Hand Surgery & Rehabilitation最新文献

{"title":"Floating phalanx of the middle finger in a young athlete","authors":"Filippo Raggini","doi":"10.1016/j.hansur.2026.102623","DOIUrl":"10.1016/j.hansur.2026.102623","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 2","pages":"Article 102623"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313647","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":"Outcomes and survival of pyrocarbon versus silicone metacarpophalangeal arthroplasty: a systematic review","authors":"Cerise Gosselin ,&nbsp;Kevin A Hao ,&nbsp;Stéphanie Delclaux ,&nbsp;Nicolas Bonnevialle ,&nbsp;Pierre Mansat ,&nbsp;Hugo Barret","doi":"10.1016/j.hansur.2026.102583","DOIUrl":"10.1016/j.hansur.2026.102583","url":null,"abstract":"<div><h3>Background</h3><div>:Pyrocarbon and silicone implants are the two main options for metacarpophalangeal (MCP) joint arthroplasty, but their comparative functional outcomes and long-term survivorship remain debated. Evidence is scattered across heterogeneous study designs, and no recent meta-analysis has directly compared both implant types.</div></div><div><h3>Purpose</h3><div>To compare functional outcomes and implant survival between pyrocarbon and silicone MCP joint arthroplasty.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. PubMed, Embase, and Cochrane Library were searched from inception to July 2024. Studies reporting postoperative outcomes after silicone or pyrocarbon MCP arthroplasty were included. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Newcastle–Ottawa Scale (with adapted criteria for single-group pre–post designs). Random-effects models were used due to anticipated heterogeneity. Functional outcomes (arc of motion, flexion, extension lag, DASH score, VAS pain) and implant survival (5- and 10-year) were pooled. Sources of heterogeneity were qualitatively explored.</div></div><div><h3>Results</h3><div>Twelve studies (1,023 implants) were included: 535 silicone and 488 pyrocarbon. Pooled analyses showed no significant differences between silicone and pyrocarbon implants for postoperative flexion, total arc of motion, or extension lag. DASH scores favored silicone implants, with significantly lower postoperative disability; however, the magnitude of this difference did not exceed the reported minimal clinically important difference. Five-year survival was high for both groups (silicone 82–97%, pyrocarbon 82–97%). Ten-year survival ranged from 70 to 89% for silicone and 81–88% for pyrocarbon. Considerable heterogeneity was present across several pooled analyses, related mainly to study design variability.</div></div><div><h3>Conclusion</h3><div>Both silicone and pyrocarbon MCP arthroplasties provide comparable improvements in pain, function, and medium-term survival. Differences in range of motion favor silicone, while long-term survivorship appears similar. Due to substantial heterogeneity and predominance of non-comparative studies, these findings should be interpreted with caution.</div></div><div><h3>Level of evidence</h3><div>III (based on retrospective comparative studies).</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 2","pages":"Article 102583"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042128","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":"The “grabbing” mechanism: a particularly severe pattern of rollover hand injuries","authors":"Thibault Druel ,&nbsp;Anaïs Rimbert ,&nbsp;Yannick Cloquell ,&nbsp;Aram Gazarian ,&nbsp;Laurent Mathieu ,&nbsp;Arnaud Walch","doi":"10.1016/j.hansur.2026.102593","DOIUrl":"10.1016/j.hansur.2026.102593","url":null,"abstract":"<div><h3>Introduction</h3><div>Rollover hand injuries are uncommon but potentially devastating lesions. While typically described as dorsal injuries, cases involving the palmar side are rare. There are two different mechanisms of rollover hand injuries: the “grabbing” or the “hanging out” mechanism. The aim of this case-report was to describe a particularly severe pattern of rollover hand injury with palmar side injuries following the “grabbing” mechanism.</div></div><div><h3>Case-report</h3><div>Three males patients sustained severe stage 3 lesions according to Coulet’s classification following dune-buggy accidents with a “grabbing” mechanism. All cases exhibited combined dorsal and palmar injuries with bone, vascular, and tendinous involvement. Infectious complications were frequent, requiring serial debridement and flap coverage using posterior interosseous or groin flaps. One patient required a trans-metacarpal amputation due to ischemia. At a median follow-up of 21 months, all surviving digits demonstrated satisfactory healing and function, despite persistent intrinsic muscle paralysis.</div></div><div><h3>Conclusion</h3><div>Buggy-specific hand injuries have so far been grouped under injuries caused by “rollover” mechanisms, involving vehicle overturning. However, the distinct mechanism of these injuries, which is linked to the presence of a safety cage, is more likely to result in palmar injuries with severe vascular damage.