HAND最新文献

{"title":"Fingertip Reconstruction With Homodigital Adipofascial Reverse Flap Versus Dermal Substitute: A Comparative Retrospective Study.","authors":"Gabriele Delia, Michele Rosario Colonna, Luigi Troisi, Fabiana Battaglia","doi":"10.1177/15589447261487627","DOIUrl":"10.1177/15589447261487627","url":null,"abstract":"<p><strong>Background: </strong>Fingertip injuries frequently involve exposure of bone, tendon, or nail bed and require reconstruction to restore function and appearance. The homodigital adipofascial reverse flap (HDARF) and bilayer dermal substitutes such as Integra are commonly employed, but few comparative studies exist.</p><p><strong>Methods: </strong>A retrospective monocentric study was conducted, including 40 patients treated between 2012 and 2024 for traumatic pulp loss: 20 with HDARF and 20 with dermal substitute plus skin graft. Outcomes were assessed using Semmes-Weinstein monofilament (SWM) test, 2-point discrimination (2PD), Cold Intolerance Symptom Severity, Michigan Hand Outcomes Questionnaire, and return-to-work time.</p><p><strong>Results: </strong>All patients achieved wound healing without major complications. Homodigital adipofascial reverse flap provided superior sensory recovery (85% with normal SWM; mean 2PD < 5 mm), lower incidence of cold intolerance and nail deformities, and shorter return-to-work intervals. Dermal substitutes required longer healing but yielded good aesthetic outcomes and preserved donor sites.</p><p><strong>Conclusions: </strong>Both HDARF and dermal substitutes are safe and effective options for fingertip reconstruction. Homodigital adipofascial reverse flap is preferable for young, active patients requiring rapid functional recovery, whereas dermal substitutes represent a valuable alternative when minimal invasiveness and donor-site preservation are prioritized.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261487627"},"PeriodicalIF":1.3,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149060374","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":"Reamed Percutaneous Arthrodesis for Distal Interphalangeal Joint Arthritis Improves Bone Fusion and Pain Compared With a Non-Reamed Technique.","authors":"Juan Maria Pardo Garcia, Pablo Sanchez-Urgelles, Belen Pardos Mayo, Eudaldo Gallo Del Valle, Ramesh C Srinivasan, James M Saucedo, Diego Gonzalez-Morgado","doi":"10.1177/15589447261487482","DOIUrl":"10.1177/15589447261487482","url":null,"abstract":"<p><strong>Background: </strong>Distal interphalangeal joint (DIPJ) arthrodesis is the treatment of choice for DIPJ arthritis when conservative measures fail. However, open arthrodesis and non-reamed percutaneous techniques have been associated with high rates of nonunion and complications. This study aimed to evaluate and compare the outcomes of a minimally invasive technique for DIPJ arthrodesis that incorporates percutaneous articular surface reaming with those of a non-reamed percutaneous technique.</p><p><strong>Methods: </strong>A retrospective study was conducted on patients with DIPJ arthritis who underwent either reamed or non-reamed percutaneous DIPJ arthrodesis using headless cannulated compression screws, with a minimum follow-up of 2 years. The outcomes assessed included preoperative and postoperative visual analog scale scores, functional outcomes (Quick Disabilities of the Arm, Shoulder, and Hand), radiographic evidence of union, degree of residual axial malalignment, complication rate, subjective osteophyte elimination, and patient satisfaction at final follow-up.</p><p><strong>Results: </strong>A total of 12 patients underwent non-reamed percutaneous DIPJ arthrodesis, and 10 patients received the reamed technique. Bone union was achieved in 100% of patients in the reamed group compared with 50% in the non-reamed group, with faster healing observed in the reamed group (6 vs 8 weeks). The complication rate was lower in the reamed group (30%) than in the non-reamed group (58%). Postoperative pain scores were also lower in the reamed group (0 vs 1.5), and functional outcomes at final follow-up were similar between groups.</p><p><strong>Conclusions: </strong>Reamed percutaneous DIPJ arthrodesis is associated with higher union rates achieved in a shorter time and reduced postoperative pain compared with the non-reamed percutaneous technique.</p><p><strong>Level of evidence: </strong>III, Therapeutic.