HAND最新文献

{"title":"Second Harmonic Generation Imaging as a Virtual Biopsy for Upper Extremity Nerve Injuries: A Cadaver Study.","authors":"Christoph A Schroen, Philip Nasser, Damien Laudier, Arne H Boecker, Paul J Cagle, Michael R Hausman","doi":"10.1177/15589447251411007","DOIUrl":"10.1177/15589447251411007","url":null,"abstract":"<p><strong>Background: </strong>A timely assessment of nerve damage is needed for early clinical decision-making. Second Harmonic Generation (SHG) microscopy visualizes collagen. This study investigated: Can SHG imaging distinguish collagenous substructures in human nerves? Can SHG imaging detect structural damage in human nerves following destructive stretch injury?</p><p><strong>Methods: </strong>Six human upper extremities were equally divided into 2 groups: A no-injury and a load-to-failure (LTF) group. The median, radial, and ulnar nerves were surgically exposed. Arms were placed on an Instron material testing system. Eight centimeters of each nerve was secured under 2 pins. A hook was raised from beneath the nerve until complete nerve transection occurred. After the experiment, LTF nerves were excised along their full length. No-injury and LTF nerves were placed in isotonic saline under an FVMPE-RS Multiphoton Microscope using a laser wavelength of 900 nm to induce an SHG signal. Z-stack images were acquired using a wavelength of 45 nm. Nerves were then harvested for histology.</p><p><strong>Results: </strong>Histology sections of NI nerves exhibited normal peripheral nerve architecture. All collagenous substructures visible on histology were clearly identifiable and distinguishable on SHG images of uninjured nerves. In LTF nerves, epineurium rupture and exposed fascicles were clearly identifiable on SHG imaging. Epineurial collagen of LTF nerves appeared heavily disorganized, with short fiber fragments following no clear trajectory. Findings were consistent among nerve types.</p><p><strong>Conclusions: </strong>This is the first study to visualize human nervous tissue using SHG microscopy. Second Harmonic Generation imaging offers detailed visualization of all collagenous substructures of peripheral nerves and detects structural damage, like epineurial collagen-disorganization, and exposure of individual fascicles in unprecedented detail.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1605-1613"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12830348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Syndactyly and Risk of Cancer.","authors":"Kira L Smith, Matthew V Abola, Logan M Good, Raymond W Liu, Apurva S Shah, Samir K Trehan, Aaron Daluiski","doi":"10.1177/15589447261416115","DOIUrl":"10.1177/15589447261416115","url":null,"abstract":"<p><strong>Background: </strong>Syndactyly is the most common upper-extremity congenital condition, and cases can be associated with genetic syndromes or arise sporadically (nonsyndromic). The purpose of this investigation was to determine rates of both malignant and benign neoplasms among pediatric patients diagnosed with nonsyndromic syndactyly compared to matched controls.</p><p><strong>Methods: </strong>The TriNetX US Collaborative database was queried using International Classification of Disease, 10th Revision codes to identify patients aged 10 years or younger diagnosed with syndactyly. Patient history of syndactyly was utilized to categorize patients into 2 cohorts. These cohorts were propensity-matched by age, sex, race, ethnicity, and congenital malformation syndromes. Subsequent rate of neoplasms was compared between patients with and without syndactyly.</p><p><strong>Results: </strong>A total of 7478 patients aged 10 years or younger diagnosed with syndactyly were identified. After 1:1 propensity matching, both cohorts included 5461 patients. The rate of digestive malignancies was significantly higher int he syndactyly cohort than that in the control cohort. The rate of benign neoplasms was significant at >5 years follow-up duration (<i>P</i> = .016, 95% CI 0.001-0.005) but was not significant at 1 year or 1 to 5 years. Similarly, rate of any neoplasm was significant at >5 years follow-up duration (<i>P</i> = .013, 95% CI 0.001-0.005) but not at 1 year or 1 to 5 years.</p><p><strong>Conclusions: </strong>Nonsyndromic syndactyly is associated with an increased rate of benign neoplasms and digestive malignancies. Further investigation is needed to better understand the relationship between the syndactyly phenotype and risk of malignancy.