</div></div><div><h3>Level of evidence</h3><div>IV.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 2","pages":"Article 102593"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146145285","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":"Comment on the article: Cognet JM, Goubau J, Levadoux M, Garret J, Obert L. Optimizing trapeziometacarpal prosthesis placement: The critical role of surgical technique. Hand Surg Rehabil 2025 Oct;44(5):102271","authors":"Stephan Schindele ,&nbsp;Miriam Marks ,&nbsp;Daniel B. Herren","doi":"10.1016/j.hansur.2026.102586","DOIUrl":"10.1016/j.hansur.2026.102586","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 2","pages":"Article 102586"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108383","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":"Arthroscopic debridement with microfragmented adipose tissue for wrist and hand chondral lesions in professional athletes","authors":"F. Raggini ,&nbsp;M.D.M. Lombardo ,&nbsp;V. Salini ,&nbsp;L. Pegoli","doi":"10.1016/j.hansur.2026.102636","DOIUrl":"10.1016/j.hansur.2026.102636","url":null,"abstract":"<div><h3>Background</h3><div>Focal chondral lesions of the wrist and hand are an underrecognized source of pain and functional limitation in athletes. Their management remains challenging due to the limited healing capacity of hyaline cartilage, the biomechanical demands of small joints, and the lack of standardized treatment algorithms. Arthroscopy allows accurate diagnosis and targeted treatment with minimal morbidity, while biologic augmentation using autologous adipose-derived products has emerged as a potential adjunct to improve clinical outcomes.</div></div><div><h3>Objective</h3><div>To evaluate the clinical outcomes of arthroscopic debridement combined with intra- and peri-articular injection of autologous microfragmented adipose tissue in professional athletes affected by focal chondral lesions of the wrist and hand.</div></div><div><h3>Patients and methods</h3><div>This prospective single-center case series included six professional athletes (5 men, 1 woman; mean age 26.3 years) treated between June 2020 and April 2022. A total of nine joints were addressed (3 radiocarpal and 6 metacarpophalangeal). All patients underwent standardized wrist or hand arthroscopy followed by intra- and peri-articular injection of autologous microfragmented adipose tissue processed using a closed mechanical system. Chondral lesions were graded according to the International Cartilage Repair Society classification. Clinical outcomes included pain (visual analog scale, VAS), upper-limb function (QuickDASH), and joint range of motion (ROM), assessed preoperatively and during follow-up. Nonparametric statistical analysis was performed.</div></div><div><h3>Results</h3><div>At a mean follow-up of 17.5 ± 8.2 months (range, 8–30 months), all patients demonstrated clinically meaningful improvement in pain, function, and joint mobility. Mean VAS scores decreased from 7.2 to 1.5, and QuickDASH scores improved from 36.9 to 8.2. Joint ROM increased across all planes. All athletes returned to their pre-injury competitive level, and activities of daily living were fully resumed within a mean of 4.8 months. No procedure-related complications or reoperations were observed.</div></div><div><h3>Conclusion</h3><div>Arthroscopic debridement combined with autologous microfragmented adipose tissue injection appears to be a safe and feasible joint-preserving option for the management of focal chondral lesions of the wrist and hand in professional athletes. The observed clinical improvements represent a preliminary signal of benefit and support further investigation in larger comparative studies.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 2","pages":"Article 102636"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391211","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":"Is the “Rugby Finger” becoming the “Soccer Finger”?","authors":"Didier Fontès","doi":"10.1016/j.hansur.2026.102590","DOIUrl":"10.1016/j.hansur.2026.102590","url":null,"abstract":"<div><div>A rupture of the distal insertion of the flexor digitorum profundus tendon is a serious avulsion that typically occurs when gripping a jersey. It is commonly known as the \"Jersey Finger\" or \"Rugby Finger\" in French literature. This injury, which primarily affects the ring finger (in 80% of cases), requires urgent diagnosis for optimal surgical management. Although rugby has seen a decrease in incidence thanks to advances in equipment, we present two cases that occurred in professional soccer, raising the question of whether the epidemiology of this pathology is changing. This discussion extends to the need for jerseys and refereeing rules to evolve to prevent this injury.