Journal of Hand Surgery-Asian-Pacific Volume最新文献

{"title":"Does Contralateral Elbow Radiography Improve Diagnostic Accuracy of Paediatric Elbow Fractures amongst Emergency Residents?","authors":"Nuphuditkan Kanjanakan, Sitthiphong Suwannaphisit, Chiroj Soorapanth, Alissara Vanichkulbodee, Chayanee Dechosilpa","doi":"10.1142/S2424835526500487","DOIUrl":"10.1142/S2424835526500487","url":null,"abstract":"<p><p><b>Background:</b> Paediatric elbow fractures are difficult to diagnose because secondary ossification centres can obscure radiographic interpretation. Emergency physicians often request contralateral elbow radiographs to improve diagnostic accuracy, although the benefit of this practice remains controversial. This study aimed to evaluate the impact of contralateral elbow radiographs and a targeted educational intervention on the diagnostic accuracy of emergency residents interpreting paediatric elbow fractures. <b>Methods:</b> This diagnostic study included 28 emergency residents at a tertiary hospital. Participants interpreted 23 paediatric elbow radiographic sets under 4 conditions: injured elbow only, injured plus contralateral elbow and the same evaluations after a targeted educational lecture. Diagnostic accuracy, sensitivity, specificity and confidence were analysed using paired statistical tests and regression models. <b>Results:</b> Mean diagnostic accuracy improved significantly after the educational lecture (median score increased from 14 to 17; <i>p</i> < 0.001). The addition of contralateral elbow radiographs did not significantly improve diagnostic accuracy or confidence either before or after the educational intervention. Regression analysis identified targeted education as the strongest predictor of improved diagnostic performance. <b>Conclusions:</b> Targeted educational interventions significantly enhance diagnostic accuracy in paediatric elbow fractures. The addition of contralateral elbow radiographs did not improve diagnostic performance in this controlled assessment setting. However, their selective use in specific clinical scenarios may still be beneficial, and clinical judgement remains essential. <b>Level of Evidence:</b> Level II (Diagnostic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"497-503"},"PeriodicalIF":0.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882367","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":"Outcomes of Nonsurgical Treatment of Ulnar-Sided Wrist Pain.","authors":"Hui-Yin Teh, Liying Pang, Un-San Tai, David Meng Kiat Tan, Ellen Y Lee","doi":"10.1142/S2424835526500451","DOIUrl":"10.1142/S2424835526500451","url":null,"abstract":"<p><p><b>Background:</b> Ulnar-sided wrist pain (USWP) is a frequent complaint, and triangular fibrocartilage complex (TFCC) injuries are amongst its most common aetiologies. Nonsurgical management of USWP is heterogeneous with variable periods of immobilisation. This study describes the outcome of a structured multiphase, conservative program for USWP that was clinically diagnosed as TFCC injuries in a single centre. <b>Methods:</b> Thirty-two individuals with USWP, foveal tenderness ± distal radio-ulnar joint (DRUJ) laxity diagnosed as TFCC injuries participated in the structured multiphase therapy program from 2020 to 2023 and were followed up prospectively. Assessments included numeric pain rating scale (NPRS), wrist range-of-motion, grip strength, weight-bearing ability, Modified Mayo Wrist Score (MMWS) and Patient-Specific Functional Scale (PSFS). The program comprised 4 weeks of splint immobilisation, 3-4 weeks of dynamic DRUJ stabiliser strengthening and 4 weeks of neuromuscular retraining. Outcomes were reassessed at 3 months and 1 year. <b>Results:</b> Twenty-nine patients were evaluated; 14 completed therapy, 15 defaulted and 21 were reviewed at 1 year. Amongst these 21 patients, mean NPRS decreased by 4 points and PSFS improved significantly. Completers also showed significant improvement in weight-bearing ability and were more likely to achieve excellent/good MMWS at 3 months than defaulters. All completers returned to regular work/activities at 1 year, compared with 9 of 10 contactable defaulters. None required surgery within 1 year. <b>Conclusions:</b> A structured multiphase therapy program for USWP clinically diagnosed as TFCC injury improved pain, function and weight-bearing ability. Completers were more likely to achieve excellent/good MMWS at 3 months, and no patient required surgery within 1 year. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"471-480"},"PeriodicalIF":0.