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1583-1589"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional Bracing Versus Rigid Plaster Casting for the Immobilization of Colles Fractures in Adults: A Meta-Analysis of Randomized Controlled Trials.","authors":"Guy Awad, Marc Boutros, Christèle Asmar, Tammam Hanna","doi":"10.1177/15589447251389659","DOIUrl":"10.1177/15589447251389659","url":null,"abstract":"<p><p>Rigid plaster casting and functional bracing are the 2 most commonly used methods for conservative immobilization in Colles fractures. Despite their widespread use, the optimal approach remains debated. A systematic literature search was conducted across PubMed, Scopus, Cochrane Library, and Google Scholar up to April 2025. Six randomized controlled trials involving 697 adult patients were included. Assessed outcomes included Visual Analogue Scale pain scores, modified Gartland and Werley functional scores, grip strength measured as a percentage of the uninjured side, modified Lidström anatomical scores, dorsal angulation, and complication rates including re-manipulation, nerve injury, complex regional pain syndrome (CRPS), upper limb dystrophy, swelling, and other adverse events. Pain scores were similar between groups at 2 and 6 weeks. Functional outcomes favored the bracing group, with significantly better scores at 12 weeks, and grip strength was also higher at 6 weeks. Bracing was associated with significantly better anatomical outcomes, as evidenced by lower dorsal angulation and better modified Lidström scores at 6 weeks, along with similar re-manipulation rates between 1 and 2 weeks post-treatment. Complication rates, including nerve injuries, CRPS, and upper limb dystrophy, were also similar between groups, with the exception of a higher incidence of hand and finger swelling in the bracing group. Taken together, functional bracing offers modest but clinically relevant advantages over plaster casting in conservatively managing Colles fractures, promoting earlier recovery and better alignment without added risk. These findings support its use in selected adults.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1693-1705"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12669006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simultaneous Carpal Tunnel Release With Forearm Fasciotomy: Are We Doing Enough?","authors":"Katelyn Koschmeder, Cara H Lai, Nathaniel B Hinckley, Jack M Haglin, Jackson G Woodrow, Kevin J Renfree","doi":"10.1177/15589447251413731","DOIUrl":"10.1177/15589447251413731","url":null,"abstract":"<p><strong>Background: </strong>Simultaneous carpal tunnel release (sCTR) with emergent forearm fasciotomy in the setting of acute compartment syndrome (ACS) has been reported, but the national incidence and cost of delayed carpal tunnel release (CTR) remain unknown. This large database study aims to evaluate how often sCTR is performed, the frequency of delayed CTR when not performed simultaneously, and the associated costs.</p><p><strong>Methods: </strong>The PearlDiver Mariner database was queried for patients who underwent forearm fasciotomies between January 1, 2015, and October 31, 2022. Patients were grouped based on CTR timing: simultaneous, within 2 weeks, 2 weeks to 1 year, 1 to 5 years, or no CTR. Reimbursement data were collected, and patient numbers and costs were analyzed across cohorts.</p><p><strong>Results: </strong>More than half of patients undergoing emergent forearm fasciotomy received sCTR. Among those who did not, 31% required CTR within 1 year and 35% within 5 years. The total cost was highest when CTR was performed within 1 year but not on the same day as fasciotomy. After 1 year, the additional cost of CTR was similar to that of patients who never underwent fasciotomy.</p><p><strong>Conclusions: </strong>This large database study shows that over one-third of patients who did not undergo sCTR at the time of emergent forearm fasciotomy required it within 1 year, incurring significantly higher costs. Including sCTR during initial fasciotomy may reduce delayed care and associated expenses. While these findings suggest that including sCTR during initial fasciotomy may reduce delayed care and expenses, the retrospective design precludes definitive recommendations, and clinical judgment remains essentialLevel of Evidence:4.