Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...最新文献

{"title":"[Results of the Intramedullary Elevation Technique for Unstable Middle Phalanx Base Impression Fractures].","authors":"Daniel Vergote, Martin Mentzel, Michael Lebelt, Richard-Tobias Moeller, Simon Bauknecht","doi":"10.1055/a-2809-2244","DOIUrl":"10.1055/a-2809-2244","url":null,"abstract":"<p><strong>Background: </strong>Impression fractures of the base of the middle phalanx represent a therapeutic challenge due to central joint incongruity and a tendency towards dorsal subluxation. This study aimed to present the clinical and radiological outcomes of a larger patient cohort treated using the intramedullary tamping technique described by Hintringer and Ender.</p><p><strong>Material and methods: </strong>A retrospective analysis of 92 patients (2012-2024) with unstable fractures of the base of the middle phalanx base was performed. Reduction was achieved percutaneously using a pre-bent intramedullary Kirschner wire, followed by retention with additional wires. Clinical and radiological endpoints, functional outcomes according to the classification of the American Society for Surgery of the Hand (ASSH), as well as complications were recorded.</p><p><strong>Results: </strong>Median impression depth was reduced from a median of 2.6 mm (0.6-5.5 mm) preoperatively to 0.7 mm (0-2.9 mm) postoperatively. The median total range of motion (ROM) was 210° (90°-335°). Outcome was excellent in 19 patients, good in 37 patients, fair in 32 patients, and poor in 4 patients based on the criteria of the American Society for Surgery of the Hand (ASSH). Patient age had a significant influence on ROM, whereas fracture type, timing of surgery, and residual impression did not reach statistical significance. Median operative time was 18 minutes. Three clinically relevant complications occurred.</p><p><strong>Conclusion: </strong>The intramedullary tamping technique according to Hintringer and Ender is a safe, time-efficient and cost-effective treatment option with low complication rates and good functional outcomes. It allows direct reduction of centrally impacted fragments and remains feasible even in cases of delayed presentation.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":"236-242"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470765","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":"An Assessment of the Effect of Intranodular Steroid Injection on Inhibiting the Progression of Early-Stage Dupuytren&apos;s Disease: A Preliminary Report.","authors":"Andrzej Zyluk, Filip Flicinski","doi":"10.1055/a-2760-7447","DOIUrl":"10.1055/a-2760-7447","url":null,"abstract":"<p><strong>Abstract: </strong>The rationale for intranodular steroid injections in Dupuytren's disease was based on clinical and experimental studies demonstrating the inhibitory effect of steroids on connective tissue proliferation and on degradation of mature collagen in hypertrophic scars. This prompted clinicians to use steroid injections to treat Dupuytren's nodules.</p><p><strong>Abstract: </strong>OBJECTIVE:  This study aimed to evaluate the effect of steroid injections into Dupuytren's nodules on inhibiting early-stage disease progression.</p><p><strong>Abstract: </strong>MATERIALS AND METHODS:  A total of 28 patients (16 men and 12 women; mean age: of 61 y) with early-stage Dupuytren's disease in 33 hands received 2 or 3 intranodular steroid injections (methylprednisolone or betamethasone) at 2-week intervals. The patients were followed for 14 months on average (range: 12-16 mo) by a phone call.</p><p><strong>Abstract: </strong>RESULTS:  A series of steroid injections resulted in pain reduction in all 17 symptomatic nodules. Softening of the nodule was observed in 22 hands (67%), softening and reduction of size in 7 hands (21%), and no changes in 4 hands (12%). No cases of disease progression and no complications were recorded.</p><p><strong>Abstract: </strong>CONCLUSIONS:  Intralesional steroid injections may be an effective first-line treatment for early-stage Dupuytren's disease, particularly in symptomatic nodules.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":"220-224"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004788","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":"Push-Up Techniques Affect Elbows and Shoulders: How Should They Be Used?","authors":"Olga Polovinets, Alon Wolf, Scott Friedlander, Ronit Wollstein","doi":"10.1055/a-2862-1658","DOIUrl":"10.1055/a-2862-1658","url":null,"abstract":"<p><strong>Background: </strong>Push-ups are performed ubiquitously as a means of strengthening/training and evaluating the upper extremity. However, push-ups performed on the hands with the wrist extended can cause wrist, elbow and shoulder injuries, which may result in disability. Conversely, individuals with a prior wrist or elbow injury are unable to perform push-ups. Our purpose was to evaluate movement patterns in two push-up styles (neutral and extended wrist) at the elbow and shoulder joints. We hypothesized that force-transfer will differ between the two styles, allowing the adjustment of training protocols according to athletic and physiologic needs.</p><p><strong>Patients and methods: </strong>Fourteen healthy right-handed male volunteers performed push-ups on a neutral wrist and a hyperextended wrist in the gait analysis laboratory. Skin markers were applied over fixed points in the upper extremity. A Vicon motion capture system was used to follow the kinematics. Force vectors were measured using force plates.