With the rapid development of 3D printing(3DP)technology in both educational and perioperative settings,a thorough evaluation of the latest literature is warranted.This semi-systematic review explores the current educ...With the rapid development of 3D printing(3DP)technology in both educational and perioperative settings,a thorough evaluation of the latest literature is warranted.This semi-systematic review explores the current educational,clinical,and rehabilitative applications of 3DP technology in hand surgery.In educational settings,student and trainee education improved with the use of inexpensive,accessible models for anatomy and surgical simulation,demonstrating an enhanced understanding of spatial relationships and increased confidence in surgical skills.Patient education and consent can be improved with the use of patient-specific models.Studies showed that patient-specific models led to higher patient comprehension and satisfaction during the consenting process.Patient-specific models also offer more comprehensive preoperative planning,and cutting guides facilitate more precise surgical techniques.Clinical outcomes indicated reduced operative times and radiation exposure,along with improved surgical accuracy.Additionally,3DP enables the creation of cost-effective implants that precisely conform to each patient's anatomy.For rehabilitative purposes,3DP can make splints that have the potential to reduce costs and improve compliance.Preliminary data indicated higher patient comfort and improved functional outcomes with 3D-printed splints.Overall,the current literature is mixed on the benefits of 3DP in hand surgery;however,many studies show promising results.As 3DP becomes more streamlined and the equipment becomes less expensive,its applications will continue to expand,and future research will be needed.Future studies should focus on long-term clinical outcomes and cost-effectiveness to fully ascertain the efficacy and value of 3DP in hand surgery.展开更多
Background: Orthopedic surgeons often refer patients to hand therapy following orthopedic injury or surgery to facilitate recovery and maximize outcomes. Patients should be a key part of the shared decision-making pro...Background: Orthopedic surgeons often refer patients to hand therapy following orthopedic injury or surgery to facilitate recovery and maximize outcomes. Patients should be a key part of the shared decision-making process when it comes to their rehabilitation. While there is existing literature investigating factors considered by patients when choosing other medical providers, there are currently no studies investigating factors considered by patients when choosing a hand therapist. Purpose: The purpose of the study is to investigate public perception of factors which are important when choosing a hand therapist. Methods: A convenience sample (N = 220) of adults over the age of 18 completed an anonymous online survey using an internet crowdsourcing platform. Respondents were asked to quantitatively rank the importance of 10 predetermined factors related to selecting a hand therapist. Results: Respondents ranked insurance coverage and credentialing as a certified hand therapist as highest in terms of importance. Conclusion: We found that the factors people consider important when selecting a hand therapist are similar to the factors described in the medical literature that are important when selecting a physician or other healthcare provider. The results have implications for physicians when ensuring continuity of care for their patients.展开更多
Sensory function is the most significant criterion when evaluating the prognosis of replanted fingers. Current clinical research has focused on surgical techniques and indications for finger replantation; however, few...Sensory function is the most significant criterion when evaluating the prognosis of replanted fingers. Current clinical research has focused on surgical techniques and indications for finger replantation; however, few studies have focused on recovery of finger sensory function af- ter replantation. This study retrospectively assessed data of eight patients who had undergone nine Zone I replantations of the fingertips in the First Affiliated Hospital of Sun Yat-sen University of China from July 2014 to January 2016. Variations in the extent of damage, with the residual vessels or nerves in some fingers being too short or even missing, prevented tension-free suture repair in some patients. Thus, re- pair of four of the nine fingertips included arteriovenous anastomosis, the remaining five undergoing arterial anastomosis during replanta- tion of the amputated fingers. Three patients underwent nerve repair, whereas the remaining six cases did not. Fingertip replantations were successful in all eight patients. Compared with the patients without vascular anastomosis, no obvious atrophy was visible in the fingertips of patients who did undergo vascular anastomosis during replantation and their sensory function did recover. Fingertip replantation pro- vides good sensory function and cosmetic outcomes when good artery and vein anastomoses have been created, even when digital nerves have not been repaired.展开更多
