Techniques in Hand and Upper Extremity Surgery最新文献

The First Year: A Conversation Across Generations in Hand Surgery. 第一年：手外科几代人的对话。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2026-10-22 DOI: 10.1097/BTH.0000000000000573

Lauren E Tagliero, Alexander Y Shin

引用次数: 0

Trans-articular Bridge Plating for Gunshot-related Periarticular Hand Fractures. 经关节桥电镀治疗手部枪击相关关节周围骨折。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2026-10-09 DOI: 10.1097/BTH.0000000000000572

Hussein Abdul-Rassoul, Cristina T Graphia, Jeffrey G Stepan, Jason Strelzow, Jennifer Moriatis Wolf

{"title":"Trans-articular Bridge Plating for Gunshot-related Periarticular Hand Fractures.","authors":"Hussein Abdul-Rassoul, Cristina T Graphia, Jeffrey G Stepan, Jason Strelzow, Jennifer Moriatis Wolf","doi":"10.1097/BTH.0000000000000572","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000572","url":null,"abstract":"The increasing incidence of civilian firearm-related injuries has placed a growing burden on hand surgeons to manage complex ballistic trauma. Periarticular hand fractures caused by firearms present a particularly difficult treatment challenge, characterized by articular comminution, bone loss, and concurrent soft tissue injury. These features frequently render standard fixation options, including plate fixation, wire pinning, and external fixation, either technically infeasible or prone to complication. This manuscript describes our technique of dorsal trans-articular bridge plating as a salvage option for gunshot-related periarticular fractures at the metacarpophalangeal and proximal interphalangeal joints of the hand. Originally developed for severely comminuted intra-articular distal radius fractures, bridge plating achieves relative reduction through ligamentotaxis while providing a robust, length-stable construct with minimal additional soft tissue disruption. We present a retrospective case series of 14 patients treated at a level 1 urban trauma center between 2021 and 2023. Nine underwent trans-articular bridge plating at the MCP joint and 5 at the PIP joint. Of the 11 patients with available postoperative data, 91% achieved radiographic fracture union. Mean pain scores improved from 5.6 of 10 at initial follow-up to 1.4 of 10 at final follow-up (mean 6.7 mo after hardware placement). Postoperative stiffness was encountered in all patients, reflecting the severity of the underlying injury. Trans-articular bridge plating is a technically reproducible salvage option for severely comminuted gunshot-related periarticular hand fractures, offering reliable restoration of digital length, alignment, and rotation with acceptable early outcomes.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138563","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}

引用次数: 0

Arthroscopic Radiolunate Fusion: Surgical Technique. 关节镜下放射月骨融合术：外科技术。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2026-09-17 DOI: 10.1097/BTH.0000000000000571

Jean-Baptiste de Villeneuve Bargemon, Thomas Daoulas, Lucas Audiffret, Camille Brenac

引用次数: 0

Intramedullary Fixation for Epibasilar Thumb Metacarpal Fractures: A Case Series. 拇指基底外侧掌骨骨折髓内固定一例。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2026-09-16 DOI: 10.1097/BTH.0000000000000570

Rachel Gottlieb, Jessica Greven, Arezo Ahmadi, Robin Kamal, Lauren M Shapiro

引用次数: 0

Anterior Deltoid to Biceps Transfer for Restoration of Elbow Flexion. 前三角肌至肱二头肌移位治疗肘关节屈曲。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2026-09-14 DOI: 10.1097/BTH.0000000000000569

Vigneswaran Varadharajan, Praveen Bhardwaj, Gugri M Sunay, Hari Venkatramani, S Raja Sabapathy

{"title":"Anterior Deltoid to Biceps Transfer for Restoration of Elbow Flexion.","authors":"Vigneswaran Varadharajan, Praveen Bhardwaj, Gugri M Sunay, Hari Venkatramani, S Raja Sabapathy","doi":"10.1097/BTH.0000000000000569","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000569","url":null,"abstract":"Major injuries to the infraclavicular or axillary region requiring axillary artery repair or reconstruction, a replantation carried out at the proximal third of the arm, or an infraclavicular brachial plexus palsy with failed nerve reconstruction pose a challenge to a reconstructive surgeon with only the shoulder remaining functional. We observed that patients with these injuries exhibited a 'trick' movement causing elbow flexion by abducting the shoulder beyond 90 degrees, which led us to use the anterior fibers of the deltoid extended with fascia lata graft as a donor to restore elbow flexion in them. 11 patients, including 9 males and 2 females, underwent the transfer. Patients were followed up at 1, 3, 6 months, and 1 year; functional outcomes were assessed at 1 year. The mean follow-up period was 27 months (4 to 88 mo). At 3 months of follow-up, all patients demonstrated active elbow flexion by initiating shoulder abduction. Nine of these patients with more than 1 year of follow-up demonstrated MRC grade 3 elbow flexion, with motion up to 120 degrees, independent of shoulder motion. Anterior deltoid transfer is a useful option for restoring elbow flexion when standard options are unavailable in selected cases and deserves a place in the reconstructive surgeon's armamentarium.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963868","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}

引用次数: 0

Pyrocarbon Hemiarthroplasty Via Lateral Approach for the Treatment of PIP Osteoarthritis. 经外侧入路热炭半关节置换术治疗PIP骨关节炎。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2026-08-24 DOI: 10.1097/BTH.0000000000000568

