nbsp;Kanchai Malungpaishrope MD ,&nbsp;Somsak Leechavengvongs MD","doi":"10.1016/j.jhsa.2025.11.006","DOIUrl":"10.1016/j.jhsa.2025.11.006","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to objectively evaluate the sensitivity and specificity of the scratch collapse test (SCT) for the diagnosis of cubital tunnel syndrome (CuTS). We conducted a comparative experimental study to measure the force of shoulder external rotation using a dynamometer instead of the subjective outcome reported by examiners.</div></div><div><h3>Methods</h3><div>The force of shoulder external rotation was measured using a dynamometer while performing a SCT. Sixteen patients with electrodiagnostically confirmed CuTS and 20 healthy volunteers were included in this study. The difference between the external rotation force before and after the SCT was calculated in Newtons and expressed as a percentage change. A negative value indicated a reduction in force after the scratch maneuver. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were calculated from the test results of the patient and control groups.</div></div><div><h3>Results</h3><div>The sensitivity of the SCT was 37%, whereas the specificity was 75%. The positive predictive value was 0.55, and the negative predictive value was 0.60. The overall accuracy of the SCT was 58%.</div></div><div><h3>Conclusions</h3><div>The SCT has been described initially as an accurate and useful diagnostic test for CuTS. Our result using a more objective method of measurement demonstrated relatively lower accuracy compared with previous studies.</div></div><div><h3>Type of study/level of evidence</h3><div>Diagnostic II.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"51 1","pages":"Pages 61.e1-61.e5"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145895854","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 Following Congenital Hand and Upper Limb Surgery: Lessons From the CoULD Registry","authors":"Donald S. Bae MD ,&nbsp;Maria F. Canizares MD, MPH ,&nbsp;Danielle L. Cook MA ,&nbsp;Ann Van Heest MD ,&nbsp;Suzanne E. Steinman MD ,&nbsp;Julie Samora MD, PhD ,&nbsp;Michelle A. James MD ,&nbsp;Douglas T. Hutchinson MD ,&nbsp;Apurva S. Shah MD, MBA ,&nbsp;Charles A. Goldfarb MD ,&nbsp;CoULD Study Group","doi":"10.1016/j.jhsa.2025.11.004","DOIUrl":"10.1016/j.jhsa.2025.11.004","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to characterize the rate and risk factors for complications following congenital upper limb surgery.</div></div><div><h3>Methods</h3><div>A total of 2,430 surgical procedures performed in 1,930 patients from 2014 to 2024 were analyzed from the Congenital Upper Limb Differences Registry. Complications were identified through surgeon self-reporting, categorized using the Clavien-Dindo classification system, and further classified based on timing (early vs late). Multivariable logistic regression analysis was used to identify independent risk factors for complications.</div></div><div><h3>Results</h3><div>There were 100 patients with 130 complications, for an overall complication rate of 5.3%. Seventy-six patients had a single complication, 18 patients had two complications, and six presented three complications. According to the Clavien-Dindo classification, there were 34 type I, 45 type II, 50 type III, and one type IV complications. There were 77 early complications and 53 late events. When excluding Clavien-–Dindo type I complications, which by definition did not affect clinical care, the complication rate was 4.1%. The most severe complications were compartment syndrome post-osteotomy for radioulnar synostosis and vascular compromise following a pollicization. More complications were seen after reconstructive surgery for syndactyly, thumb deficiency, and polydactyly. No considerable associations were detected between postoperative complications and medical comorbidities, syndromic associations, bilateral involvement, or hand plate malformations.