British Society for Surgery of the Hand

The development of the ulnar collateral ligament (UCL) guideline was undertaken in accordance with the British Society for Surgery of the Hand Evidence for Surgical Treatment (BEST) Process Manual, which has been accredited by the National Institute for Health and Care Excellence, UK. This review article serves as a summary of the systematic reviews and the final guideline. The group included two patients, a radiologist, a commissioner, an emergency medicine doctor, hand therapists and hand surgeons. The group's recommendations are that patients with acute UCL injuries should be assessed with a history, clinical examination and radiographs. Patients without significant joint laxity can be treated non-surgically. Patients with significant joint laxity on clinical examination may be treated with non-surgical joint immobilization or surgical repair and should reach a shared decision with their clinician about the definitive treatment within 2 weeks of presentation.

This study aims to clarify the relationship between peripheral neuropathy in hand-arm vibration syndrome and cumulative exposure index. 68 participants without symptoms were surveyed. The participants were divided into three groups based on past and current vibration exposure (VE). Comparison among groups according to past VE showed that the median and ulnar sensory nerve conduction velocities and median sensory nerve action potential (SNAP) amplitude were significantly lower in past high and low exposure groups than in the past nonexposure group. Comparison among groups according to current VE showed that the median and ulnar SNAP amplitudes were significantly lower in the current high exposure group than in the current low or nonexposure group. Vibration tool handlers have potential peripheral nerve lesions at a certain stage without subjective symptoms of the finger.

The purpose of the present study was to test the responsiveness of the Japanese Society for Surgery of the Hand version of the Disability of the Arm, Shoulder and Hand questionnaire (DASH-JSSH) by evaluating effect size (ES) and standardised response mean (SRM) in patients undergoing carpal tunnel release. Subjects comprised 25 patients with carpal tunnel syndrome. All subjects completed the DASH-JSSH, medical outcomes 36-item short-form health survey (SF-36) and visual analogue scale (VAS) for pain and underwent objective assessment of grip strength, pinch strength and static two-point discrimination before and three months after surgery. DASH-JSSH displayed the highest sensitivity to changes at three months, followed by VAS. All subscales of SF-36 were much less sensitive and both grip and pinch strength were unchanged over the three-month period. DASH-JSSH demonstrated more responsiveness to changes after carpal tunnel release than SF-36, VAS and physical measurements, and displayed correlations with subscales of SF-36.