Hand Surgery & Rehabilitation最新文献

{"title":"Musculotendinous lengthening procedures and tendon transfers for upper limb spasticity","authors":"Bertrand Coulet, Pierre Louis Coulet, Pierre Emmanuel Chammas, Flavia Coroian, Isabelle Laffont","doi":"10.1016/j.hansur.2026.102744","DOIUrl":"10.1016/j.hansur.2026.102744","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 ","pages":"Article 102744"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Operative management of self-inflicted upper extremity amputations: A retrospective case series","authors":"Yehuda A. Masturov,&nbsp;Annie C. Schmidt,&nbsp;Keziah Smallhorne,&nbsp;Jacob Zeitlin,&nbsp;Christopher Ferry,&nbsp;Andrew Miller","doi":"10.1016/j.hansur.2026.102682","DOIUrl":"10.1016/j.hansur.2026.102682","url":null,"abstract":"<div><h3>Introduction</h3><div>Self-inflicted upper extremity amputation is a rare injury which leaves surgeons with unique operative considerations. Although psychiatric decompensation is traditionally considered a contraindication to replantation, available evidence is limited to isolated case reports and small series. Hence, we sought to describe the injury characteristics, psychiatric comorbidities, operative decision-making, and clinical outcomes of patients with self-inflicted upper extremity amputations.</div></div><div><h3>Methods</h3><div>A retrospective review of traumatic upper extremity amputations and replantations was performed from January 1, 2017, to December 31, 2024. Accidental, occupational, non–self-inflicted injuries and all lower extremity amputations were excluded. Demographics, psychiatric history, injury characteristics, operative management, postoperative course, adherence to therapy, and clinical outcomes were summarized descriptively.</div></div><div><h3>Results</h3><div>Seven patients met inclusion criteria; five were male (71%). Most patients reported the injury as a suicide attempt (71%). Major depressive disorder was the most common psychiatric diagnosis (57%). Injury mechanisms were knife (43%), saw (43%), and lawnmower-related trauma (14%). Amputation levels included digits (43%), midcarpal row (29%), and distal forearm (29%); 29% were bilateral. Three patients (43%) underwent replantation and four (57%) underwent revision amputation. All patients underwent surgical intervention prior to psychiatric consultation, and no patient was denied replantation due to psychiatric instability. No acute postoperative suicide attempts or attempts at re-amputation were documented in the replantation group.</div></div><div><h3>Conclusion</h3><div>Psychiatric comorbidity did not preclude operative replantation and no patients attempted reinjury or re-amputation during observed follow-up. Although the heterogeneity of these injuries confers unique reconstructive challenges and rehabilitation demands, replantation decisions should be guided by objective surgical criteria, anticipated postoperative engagement, rehabilitation potential, and the likelihood of achieving meaningful functional recovery, with early psychiatric involvement to support stability and optimize longitudinal outcomes.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 4","pages":"Article 102682"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carpal tunnel-targeted treatment in patients with CRPS-like symptoms: a retrospective cohort study of irritative carpal tunnel syndrome","authors":"Cyrielle Lavigogne,&nbsp;Michiel Cromheecke,&nbsp;Pieter-Bastiaan De Keyzer,&nbsp;Peter Coeman,&nbsp;Jean Goubau","doi":"10.1016/j.hansur.2026.102715","DOIUrl":"10.1016/j.hansur.2026.102715","url":null,"abstract":"<div><h3>Background</h3><div>Complex Regional Pain Syndrome (CRPS) of the upper limb represents a heterogeneous clinical condition with an incompletely understood pathophysiology and often unsatisfactory treatment outcomes. Mechanical contributors within the carpal tunnel, including impaired neural and tendinous gliding, have recently been proposed as a potential factor in a subset of patients presenting with CRPS-like symptoms, conceptualized as ‘irritative carpal tunnel syndrome (ICTS)’. The clinical impact of this hypothesis remains under investigation.</div></div><div><h3>Objective</h3><div>This study aimed to explore clinical and functional outcomes following targeted carpal tunnel treatment, including corticosteroid injection and transverse carpal ligament release, in patients presenting with CRPS-like symptoms and clinical features suggestive of irritative carpal tunnel syndrome.</div></div><div><h3>Methods</h3><div>A retrospective cohort of 26 patients presenting with CRPS-like symptoms after upper limb trauma or prior surgery between June 2021 and April 2024 was evaluated; 2 patients were totally lost to follow-up, leaving an evaluation of 24 patients. All patients fulfilled the Budapest criteria for CRPS and demonstrated clinical features suggestive of the irritative carpal tunnel syndrome. Patients were managed with corticosteroid injection and/or surgical release of the transverse carpal ligament based on clinical presentation. Outcomes were assessed using the Visual Analog Scale (VAS) for pain, the QuickDASH questionnaire, and patient satisfaction.