Hand Surgery & Rehabilitation最新文献

{"title":"Fractal geometry in wrist biomechanics: A preliminary study with implications for arthroplasty and surgery","authors":"Lauren Gorelick ,&nbsp;Amir Oron ,&nbsp;Gil Gannot ,&nbsp;Raphael Israeli","doi":"10.1016/j.hansur.2025.102203","DOIUrl":"10.1016/j.hansur.2025.102203","url":null,"abstract":"<div><h3>Background</h3><div>Traditional biomechanical theories of wrist motion—such as row, column, and link joint<span><span> models—offer limited explanations for the complex, multidirectional kinematics observed clinically. Emerging perspectives suggest fractal geometry, represented by the Golden Ratio (φ = 1.618), might underlie wrist </span>biomechanics, providing a more comprehensive and clinically relevant framework.</span></div></div><div><h3>Objectives</h3><div><span>This preliminary radiographic study aims to investigate whether wrist anthropometric ratios align significantly with fractal geometry principles, specifically evaluating their consistency with the Golden Ratio. Additionally, the study explores potential implications for wrist </span>arthroplasty design and surgical practice.</div></div><div><h3>Methods</h3><div>A cross-sectional radiographic analysis was conducted on 210 healthy adult wrist radiographs. Anthropometric measurements included ratios between ulnar styloid, radial styloid, and the capitate bone, defined as A/B and (A + B)/C, and were statistically compared to the Golden Ratio. Statistical analyses incorporated tolerance intervals calculated under both normal and log-normal distribution assumptions, with a significance level set at P &lt; 0.05.</div></div><div><h3>Results</h3><div>Mean anthropometric ratios closely matched the Golden Ratio, with an A/B mean of 1.615 (95% CI: 1.503–1.735) and an (A + B)/C mean of 1.620 (95% CI: 1.503–1.735). Tolerance intervals indicated that 95% of the study population fell within the fractal range (1.503–1.735), irrespective of age, gender, or laterality. High interobserver reliability (ICC = 0.91) further validated the consistency of these measurements.</div></div><div><h3>Conclusion</h3><div>The findings support the hypothesis that wrist biomechanics<span> may be fundamentally organized by fractal geometry. These preliminary results challenge existing biomechanical paradigms and highlight potential applications in designing more biomechanically accurate wrist prostheses and enhancing surgical precision. Future research should assess clinical outcomes related to fractal-based prosthetic designs and explore fractal deviations as early indicators of wrist pathology.</span></div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102203"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251552","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":"Vascularized rib graft for proximal scaphoid reconstruction: An anatomical study","authors":"Yaniv Bismuth ,&nbsp;Charlotte Jaloux ,&nbsp;Julien Gaillard ,&nbsp;Alain Sautet ,&nbsp;Adeline Cambon ,&nbsp;Claire Bastard","doi":"10.1016/j.hansur.2025.102214","DOIUrl":"10.1016/j.hansur.2025.102214","url":null,"abstract":"<div><div>The loss of cartilaginous substance at the proximal pole of the scaphoid bone poses a therapeutic challenge, with 10% of fractures in this area progressing to pseudarthrosis and necrosis of the proximal pole. Our aim is to propose a conservative surgical alternative involving replacing the necrotic scaphoid with a vascularized osteochondral graft taken from the fourth rib. Angiography of the donor site was performed on seven hemithoraxes to analyze the osteochondral vascularization. Twenty vascularized osteochondral grafts were then performed on anatomical subjects after the proximal pole of the scaphoid was excised. The osteochondral vascularization of the donor site remained consistent, with the presence of a posterior intercostal collateral artery at each level. The harvested grafts averaged 3.1 cm in length and 1.2 cm in thickness. The average arterial diameter was 2.5 mm, the venous diameter was 3 mm, and the average pedicle length was 2.9 cm. We present a reliable and reproducible technique that offers satisfactory anatomical reconstruction.</div></div><div><h3>Level of evidence</h3><div>V.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102214"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621553","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":"German translation and linguistic validation of the HAND-Q","authors":"Jann D. ,&nbsp;Politikou O. ,&nbsp;Giovanoli P. ,&nbsp;Calcagni M. ,&nbsp;Besmens I.S.","doi":"10.1016/j.hansur.2025.102219","DOIUrl":"10.1016/j.hansur.2025.102219","url":null,"abstract":"<div><h3>Background</h3><div>Hand injuries can severely affect physical function and quality of life. Patient-reported outcome measures (PROMs) are vital for capturing patient perspectives. The HAND-Q is a validated, modular PROM developed for individuals with hand conditions. To support its use in German-speaking populations, a culturally adapted German version was needed.