Ultrasound-guided motor-sparing forearm blocks for hand surgery: surgical and anesthetic perspectives
Bibliographic record
Abstract
INTRODUCTION: Certain specialized hand surgery procedures benefit from intraoperative motor testing and patient-demonstrated active range of motion. This requires motor-sparing regional anesthesia of the hand using targeted ultrasound-guided nerve blocks in the forearm. OBJECTIVE: We present a joint surgical and anesthetic perspective covering the utility and indications for motor-sparing forearm blocks. We describe the anatomical principles and technical details of their performance and discuss other considerations for surgical and anesthetic success. FINDINGS: Patient selection and expectation setting are critical for success. Four terminal nerves must be blocked: median nerve, ulnar nerve, superficial radial nerve, and lateral antebrachial cutaneous nerve. These must be targeted distal to origin of motor branches to extrinsic muscles of the hand, with precise deposition of limited volumes of local anesthetic. The nerves can be readily identified with ultrasound imaging by their predictable anatomical relationship to specific muscles and blood vessels. CONCLUSION: Intraoperative motor testing in complex surgical repair of the hand is associated with improved surgical outcomes, as well as greater patient satisfaction. Ultrasound-guided motor-sparing forearm blocks are a safe and effective method for achieving surgical anesthesia and optimal operating conditions in this context.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".