{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T17:00:14Z","timestamp":1791392414109,"version":"4.3.3"},"reference-count":44,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction\/Aims<\/jats:title>\n                    <jats:p>High\u2010resolution ultrasound (HRUS) may help evaluate traumatic peripheral nerve injuries (PNIs), but the sonographic features that distinguish low\u2010 from high\u2010grade injury remain poorly defined. This study evaluated the utility of HRUS for differentiating injury severity by synthesizing data from the literature and applying these findings to an illustrative institutional patient series.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We queried for studies reporting HRUS findings in iatrogenic\/traumatic PNI resulting in neurapraxia or axonotmesis. Individual participant data (IPD) were extracted and synthesized. Meta\u2010analysis was performed via a 1\u2010stage IPD approach to estimate associations between HRUS findings and injury grade. Findings from the review were then applied to an illustrative institutional series of five patients who underwent HRUS during initial clinical evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The systematic review included 74 patients from 24 studies. Focal nerve enlargement, hypoechoic nerve perimeter, and disruption of fascicular echotexture were observed in 82.4%, 63.5%, and 45.9% of patients, respectively. Fascicular echotexture disruption was present in 73.8% of high\u2010grade injuries compared to 9.4% of low\u2010grade injuries. Meta\u2010analysis revealed fascicular echotexture disruption was independently associated with high\u2010grade injury (aOR\u2009=\u200921.6; 95% CI [4.02\u2013116],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). Patient series findings were similar; one patient had preserved fascicular architecture and recovered under conservative management (low\u2010grade PNI), while four patients had disrupted fascicular echotexture and were confirmed intraoperatively to have high\u2010grade axonotmesis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Traumatic PNIs demonstrated categorizable HRUS findings that may serve as a useful adjunct in multimodal assessment of injury severity. Disruption of fascicular echotexture appeared most associated with high\u2010grade lesions\u2010in\u2010continuity, although prospective validation with standardized imaging protocols is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mus.70393","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:42:48Z","timestamp":1788846168000},"page":"1406-1414","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High\u2010Resolution Ultrasound for Diagnosing Severity of Traumatic Peripheral Nerve Injuries\u2010in\u2010Continuity: A Systematic Review, Meta\u2010Analysis of Individual Participants' Data, and Illustrative Patient Series"],"prefix":"10.1002","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6230-5044","authenticated-orcid":false,"given":"Jackson M.","family":"Cathey","sequence":"first","affiliation":[{"name":"Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4015-9695","authenticated-orcid":false,"given":"Christian F.","family":"Zirbes","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2742-4319","authenticated-orcid":false,"given":"Kevin M.","family":"Klifto","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery University of Missouri School of Medicine  Columbia Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Y.","family":"Joh","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Division of Hand, Upper Extremity, and Microvascular Surgery Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline M.","family":"Wu","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"French","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic Arizona  Scottsdale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliana B.","family":"Saltzman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Division of Hand, Upper Extremity, and Microvascular Surgery Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neill Y.","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Division of Hand, Upper Extremity, and Microvascular Surgery Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/66.4.237"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/74.4.491"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002081"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/cjn.2023.315"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.28364"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13311\u2010021\u201001166\u20108"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2024.08.014"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/WNP.0000000000000233"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics11010030"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40477\u2010022\u201000756\u20102"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3171\/2010.2.JNS091324"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e318263a130"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.3171\/2015.6.JNS151001"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1179\/1743132811Y.0000000048"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.3656"},{"key":"e_1_2_11_17_1","unstructured":"Cochrane Handbook for Systematic Reviews of Interventions accessed March 11 2025 https:\/\/training.cochrane.org\/handbook."},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjebm\u20102017\u2010110853"},{"key":"e_1_2_11_19_1","first-page":"360","article-title":"Understanding Interobserver Agreement: The Kappa Statistic","volume":"37","author":"Viera A. 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