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882473","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":"Revascularisation Beyond the Golden Hour: Managing Traumatic Brachial Artery Injuries in a Developing Country.","authors":"Sanjay Kumar Giri, Santanu Suba, Surya Yashaswi P V S, Reena Minz, Vishnu Swaroop Reddy","doi":"10.1142/S2424835526500529","DOIUrl":"10.1142/S2424835526500529","url":null,"abstract":"<p><p><b>Background:</b> Brachial artery injuries are common in upper limb trauma and require timely repair to prevent ischemia and limb loss. In developing countries like India, delayed presentation is frequent due to limited access to specialised care, inadequate infrastructure and delays in multidisciplinary coordination, complicating timely revascularisation. This study aimed to evaluate limb salvage outcomes and factors influencing prognosis in patients undergoing delayed repair of traumatic brachial artery injuries. <b>Methods:</b> This prospective study included 30 male patients (ages 18-58 years) with traumatic brachial artery injuries treated over 2 years. All patients presented more than 6 hours after injury. Emergency surgical repair was performed using either primary anastomosis or reversed vein grafts, with the great saphenous vein used in 14 patients and upper limb veins in others. Associated nerve and tendon injuries were repaired simultaneously. Fasciotomy was performed in 20 patients. Patients were followed up at regular intervals (2 weeks to 6 months), and outcomes were assessed in terms of limb salvage, complications and secondary procedures. <b>Results:</b> Out of 30 patients, 26 limbs (86.6%) were salvaged, and 4 (13.4%) required above-elbow amputation due to gangrene. Most patients (20/30) presented between 12 and 24 hours, with one case successfully revascularised at 92 hours post-injury. Ten patients underwent primary repair; 20 required vein grafting. Concomitant nerve injury was found in 26 patients, primarily affecting the median nerve (16 patients). Fasciotomy helped prevent irreversible ischemic damage. Two patients developed acute kidney injury, and 10 required negative pressure wound therapy followed by skin grafting. <b>Conclusions:</b> Delayed surgical repair of brachial artery injuries, even beyond conventionally accepted ischemic time thresholds, can achieve high limb salvage rates. However, systemic limitations in developing countries continue to pose major challenges to achieving timely intervention and optimal outcomes. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"527-536"},"PeriodicalIF":0.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882474","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":"Paediatric Hand Compartment Syndrome Secondary to Intravenous Contrast Extravasation: A Case Report.","authors":"Mehmet Ince, Evren Karaali, Mustafa Yasin Hatipoğlu","doi":"10.1142/S242483552672015X","DOIUrl":"10.1142/S242483552672015X","url":null,"abstract":"<p><p>Iodinated contrast extravasation is usually self-limited; however, in confined regions such as the dorsum of the hand - especially in paediatric patients - it can progress to acute compartment syndrome. We report a 9-year-old girl who developed hand compartment syndrome following extravasation of 50 mL iohexol (350 mgI/mL) via a 22G catheter during contrast-enhanced abdominal computed tomography. Despite standard extravasation management, symptoms progressed rapidly. Compartment syndrome was diagnosed clinically based on pain disproportionate to injury, refractory to analgesics, exacerbated by passive stretch, with paraesthesia and prolonged capillary refill. Emergency decompression was performed through five incisions. Delayed primary closure was achieved on postoperative day 5 without vacuum-assisted closure or skin grafting. At 6-month follow-up, grip strength equalled the contralateral side and QuickDASH score was 0. This case emphasises that moderate-volume contrast extravasation can rapidly cause compartment syndrome in the paediatric hand, and that standard extravasation protocols become contraindicated once compartment syndrome is suspected. <b>Level of Evidence:</b> V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"553-558"},"PeriodicalIF":0.