Journal of Hand Surgery Global Online最新文献

{"title":"Introduction to the Conference Proceedings from the 2025 Nerve SPACE Conference","authors":"Christopher J. Dy MD, MPH","doi":"10.1016/j.jhsg.2026.100946","DOIUrl":"10.1016/j.jhsg.2026.100946","url":null,"abstract":"","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 3","pages":"Article 100946"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193170","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":"Attritional Carpal Dislocation and Flexor Tendon Rupture as a Rare Complication of Conservatively Managed Distal Radius Fracture in a Rheumatoid Patient","authors":"Alexandre Vesselle MD ,&nbsp;Ian Christman MD ,&nbsp;Christopher Cheng MD ,&nbsp;Blaine Bafus MD","doi":"10.1016/j.jhsg.2025.100933","DOIUrl":"10.1016/j.jhsg.2025.100933","url":null,"abstract":"<div><div>Distal radius malunions are known in rare instances to present a risk of tendon rupture. Rheumatoid arthritis and other inflammatory arthropathies also place patients at-risk of attritional tendon rupture as a sequelae of tendon degeneration from the underlying disease process. In this case report, we present a patient with psoriatic arthritis who sustained a distal radius fracture malunion after initially electing to pursue nonsurgical management, subsequently sustaining attritional dorsal carpal dislocation and ruptures of multiple flexor tendons 3 years after her initial injury resulting in considerable hand disability. She would then undergo wrist fusion and distal ulna resection with pending future staged flexor tendon reconstruction. Given the poor outcomes associated with multiple flexor tendon attritional ruptures, this case represents a cautionary example of the risks associated with nonsurgical management of distal radius fractures in patients with inflammatory arthropathies.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 3","pages":"Article 100933"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193172","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":"Commentary: Quantitative Scratch Collapse Test Methodology with Handheld Dynamometer: Normative Upper-Extremity Force Data and Reliability Analysis","authors":"Aneri U. Patel BS,&nbsp;Andrea Biaggi-Ondina MD,&nbsp;Susan E. Mackinnon MD","doi":"10.1016/j.jhsg.2026.100995","DOIUrl":"10.1016/j.jhsg.2026.100995","url":null,"abstract":"","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 3","pages":"Article 100995"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849443","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":"Quantitative Scratch Collapse Test Methodology With Handheld Dynamometer: Normative Upper-Extremity Force Data and Reliability Analysis","authors":"Alicia Faszholz BS, BA ,&nbsp;Makena Davidson BS ,&nbsp;Stephen Pullman BSA ,&nbsp;Jonathan Cheng MD","doi":"10.1016/j.jhsg.2026.100966","DOIUrl":"10.1016/j.jhsg.2026.100966","url":null,"abstract":"<div><h3>Purpose</h3><div>The scratch collapse test (SCT) has variable sensitivity and specificity due to inconsistent protocols and subjective interpretation. This study aimed to establish normative upper-extremity force and torque values in healthy adults and to assess the inter- and intra-examiner reliability of a standardized quantitative SCT approach.</div></div><div><h3>Methods</h3><div>Healthy adult participants performed maximal isometric shoulder external-rotation resistance, whereas two independent examiners (A.M.F. and M.D.) each conducted repeated trials per arm. Force and torque values were recorded using a handheld dynamometry device. Reliability was assessed across examiners and within examiners to evaluate consistency of measurements.</div></div><div><h3>Results</h3><div>Normative force and torque values were obtained for both upper extremities. Interrater reliability was determined to be good to excellent, and intrarater reliability was excellent. No meaningful systematic differences were identified between examiners.</div></div><div><h3>Conclusions</h3><div>The quantitative SCT protocol using handheld dynamometry provides reproducible normative values, and initial results demonstrate high reliability in healthy adults. By reducing examiner variability, this standardized approach strengthens the foundation for future validation studies in patient populations and may support more objective clinical application of the SCT in peripheral nerve compression syndromes.