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261487482"},"PeriodicalIF":1.3,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038206","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":"Meniscus Allograft Interpositional Arthroplasty With Elastic Intramedullary Bioabsorbable Pin Fixation for Proximal Interphalangeal Joint Contracture.","authors":"Ching-Hsin Chou, Yu-Cheng Lin, Yi-Chen Li, Chen-Chie Wang, Po-Chih Chow","doi":"10.1177/15589447261483166","DOIUrl":"10.1177/15589447261483166","url":null,"abstract":"<p><p>Advanced proximal interphalangeal (PIP) joint contracture presents a surgical challenge, particularly in patients who require preservation of joint motion. Arthrodesis provides reliable pain relief, but eliminates motion, whereas implant arthroplasty may be associated with mechanical complications and implant failure. We report a case of severe degenerative PIP joint contracture treated with meniscus allograft interpositional arthroplasty combined with intramedullary bioabsorbable pin fixation. Preoperatively, the joint was fixed at 60° of flexion. At 1-year follow-up, active range of motion improved to 20° to 105°, with passive motion of 0° to 115°. Functional outcomes improved, with the Quick Disabilities of the Arm, Shoulder, and Hand score decreasing from 56.8 to 15.9 and the visual analog scale pain score improving from 7 to 1. Radiographs demonstrated maintained joint alignment without graft migration or subluxation. This case demonstrates that meniscus allograft interposition with intramedullary bioabsorbable fixation may provide a motion-preserving reconstructive option for selected patients with advanced PIP joint contracture.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261483166"},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038155","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":"The Role of Electrocauterization in Preventing Ganglion Recurrence: Evaluating Adjuncts to Standard Surgical Excision.","authors":"Jessica J Farzan, Sivana L Barron, Yiming Zhang, Anselm H Wong, Douglas M Rothkopf","doi":"10.1177/15589447261485508","DOIUrl":"10.1177/15589447261485508","url":null,"abstract":"<p><strong>Background: </strong>Ganglion cysts are the most common soft-tissue tumors of the hand and wrist, frequently recurring after surgical excision (6%-41%). Open resection is the treatment of choice, yet significant variation persists in techniques from basic stalk resection to tissue window excision and sclerosing agents, with no established optimal approach. We investigated the efficacy of electrocauterization of cyst remnants, based on the premise that scar formation may reduce recurrence.</p><p><strong>Methods: </strong>A retrospective cohort study analyzed 181 patients (189 cysts) undergoing open ganglion excision by 2 surgeons (2018-2024). Patients were stratified into cauterized (n = 113, 116 cysts) and non-cauterized (n = 68, 73 cysts) groups. The primary outcome was recurrence. Secondary analysis assessed combined techniques. Fisher exact test compared outcomes.</p><p><strong>Results: </strong>No significant difference in recurrence was observed between groups (cauterized: 5/116, non-cauterized: 7/73). Zero recurrences occurred with cauterization plus tissue window excision (n = 31) versus 1 recurrence in non-cauterized window excisions (n = 12). Capsular closure alone had higher recurrence (6/44 vs 2/7 with cauterization). Recurrences predominantly involved dorsal cysts (69%), small size (<2 cm, 46%), and patients with manual occupations.</p><p><strong>Conclusion: </strong>Although statistically insignificant, cauterization showed a meaningful trend toward reduced recurrence (4.3% vs 9.5% without cauterization). For dorsal ganglions, cauterization combined with window excision may reduce recurrence, while capsular closure alone may increase risk. We hypothesize that leaving the capsular defect open may allow continuous drainage, mitigating fluid reaccumulation, whereas closure could inadvertently trap residual fluid if any cystic or valvular remnants remain. A larger study investigating window excision combined with electrocautery deserves further attention.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261485508"},"PeriodicalIF":1.