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882484","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":"Persistent Radial or Midcarpal Malalignment after Corrective Osteotomy Does Not Affect Functional Outcome.","authors":"Simon B Kramer, Alexander Drost, Inger B Schipper, Niels W L Schep","doi":"10.1142/S2424835526500463","DOIUrl":"10.1142/S2424835526500463","url":null,"abstract":"<p><p><b>Background:</b> Distal radius malunion accompanied by increased dorsal angulation tends to alter wrist biomechanics, leading to a range of carpal malalignment patterns, which may affect both the radiocarpal (radiolunate) and midcarpal (capitolunate) joints. One type has radiocarpal malalignment with an aligned midcarpal joint, and the second type has midcarpal malalignment with an aligned radiocarpal joint. Previous studies have demonstrated that corrective osteotomy tends to restore normal radiocarpal and midcarpal alignment. However, we observed that radiocarpal and midcarpal malalignment persist in a subset of patients, despite appropriate correction of the malunited distal radius. The primary aim was to assess the effects of postoperative persistent carpal malalignment on functional outcomes by comparing the Patient-Rated Wrist Evaluation (PRWE) of patients with and without persistent radiocarpal or midcarpal malalignment following a corrective osteotomy of the distal radius. <b>Methods:</b> For this retrospective study, we screened all consecutive adult patients who had an extra-articular corrective osteotomy between January 2019 and 2024 for a distal radius malunion. Radiocarpal and midcarpal malalignment was assessed on pre- and postoperative radiographs by two researchers. The PRWE was evaluated during the standard postoperative follow-up. <b>Results:</b> This study showed that PRWE scores of patients with carpal malalignment did not differ from those of patients with normal carpal alignment, both preoperatively and postoperatively. Furthermore, the prevalence of all types of malalignment decreased following the corrective osteotomy, and all patients reported improved hand and wrist function, with a median improvement of 50 points on the PRWE. <b>Conclusions:</b> Midcarpal malalignment is common in distal radius malunions and may exist simultaneously with radiocarpal malalignment. Despite the presence of malalignment, all patients experienced improved function after the corrective osteotomy. Therefore, we conclude that persistent radial or midcarpal malalignment following a corrective osteotomy does not have an adverse effect on functional outcome. <b>Level of evidence:</b> Level III (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"481-488"},"PeriodicalIF":0.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882519","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":"Salvage Arthrodesis after Failed Trapeziometacarpal Total Joint Replacement: A Technical Note.","authors":"Rasmus Dehli Thorkildsen, Magne Røkkum","doi":"10.1142/S2424835526970076","DOIUrl":"10.1142/S2424835526970076","url":null,"abstract":"<p><p>In cases of failure of trapeziometacarpal total joint replacements, we have chosen a different strategy than trapeziectomy for high-demand patients (or patients dissatisfied with a contralateral previous trapeziectomy), performing a trapeziometacarpal arthrodesis with an interposed corticocancellous iliac crest graft. This article aims to describe the technique and report our results in three patients. Median age at revision arthrodesis was 60 years. The stems were removed with a dorsal bone-lid, leaving a defect into which the bone graft was fitted and fixed with cortical screws before impaction of the graft into the trapezial remnant with K-wire fixation proximally. Cast immobilisation was used for 8 weeks. At final follow-up, all fusions had healed, and patients were satisfied according to strength measurements and PROMs. While further validation in a larger cohort with longer follow-up is required, we believe the technique may be of value, particularly in high-demand patients. <b>Level of Evidence:</b> Level V (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"559-563"},"PeriodicalIF":0.