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"1627-1634"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12834683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146051661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rising Revision Burden in Total Wrist Arthroplasty: National Medicare Trends and Projections to 2060.","authors":"Paul G Mastrokostas, Luke B Schwartz, Alejandro J Friedman, Leonidas E Mastrokostas, Scott Liu, Katherine M Connors, Jennifer Hashem","doi":"10.1177/15589447261495094","DOIUrl":"https://doi.org/10.1177/15589447261495094","url":null,"abstract":"<p><strong>Background: </strong>Total wrist arthroplasty (TWA) is an alternative to arthrodesis for end-stage wrist arthritis, offering preserved wrist motion and functional improvement. Historically limited by high complication and revision rates, TWA has seen renewed interest with advances in implant design and expanding indications beyond rheumatoid arthritis. The purpose of this study was to analyze national trends in TWA utilization and project future procedure volumes for both primary and revision TWA through 2060 using Medicare data.</p><p><strong>Methods: </strong>Procedure volumes for Medicare Part B beneficiaries undergoing primary or revision TWA between 2000 and 2022 were obtained from Centers for Medicare and Medicaid Services Medicare Part B data and adjusted for Medicare Advantage enrollment. Forecasting models were applied to project annual volumes through 2060.</p><p><strong>Results: </strong>From 2000 to 2022, primary TWA increased from 107 to 292 procedures, and revision TWA increased from 47 to 283 procedures. By 2060, annual primary TWA volume is projected to increase to approximately 1040 procedures, while annual revision TWA volume is projected to increase to approximately 3262 procedures. Revision procedures are expected to grow at a faster annual rate (6.6%) compared to primary TWA (3.8%).</p><p><strong>Conclusions: </strong>Total wrist arthroplasty volumes among Medicare beneficiaries are projected to rise through 2060, particularly for revision procedures. These projections may inform future resource planning and highlight the importance of ongoing surveillance of long-term utilization patterns.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261495094"},"PeriodicalIF":1.3,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early PROMIS Outcomes After Cubital Tunnel Release With and Without Anterior Transposition.","authors":"Dominique Rinfret, Justin Wong, Gabriel Ramirez, Thomas Carroll, Constantinos Ketonis","doi":"10.1177/15589447261487693","DOIUrl":"10.1177/15589447261487693","url":null,"abstract":"<p><strong>Background: </strong>Cubital tunnel syndrome is the second most common upper extremity neuropathy and is treated surgically with either in situ decompression or anterior transposition of the ulnar nerve. Although both approaches achieve comparable long-term outcomes, variation persists in surgical selection and reported complication rates. Limited data describe how patient characteristics, electrodiagnostic severity, and early patient-reported outcomes differ between techniques.</p><p><strong>Methods: </strong>Adult patients who underwent cubital tunnel release between 2015 and 2022 at a single institution were retrospectively reviewed. Patients with prior trauma, elbow surgery, or concomitant procedures were excluded. Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity, Physical Function, Pain Interference, and Depression scores were collected preoperatively and at 2-week and 6-week follow-up. Longitudinal mixed-effects regression assessed score changes, adjusted for demographic and clinical covariates. Complications, revisions, and operative characteristics were compared between groups.</p><p><strong>Results: </strong>Of 1892 screened patients, 210 met inclusion criteria (147 in situ, 63 transposition). Demographics and electrodiagnostic severity were comparable, though instability was more frequent in the transposition group. Complication (0.7% vs 3.2%) and revision rates (4.1% vs 1.6%) were low, precluding statistical analysis. At 2 weeks, transposition patients demonstrated greater decline in Physical Function (-6.1) and Upper Extremity (-4.4) and increased Pain Interference (+2.9, below minimal clinically important difference [MCID]) relative to baseline, with convergence of scores between groups by 6 weeks. In situ patients had a modest decrease in pain interference scores from pre-op to six weeks post-operatively (-3.2, below MCID).</p><p><strong>Conclusions: </strong>Patient-Reported Outcomes Measurement Information System detected transient early differences in recovery between techniques, with slower initial improvement after transposition but comparable outcomes by 6 weeks. These findings highlight PROMIS as a sensitive measure for short-term recovery and a useful tool for postoperative monitoring and patient counseling.