</div></div><div><h3>Type of study/level of evidence</h3><div>Diagnostic II</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 3","pages":"Article 100966"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849442","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":"Short-Term Outcomes of Digitalis Silicone Implant for Proximal Interphalangeal Joint Osteoarthritis and a Proposed Functional-Radiological Classification","authors":"Sergi Barrera-Ochoa MD, PhD ,&nbsp;Melissa Bonilla-Chaperon MD ,&nbsp;Leobardo Alexis Alvarez-Villalobos MD ,&nbsp;Neri Alejandro Alvarez-Villalobos MD ,&nbsp;Gerardo Mendez-Sanchez MD","doi":"10.1016/j.jhsg.2025.100911","DOIUrl":"10.1016/j.jhsg.2025.100911","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the clinical and functional outcomes of a novel silicone implant (BRM Digitalis) for proximal interphalangeal joint (PIPJ) osteoarthritis and to propose a novel functional-radiological classification system (PIP-Kellgren) adapted from the Kellgren-Lawrence scale.</div></div><div><h3>Methods</h3><div>This retrospective longitudinal study included 33 patients with symptomatic PIPJ osteoarthritis treated using the BRM Digitalis silicone implant, with a minimum follow-up of 24 months. Subjective outcomes were assessed using the <em>Quick</em>DASH (Disabilities of the Arm, Shoulder, and Hand) questionnaire, visual analog scale for pain, and a seven-item Likert satisfaction score. Objective clinical and radiographic data were collected by measuring range of motion (ROM), extension lag, grip and pinch strength, pulp-to-palm distance, and evaluating implant position and integrity on final radiographs.</div></div><div><h3>Results</h3><div>Statistically significant improvements were observed in total ROM, extension lag, grip strength, and <em>Quick</em>DASH and visual analog scale scores. No implant fractures or infections were recorded. The average Likert satisfaction score was 3.97 of 5 (range, 3−5). Using the proposed PIP-Kellgren functional-radiological classification, grade 4 patients showed considerably greater improvements in ROM and <em>Quick</em>DASH compared with grade 3, with no differences in satisfaction. The reintervention rate was higher in grade 4.</div></div><div><h3>Conclusions</h3><div>The BRM Digitalis silicone implant offers consistent improvements in pain, motion, and strength for patients with advanced PIPJ osteoarthritis. The proposed PIP-Kellgren functional-radiological classification system may help stratify surgical candidates and standardize severity assessment.</div></div><div><h3>Type of study/Level of evidence</h3><div>Therapeutic IV.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 3","pages":"Article 100911"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193138","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":"Is Cannabis Dependence Associated with Postoperative Infections in Hand and Wrist Surgeries?","authors":"Christopher M. Dussik MD,&nbsp;Jeffrey Coombs MD,&nbsp;Amy Phan MD,&nbsp;Yasmine Ghattas MD,&nbsp;Joseph Ferraro MD,&nbsp;Constantinos Ketonis MD, PhD","doi":"10.1016/j.jhsg.2026.100948","DOIUrl":"10.1016/j.jhsg.2026.100948","url":null,"abstract":"<div><h3>Purpose</h3><div>Recreational cannabis use has been increasing alongside broader legalization efforts worldwide. Despite this trend, relatively little data exist regarding the impact of cannabis dependence on postoperative complications. This knowledge gap is even more pronounced in the context of hand surgery. This study used a large, multi-institutional database to evaluate perioperative complications following soft–tissue surgical procedures of the hand and wrist in patients with documented cannabis dependence versus nondependent patients.</div></div><div><h3>Methods</h3><div>The TriNetX database was queried to determine the incidence of 90-day perioperative complications following soft–tissue surgical procedures involving the hand and wrist. Complications assessed included postoperative admissions, emergency department visits, superficial soft-tissue infections or wound breakdown, systemic infections, and deep surgical site infections. Propensity score matching was performed to control for potential confounding variables and odds ratios were calculated.</div></div><div><h3>Results</h3><div>We identified 498,150 patients who underwent soft–tissue surgical procedures involving the hand and wrist. Among these, 5,607 patients were diagnosed with preoperative cannabis dependence, whereas 492,543 had no history of preoperative cannabis use. Matched analyses revealed increased odds for superficial wound complications/infections (OR 1.9; 95% confidence interval [CI ]1.6–2.3), postoperative admissions (OR 2.5; 95% CI 1.7–3.6), and emergency department visits (OR 1.8; 95% CI 1.6–2.0). Additionally, there were increased odds of sepsis (OR 2.3; 95% CI 1.5–3.6) and subsequent return to the operating room for deep surgical site infections (OR 2.6; 95% CI 1.6–4.6).</div></div><div><h3>Conclusions</h3><div>Patients with documented cannabis dependence demonstrated higher odds of developing wound complications following hand and wrist soft–tissue surgical procedures. This is accompanied by a higher risk of health care utilization, including readmissions and emergency department visits. Although these findings reflect an association rather than a causal relationship, cannabis dependence may serve as a useful variable in perioperative risk stratification and patient counseling.