BACKGROUND Trigger finger is a common disorder of the hand that can cause disabling symptoms.Treatment options range from conservative management with observation and splinting,to surgical release,but there is current...BACKGROUND Trigger finger is a common disorder of the hand that can cause disabling symptoms.Treatment options range from conservative management with observation and splinting,to surgical release,but there is currently not a consensus on a treatment algorithm.AIM To determine patient preference for the treatment of trigger finger using an online survey.METHODS An online crowdsourcing platform,Amazon Mechanical Turk,was used to recruit participants for this study.Participants were led through a scenario in which they were diagnosed with trigger finger.They were then asked to rank their preference of treatment options from the following:Observation,splinting,corticosteroid injection,surgery.The results of the surveys were then analyzed using R software.RESULTS Of 323 participants completed the survey.7 participants were excluded because they failed to correctly answer the attention question,leaving 316 participants whose results were included.As a first choice for treatment 117(37%)of the included participants chose observation,86(27%)chose splinting,61(19%)chose corticosteroid injection,and 52(16%)chose surgery.The mean rank for observation was 2.26,for splinting was 2.30,for corticosteroid injection was 2.53,and for surgery was 2.91.The ranking of each treatment option was statistically different(P value<0.05)from the others except for observation and splinting.CONCLUSION The practice of shared decision making with patients is imperative to providing the best care possible.The results from this study,especially the preference for less invasive treatment,may help providers better frame discussion around treatment options of trigger fingers.This in turn,may increase patient satisfaction in the treatment of trigger finger.展开更多
BACKGROUND Surgical care of the hand plays a crucial role in the medical field,as problems with the hand can profoundly affect a patient's quality of life and function.In order to meet the needs of patients,improv...BACKGROUND Surgical care of the hand plays a crucial role in the medical field,as problems with the hand can profoundly affect a patient's quality of life and function.In order to meet the needs of patients,improve patient satisfaction and improve treatment outcomes,high-quality service models have been introduced in the field of nursing.AIM To explore the effect analysis of applying high-quality service model to surgical nursing.METHODS We conducted a retrospective study of patients who underwent hand surgery at our hospital between 2019 and 2022,using a quality service model that included improved patient education,pain management,care team collaboration,and effective communication.Another group of patients received traditional care as a control group.We compared postoperative recovery,satisfaction,complication rate,and length of hospital stay between the two groups.Inferential statistics were used to compare the difference between the two groups by independent sample t test,Chi-square test and other methods to evaluate the effect of intervention measures.RESULTS Postoperative recovery time decreased from 17.8±2.3 d to 14.5±2.1 d,pain score decreased from 4.7±1.9 to 3.2±1.4,and hand function score increased from 78.4±7.1 to 88.5±6.2.In terms of patient satisfaction,the quality service model group scored 87.3±5.6 points,which was significantly higher than that of the traditional care group(74.6±6.3 points).At the same time,patients'understanding of medical information also improved from 6.9±1.4 to 8.6±1.2.In terms of postoperative complications,the application of the quality service model reduced the incidence of postoperative complications from 26%to 10%,the incidence of infection from 12%to 5%,and the incidence of bleeding from 10%to 3%.The reduction in these data indicates that the quality service model plays a positive role in reducing the risk of complications.In addition,the average hospital stay of patients in the quality service model group was shortened from 6.8±1.5 d to 5.2±1.3 d,and the hospitalization cost was also reduced from 2800±600 yuan to 2500±500 yuan.CONCLUSION Applying a quality service model to hand surgery care can significantly improve patient clinical outcomes,including faster recovery,less pain,greater satisfaction,and reduced complication rates.展开更多
Ultraviolet (UV) lamps are used in nail salons as part of standard gel nail manicures. While UV radiation is a known risk factor for the development of skin cancers, the risk from exposure to UV nail lamps is unclear....Ultraviolet (UV) lamps are used in nail salons as part of standard gel nail manicures. While UV radiation is a known risk factor for the development of skin cancers, the risk from exposure to UV nail lamps is unclear. We present a case of a woman who developed squamous cell carcinoma in one finger after exposure to UV lamps. A discussion of the correlation between UV nail lamps and squamous cell carcinoma (SCC) is provided. Orthopedic surgeons frequently encounter skin cancers of the hand however the role of UV nail lamps has not yet been elucidated in the orthopedic literature. This manuscript aims to address that gap and facilitate patient counseling during such consultations.展开更多
Nerve transfers were used,originally,to restore shoulder and elbow function in brachial plexus lesions.This concept has been developed over the years and applied to distal nerve injuries in which lower functionality w...Nerve transfers were used,originally,to restore shoulder and elbow function in brachial plexus lesions.This concept has been developed over the years and applied to distal nerve injuries in which lower functionality was expected because of the gap between the injury site and the target muscle.The aim of this review is to describe nerve transfers in the distal forearm and hand for isolated lesions of the median,ulnar and radial nerves.The different advantages achieved by transposition of a functional nerve stump near the effector muscle have opened up new options for the management of nerve lesions.Some of these alternatives have only been recently reported and a few are exclusively case reports.展开更多