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149011987","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":"Radiographic Outcomes of Distal Radial Fractures in Patients Older Than 90 Years: Preoperative and Postoperative Correlations.","authors":"Roya Khorram, Bankole Olowofela, Oluwatosin Oyedemi, Ehsan Fayyazi Shishavan, Pedro K Beredjiklian, Amir R Kachooei","doi":"10.1177/15589447261479356","DOIUrl":"10.1177/15589447261479356","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates longitudinal changes in key radiographic parameters and examines their correlation with clinical outcomes following surgical treatment of distal radius fractures (DRFs) in patients aged 90 years and older, while also assessing the safety and complications associated with this treatment in nonagenarians.</p><p><strong>Methods: </strong>A retrospective review was performed of patients aged 90 years and older who underwent surgical treatment for DRFs. Demographic data were collected. Radiographic alignment was assessed preoperatively, immediately postoperatively, and at final follow-up using dorsal tilt, ulnar variance, radial inclination, and radial height. Functional outcomes were evaluated at final follow-up using the Disabilities of the Arm, Shoulder, and Hand (DASH) score and visual analog scale. Surgical complications and reoperations were also recorded.</p><p><strong>Results: </strong>Seventy-three patients aged 90 years and older (mean age, 92 ± 2 years; 89% women) were included. All radiographic parameters improved and were maintained at final follow-up with a mean of 4.1 months. The final mean DASH score was 29. No significant correlations were observed between preoperative radiographic alignment and final function; however, a weak correlation was found between immediate postoperative height and final DASH score. Overall, minor and major complications occurred in 15% (n = 11) of patients.</p><p><strong>Conclusions: </strong>Surgical treatment of DRFs results in sustained radiographic alignment and meaningful improvements in pain and function, with an acceptable complication profile in nonagenarian patients. Although correlations between radiographic alignment and functional outcomes were modest, operative management appears to be a safe and effective option in carefully selected patients aged 90 years and older.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261479356"},"PeriodicalIF":1.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012040","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":"More Than Worth It: The Economic Impact of Shifting Soft Tissue Hand Procedures From the Operating Room to the Procedure Room.","authors":"Thompson Zhuang, George R Nageeb, Lauren M Shapiro, Paige M Fox, Brady T Evans, Robin N Kamal","doi":"10.1177/15589447261485598","DOIUrl":"10.1177/15589447261485598","url":null,"abstract":"<p><strong>Background: </strong>To inform value-driven efforts to improve adoption of procedure room (PR) hand surgery, we conducted a population-level comparative cost analysis of hand procedures performed in the PR versus operating room (OR) from the payer perspective.</p><p><strong>Methods: </strong>Using a national administrative database, we identified adult patients undergoing common soft tissue hand procedures. Patients were divided into cohorts based on site of service and anesthesia type (PR, OR without anesthesia, OR with anesthesia). Professional (surgeon, anesthesia) and facility reimbursements and total day-of-surgery and 90-day costs were compared. The cost savings from transitioning each procedure from the OR to the PR were calculated and used to model cumulative savings over 10 years from shifting 1000 cases per year to the PR.</p><p><strong>Results: </strong>The difference in surgeon reimbursements for procedures performed in the PR compared with the OR with anesthesia ranged from +24.2% for DeQuervain release to +85.7% for endoscopic carpal tunnel release. The difference in surgeon reimbursements for procedures performed in the PR compared with the OR without anesthesia ranged from +9.8% for DeQuervain release to +75.3% for endoscopic carpal tunnel release. Large savings in day-of-surgery costs were achieved in the PR compared with the OR, driven by elimination of the facility fee. Projected cumulative 10-year cost savings for 1000 cases per year transitioned to the PR setting totaled over $20 million for OR cases with anesthesia and $13 million to $20 million for OR cases without anesthesia.</p><p><strong>Conclusions: </strong>Transitioning soft tissue hand procedures from the OR to the PR can result in large cost savings from the payer perspective.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261485598"},"PeriodicalIF":1.