</div></div><div><h3>Conclusions</h3><div>The overall complication rate following congenital upper limb surgery was approximately 5.3%, with most events being minor and not requiring additional surgery. Complications were most frequently observed following procedures for syndactyly, thumb hypoplasia, and polydactyly; however, no definitive patient-specific risk factors were found. These results, drawn from high-volume pediatric centers, underscore the multifactorial nature of surgical outcomes and the value of prospective multicenter data in benchmarking complication rates.</div></div><div><h3>Type of study/level of evidence</h3><div>Prognosis IIb.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"51 1","pages":"Pages 62-70"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145895855","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":"Arthroscopic Resection of the Proximal Capitate With Tendon Interposition for Isolated Capitolunate Osteoarthritis: A Retrospective Series of Six Cases","authors":"Alexandre Quemener-Tanguy MD ,&nbsp;Axel Koehly MD ,&nbsp;Grégoire Van Straaten MD ,&nbsp;Antoine Martins MD ,&nbsp;Michel Levadoux MD, PhD ,&nbsp;Jean-Baptiste de Villeneuve Bargemon MD","doi":"10.1016/j.jhsa.2025.06.004","DOIUrl":"10.1016/j.jhsa.2025.06.004","url":null,"abstract":"<div><h3>Purpose</h3><div><span>Isolated capitolunate joint osteoarthritis<span> is a rare condition with a poorly understood pathophysiology<span>. To avoid midcarpal arthrodesis in active patients, we propose </span></span></span>arthroscopic resection of the proximal pole of the capitate with tendon interposition (arthroscopic capitolunate tendinous interposition [ACLTI]). This study aimed to present the outcomes of patients after undergoing ACLTI.</div></div><div><h3>Methods</h3><div>This retrospective, single-center study included six patients with isolated capitolunate osteoarthritis who underwent capitate resection combined with ACLTI. The mean follow-up period was 89.3 months. Assessments included the visual analog scale score for pain, joint range of motion, grip strength, Patient-Rated Wrist Evaluation (PRWE) score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score. A descriptive and comparative preoperative and postoperative analysis was conducted.</div></div><div><h3>Results</h3><div>The postoperative results showed substantial improvement in the median pain scores, with a visual analog scale score of 0/10 compared with 5/10 before surgery. The mean PRWE score improved to 17.2 ± 14.2, QuickDASH score to 21.5 ± 6.5, extension to 74.2° ± 11.1°, flexion to 70° ± 13.8°, and grip strength to 25 ± 9.5 kg. No complications were reported.</div></div><div><h3>Conclusions</h3><div>Arthroscopic resection of the proximal capitate with tendon interposition appears to be an effective therapeutic option for active patients with isolated capitolunate osteoarthritis. This approach does not preclude the possibility of secondary arthrodesis in case of failure.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic V.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"51 1","pages":"Pages 16-24"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610324","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":"Revisiting the Critical Pathology of Primary Thumb Trapeziometacarpal Osteoarthritis: Volar Beak Ligament Degeneration","authors":"Vincent D. Pellegrini Jr. MD ,&nbsp;Michael W. Fort MD, MPH ,&nbsp;Emmalin B. Nelton MD ,&nbsp;Alexander M. Chiaramonti MD ,&nbsp;Yongren Wu PhD","doi":"10.1016/j.jhsa.2025.10.015","DOIUrl":"10.1016/j.jhsa.2025.10.015","url":null,"abstract":"<div><h3>Purpose</h3><div>Volar and dorsal capsular contributions to trapeziometacarpal joint stability have been extensively studied in laboratory models. We investigated the less-understood relationship between trapeziometacarpal joint osteoarthritis and capsuloligamentous integrity in human thumbs.</div></div><div><h3>Methods</h3><div>Eighty thumb trapeziometacarpal joints from two distinct groups of 20 anatomical donors were prospectively specified for dissection through either a dorsal (20 men, 20 women; mean age 83 (72–100) years) or volar (24 men, 16 women; mean age 90 (76–100) years) arthrotomy. One thumb evidenced prior anatomical dissection, another underwent surgical arthrodesis, and 78 were anatomically undisturbed. Seven joints exhibited inflammatory arthritis, leaving 71 available for study. Capsuloligamentous structures were characterized through an opposite side arthrotomy, and articular surfaces were stained with methylene blue. Trapezium/metacarpal surface eburnation ratios were calculated using ImageJ analysis and digitally summed to display aggregate topographical wear pattern heat maps by arthritis stage.