</div><div><em>Type of study/level of evidence</em>: Prognostic IIc.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 3","pages":"Article 100948"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193268","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":"Soil to Sheath: Nocardia Flexor Tenosynovitis in an Immunocompetent Pottery Artist","authors":"James Anundson MS, BS ,&nbsp;Sean Bae BS ,&nbsp;Michael Kessler MD","doi":"10.1016/j.jhsg.2025.100934","DOIUrl":"10.1016/j.jhsg.2025.100934","url":null,"abstract":"<div><div>Stenosing flexing tenosynovitis (trigger finger) is a chronic, noninfectious condition of the flexor tendon sheath, whereas infectious flexor tenosynovitis is an acute hand infection that requires urgent recognition and treatment. Infectious flexor tenosynovitis involves bacterial inoculation of the flexor tendon sheath and can rapidly progress to tendon necrosis, stiffness, and even amputation if diagnosis and surgical management are delayed. It is classically associated with Kanavel’s four cardinal signs and is considered a surgical emergency in the hand.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 3","pages":"Article 100934"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193171","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":"Clinical Outcomes of Flexor Tenolysis Following Zone 2-3 Flexor Tendon Repair: A Retrospective Review","authors":"Christian Shigley MD ,&nbsp;Annie Squires BS ,&nbsp;Chelsea Boe MD ,&nbsp;Jerry I. Huang MD","doi":"10.1016/j.jhsg.2025.100941","DOIUrl":"10.1016/j.jhsg.2025.100941","url":null,"abstract":"<div><h3>Purpose</h3><div>Adhesions and finger stiffness are common complications following zone 2 and zone 3 flexor tendon repairs. When active finger flexion recovery has plateaued, flexor tenolysis can be an effective surgical option. However, literature reporting the outcomes of flexor tenolysis is scarce.</div></div><div><h3>Methods</h3><div>Medical records were reviewed for patients who underwent flexor tenolysis after primary repair over a 10-year period. Clinical outcomes, including active range of motion, total active motion, pain scores, and composite flexion, were assessed after surgery.</div></div><div><h3>Results</h3><div>68 digits in 31 patients met study criteria. At the 12-week follow-up, total active motion improved considerably from 146.8° to 183.5°, and active range of motion at the proximal interphalangeal joint increased from 46.1° to 60.0°. Composite flexion improved from 2.5 to 1.9 cm from the distal palmar crease. Half of the digits achieved excellent or good outcomes based on the Modified Strickland score. Reoperation was the most common complication. Flexor tendon rupture occurred in 3% of cases.</div></div><div><h3>Conclusions</h3><div>Flexor tenolysis can be effective for improving motion following tendon repair, particularly in primary procedures and isolated tendon injuries. Revision tenolysis, dual tendon repairs, and associated digital nerve injuries were associated with poorer outcomes.</div></div><div><h3>Clinical relevance</h3><div>Flexor tenolysis offers meaningful, though modest, improvements in motion for patients with stiffness after zone 2–3 flexor tendon repair, reinforcing its role as a valuable secondary procedure when recovery plateaus. This study further clarifies which patient and injury characteristics predict better or poorer outcomes, helping surgeons counsel patients more accurately and tailor expectations for recovery.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 3","pages":"Article 100941"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146154172","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":"Ongoing Clinical Challenges in Nerve Surgery (Nerve SPACE 2025)","authors":"Katherine M. Gerull MD ,&nbsp;David M. Brogan MD, MSc ,&nbsp;Harvey Chim MD ,&nbsp;Bryan J. Loeffler MD ,&nbsp;Megan M. Jack MD ,&nbsp;Robert J. Spinner MD ,&nbsp;Macyn M. Stonner OTD","doi":"10.1016/j.jhsg.2025.100938","DOIUrl":"10.1016/j.jhsg.2025.100938","url":null,"abstract":"<div><h3>Where are we?