Digit amputations are the most common amputation worldwide.This manuscript describes the impairments imposed by digit loss and the potential benefits of digit prosthetics.This review of the literature is designed to p...Digit amputations are the most common amputation worldwide.This manuscript describes the impairments imposed by digit loss and the potential benefits of digit prosthetics.This review of the literature is designed to provide a reference for healthcare workers and patients for identifying and selecting prosthetic options for digit amputees.展开更多
Hand surgery has undergone substantial changes in recent years,especially for reconstructive surgery techniques.We discuss the management of soft tissue defects of the thumb,discussing indications,and operative pearls...Hand surgery has undergone substantial changes in recent years,especially for reconstructive surgery techniques.We discuss the management of soft tissue defects of the thumb,discussing indications,and operative pearls and pitfalls.We cover non-operative treatment and local advancement flaps for small distal soft tissue defects and pedicled flaps for more significant defects.We also discuss composite vascularized free flaps such as second-toe neurocutaneous flaps and partial hallux transfer for compound defects or total amputations.This article aims to provide hand surgeons with an update on reconstructing an injured thumb.展开更多
Among the many challenges that the hand surgeon has to face in his daily work,nerve defects of the hand represent one of the hardest;unsatisfactory results in their treatment may cause severe limitations for the pati...Among the many challenges that the hand surgeon has to face in his daily work,nerve defects of the hand represent one of the hardest;unsatisfactory results in their treatment may cause severe limitations for the patient’s social and working life.Many advances have been made over the years in the treatment of such conditions,and at the current state,surgical treatment can achieve satisfactory results.This article aims to review the current concepts in hand innervation and nerve pathophysiology and to describe traditional and novel surgical techniques currently employed to correct these defects.展开更多
This review discusses the latest literature-based evidence on reconstructive strategies following tendon losses,with a final focus on the innovative regenerative approach.Significant improvements in primary tendon rep...This review discusses the latest literature-based evidence on reconstructive strategies following tendon losses,with a final focus on the innovative regenerative approach.Significant improvements in primary tendon repair techniques have radically reduced the failure rate and therefore decreased the use of reconstructive procedures.However,in specific conditions,such as crush injuries with loss of substance,avulsion injuries and inveterate injuries,the tendon gap cannot be repaired with a primary suture,making the procedure much more challenging for the surgeon.This article aims to guide the treatment of tendon losses,which is still a complex topic in hand surgery.展开更多
Digital neuromas can be psychologically and functionally debilitating.While typically the result of penetrating traumatic injury,neuromas also stem from blunt trauma,chronic irritation,or prior inadequate repair.Abnor...Digital neuromas can be psychologically and functionally debilitating.While typically the result of penetrating traumatic injury,neuromas also stem from blunt trauma,chronic irritation,or prior inadequate repair.Abnormal axonal regeneration without an appropriate distal target following nerve injury results in the formation of end-neuromas,often leading to significant pain.Conservative management is centered around a combination of pharmacological interventions and therapeutic modalities.In the setting of failed conservative management,surgical intervention is employed with the goals of excising the neuroma and redirecting axonal growth into healthy tissue.This article focuses on painful digital neuromas and options for both nonoperative and operative management.展开更多
文摘With the rapid development of 3D printing(3DP)technology in both educational and perioperative settings,a thorough evaluation of the latest literature is warranted.This semi-systematic review explores the current educational,clinical,and rehabilitative applications of 3DP technology in hand surgery.In educational settings,student and trainee education improved with the use of inexpensive,accessible models for anatomy and surgical simulation,demonstrating an enhanced understanding of spatial relationships and increased confidence in surgical skills.Patient education and consent can be improved with the use of patient-specific models.Studies showed that patient-specific models led to higher patient comprehension and satisfaction during the consenting process.Patient-specific models also offer more comprehensive preoperative planning,and cutting guides facilitate more precise surgical techniques.Clinical outcomes indicated reduced operative times and radiation exposure,along with improved surgical accuracy.Additionally,3DP enables the creation of cost-effective implants that precisely conform to each patient's anatomy.For rehabilitative purposes,3DP can make splints that have the potential to reduce costs and improve compliance.Preliminary data indicated higher patient comfort and improved functional outcomes with 3D-printed splints.Overall,the current literature is mixed on the benefits of 3DP in hand surgery;however,many studies show promising results.As 3DP becomes more streamlined and the equipment becomes less expensive,its applications will continue to expand,and future research will be needed.Future studies should focus on long-term clinical outcomes and cost-effectiveness to fully ascertain the efficacy and value of 3DP in hand surgery.