</div></div><div><h3>Results</h3><div>Osteoarthritic eburnation was similar in both arthrotomy groups. Twenty (28%) joints contained no surface eburnation, 15 (21%) early osteoarthritis, 17 (24%) advanced osteoarthritis, and 19 (27%) end-stage osteoarthritis. Early arthritis specimens exhibited greater trapezial than metacarpal eburnation; Trapezium/metacarpal ratios were 1.22, 1.07, and 0.98 for early, advanced, and end-stage, respectively. Through a dorsal arthrotomy, complete beak ligament detachment from the metacarpal was observed in 8 of 8 end-stage, 7 of 8 advanced, and 6 of 7 early osteoarthritis specimens. Eleven of 12 thumbs without eburnation exhibited no beak ligament degeneration. Through a volar arthrotomy, none of 36 specimens exhibited dorsal capsuloligamentous degeneration irrespective of articular surface eburnation.</div></div><div><h3>Conclusions</h3><div>Volar beak ligament detachment from the thumb metacarpal, not dorsal capsular degeneration, is strongly associated with trapeziometacarpal osteoarthritis in elderly cadaveric thumbs. Greater trapezial eburnation in early-stage osteoarthritis suggests translational metacarpal instability.</div></div><div><h3>Clinical relevance</h3><div>Volar beak ligament degeneration and trapeziometacarpal instability represent the primary pathology associated with age-related osteoarthritis and should inform surgical treatment.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"51 1","pages":"Pages 3-11"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582289","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":"Investigating Optimal Osteotomy Angles for Kienböck and Preiser Disease Using Finite Element Analysis: Stress Changes in the Lunate and Scaphoid Bones Associated With Closing Radial Wedge Osteotomy","authors":"Atsushi Hojo MD ,&nbsp;Yusuke Matsuura MD, PhD ,&nbsp;Takahiro Yamazaki MD, PhD ,&nbsp;Takane Suzuki MD, PhD ,&nbsp;Seiji Ohtori MD, PhD","doi":"10.1016/j.jhsa.2025.05.014","DOIUrl":"10.1016/j.jhsa.2025.05.014","url":null,"abstract":"<div><h3>Purpose</h3><div><span>To evaluate the biomechanical effects of varying closing radial wedge osteotomy (CRWO) angles on the scaphoid and lunate using </span>finite element analysis (FEA) and to identify the optimal osteotomy angle for treating Kienböck and Preiser diseases.</div></div><div><h3>Methods</h3><div>Eight fresh-frozen cadaveric upper extremities (5 men, 3 women; mean age, 89.4 years) were analyzed. Specimen-specific computed tomography-based FEA models were developed to simulate carpal alignment changes in neutral and ulnar-deviated wrist positions with simulated CRWO angles of 5°, 10°, 15°, and 20°. A physiological load of 102 N was applied to the metacarpal heads. Stress distribution was analyzed across 3 scaphoid regions (proximal, body, distal) and 2 lunate regions (radial, ulnar). Changes in equivalent stress and minimum principal stress were compared with pre-osteotomy levels.</div></div><div><h3>Results</h3><div>A 20° osteotomy resulted in a reduction of minimum principal stress in the lunate (−29.9%) and a decrease in the scaphoid (−9.2%). With increasing osteotomy angles, stress distribution changed with measured stress values shifting in the proximal regions of the scaphoid and radial potion of the lunate. The triquetrum exhibited varying responses, with stress measurements showing changes from +8.6% to −9.1% at lower osteotomy angles (5° to 10°) and reductions at higher angles (15° to 20°).</div></div><div><h3>Conclusions</h3><div>FEA-based analysis showed stress reductions in the lunate at osteotomy angles between 10° and 20°, with measurements indicating that a 20° angle resulted in the greatest measured stress reduction in both the lunate and scaphoid.</div></div><div><h3>Clinical relevance</h3><div>This study provides biomechanical evidence supporting CRWO for Kienböck and Preiser diseases and offers guidance on selecting osteotomy angles for improved clinical outcomes.