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149011989","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":"Association Between Orthotic Wear Duration and Pain Reduction in Thumb Carpometacarpal Osteoarthritis.","authors":"Hirotomo Shibahashi, Kotaro Saka, Koichiro Abe, Kanta Ohno, Keizo Fukumoto","doi":"10.1177/15589447261487489","DOIUrl":"10.1177/15589447261487489","url":null,"abstract":"<p><strong>Background: </strong>Orthotic stabilization is a recommended first-line conservative option for thumb carpometacarpal (CMC) osteoarthritis, and randomized controlled trials have shown that it relieves pain. Because its effect depends on actual exposure, however, the benefit hinges on patient adherence, commonly expressed as daily wear duration. It remains unclear whether wear time is independently related to changes in pain over time.</p><p><strong>Methods: </strong>This retrospective study included 63 orthosis-treated thumbs from 56 consecutive patients with thumb CMC osteoarthritis. Pain severity was assessed using a 100-mm visual analog scale (VAS) at baseline and 3 months. At 3 months, patients retrospectively reported their average daily orthotic wear time. Linear mixed-effects models examined the relationship between wear duration and pain change over time, incorporating a prespecified time-by-wear-duration interaction and adjusting for age, sex, and radiographic severity.</p><p><strong>Results: </strong>Median VAS scores improved from 65 at baseline to 30 at 3 months (<i>P</i> < .001). HAND20 scores improved significantly, whereas pinch strength did not. However, time-by-wear-duration interactions were not significant for VAS or HAND20, indicating no evidence that longitudinal improvements varied according to orthotic wear duration.</p><p><strong>Conclusions: </strong>In thumb CMC osteoarthritis, orthotic management was associated with meaningful short-term gains in pain and function. Across the range of use commonly seen in practice, daily wear duration showed no independent association with longitudinal pain reduction. These findings suggest that therapeutic benefit may depend more on appropriate, activity-specific use than on maximizing daily wear time.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261487489"},"PeriodicalIF":1.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149011991","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":"Patient Expectations After Distal Radius ORIF: A Guide for Surgeons.","authors":"Jude G Kolodisner, Matthew W Scarsbrook, Sohail R Daulat, Cameron Roth","doi":"10.1177/15589447261483202","DOIUrl":"10.1177/15589447261483202","url":null,"abstract":"<p><strong>Background: </strong>Volar plate fixation is commonly used by orthopedic surgeons to treat distal radius fractures. This study aims to describe timelines and provide a practical guide for patient counseling following distal radius open reduction internal fixation.</p><p><strong>Methods: </strong>A retrospective observational study of patients undergoing fixation of distal radius fractures (Current Procedural Terminology [CPT] codes 25607-25609) by a single surgeon at a private orthopedic practice between December 2023 and June 2025. The study analyzed deidentified postoperative survey data, including pain, subjective function, return to work, driving, and hand therapy utilization.</p><p><strong>Results: </strong>Thirty-four patients (mean age = 51.3 ± 17.1 years; 85.3% female) were included. Mean pain decreased from 4.34 ± 2.84 at 2 weeks to 1.08 ± 1.39 at 3 months, whereas subjective function improved from 18.4% ± 20.5% to 84.0% ± 14.2% of normal over the same period; the mean times to return to driving and work were 12.0 ± 11.4 days and 23.0 ± 25.3 days, respectively. Higher pain was consistently associated with lower functional recovery at all time points (<i>r</i> = -0.41 to -0.56, all <i>P</i> ≤ .016), and the CPT code 25608 was associated with lower odds of achieving this threshold (odds ratio, 0.06; <i>P</i> = .023).</p><p><strong>Conclusions: </strong>Patients undergoing volar plate fixation of distal radius fractures demonstrated pain reduction and improvement in function by 3 months, with variable return-to-work and driving timelines. These findings provide preliminary patient-centered recovery benchmarks that may help improve counseling and patient satisfaction but require validation in larger studies.<b>Level of Evidence:</b> Therapeutic III.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261483202"},"PeriodicalIF":1.