文摘Background: Orthopedic surgeons often refer patients to hand therapy following orthopedic injury or surgery to facilitate recovery and maximize outcomes. Patients should be a key part of the shared decision-making process when it comes to their rehabilitation. While there is existing literature investigating factors considered by patients when choosing other medical providers, there are currently no studies investigating factors considered by patients when choosing a hand therapist. Purpose: The purpose of the study is to investigate public perception of factors which are important when choosing a hand therapist. Methods: A convenience sample (N = 220) of adults over the age of 18 completed an anonymous online survey using an internet crowdsourcing platform. Respondents were asked to quantitatively rank the importance of 10 predetermined factors related to selecting a hand therapist. Results: Respondents ranked insurance coverage and credentialing as a certified hand therapist as highest in terms of importance. Conclusion: We found that the factors people consider important when selecting a hand therapist are similar to the factors described in the medical literature that are important when selecting a physician or other healthcare provider. The results have implications for physicians when ensuring continuity of care for their patients.
基金supported by a grant from the Department of Health of Guangdong Province of China,No.A2016018the Specialized Research Fund for the Doctoral Program of Higher Education,No.20120171120075+3 种基金a grant from the Science and Technology Project of Guangdong Province of China,No.2014A020212479a grant from the Science and Technology Project of Guangdong Province of China,No.2016A010103012a grant from the Science and Technology Program of Guangzhou City of China,No.201300000174a grant from the Doctoral Start-up Project of the Natural Science Foundation of Guangdong Province of China,No.2017A030310302
文摘Sensory function is the most significant criterion when evaluating the prognosis of replanted fingers. Current clinical research has focused on surgical techniques and indications for finger replantation; however, few studies have focused on recovery of finger sensory function af- ter replantation. This study retrospectively assessed data of eight patients who had undergone nine Zone I replantations of the fingertips in the First Affiliated Hospital of Sun Yat-sen University of China from July 2014 to January 2016. Variations in the extent of damage, with the residual vessels or nerves in some fingers being too short or even missing, prevented tension-free suture repair in some patients. Thus, re- pair of four of the nine fingertips included arteriovenous anastomosis, the remaining five undergoing arterial anastomosis during replanta- tion of the amputated fingers. Three patients underwent nerve repair, whereas the remaining six cases did not. Fingertip replantations were successful in all eight patients. Compared with the patients without vascular anastomosis, no obvious atrophy was visible in the fingertips of patients who did undergo vascular anastomosis during replantation and their sensory function did recover. Fingertip replantation pro- vides good sensory function and cosmetic outcomes when good artery and vein anastomoses have been created, even when digital nerves have not been repaired.
文摘BACKGROUND Trigger finger is a common disorder of the hand that can cause disabling symptoms.Treatment options range from conservative management with observation and splinting,to surgical release,but there is currently not a consensus on a treatment algorithm.AIM To determine patient preference for the treatment of trigger finger using an online survey.METHODS An online crowdsourcing platform,Amazon Mechanical Turk,was used to recruit participants for this study.Participants were led through a scenario in which they were diagnosed with trigger finger.They were then asked to rank their preference of treatment options from the following:Observation,splinting,corticosteroid injection,surgery.The results of the surveys were then analyzed using R software.RESULTS Of 323 participants completed the survey.7 participants were excluded because they failed to correctly answer the attention question,leaving 316 participants whose results were included.As a first choice for treatment 117(37%)of the included participants chose observation,86(27%)chose splinting,61(19%)chose corticosteroid injection,and 52(16%)chose surgery.The mean rank for observation was 2.26,for splinting was 2.30,for corticosteroid injection was 2.53,and for surgery was 2.91.The ranking of each treatment option was statistically different(P value<0.05)from the others except for observation and splinting.CONCLUSION The practice of shared decision making with patients is imperative to providing the best care possible.The results from this study,especially the preference for less invasive treatment,may help providers better frame discussion around treatment options of trigger fingers.This in turn,may increase patient satisfaction in the treatment of trigger finger.