</p><p><strong>Type of study/level of evidence: </strong>Therapeutic, Level III.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261487693"},"PeriodicalIF":1.3,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distal Ulna Hook Locking Plate Fixation for Unstable Distal Ulna Fractures: A Prospective Clinical Study.","authors":"Sherif Nabil Amin, Moustafa Mahmoud Hassanin, Ayman Mahmoud Mansour, Fared A Ahmed Radwan","doi":"10.1177/15589447261493991","DOIUrl":"10.1177/15589447261493991","url":null,"abstract":"<p><strong>Background: </strong>Distal ulna fractures, particularly when displaced or unstable, play a critical role in the stability and function of the distal radioulnar joint. Inadequate treatment may result in persistent pain, instability, and impaired wrist function. Recent advances in angular stable fixation have led to the development of anatomically contoured distal ulna hook locking plates; however, clinical data regarding their outcomes remain limited.</p><p><strong>Objective: </strong>To evaluate the radiological and functional outcomes of distal ulna fractures treated with open reduction and internal fixation using a distal ulna hook locking compression plate.</p><p><strong>Methods: </strong>This prospective study included 30 patients with displaced or unstable distal ulna fractures treated with a distal ulna hook locking plate. Patients were followed for a minimum of 6 months. Clinical assessment included wrist range of motion, grip strength, and functional evaluation using the Modified Mayo Wrist Score.</p><p><strong>Results: </strong>Radiological union was achieved in all patients, with a mean time to union of 12.7 ± 3.4 weeks (range, 8-24 weeks). Three patients (10%) demonstrated delayed union, and no cases of nonunion were recorded. At final follow-up, mean wrist flexion and extension were 70° and 71°, respectively, while mean pronation and supination were 73.2° and 73°. Mean grip strength was 89% of the contralateral side. The mean Modified Mayo Wrist Score was 82.4 ± 9.1, with excellent results in 19 patients (63.3%), good results in 8 patients (26.7%), and satisfactory results in 3 patients (10%); no patient had a poor outcome.</p><p><strong>Conclusion: </strong>Distal ulna hook locking plate fixation provides reliable fracture union, satisfactory functional outcomes, and a low complication rate in the treatment of displaced and unstable distal ulna fractures.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261493991"},"PeriodicalIF":1.3,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning in Hand Pathology Diagnosis: A Narrative Review of Current Insights.","authors":"Bryan Lim, Ishith Seth, Richard J Ross, Warren M Rozen","doi":"10.1177/15589447261493988","DOIUrl":"10.1177/15589447261493988","url":null,"abstract":"<p><p>Machine learning (ML), a subset of artificial intelligence (AI), is revolutionizing health care. Given the intricate anatomy and functional complexity of the hand, AI applications in hand pathology are gaining prominence, particularly in the diagnosis of fractures, nerve injuries, and musculoskeletal disorders. This review summarizes ML advancements in hand pathology diagnosis, enhancing clinical history analysis, examination findings interpretation, and imaging assessment. A systematic search of PubMed, Google Scholar, EMBASE, Cochrane CENTRAL, Scopus, and Web of Science from 1901 to March 2025 was conducted, focusing on ML applications in diagnosing hand fractures, tendon injuries, and nerve compressions. The inclusion criteria encompassed original research, systematic reviews, meta-analyses, and observational studies that demonstrated the use of AI in diagnostic imaging, preoperative assessment, or postoperative management. Studies that did not involve AI-driven diagnostic applications or lacked sufficient methodological transparency were excluded. Machine learning models, particularly convolutional neural networks (CNNs), have demonstrated high diagnostic accuracy in detecting fractures. Studies have validated CNNs in the detection of distal radius and ulna fractures, outperforming trainees and urgent care physicians. In addition, AI has enhanced clinical examination by integrating wearable motion sensors for objective joint assessment. However, challenges such as external validation, interpretability, and integration into clinical workflows remain, limiting broader clinical adoption. Machine learning shows promise in hand pathology diagnosis, but widespread adoption requires improved external validation, standardized methods, and interdisciplinary collaboration. Future research should prioritize multicentric studies and explainable AI to enhance trust and integration.