</div></div><div><h3>Results</h3><div>Twenty-one patients underwent surgical transverse carpal ligament release, while three achieved sustained improvement following corticosteroid injection alone. Among patients completing full outcome measures (n = 18), mean VAS pain scores decreased from 70/100 pre-treatment to 11/100 post-treatment, with 56% of respondents reporting complete pain relief (p &lt; 0.001). Mean QuickDASH scores (n = 14) improved by 38 points, from 59/100 to 21/100 (p &lt; 0.001). Overall patient satisfaction was high, with 94% of respondents reporting a satisfaction score ≥8/10. No major treatment-related complications were observed.</div></div><div><h3>Conclusion</h3><div>Carpal tunnel-targeted treatment was associated with substantial pain reduction and functional improvement in a subset of patients presenting with CRPS-like symptoms and clinical features suggestive of irritative carpal tunnel syndrome. These findings support the potential role of mechanical contributors within the carpal tunnel in the heterogeneous clinical spectrum of CRPS and warrant further prospective investigation.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 4","pages":"Article 102715"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple tendon transfer under WALANT — A retrospective case series","authors":"Zhi Yang Ng,&nbsp;Leo Tsz-Ching Chau,&nbsp;Camelia Qian Ying Tang,&nbsp;Michael Chu-Kay Mak,&nbsp;Wing-Lim Tse,&nbsp;Pak-Cheong Ho","doi":"10.1016/j.hansur.2026.102722","DOIUrl":"10.1016/j.hansur.2026.102722","url":null,"abstract":"<div><h3>Background</h3><div>Wide awake local anaesthesia no tourniquet (WALANT) has gained wide acceptance in Hand Surgery. However, despite its purported benefits in tendon surgery, the current literature is scarce regarding multiple tendon transfers for addressing nerve palsies. The purpose of the current study is to report on the clinical and functional outcomes of multiple tendon transfers under WALANT.</div></div><div><h3>Methods</h3><div>Patients with peripheral nerve palsies who underwent multiple tendon transfers under WALANT from March 2015 to March 2025 are retrospectively recruited from a territory orthopaedic referral hospital.</div></div><div><h3>Results</h3><div>14 patients with various types of nerve palsies (4 radial, 7 PIN, 2 ulnar, 1 median) underwent multiple tendon transfers and various ancillary procedures under WALANT (average volume administered = 68.9 ml; range, 30–115) were recruited. The average age of this cohort was 49 years (range, 24−69), with an average operative time of 207 min (range, 122–265). The mean follow-up was 37 months (range, 1−106) with no secondary revision procedures required. Patients achieved a mean of 3.7 (range, 1−5) on the MRC scale following tendon transfer. This is the largest reported series of multiple tendon transfers performed under WALANT to date.</div></div><div><h3>Level of evidence</h3><div>IV.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 4","pages":"Article 102722"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoid osteoma of the ulnar sesamoid of the thumb metacarpophalangeal joint: an exceptional cause of chronic thumb pain","authors":"Stéphane MEO","doi":"10.1016/j.hansur.2026.102643","DOIUrl":"10.1016/j.hansur.2026.102643","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 4","pages":"Article 102643"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147506038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proximally ascending Dupuytren’s contracture with wrist and elbow involvement: a 22-year clinical course","authors":"Kaitlyn M. Hohl,&nbsp;Krishna D. Unadkat,&nbsp;Shelley S. Noland,&nbsp;Marco Rizzo","doi":"10.1016/j.hansur.2026.102690","DOIUrl":"10.1016/j.hansur.2026.102690","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 4","pages":"Article 102690"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148019654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distal radioulnar joint pseudotumoral calcinosis in scleroderma: A case report","authors":"Jeanne Chartrin,&nbsp;Philippe Liverneaux","doi":"10.1016/j.hansur.2026.102694","DOIUrl":"10.1016/j.hansur.2026.102694","url":null,"abstract":"<div><div>Systemic sclerosis is a rare autoimmune connective tissue disorder that may be associated with soft tissue calcinosis, most commonly involving the fingers. Peri-articular involvement of the wrist is exceptional and rarely described.</div><div>We report the case of a 56-year-old man with systemic sclerosis who presented with progressive functional impairment of the right wrist, characterized by pain, decreased strength, and reduced range of motion, without neurological involvement. Imaging demonstrated peri-articular calcinosis of the distal radioulnar joint.</div><div>Surgical excision of the calcinosis combined with distal radioulnar joint arthrolysis was performed. Postoperative outcomes were marked by significant clinical improvement, including pain reduction, recovery of strength, and improved range of motion.</div><div>This case highlights the importance of considering this diagnosis in patients presenting with progressive wrist dysfunction and supports the role of targeted surgical management in localized and symptomatic forms.