</p><p><strong>Results: </strong>The movement and transfer of forces through the shoulder and elbow differ between the push-up styles. The shoulder moves more, in general, in a circular direction, when a push-up is performed on a neutral wrist compared to a push-up performed on an extended wrist. The shoulder is exposed to more load when the push-up is performed on a neutral wrist. The elbow moves less in general, and less in the medial and lateral planes, when the push-up is performed on a neutral wrist. The elbow is exposed to less load when the push-up is performed on a neutral wrist. The direction of forces through the joints differs between the two styles and the amount of force traversing the joints is inverse between the two styles.</p><p><strong>Conclusions: </strong>The movement through the elbow and shoulder is distributed differently during different styles of push-ups. The wrist and elbow can be relatively protected from ligament injury when push-ups are performed on a neutral wrist.</p><p><strong>Conclusions: </strong>Understanding the kinematics during different patterns of loading of the upper extremity can enable a tailored approach to strengthening training, treatment, and rehabilitation of the upper extremity. Specifically, differential strengthening and loading certain areas may be used for training protocols for a specific athletic task (such as throwing).</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":"58 3","pages":"243-251"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221595","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":"[Acute reconstruction of the thumb utilizing a microvascularized femoral condyle flap].","authors":"Stephan Paier, Stefanie Tegelhofer, Martin Liebhauser, Maximilan Neuwirth, Matthias Rab, Heinz K Bürger","doi":"10.1055/a-2849-0198","DOIUrl":"10.1055/a-2849-0198","url":null,"abstract":"","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":"277-279"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849060","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 Hand Trauma Registry of the German Society for Hand Surgery: Analysis of National Treatment Trends During the COVID-19 Pandemic].","authors":"Simeon C Daeschler, Martin Aman, Philipp Rieth, Benjamin Panzram, Arne Hendrik Böcker, Leila Harhaus","doi":"10.1055/a-2836-6004","DOIUrl":"10.1055/a-2836-6004","url":null,"abstract":"<p><strong>Background: </strong>The Hand Trauma Registry (HTR) of the German Society for Hand Surgery (DGH) was established to systematically and nationally record hand injuries and their treatment. The aim of this study was to examine the impact of the COVID-19 pandemic on injury patterns, mechanisms of trauma, and the treatment of hand injuries.</p><p><strong>Materials and methods: </strong>In this retrospective multicenter registry study, 14,072 patients with a total of 41,119 surgically treated hand injuries were analyzed from the HTR. Data were grouped according to five defined pandemic phases and compared with regard to age, injury pattern, insurance type, mechanism of injury, and treatment timing (significance level p<0.05).</p><p><strong>Results: </strong>The age distribution changed significantly during the pandemic (p<0.001): during the first lockdown, the proportion of children and adolescents decreased, while the 19-30-year age group was more frequently affected. Isolated hand injuries occurred less often (32.1% vs. 42.7% pre-pandemic), while the frequency of multiple injuries increased (p<0.001). Among patients with statutory accident insurance, fall injuries rose from 10.9% to 19.2%, while circular saw injuries significantly increased among those with public health insurance during the first lockdown (p<0.001). The time to surgical treatment decreased from 52.6 to 27.1 hours (p<0.001), while the proportion of definitive treatments remained consistently above 90% across all phases.</p><p><strong>Conclusion: </strong>The COVID-19 pandemic had significant effects on the epidemiology, mechanisms of injury, and timing of treatment for hand injuries in Germany. These changes illustrate how external crises can influence medical care delivery. The HTR enables data-based analysis of such developments and supports evidence-based planning of future treatment and prevention strategies.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":"194-201"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849057","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":"State of the Art: Scapholunate Ligament Injuries.","authors":"Dany Y Matar, Adriana Panayi, Martin Aman, Gabriel Hundeshagen, Sami Tuffaha, Leila Harhaus, Frank Eichenauer","doi":"10.1055/a-2807-3475","DOIUrl":"10.1055/a-2807-3475","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Abstract: &lt;/strong&gt;Scapholunate ligament injuries are the most common ligamentous injuries of the wrist and typically result from high-energy trauma, most often following a fall onto the outstretched hand. This comprehensive review summarizes the current knowledge regarding scapholunate ligament injuries, including anatomy, pathophysiology, diagnostic approaches, and management strategies. Scapholunate ligament injuries primarily affect individuals aged 20-50 years, with male patients at higher risk due to participation