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882574","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":"Staged Centralisation and Pollicisation for Radial Longitudinal Deficiency: A Case Series Emphasising Pre-pollicisation Index-Middle Finger Pinch Training.","authors":"Akira Kodama, Naoya Goto, Masaru Munemori, Yuichi Sumida, Shigeki Ishibashi, Nobuo Adachi","doi":"10.1142/S2424835526500384","DOIUrl":"10.1142/S2424835526500384","url":null,"abstract":"<p><p><b>Background:</b> Radial longitudinal deficiency (RLD) is a rare congenital malformation that severely impairs grasp and pinching due to radial ray and thumb hypoplasia or aplasia. Standard management typically involves early centralisation to align and stabilise the wrist, followed by pollicisation when the thumb cannot be reconstructed. However, little attention has been paid to pre-pollicisation-rehabilitation strategies that might facilitate the acquisition of postoperative pinch function. This study aimed to report early functional outcomes after staged reconstruction for severe RLD, highlighting a structured pre‑pollicisation programme that establishes index-middle finger pinch after wrist centralisation. <b>Methods:</b> We retrospectively reviewed four children (six hands) with RLD treated between 2022 and 2024 with staged reconstruction: (1) early orthotic management, (2) wrist centralisation at approximately 1 year of age and (3) pollicisation of the index finger at 2-3 years of age. All patients underwent a structured pre-pollicisation rehabilitation programme focussing on the development of index-middle finger pinch after centralisation. Outcomes at 6-18 months after pollicisation included grasp patterns and a tape measure-based pinch test. <b>Results:</b> All hands achieved cylindrical and spherical grasps, and four hands demonstrated early fine motor tasks, such as scissor use and pre-writing. The mean tape measure-pinch score was 3.5 points (range: 1-4) on a 5-point scale. One hand showed poorer function, corresponding to marked preoperative hypoplasia of the index donor finger. Wrist alignment and thumb opposition posture were maintained during the short-term follow-up period. <b>Conclusions:</b> Staged centralisation and pollicisation produced encouraging early functional outcomes in children with severe RLD. Pre-pollicisation-training to establish index-middle finger pinch after centralisation appeared to facilitate early acquisition of post-pollicisation-pinch and grasp, and may represent a simple, practical adjunct to standard surgical care. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"383-389"},"PeriodicalIF":0.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254449","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":"Quantification of Ulnar Nerve Elastic Modulus Using Shear Wave Elastography: A Study of Sex Differences in Healthy Adults.","authors":"Yumiko Yasuda, Akira Hara, Yoshihiro Shimomura","doi":"10.1142/S2424835526500414","DOIUrl":"10.1142/S2424835526500414","url":null,"abstract":"<p><p><b>Background:</b> In recent years, there has been a growing interest in the use of shear wave elastography (SWE) to evaluate neuromuscular lesions and follow-up treatment progress. SWE is a technique used to measure tissue stiffness; however, the factors influencing the elastic modulus obtained by SWE, as well as the reliability of the measured values, have not been sufficiently examined. This study introduces a reproducible SWE protocol for assessing the ulnar nerve in healthy adults and investigates differences in elastic modulus by sex, side (left/right), measurement site and the presence or absence of ulnar nerve dislocation. <b>Methods:</b> A total of 48 ulnar nerves of 24 healthy adults were evaluated. The elastic modulus was measured using SWE. The elastic modulus was measured at two locations with the elbow in full extension (0°): 5 cm proximal to the medial epicondyle (ME; upper arm) and 5 cm distal to the ME (forearm). <b>Results:</b> The coefficient of variance for the elastic modulus was <0.05, indicating stable measurement. No significant differences or interactions were observed based on side (left/right), measurement site or ulnar nerve dislocation status. However, a significant sex difference in the ulnar nerve elastic modulus was found (<i>F</i> = 47.74, <i>p</i> < 0.001), indicating that the nerve was stiffer in males than in females. In the elastic modulus distribution, males tended to have a higher median value in the right forearm, whereas females showed significant asymmetry between the left and right forearms. <b>Conclusions:</b> This study established a reproducible SWE protocol and explored sex-based and anatomical differences in ulnar nerve elastic modulus, providing foundational data for future cubital tunnel syndrome (CuTS) diagnostics. <b>Level of Evidence:</b> Level IV (Diagnostic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"407-414"},"PeriodicalIF":0.