The Journal of hand surgery, European volume最新文献

This study aimed to establish whether virtual reality can reduce patient anxiety and improve surgical satisfaction during wide-awake local anaesthetic no tourniquet hand procedures. Previously validated questionnaires were used to assess subjective anxiety and patient satisfaction. Objective anxiety was determined using patient blood pressure and heart rate measured four times during the procedure. The median difference in intra-operative minus pre-operative diastolic blood pressure was significantly lower in the virtual reality group compared with the control group (p = 0.003). There was a significant decrease in heart rate from pre-operative to post-operative within the virtual reality group (p < 0.001). No differences were observed in subjective anxiety or surgical satisfaction between the groups. Virtual reality can benefit wide-awake patients during hand procedures, particularly where patient preference exists.Level of evidence: Level I, Randomized Controlled Trial.

This paper discusses the current literature surrounding the potential use of artificial intelligence and machine learning models in the diagnosis of acute obvious and occult scaphoid fractures. Current studies have notable methodological flaws and are at high risk of bias, precluding meaningful comparisons with clinician performance (the current reference standard). Specific areas should be addressed in future studies to help advance the meaningful and clinical use of artificial intelligence for radiograph interpretation.

In a series of 271 consecutive duplicated thumbs, an angular, hypertrophied epiphysis was detected in 13 thumbs. We propose a revised version of the radial polydactyly classification that includes this pattern as a separate type from triphalangeal thumb.

In a recent operation, we unexpectedly encountered a digital neural loop in the palm. To our surprise we found out that these have a high prevalence but a survey that we carried out showed that there is a low clinical awareness of them.Level of evidence: V.

We investigated the safety and effectiveness of percutaneous release for de Quervain's disease using Sono-Instruments® in cadaveric specimens. The mean procedure duration was 4 minutes, and complete release was achieved in all specimens.

The Patient-Rated Wrist and Hand Evaluation is an outcome measure for patients with conditions affecting the wrist or hand. We evaluated the structural validity of the Patient-Rated Wrist and Hand Evaluation using psychometric techniques, then developed computerized adaptive testing algorithms. Factor analysis found two health constructs consistent with 'Pain' and 'Motor Function'. Two computerized adaptive tests were developed, which reduced the number of items from five to a median of one ('Pain'), and from 10 to two ('Motor Function'). Both computerized adaptive tests achieved high levels of precision (standard error of measurement <0.3) and similar scores to the full-length measure, demonstrated by Bland-Altman analysis. Dividing the Patient-Rated Wrist and Hand Evaluation into two subscales could reduce the response burden, improve standardization of outcome measurement for clinicians and provide precise insight into patient symptoms.Level of evidence: N/A.

We report a series of 12 patients who developed early distal radioulnar joint subluxation after a distal radial fracture, not present on the initial radiographs. Early identification and management of this condition can give good clinical results.Level of evidence: IV.

This study assessed the effectiveness of adding leukocyte-poor platelet-rich plasma (PRP) during carpal tunnel release surgery for patients with moderate to severe carpal tunnel syndrome. In a randomized controlled trial, 70 patients were assigned to either standard carpal tunnel release (control group) or release with leukocyte-poor PRP applied to the median nerve (PRP group). Primary outcomes were measured using the Boston Carpal Tunnel Questionnaire at 3 months, and secondary outcomes included pain, strength, sensation and electrodiagnostic examinations at multiple time points. Both groups showed similar improvements in pain, function, grip and pinch strength and electrophysiological recordings. However, the PRP group had better resolution of numbness at 3 months. These findings suggest that local PRP augmentation does not provide significant additional benefits beyond those of carpal tunnel release alone, apart from some improvement in patients' perception of numbness.Level of evidence: II.