in high-impact activities. Despite their prevalence, these injuries are challenging to diagnose due to subtle clinical presentations and limitations of imaging modalities, often leading to delayed recognition and progression to scapholunate advanced collapse, a severe form of wrist arthritis. The scapholunate ligament plays a critical role in maintaining wrist stability, with its dorsal component being biomechanically most important. Pathophysiology ranges from partial tears causing dynamic instability to complete disruptions leading to static malalignment and degenerative changes. Advances in diagnostic modalities, including high-resolution magnetic resonance imaging, wrist arthroscopy, and dynamic computed tomography or ultrasonography, have improved detection. Meanwhile, classification systems like Geissler, Mayo and Garcia-Elias help guide treatment strategies. Management is determined by injury severity and chronicity. Conservative approaches, such as immobilization and physical therapy, are effective for partial injuries, while surgical interventions, including ligament repair, reconstruction, and salvage procedures, are reserved for more severe cases. Newer arthroscopic techniques, biological augmentations, and minimally invasive approaches have improved outcomes and reduced complication rates. Rehabilitation and long-term follow-up remain essential to optimize recovery and monitor for degenerative changes. Emerging technologies, including dynamic implants and artificial intelligence for diagnostics, promise further advances. Nevertheless, early diagnosis and timely intervention remain critical to preventing chronic dysfunction and improving patient quality of life.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Zusammenfassung: &lt;/strong&gt;Verletzungen des Skapholunären-Bandapparates (SLLI) sind die häufigsten Bandläsionen des Handgelenks und entstehen meist nach hochenergetischen Traumata, typischerweise nach Stürzen auf die ausgestreckte Hand. Diese Übersicht bündelt den aktuellen Stand zu Anatomie, Pathophysiologie, Diagnostik und Therapie. Betroffen sind vor allem 20- bis 50-Jährige; Männer tragen durch belastungsintensive Aktivitäten ein höheres Risiko. Trotz ihrer Häufigkeit bleiben SLLI wegen subtiler klinischer Zeichen und Grenzen der Bildgebung oft lange unentdeckt, was das Fortschreiten bis zum fortgeschrittenen skapholunären-Kollaps - einer schweren Form der Handgelenksarthrose - begünstigt. Das scapholunare Band (SLL) ist essentiell fü","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":"252-264"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147877207","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":"[Clearing the Path: Enhancing Kidney Transplant Access Through Panniculectomy].","authors":"Dominik Promny, Adrian Sebald, Katharina Heller, Theresa Promny, Andreas Arkudas, Ingo Ludolph, Raymund E Horch","doi":"10.1055/a-2763-5531","DOIUrl":"https://doi.org/10.1055/a-2763-5531","url":null,"abstract":"<p><strong>Background and objective of the study: </strong>Obesity poses an increasing challenge in transplant medicine for patients with end-stage renal disease (ESRD). Despite weight reduction, many of these patients are excluded from kidney transplantation due to a pronounced abdominal panniculus, as this region is prone to wound healing complications and impedes surgical access. The aim of this study was to further evaluate the safety and clinical relevance of abdominal panniculectomy - previously investigated in a pilot study - as a means to improve transplant eligibility in obese ESRD patients.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 16 ESRD patients who underwent panniculectomy between 2016 and 2025 in preparation for a planned kidney transplantation. Collected data included demographic characteristics, perioperative parameters, postoperative complications, and transplant outcomes.</p><p><strong>Results: </strong>At the initial presentation to the transplant centre, the mean body mass index (BMI) was 41.1 kg/m² (range 28.5-58.1 kg/m²) and was reduced to 32.1 kg/m² (range 28.1-36.7 kg/m²) prior to panniculectomy. No major complications occurred; only two patients experienced minor wound healing issues that did not require surgical revision. All patients except one were listed as active transplant candidates six weeks after panniculectomy. No postoperative wound complications occurred in the transplanted patients.</p><p><strong>Conclusion: </strong>Abdominal panniculectomy is a safe and effective procedure for optimising the surgical conditions in obese ESRD patients. In an interdisciplinary, two-stage approach, it can successfully prepare patients previously ineligible for kidney transplantation. The study highlights the importance of individualised surgical strategies in highly selective high-risk populations.