</h3><div>There have been numerous advances over the last decade in peripheral nerve surgery and rehabilitation following nerve transfers. In particular, advances in nerve allografts, nerve wraps, peripheral nerve sheath tumor treatment, and bionic limb technology have expanded the therapeutic landscape for patients with nerve injuries, tumors, and limb loss. Rehabilitation strategies have improved significantly, largely through advances such as the Donor Activation Focused Rehabilitation Approach. Nerve allografts show promise for short digital nerve gaps, though outcomes for proximal injuries remain controversial. Nerve wraps and connectors are widely available, but their efficacy has been controversial, perhaps due to heterogeneity in materials and limited high-quality research studies. In peripheral nerve sheath tumors, molecular subtyping has improved classification, yet reliable preoperative distinction between benign and malignant tumors remains a challenge. Bionic limb reconstruction has been improved through advances in targeted reinnervation, osseointegration, and myoelectric control, although prosthetic abandonment, phantom limb pain, and high costs remain barriers.</div></div><div><h3>Where do we need to go?</h3><div>Future progress requires rigorous empirical evidence to define effective rehabilitation protocols, clarifying the role of allografts versus autografts and determining the clinical utility of nerve wraps and connectors. Improved diagnostic tools are necessary for accurate tumor characterization, and novel systemic therapies are needed for malignant tumors with poor survival outcomes. In bionic limb reconstruction, future advances should integrate intuitive prosthetic control, sensory feedback, and improve pain management while ensuring equitable access to these technologies.</div></div><div><h3>How do we get there?</h3><div>Achieving these goals will require multicenter, nonconflicted, randomized clinical trials; the development of standardized outcome measures; and investment in translational research across cellular biology, imaging, and device development. Collaborative interdisciplinary research is critical to developing evidence-based protocols and technologies. Together, these strategies can continue to accelerate our understanding of peripheral nerve injury, disease, and rehabilitation.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 2","pages":"Article 100938"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077558","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":"The Prevalence of Focal Carpal Chondromalacia Concurrent With Chronic Dynamic Scapholunate Instability","authors":"Kian Steppe BS ,&nbsp;Houshang Seradge MD ,&nbsp;Kamran Steppe BS ,&nbsp;Cyrus Steppe MD ,&nbsp;Carrie Seradge BS ,&nbsp;Winfred Parker BS","doi":"10.1016/j.jhsg.2025.100912","DOIUrl":"10.1016/j.jhsg.2025.100912","url":null,"abstract":"<div><h3>Purpose</h3><div>There is a paucity of information regarding the prevalence of focal chondromalacia with chronic dynamic scapholunate instability (CDSI), and current treatment algorithms do not account for its presence. We aimed to determine the prevalence and distribution of chondromalacia in CDSI.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, longitudinal, cohort study of all wrist arthroscopies performed from January 2008 to December 2020. We included wrists with an arthroscopically confirmed primary diagnosis of CDSI. Patients were grouped based on the presence (CDSI+C) or absence (CDSI−C) of focal carpal chondromalacia. All ligament <em>tears</em> were debrided, and focal chondral lesions were treated with chondral shaving to partial carpectomy. We followed the Debride-First-Then-Wait protocol, which incorporates a waiting period for patients to assess if arthroscopic intervention alone is sufficient to return to normal daily activities. The surgeon considers the patient’s perceived wellness when determining the need for a subsequent Dynadesis (tendon-to-tendon transfer through the distal scaphoid) or partial fusion.</div></div><div><h3>Results</h3><div>Of 255 wrist arthroscopies, 164 wrists (155 patients) met the inclusion criteria. Focal chondromalacia was arthroscopically identified in 48% of wrists, with a notably higher occurrence in older patients and those with lunotriquetral ligament or triangular fibrocartilage tears. The most frequent sites of chondromalacia were the radial styloid (27%) and the scaphoid body (15%). Dynadeis was performed in 29% of wrists in the CDSI+C cohort and 47% in the CDSI−C cohort. Four percent of CDSI+C wrists necessitated partial wrist fusion.</div></div><div><h3>Conclusions</h3><div>Focal chondromalacia is common in patients with CDSI. The presence of focal lesions alone did not notably decrease the efficacy of arthroscopic treatment as &lt;50% of patients needed a secondary procedure (7.4-year follow-up). The distribution of focal chondromalacia suggests injuries to other wrist ligaments. We recommend using the Debride-First-Then-Wait protocol to aid in selecting a personalized and lower-risk treatment for CDSI.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic IIb.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"8 2","pages":"Article 100912"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841032","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}