The Journal of hand surgery, European volume最新文献

Artificial intelligence has evolved significantly since its inception, becoming a powerful tool in medicine. This paper provides an overview of the core principles, applications and future directions of artificial intelligence in hand surgery. Artificial intelligence has shown promise in improving diagnostic accuracy, predicting outcomes and assisting in patient education. However, despite its potential, its application in hand surgery is still nascent, with most studies being retrospective and limited by small sample sizes. To harness the full potential of artificial intelligence in hand surgery and support broader adoption, more robust, large-scale studies are needed. Collaboration among researchers, through data sharing and federated learning, is essential for advancing artificial intelligence from experimental to clinically validated tools, ultimately enhancing patient care and clinical workflows.

We describe a simple and effective technique to retrieve a retracted flexor tendon without a palmar incision.Level of evidence: V.

This study assessed rotation control elastic strapping as a treatment for proximal phalanx spiral fractures in adults, with good clinical outcomes. This is a cheap, simple and reliable management technique that avoids potential operative complications.

This study reviews the performance of the Aptis distal radioulnar joint arthroplasty by comparing multiple kinematic and geometric measurements in the operated and contralateral healthy forearm to elucidate whether these are altered after arthroplasty. Forearm geometry and motion were captured using 3-D and 4-D computed tomography in 12 patients with unilateral Aptis arthroplasties. After segmentation and registration, the axis of forearm rotation, translation of the radius along the ulna and range of wrist flexion-extension were measured, and the Dice coefficient and Hausdorff distance were calculated. The forearm rotation axis in the corrected arm deviated 2.3° from the healthy contralateral rotation axis, radial translation along the ulna decreased by 45% and wrist flexion-extension also decreased significantly. Multiple intra-individual geometric differences were observed. The Aptis distal radioulnar joint arthroplasty considerably alters forearm kinematics, which can have clinical implications.Level of evidence: IV.

In this study, we report the functional and perceived outcomes of 51 posterior deltoid-to-triceps transfers in patients with tetraplegia. With a minimum follow-up of 12 months, patients were divided into two subcategories based on preoperative posterior deltoid strength: Medical Research Council (MRC) 3 and MRC 4/5. At 12-month follow-up, all patients achieved antigravity elbow extension. Patients with a stronger posterior deltoid (MRC 4/5) attained an elbow extension with a strength grade MRC 3.7 (SD 0.6), while those with a weaker posterior deltoid (MRC 3) reached an elbow extension of MRC 3.1 (SD 0.6). Patient-reported outcome measure was evaluated using the Canadian Occupational Performance Measure (COPM) and demonstrated a significant improvement for both performance and satisfaction. No difference in the COPM scores could be found between the two subcategories. This study indicates that tetraplegic patients with a posterior deltoid strength grade of both MRC 4/5 as well as MRC 3 benefit from the procedure.Level of evidence: III.

Melone introduced a classification system for distal radial fractures, emphasizing the intra-articular patterns. We explore the significance of key part fragments and introduce a three-dimensional fracture tagging system based on an updated version of Melone's concept.

Despite significant advancements in flexor tendon repair techniques and rehabilitation strategies, achieving complete restoration of digital motion remains a formidable challenge. The most prevalent complications associated with tendon repair are the development of tendon adhesions and joint contractures. Left unaddressed, these complications can further lead to secondary pathomechanical changes, resulting in fixed deformities significantly affecting hand function. This review of zone-specific considerations in flexor tendon rehabilitation provides an in-depth analysis of the dynamics of tendon motion after repair and strategies to minimize common secondary complications.

This cross-sectional study looked for factors associated with feelings of weakness, level of capability and pain intensity in people seeking musculoskeletal speciality care for non-traumatic upper extremity conditions. A survey was conducted in 139 English-speaking adults, with 135 participants completing it. We found that greater intensity of feelings of weakness correlated with higher distress regarding symptoms and with older age. Lower level of capability was associated with greater intensity of feelings of weakness, greater distress regarding symptoms and older age. Higher pain intensity was associated with greater distress regarding symptoms and greater intensity of feelings of weakness. These findings suggest that the symptom of weakness may be a cue to explore potential distress about symptoms in addition to examining for actual weakness. This understanding could be a guide to a more compassionate approach to alleviate distress rather than focusing on neuromuscular pathophysiology alone, with the potential to reduce unnecessary tests and treatments.Level of evidence: IV.