文摘BACKGROUND Surgical care of the hand plays a crucial role in the medical field,as problems with the hand can profoundly affect a patient's quality of life and function.In order to meet the needs of patients,improve patient satisfaction and improve treatment outcomes,high-quality service models have been introduced in the field of nursing.AIM To explore the effect analysis of applying high-quality service model to surgical nursing.METHODS We conducted a retrospective study of patients who underwent hand surgery at our hospital between 2019 and 2022,using a quality service model that included improved patient education,pain management,care team collaboration,and effective communication.Another group of patients received traditional care as a control group.We compared postoperative recovery,satisfaction,complication rate,and length of hospital stay between the two groups.Inferential statistics were used to compare the difference between the two groups by independent sample t test,Chi-square test and other methods to evaluate the effect of intervention measures.RESULTS Postoperative recovery time decreased from 17.8±2.3 d to 14.5±2.1 d,pain score decreased from 4.7±1.9 to 3.2±1.4,and hand function score increased from 78.4±7.1 to 88.5±6.2.In terms of patient satisfaction,the quality service model group scored 87.3±5.6 points,which was significantly higher than that of the traditional care group(74.6±6.3 points).At the same time,patients'understanding of medical information also improved from 6.9±1.4 to 8.6±1.2.In terms of postoperative complications,the application of the quality service model reduced the incidence of postoperative complications from 26%to 10%,the incidence of infection from 12%to 5%,and the incidence of bleeding from 10%to 3%.The reduction in these data indicates that the quality service model plays a positive role in reducing the risk of complications.In addition,the average hospital stay of patients in the quality service model group was shortened from 6.8±1.5 d to 5.2±1.3 d,and the hospitalization cost was also reduced from 2800±600 yuan to 2500±500 yuan.CONCLUSION Applying a quality service model to hand surgery care can significantly improve patient clinical outcomes,including faster recovery,less pain,greater satisfaction,and reduced complication rates.
文摘Ultraviolet (UV) lamps are used in nail salons as part of standard gel nail manicures. While UV radiation is a known risk factor for the development of skin cancers, the risk from exposure to UV nail lamps is unclear. We present a case of a woman who developed squamous cell carcinoma in one finger after exposure to UV lamps. A discussion of the correlation between UV nail lamps and squamous cell carcinoma (SCC) is provided. Orthopedic surgeons frequently encounter skin cancers of the hand however the role of UV nail lamps has not yet been elucidated in the orthopedic literature. This manuscript aims to address that gap and facilitate patient counseling during such consultations.
文摘Nerve transfers were used,originally,to restore shoulder and elbow function in brachial plexus lesions.This concept has been developed over the years and applied to distal nerve injuries in which lower functionality was expected because of the gap between the injury site and the target muscle.The aim of this review is to describe nerve transfers in the distal forearm and hand for isolated lesions of the median,ulnar and radial nerves.The different advantages achieved by transposition of a functional nerve stump near the effector muscle have opened up new options for the management of nerve lesions.Some of these alternatives have only been recently reported and a few are exclusively case reports.
文摘Digit amputations are the most common amputation worldwide.This manuscript describes the impairments imposed by digit loss and the potential benefits of digit prosthetics.This review of the literature is designed to provide a reference for healthcare workers and patients for identifying and selecting prosthetic options for digit amputees.
文摘Hand surgery has undergone substantial changes in recent years,especially for reconstructive surgery techniques.We discuss the management of soft tissue defects of the thumb,discussing indications,and operative pearls and pitfalls.We cover non-operative treatment and local advancement flaps for small distal soft tissue defects and pedicled flaps for more significant defects.We also discuss composite vascularized free flaps such as second-toe neurocutaneous flaps and partial hallux transfer for compound defects or total amputations.This article aims to provide hand surgeons with an update on reconstructing an injured thumb.
文摘Among the many challenges that the hand surgeon has to face in his daily work,nerve defects of the hand represent one of the hardest;unsatisfactory results in their treatment may cause severe limitations for the patient’s social and working life.Many advances have been made over the years in the treatment of such conditions,and at the current state,surgical treatment can achieve satisfactory results.This article aims to review the current concepts in hand innervation and nerve pathophysiology and to describe traditional and novel surgical techniques currently employed to correct these defects.
文摘This review discusses the latest literature-based evidence on reconstructive strategies following tendon losses,with a final focus on the innovative regenerative approach.Significant improvements in primary tendon repair techniques have radically reduced the failure rate and therefore decreased the use of reconstructive procedures.However,in specific conditions,such as crush injuries with loss of substance,avulsion injuries and inveterate injuries,the tendon gap cannot be repaired with a primary suture,making the procedure much more challenging for the surgeon.This article aims to guide the treatment of tendon losses,which is still a complex topic in hand surgery.
文摘Digital neuromas can be psychologically and functionally debilitating.While typically the result of penetrating traumatic injury,neuromas also stem from blunt trauma,chronic irritation,or prior inadequate repair.Abnormal axonal regeneration without an appropriate distal target following nerve injury results in the formation of end-neuromas,often leading to significant pain.Conservative management is centered around a combination of pharmacological interventions and therapeutic modalities.In the setting of failed conservative management,surgical intervention is employed with the goals of excising the neuroma and redirecting axonal growth into healthy tissue.This article focuses on painful digital neuromas and options for both nonoperative and operative management.