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261493988"},"PeriodicalIF":1.3,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scaphoidectomy and Lunocapitate Fusion: A Systematic Review.","authors":"Hong Swo Tan, Shilpi Yadav, Mohammed Baba","doi":"10.1177/15589447261485502","DOIUrl":"10.1177/15589447261485502","url":null,"abstract":"<p><p>Scaphoidectomy and lunocapitate fusion (LCF) is a motion-preserving salvage procedure for scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC). This systematic review evaluates its clinical outcomes and complication rates. A systematic search of PubMed, MEDLINE, Embase and Google Scholar identified studies on LCF published between 1993 and 2024. Extracted outcomes included range of motion, grip strength, visual analog scale pain score, Disabilities of the Arm, Shoulder. and Hand (DASH) scores and complications such as nonunion and reoperation rates. Pooled data means were calculated for clinical outcomes for comparison. Nineteen studies comprising 329 patients met inclusion criteria. The flexion-extension arc improved from 74° to 77°, and the radio-ulnar deviation arc improved from 34° to 38°. Grip strength increased from 19.3 to 28.9 kg. Visual analog scale pain scores improved from 5.9 to 1.2. Postoperative DASH scores averaged 21. The nonunion rate was 10% with an average time to union of 11 weeks. The reoperation rate was 13.4%, with hardware-related complications being the leading cause for reoperation. Lunocapitate fusion is a viable treatment option for SLAC and SNAC, demonstrating favourable clinical outcomes. However, higher complication and nonunion rates highlight the need for further research to refine surgical techniques and optimize patient selection.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261485502"},"PeriodicalIF":1.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Analysis of Surgical Treatment for First Carpometacarpal Osteoarthritis: A Systematic Review and Pooled Analysis of Randomized Controlled Trials.","authors":"Justin Le, Nazanin Kermanshahi, Jason Tran, Zachary Coren, Nicholas Moscardelli, Rick Tosti, Michael Rivlin","doi":"10.1177/15589447261487487","DOIUrl":"10.1177/15589447261487487","url":null,"abstract":"<p><strong>Background: </strong>First carpometacarpal osteoarthritis (CMC1-OA) is a common degenerative condition causing pain, functional loss, and reduced grip strength. While trapeziectomy remains the standard surgical treatment, reconstructive procedures and implant arthroplasties are increasingly used. However, differences in postoperative recovery between these approaches remain unclear. This study provides an indirect pooled comparison of reconstructive, non-reconstructive, and dual-mobility implant procedures for CMC1-OA.</p><p><strong>Methods: </strong>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, randomized controlled trials (RCTs) evaluating surgical treatment of CMC1-OA were included. Procedures were categorized as reconstructive, non-reconstructive, or dual-mobility implants. Outcomes included visual analog scale (VAS), Disabilities of the Arm, Shoulder, and Hand, hand grip, tip pinch, lateral pinch, and complications at 3- and 12-month follow-up.</p><p><strong>Results: </strong>Seven RCTs comprising 409 hands were included. At 3 months, dual-mobility implants demonstrated the greatest reduction in VAS pain scores (Δ = 6.05), compared with reconstructive (Δ = 3.52) and non-reconstructive procedures (Δ = 2.86). Disabilities of the Arm, Shoulder, and Hand scores improved across all groups, most prominently in implant procedures (Δ = 29.48 at 3 months; Δ = 35.35 at 12 months). Strength outcomes varied between groups, though implants demonstrated the greatest improvement in lateral pinch strength at 12 months. Complication rates differed between reconstructive (20.61%), implant (24.49%), and non-reconstructive procedures (51.61%), though only 1 study reported complications in the non-reconstructive group.</p><p><strong>Conclusion: </strong>Although 12-month pain and functional outcomes were comparable, dual-mobility implants demonstrated greater early improvements in pain, function, and lateral pinch strength. These findings suggest that differences may exist between surgical approaches for CMC1-OA.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261487487"},"PeriodicalIF":1.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}