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937142","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":"[Soft Tissue-Preserving Osteosynthesis Techniques and Surgical Approaches in Extremity Reconstruction: A Review].","authors":"Katharina Sommer, Ingo Marzi, Johannes Frank","doi":"10.1055/a-2781-1450","DOIUrl":"10.1055/a-2781-1450","url":null,"abstract":"<p><p>Minimally invasive osteosynthesis techniques have gained widespread acceptance in the surgical management of extremity fractures due to their potential to reduce complication rates and enhance both wound and fracture healing. Ongoing development and validation of novel techniques and surgical approaches have allowed for a continuous expansion of indications. In addition, emerging technologies such as computer-assisted navigation and three-dimensional planning - utilizing patient-specific, 3D-printed reduction guides and implants - are expected to further expand and refine minimally invasive approaches in the future. Nevertheless, appropriate indication and a precise understanding of regional anatomy remain critical to avoid complications such as nerve injuries or nonunion resulting from inadequate osteosynthesis.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":"58 2","pages":"151-163"},"PeriodicalIF":0.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694720","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 Evolution of Orthoplastic Surgery: Interdisciplinary Collaboration as the Key to Limb Salvage].","authors":"Lucian P Jiga, Benedikt Merwart, Zaher Jandali, Heinz Bürger","doi":"10.1055/a-2781-1389","DOIUrl":"10.1055/a-2781-1389","url":null,"abstract":"<p><p>Groundbreaking technological advances in plastic and orthopedic surgery have contributed to substantially increasing the overall limb-salvage rates over recent decades. Adequate reconstruction of complex tissue defects of diverse etiologies - including traumatic, oncologic, ischemic, and infectious causes - has become highly feasible through the application of advanced reconstructive techniques and plays a pivotal role in preserving limb function and markedly improving patients' quality of life. The success of such complex reconstructive strategies requires a multidisciplinary team capable of integrating diverse surgical competencies - such as skeletal stabilization, soft-tissue coverage, and vascular reconstruction - into a coherent treatment pathway. Orthoplastic surgery is founded on the close collaboration between orthopedic surgeons and plastic-reconstructive microsurgeons, whose complementary expertise facilitates both the execution of intricate reconstructions and a well-founded assessment of limb-salvage potential. This article outlines the roles of orthopedic and plastic-reconstructive surgeons as core pillars of an orthoplastic care model and illustrates how this interdisciplinary approach can address the multifaceted challenges in limb reconstruction.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":"58 2","pages":"164-173"},"PeriodicalIF":0.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694761","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 Detection of Systemic Amyloidosis through Routine Histological Examination in Risk Patients Undergoing Carpal Tunnel Surgery].","authors":"Irene Mesas Aranda, Stéphanie Kristina Schwarting, Anne Mieke Kaas, Christoph Röcken, Casra Sam Shahidi, Cecilia Mentz, Frederick Klauschen, Riccardo E Giunta","doi":"10.1055/a-2778-5013","DOIUrl":"10.1055/a-2778-5013","url":null,"abstract":"<p><p>Carpal tunnel syndrome (CTS) may represent an early manifestation of systemic amyloidosis. Musculoskeletal manifestations such as CTS, trigger finger, or Dupuytren's disease may precede cardiac or neurological symptoms by many years, thereby opening a potentially relevant diagnostic window.We conducted a retrospective-prospective analysis of all carpal tunnel release procedures performed at our center between 2013 and 2025. For the period from 2013 to 2023, demographic data and information on tissue excision and histological examination were collected. For 2024, an additional retrospective histological re-examination of available specimens was performed using Congo red staining and polarization microscopy. Beginning in May 2025, biopsies from trigger finger release and partial aponeurectomy for Dupuytren's disease were also prospectively examined. In addition, a narrative literature review on the clinical relevance of musculoskeletal manifestations in amyloidosis was conducted.Among 990 carpal tunnel releases, tissue samples were obtained in 32.4% (n=321), and 25.2% (n=81) were histologically examined. Amyloid deposits were detected in 18.8% (n=15) of the samples. The median age of amyloid-positive patients was 82 years; men were more frequently affected (73%; OR 4.6; p=0.001). Musculoskeletal red-flag conditions were strongly associated with amyloid detection (RR 6.0; p<0.001). Cardiac comorbidities were present in 37.5% of amyloid-positive patients, including two with confirmed cardiac amyloidosis. Five patients showed neither cardiac nor neurological symptoms. In biopsies obtained during trigger finger release (since May 2025), amyloid deposits were identified in 15.4%, while no deposits were found in partial aponeurectomies for Dupuytren's disease.Our results support the observation that amyloid deposits can be detected during hand surgery procedures. Targeted histopathological examination of synovial tissue samples obtained during carpal tunnel or A1 pulley release procedures may serve as a valuable tool for the early detection of systemic amyloidosis. Given the high number of undiagnosed cases and the prognostic relevance, the integration of a risk-adapted biopsy strategy into existing guidelines should be considered.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":"58 2","pages":"98-110"},"PeriodicalIF":0.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694767","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}