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254424","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":"Time-Dependent Features of Complications Following Surface Replacement Arthroplasty for Primary Osteoarthritis of Proximal Interphalangeal Joint.","authors":"Ryosuke Sato, Yoshitaka Hamada, Yoshitaka Minamikawa, Takeyasu Toyama, Takanori Saito, Koichi Sairyo","doi":"10.1142/S2424835526500372","DOIUrl":"10.1142/S2424835526500372","url":null,"abstract":"<p><p><b>Background:</b> The extended dorsal central splitting approach (EDCSA) in surface replacement arthroplasty (SRA) for primary osteoarthritis of the proximal interphalangeal (PIP) joint contributes to overcoming problems associated with the volar approach. However, new issues associated with the dorsal approach have become apparent. This study aimed to evaluate the time-dependent features of complications following SRA performed using the EDCSA for primary osteoarthritis of the PIP joint. <b>Methods:</b> This retrospective case series study included 188 patients (140 women and 48 men; 240 fingers) who underwent SRA for primary osteoarthritis of a PIP joint between 2017 and 2024 and were followed up for at least 1 year. Medical records and radiographs were reviewed to identify complications and any revision procedures performed during follow-up. <b>Results:</b> The mean duration of postoperative follow-up was 5.3 years. The mean active arc of motion at the PIP joint improved from 39° preoperatively to 64° at the latest follow-up. Postoperative complications occurred in 62 fingers (26%), and 33 fingers (14%) required revision surgery. Complications involving soft tissues were most common, followed by extension contracture or flexion contracture. The temporal distribution of complications revealed two distinct peaks: early complications within 6 months, which were predominantly flexion contracture, and late complications after 12 months, which were mainly extension contracture with or without swan-neck deformity. No serious new complications were identified beyond 3 years after surgery. <b>Conclusions:</b> SRA for osteoarthritis of a PIP joint continues to be refined, with ongoing efforts to improve outcomes and reduce the risk of complications. The EDCSA provides reliable exposure and allows early rehabilitation, resulting in favourable medium-term outcomes with respect to range of motion, but still has a non-negligible complication rate. Complications show characteristic time-dependent patterns and can be attenuated by timely intervention. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"376-382"},"PeriodicalIF":0.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254454","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":"Systematic Review of Outcomes Following Single Central Ray Amputation of the Hand.","authors":"Julia Nazario Motta, Stefano Capella, Holly Morris, Katharine Hamlin","doi":"10.1142/S2424835526500438","DOIUrl":"10.1142/S2424835526500438","url":null,"abstract":"<p><p><b>Background:</b> Ray amputation is an uncommon but occasionally necessary procedure in select clinical scenarios. The ray can be resected at different skeletal levels. This systematic review aimed to evaluate the outcomes following single central ray amputation, with particular attention to functional recovery, return to work and complications and compare them by bony resection level. <b>Methods:</b> A systematic review of the literature was undertaken, identifying 25 studies reporting on 238 patients who had undergone single central ray amputation. Extracted data included range of motion (ROM), grip strength, return to work, patient-reported outcome measures (PROMs) and post-operative complications. <b>Results:</b> Of those reported, 90% of patients achieved a 'full' ROM following surgery. The mean time off work was 95 days, with 71% returning to their previous occupation. Average grip strength was 69% of the contralateral hand. No technique emerged as superior for the outcomes measured. Functional tests and PROMs were infrequently reported. Complications such as scissoring, malrotation and painful neuroma were described. <b>Conclusions:</b> The overall quality of evidence was low, with considerable heterogeneity between studies, thereby limiting direct comparisons. The most important determinant of outcome appeared to be the degree of concomitant trauma sustained by the remaining structures of the hand. <b>Level of Evidence:</b> Level IV (Therapeutic).</p>","PeriodicalId":51689,"journal":{"name":"Journal of Hand Surgery-Asian-Pacific Volume","volume":" ","pages":"422-434"},"PeriodicalIF":0.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254489","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}