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"51 1","pages":"Pages 15.e1-15.e10"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592973","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":"Anatomy of the Scaphotrapezial Ligament Complex and its Implications for Distal Scaphoid Resection","authors":"Yukiko Yoshimura MD ,&nbsp;Atsushi Yokota MD, PhD ,&nbsp;Keitaro Fujino MD, PhD ,&nbsp;Yoichi Kondo MD, PhD ,&nbsp;Masashi Neo MD, PhD ,&nbsp;Shuhei Otsuki MD, PhD","doi":"10.1016/j.jhsa.2025.09.010","DOIUrl":"10.1016/j.jhsa.2025.09.010","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to describe the detailed configuration and bony attachment of the scaphotrapezial (ST) ligaments to clarify the risk of postoperative dorsal intercalated segment instability in distal scaphoid resection.</div></div><div><h3>Methods</h3><div>Twenty-nine hands from 19 formalin-fixed cadavers (13 men and 6 women) were included. We examined the ST ligaments macroscopically and analyzed the bone morphology using computed tomography images and the location of the ligamentous attachments using a defined coordinate system. Additionally, histological examinations of the ST ligaments were performed using Masson’s trichrome and toluidine blue staining.</div></div><div><h3>Results</h3><div>The ST ligament comprised three distinct fascicles—superficial, intermediate, and deep—each attached to individual facets; each fascicle was attached to the scaphoid tuberosity at a height of 6.4 ± 1.2, 4.4 ± 1.1, and 3.3 ± 1.0 mm, respectively, from the most distal point of the articular ridge on the distal scaphoid joint surface. Histologically, the deep fascicle demonstrated characteristics of a capsular ligament.</div></div><div><h3>Conclusions</h3><div>The ST ligament has three fascicles that are separate entities, including the deep fascicle that attaches 3.3 mm from the most distal point of the scaphoid.</div></div><div><h3>Clinical relevance</h3><div>Our findings suggest that preserving the deep fascicle by limiting bone resection to no more than approximately 3 mm at the scaphoid tuberosity during distal scaphoid resection may be important in preventing postoperative dorsal intercalated segment instability.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"51 1","pages":"Pages 25.e1-25.e8"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314292","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":"Effect of Early Hematopoietic Stem Cell Transplantation on Carpal Tunnel Syndrome Surgery in Patients With Hurler Syndrome","authors":"Nicholas Reiners MD ,&nbsp;Lynsey Malin MS, MD ,&nbsp;Ryan Shanley MS ,&nbsp;Paul Orchard MD ,&nbsp;Ann Van Heest MD","doi":"10.1016/j.jhsa.2025.09.018","DOIUrl":"10.1016/j.jhsa.2025.09.018","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to investigate whether early hematopoietic stem cell transplantation (HSCT) in infants with Hurler syndrome affects the timing of carpal tunnel syndrome (CTS) surgery.</div></div><div><h3>Methods</h3><div>Forty-seven patients with Hurler syndrome who underwent allogeneic HSCT at the University of Minnesota between 2005 and 2020 at early (3–13 months), middle (13–18 months), and late (18–35 months) age tertiles were followed for at least 4 years to determine (1) the timing of CTS diagnosis based on electrodiagnostic testing and (2) the timing of surgical intervention for CTS. A cumulative incidence function was used to estimate the time to surgery.</div></div><div><h3>Results</h3><div>Based on electrodiagnostic testing, the risk of CTS diagnosis after HSCT increased as age at HSCT increased from 3 to 15 months old. Surgery was also performed later in patients who were transplanted at younger ages, occurring at a median of 7.3 years after HSCT for the early tertile of transplant ages versus 3.5 years after HSCT for the middle and late tertiles of transplant ages.</div></div><div><h3>Conclusions</h3><div>Early HSCT in patients with Hurler syndrome may delay the need for CTS surgery.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic IV.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"51 1","pages":"Pages 71.e1-71.e5"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145440048","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}