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 4","pages":"Article 102694"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical decision-making for thumb carpometacarpal osteoarthritis in patients younger than 50, how anticipate?","authors":"Nicolas Bigorre,&nbsp;Christophe Andro,&nbsp;Guillaume Bacle,&nbsp;Isabelle Brechet,&nbsp;Frédéric Degez,&nbsp;Morgan Freslon,&nbsp;Tristan Lascar,&nbsp;François Loisel,&nbsp;Flore-Anne Lecoq,&nbsp;Maxence Liot,&nbsp;Laurent Obert,&nbsp;Fabrice Rabarin,&nbsp;Adeline Cambon","doi":"10.1016/j.hansur.2026.102718","DOIUrl":"10.1016/j.hansur.2026.102718","url":null,"abstract":"<div><h3>Background</h3><div>Carpometacarpal osteoarthritis of the thumb is classically considered a degenerative disease of middle-aged and elderly patients but may present before age 50. In this younger population, surgical decisions are especially challenging: patients have long remaining hand-use expectations, and any operative intervention, regardless of technique, carries a risk of deterioration, failure, or need for revision. This narrative review aims to analyse the specific challenges associated with the management of carpometacarpal osteoarthritis of the thumb in patients under 50 years of age and to introduce the concept of early surgical intervention. This narrative review aims to analyse the specific challenges associated with the management of the first carpometacarpal osteoarthritis of the thumb in patients under the age of 50, to better define the indications and expected outcomes of early surgical intervention, and to situate the decision to undergo surgery within the context of a long-term preventive strategy.</div></div><div><h3>Methods</h3><div>A narrative review of the literature was conducted, focusing on epidemiology, biomechanics, non-surgical treatment and the main surgical options reported for young or active patients, including arthroscopy, denervation, metacarpal osteotomy, chondrocostal grafting, trapeziectomy, pyrocarbon interposition, total arthroplasty and arthrodesis.</div></div><div><h3>Results</h3><div>The available literature remains heterogeneous and primarily specific to certain techniques, with variable age thresholds and limited data devoted exclusively to patients under 50 years of age. Most procedures can provide pain relief and functional improvement, but each option has specific limitations. Joint-preserving procedures may delay more definitive surgery but depend on the stage of the disease and the morphology of the joint. Trapeziectomy remains reliable for pain relief but may compromise the height and strength of the thumb. \"Interposition implants and total joint prosthetic arthroplasty\" may allow for a faster recovery and preserve thumb length but require long-term monitoring and expose patients to mechanical failure or revision. Arthrodesis provides stability and strength but sacrifices mobility and may lead to non-union or adjacent joint degeneration.</div></div><div><h3>Conclusion</h3><div>In patients under 50 years of age, treatment should not be based solely on anticipated short-term improvement. Surgical indications must be determined upfront, considering disease stage, occupational demands, expected durability, revision risk, and the feasibility and quality of potential salvage procedures.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 4","pages":"Article 102718"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External rotation osteotomy of the humerus combined with low trapezius transfer for long-standing obstetric brachial plexus palsy","authors":"Leonardo Bradaschia,&nbsp;Tareq Abu Zamzam,&nbsp;Inga Lubotzki,&nbsp;Nikolay Nikolov,&nbsp;Christian Heinen","doi":"10.1016/j.hansur.2026.102695","DOIUrl":"10.1016/j.hansur.2026.102695","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe the effectiveness of a combined surgical approach—humeral rotational osteotomy and lower trapezius transfer—in improving shoulder function in an adult patient with long-standing obstetric brachial plexus palsy.</div></div><div><h3>Methods</h3><div>The case of a 27-year-old male with sequelae of Erb’s palsy (Narakas type II), initially treated in infancy with nerve reconstruction and subsequently lost to follow-up is presented. At re-evaluation, the patient exhibited severe limitation of shoulder external rotation and abduction. Following multidisciplinary assessment, he underwent external rotational osteotomy of the humerus combined with lower trapezius transfer using a bone-to-bone fixation technique. Clinical and radiographic follow-up was performed up to 12 months postoperatively.</div></div><div><h3>Results</h3><div>The postoperative course was uneventful, with no complications. At 6 months, the patient was able to bring his hand to his mouth and demonstrated recovery of active abduction. At 12 months, he achieved 90 ° of abduction and 90 ° of external rotation, with significant functional improvement (Mallet score improved to III–IV) and the ability to perform movements such as placing the hand behind the head without compensatory mechanisms.</div></div><div><h3>Conclusion</h3><div>The combination of humeral rotational osteotomy and lower trapezius transfer represents an effective surgical option for adult patients with long-standing obstetric brachial plexus palsy. This approach improves both passive alignment and active shoulder function, enabling meaningful functional recovery even decades after the initial injury. Further studies with larger cohorts are needed to validate these findings.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 4","pages":"Article 102695"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148102367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking the true incidence and diagnostic challenges of neuralgic amyotrophy","authors":"Wei Chen,&nbsp;Kexin Ye,&nbsp;Jun Ma,&nbsp;Jiayuan Yang","doi":"10.1016/j.hansur.2026.102685","DOIUrl":"10.1016/j.hansur.2026.102685","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 4","pages":"Article 102685"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}