Istvan Zoltan Rigo, Preben Olsson Dovland, Asgeir Amundsen

引用次数: 0

Capsuloplasty of the Dorsal Carpometacarpal Ligament Complex by Arthroscopy in Carpometacarpal Instability Arthroscopic Assisted. 关节镜辅助下腕掌骨不稳患者掌背韧带复合体的关节囊成形术。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2026-08-12 DOI: 10.1097/BTH.0000000000000567

Fabio A Tandioy-Delgado, Andrea Atzei, Lucian L Marcovici, Riccardo Luchetti

{"title":"Capsuloplasty of the Dorsal Carpometacarpal Ligament Complex by Arthroscopy in Carpometacarpal Instability Arthroscopic Assisted.","authors":"Fabio A Tandioy-Delgado, Andrea Atzei, Lucian L Marcovici, Riccardo Luchetti","doi":"10.1097/BTH.0000000000000567","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000567","url":null,"abstract":"Background: Carpometacarpal (CMC) joint instability can arise from multiple factors, including rheumatoid arthritis, congenital abnormalities, connective tissue disorders, and acute or cumulative trauma. Early detection is crucial, as ligamentous laxity leads to joint incongruence, which, if left untreated, may progress to osteoarthritis(45) First-line treatment consists of immobilization with a splint combined with physical therapy. However, when conservative management fails, surgical stabilization of the CMC-1 joint becomes necessary. Traditional open techniques typically require bone tunnels and tendon harvesting. Technique: We present a novel arthroscopic technique that is less invasive and reinforces the dorsal capsule and dorsal ligaments complex. This approach, inspired by the Birman open procedure, is based on the concept that the dorsal ligament complex is the primary stabilizer of the CMC-1 joint. Results: Seven cases were followed for an average of 24 months. The mean visual analog scale (VAS) pain score was 0. The Kapandji score was 10. Grip strength reached 95% and pinch strength 92.5% of the contralateral hand. One complication was observed: transient irritation of the dorsal radial nerve.Conclusion: Arthroscopy is a viable option for capsuloplasty of the dorsal carpometacarpal ligament of the CMC-1 joint. It offers a minimally invasive alternative with fewer risks and less tissue damage while providing improved visualization of the joint, bone, and soft tissues and avoiding the need for complex joint reconstructions.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714067","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}

引用次数: 0

Counting the Crowd, Missing the Cliff: Why Surgeon Opinion Is Not Evidence. 数人群，错过悬崖：为什么外科医生的意见不是证据。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2026-07-24 DOI: 10.1097/BTH.0000000000000566

Alexander Y Shin, Nicholas Pulos

引用次数: 0

Reinsertion of the Extensor Pollicis Brevis for Correction of Z-Deformity in Advanced Thumb Carpometacarpal Osteoarthritis. 拇短伸肌置入矫治晚期拇指掌骨关节炎z型畸形。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2026-06-26 DOI: 10.1097/BTH.0000000000000564

Lorenzo Rocchi, Andrea Cruciani, Stella La Rocca, Arturo Militerno, Rocco De Vitis, Camillo Fulchignoni

{"title":"Reinsertion of the Extensor Pollicis Brevis for Correction of Z-Deformity in Advanced Thumb Carpometacarpal Osteoarthritis.","authors":"Lorenzo Rocchi, Andrea Cruciani, Stella La Rocca, Arturo Militerno, Rocco De Vitis, Camillo Fulchignoni","doi":"10.1097/BTH.0000000000000564","DOIUrl":"10.1097/BTH.0000000000000564","url":null,"abstract":"Thumb carpometacarpal (CMC) osteoarthritis in advanced stages is frequently associated with metacarpophalangeal (MCP) hyperextension, resulting in the characteristic Z-deformity and reduced pinch stability. Standard basal joint reconstruction may fail to correct MCP hyperextension, contributing to persistent functional impairment. Prosthetic trapeziometacarpal arthroplasty may partially correct Z-deformity but becomes unreliable when MCP hyperextension exceeds 30 degrees. This article describes a reproducible surgical technique combining trapeziectomy, APL suspension arthroplasty, and EPB reinsertion onto the dorsal aspect of the first metacarpal head to restore sagittal balance of the MCP joint. In this configuration, the EPB is intentionally converted from an active extensor into a passive dorsal stabilizer, providing a tenodesis-like restraint against hyperextension while preserving flexion arc. In 10 consecutive patients with Eaton-Littler stage III-IV disease and MCP hyperextension ≥30 degrees, mean hyperextension improved from 38.6 degrees preoperatively to 5.4 degrees at 12-month follow-up, with preservation of MCP flexion and improvement of key pinch strength and QuickDASH scores. This approach provides stable correction of MCP hyperextension while maintaining MCP motion, offering a motion-preserving alternative to capsulodesis or arthrodesis.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296704","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}

引用次数: 0

Metacarpal Malunion Correction With Crescentic Osteotomy. 新月形截骨术矫正掌骨畸形愈合。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2026-06-01 DOI: 10.1097/BTH.0000000000000550

Thomas J Berault, Andrew D Henebry

引用次数: 0