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 2","pages":"Article 102590"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138255","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":"Comparing the readability of carpal tunnel patient information between American academy of orthopedic surgeons’ orthoinfo and artificial intelligence","authors":"Jonathan J. Huang ,&nbsp;Matthew D. Ramey ,&nbsp;Auston R. Locke ,&nbsp;Niklas H. Koehne ,&nbsp;Christoph A. Schroen ,&nbsp;Jamie Kator ,&nbsp;Jaehon Kim ,&nbsp;Michael Hausman","doi":"10.1016/j.hansur.2026.102592","DOIUrl":"10.1016/j.hansur.2026.102592","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients have become increasingly reliant on the internet to seek health-related information (HRI). The newfound popularity of artificial intelligence (AI) search engines has created interest in their ability to provide HRI. This study aimed to quantify and compare the readability of carpal tunnel syndrome (CTS) HRI from the American Academy of Orthopaedic Surgeons OrthoInfo and AI search engines.</div></div><div><h3>Methods</h3><div>Six prompts were developed using the OrthoInfo page on CTS. These prompts were entered to ChatGPT-4 and Google Gemini 2.0 Flash to generate AI responses. The readability of this information was calculated using the Flesch–Kincaid Reading Ease Index, Coleman-Liau Index, Flesch–Kincaid Grade Level, FORCAST Readability Formula, Gunning Fog index, and Simple Measure of Gobbledygook Index. Statistical testing was performed using the Kruskal-Wallis nonparametric One-Way Analysis of Variance test.</div></div><div><h3>Results</h3><div>The mean grade level readability score across all platforms, questions, and testing metrics was 12.6. No significant differences were observed between the overall mean grade level readability scores of OrthoInfo, ChatGPT, and Gemini, nor were they observed for any specific prompt. The only significant differences were found using the Flesch–Kincaid Grade Level test, for which ChatGPT had the lowest scores.</div></div><div><h3>Conclusion</h3><div>The readability of carpal tunnel syndrome health-related information from OrthoInfo, ChatGPT, and Gemini is similar. Physicians should advise patients to continue using OrthoInfo as a primary source of carpal tunnel syndrome information, although artificial intelligence search engines are useful to supplement when patient concerns require more tailored responses. Notably, no text included in this study was at recommended reading level thresholds.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 2","pages":"Article 102592"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133821","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":"Current clinical use and perceived impact of the sensory collapse test: A survey of peripheral nerve surgeons and hand therapists","authors":"Veronica Machado ,&nbsp;Thomas Apard ,&nbsp;Elisabeth Hagert","doi":"10.1016/j.hansur.2026.102624","DOIUrl":"10.1016/j.hansur.2026.102624","url":null,"abstract":"<div><h3>Background</h3><div>The Sensory Collapse Test (SCT) is a clinical maneuver used in the assessment of peripheral nerve compression. Despite being widely described, its actual use and perceived impact in clinical practice remain unclear.</div></div><div><h3>Objectives</h3><div>To evaluate the current clinical use of the SCT, factors associated with its adoption, and its perceived influence on clinical decision-making among professionals involved in peripheral nerve care.</div></div><div><h3>Methods</h3><div>An international, web-based survey was conducted among clinicians involved in peripheral nerve surgery and hand therapy. The questionnaire assessed familiarity with the SCT, training background, frequency of use, confidence in its diagnostic value, and perceived impact on clinical decision-making. Descriptive statistics and comparative analyses were performed, including subgroup analyses and multivariable logistic regression to identify factors associated with SCT use.</div></div><div><h3>Results</h3><div>A total of 136 responses from 38 countries were analyzed. Most respondents were familiar with the SCT (86%), although its use varied: 55% reported frequent use and 11% reported never using the test. Formal training and greater professional experience were independently associated with SCT use (<em>p</em> &lt; 0.05). Confidence was higher when the SCT was used as a complementary rather than a standalone diagnostic tool and correlated positively with frequency of use. Frequent users more commonly reported that the SCT influenced clinical decision-making, particularly regarding localization of nerve compression and surgical planning.</div></div><div><h3>Conclusions</h3><div>The SCT is widely recognized but inconsistently used. Its adoption is associated with training and experience, and it is generally perceived as a useful complementary tool. Further studies are needed to better define its diagnostic accuracy and clinical role.