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982535","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":"Quantitative Analysis of Flexor Tendon Gliding Sounds of the Hand in Healthy Volunteers Using a Digital Stethoscope.","authors":"Takanobu Higashi, Atsuyuki Inui, Yutaka Mifune, Kohei Yamaura, Issei Shinohara, Yutaka Ehara, Shunsaku Takigami, Shin Osawa, Daiji Nakabayashi, Ryota Wakamatsu, Ryohei Nako, Tomohiro Date, Ryosuke Kuroda","doi":"10.1177/15589447261483211","DOIUrl":"10.1177/15589447261483211","url":null,"abstract":"<p><strong>Background: </strong>Smooth flexor tendon gliding depends on the structural harmony between the flexor tendon and its sheath. Because tendon dimensions and joint kinematics differ among digits, gliding dynamics may also differ, but in vivo assessment during active motion remains limited. The purpose of this study was to clarify whether the acoustic characteristics of flexor tendon gliding sounds at the metacarpophalangeal (MCP) joint differ among the index, middle, and ring fingers.</p><p><strong>Methods: </strong>Gliding sounds were recorded from 40 hands of 20 healthy volunteers using a digital stethoscope placed at the palmar aspect of the MCP joint during active flexion-extension. A single examiner performed all recordings in a fixed finger order. Signals were filtered (20-500 Hz), and mean amplitude, mean power frequency (MPF), median power frequency (MDF), spectral flatness, and zero-crossing rate were extracted. A linear mixed-effects model with random intercepts for participant and for hand nested within participant was used.</p><p><strong>Results: </strong>Significant digit-specific differences were found in mean amplitude, MPF, MDF, and spectral flatness (all <i>P</i> < .001), whereas the zero-crossing rate did not differ. The index finger showed lower amplitude and higher MPF and MDF than the other digits, and the middle finger showed the highest spectral flatness, with moderate-to-large pairwise effect sizes.</p><p><strong>Conclusions: </strong>Flexor tendon gliding produces distinct acoustic signatures that differ among digits, consistent with known anatomical and kinematic characteristics. Because tendon-pulley friction cannot be directly quantified using routine clinical imaging, these findings provide preliminary healthy-reference data for acoustic profiling of tendon disorders such as trigger finger.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261483211"},"PeriodicalIF":1.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982582","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":"Mid- to Long-term Outcomes of Aptis Distal Radioulnar Joint Arthroplasty: A Systematic Review of Studies With Minimum 5-Year Follow-up.","authors":"Anderson Lee, Robert B Ponce, Abdul Khan, Claire Huff, Quinn Steiner, Sunishka Wimalawansa","doi":"10.1177/15589447261483187","DOIUrl":"10.1177/15589447261483187","url":null,"abstract":"<p><p>Total distal radioulnar joint (DRUJ) arthroplasty with the Aptis prosthesis is an increasingly used salvage procedure for refractory DRUJ pathology, though prior studies often rely on mean rather than minimum follow-up, limiting assessment of true mid- to long-term durability. This systematic review evaluated implant survivorship, complications, and functional outcomes following total DRUJ arthroplasty with a minimum follow-up of 60 months. A systematic review of PubMed, Embase, and Cochrane databases was performed, including patients who underwent total DRUJ arthroplasty with reported survivorship or complication data and a minimum of 60-month follow-up. Seven studies met the inclusion criteria, comprising 66 implants meeting the follow-up threshold. Implant survivorship at final follow-up was 96.0%, with an overall complication rate of 51.0% and reoperation rate of 44.9%; the most common complications were extensor carpi ulnaris tendonitis, heterotopic ossification, and hardware loosening. Weighted mean postoperative supination and pronation were 74° and 78°, respectively, with mean grip strength of 29 kg. Outcome scores demonstrated meaningful improvement. Total DRUJ arthroplasty shows appropriate mid- to long-term implant survivorship and satisfactory functional gains, though complication and reoperation rates warrant cautious interpretation. It remains a viable salvage option in appropriately selected patients, underscoring the need for thorough preoperative counseling.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447261483187"},"PeriodicalIF":1.3,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148967816","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}