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 2","pages":"Article 102624"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260535","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":"Appraising the value of AI in wrist fracture detection: A clinical review","authors":"Aidin Gharavi ,&nbsp;Sergio M. Navarro ,&nbsp;Andy Tom ,&nbsp;Audrey Bankes ,&nbsp;Matthew Gish ,&nbsp;Michele McGinnis ,&nbsp;Matthew D. Rich","doi":"10.1016/j.hansur.2026.102597","DOIUrl":"10.1016/j.hansur.2026.102597","url":null,"abstract":"<div><h3>Introduction</h3><div>Artificial intelligence (AI) has become increasingly tested for improving fracture detection. This scoping review evaluates how AI can improve human performance in detecting traumatic wrist fractures.</div></div><div><h3>Methods</h3><div>A scoping review was conducted to identify studies comparing AI and human performance for wrist fracture detection. Nine resources were searched, including key databases Embase, MEDLINE, and SCOPUS. Studies which did not include AI being used as an assistant were excluded.</div></div><div><h3>Results</h3><div>Nine studies were included in the review, where AI models demonstrated sensitivity from 83% to 97.7%, specificity from 77% to 96%, negative predictive value (NPV) from 89% to 90%, and positive predictive value (PPV) from 83% to 92%. Human performance demonstrated sensitivity from 58% to 94%, specificity from 77% to 97%, a NPV from 62% to 87%, and a PPV from 74% to 93%. When AI was used as a diagnostic aid, combined performance generally improved across all studies. Sensitivity gains ranged from 3% to 19%, with greater improvements among less experienced readers. Specificity changed between −4% to 11% when AI was used as a diagnostic aid. NPV and PPV changed from 6% to 13% and –5% to 7% when AI was used as a diagnostic aid, respectively.</div></div><div><h3>Conclusion</h3><div>Models using AI improved sensitivity and negative predictive value across all readers, while some readers had a reduced specificity or positive predictive value when using AI. Overall, AI has demonstrated promising results in traumatic wrist fracture detection when used as an assistant to support diagnosis.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 2","pages":"Article 102597"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195438","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":"Less is More in Acute Perilunate Injuries? Early Success with Arthroscopic-Assisted Fixation of The Proximal Row without Ligament Repair","authors":"Jonathan Persitz ,&nbsp;Anne Doi ,&nbsp;Sam Keshen ,&nbsp;Andrea Chan ,&nbsp;Norah Matthies ,&nbsp;Ryan Paul","doi":"10.1016/j.hansur.2026.102640","DOIUrl":"10.1016/j.hansur.2026.102640","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the short-term safety and clinical effectiveness of arthroscopic-assisted reduction with percutaneous proximal-row stabilization performed without intrinsic ligament repair for acute perilunate injuries.</div></div><div><h3>Methods</h3><div>Patients with acute, isolated perilunate injuries treated by a single surgeon between 2021 and 2025 were prospectively enrolled. All underwent arthroscopic-assisted reduction and percutaneous proximal-row stabilization without intrinsic ligament repair. Clinical evaluation included objective functional assessment and patient-reported outcome measures. Radiographic analysis included measurement of the scapholunate interval, scapholunate, radiolunate and radioscaphoid angles, dorsal scaphoid translation, fracture union, and presence of degenerative changes.</div></div><div><h3>Results</h3><div>Ten male patients (36 ± 14 years) were treated at a mean of 5 ± 3 days post-injury; 40% presented with median neuropathy. Eight injuries were Mayfield stage III and two stage IV, with five fracture–dislocation patterns. At a mean 14-month follow-up, patients demonstrated favorable early outcomes (Disabilities of the Arm, Shoulder and Hand score 7 ± 10, Modified Mayo Wrist Score 89 ± 7, Patient-Rated Wrist Evaluation 14.6 ± 15.1, and Visual Analog Scale pain score 0.4 ± 1), near-symmetric motion and grip strength, and maintained radiographic alignment (mean scapholunate gap 2.3 ± 0.8 mm). All fractures united, there were no post-operative complications, and all manual laborers returned to unrestricted work at 28 ± 16 weeks.</div></div><div><h3>Conclusion</h3><div>Arthroscopic-assisted reduction and percutaneous proximal-row fixation without ligament repair appears feasible and safe, yielding excellent short-term functional and radiographic outcomes with minimal morbidity. Larger studies with longer follow-up are needed to determine long-term durability.</div></div><div><h3>Prospective case series</h3><div>Level IV.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 2","pages":"Article 102640"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470659","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}