</div></div><div><h3>Methods</h3><div>Translation and linguistic validation followed WHO and ISPOR guidelines. Two independent forward translations were reconciled by an expert panel, followed by a backward translation compared with the original English version. Discrepancies were resolved with the HAND-Q developers. Eight patients with upper extremity injuries participated in cognitive debriefing interviews to assess clarity and cultural relevance.</div></div><div><h3>Results</h3><div>Minor discrepancies during translation were related to response consistency, cultural nuances, and gender-neutral language and were resolved through expert consensus. Cognitive interviews led to revisions in five items. The final German (Switzerland) HAND-Q includes 14 scales and 133 items, maintaining conceptual equivalence with the original.</div></div><div><h3>Conclusions</h3><div>The German HAND-Q was successfully translated and validated for clinical and research use. It enables standardized assessment of outcomes in German-speaking patients with hand conditions, supporting both patient-centred care and hand surgery research.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102219"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644372","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":"Four-corner fusion with Two cannulated headless compression screws","authors":"Francis Bonte,&nbsp;Dries Verrewaere,&nbsp;Pieter Pierreux,&nbsp;Hanne Vandevivere,&nbsp;Filip Stockmans,&nbsp;Bart Berghs","doi":"10.1016/j.hansur.2025.102223","DOIUrl":"10.1016/j.hansur.2025.102223","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102223"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719281","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":"Flexor tendon repair in zone II of the hand: Evidence-based management","authors":"Thomas A. Douwes ,&nbsp;Anne Eva J. Bulstra ,&nbsp;Geert Alexander Buijze","doi":"10.1016/j.hansur.2025.102230","DOIUrl":"10.1016/j.hansur.2025.102230","url":null,"abstract":"<div><h3>Introduction</h3><div>Flexor tendon injuries require precise surgical repair followed by rehabilitation to ensure optimal recovery and reduce the risk of complications such as tendon rupture, scarring and adhesions. Zone II flexor tendon injuries, which are located between the flexor digitorum superficialis insertion and the A1 pulley, are particularly challenging due to the complex anatomy and the high risk of complication, earning it the nickname \"no man's land\".</div></div><div><h3>Material and methods</h3><div>This systematic review was conducted in accordance with the principles of evidence-based medicine (EBM), which involve formulating a clinical question, searching for relevant studies, and critically appraising the quality of the evidence. This included evaluating study design, methods, sample size, and bias. Recommendations were made based on the strength of evidence and the impact of bias. This review addressed eight key questions concerning the diagnosis, repair, and rehabilitation of zone II flexor tendon injuries.</div><div>Three review authors independently examined the titles and abstracts of the references retrieved from the searches, selecting all those that were potentially relevant.</div></div><div><h3>Results</h3><div>Imaging still plays a limited role in diagnosis. Up to an unknown percentage of partial tears may be treated conservatively when comparable stringent rehabilitation principles are used. WALANT technique is not superior. Repair requires a four-strand or multi-strand core suture, with or without an epitendinous suture. Judicious pulley venting is safe and effective. The cornerstone of effective post-operative management in zone II flexor tendon injuries is early controlled mobilization, either passive or active, based on the strength of the repair and patient adherence. Combining this approach with structured therapy and vigilant follow-up is associated with improved range of motion, minimized adhesion formation and optimal functional outcomes in clinical practice.</div></div><div><h3>Level of evidence</h3><div>V.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102230"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796497","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: Hourglass-like constriction is a hallmark of neuralgic amyotrophy (Parsonage-Turner syndrome). Hand Surg Rehabil. 2025;44(2):102090”","authors":"Bukola A. Olarewaju ,&nbsp;Ehab Y. Harahsheh ,&nbsp;Shaymaa Shurrab ,&nbsp;Misha B. Asif ,&nbsp;Mayowa A. Osundiji","doi":"10.1016/j.hansur.2025.102200","DOIUrl":"10.1016/j.hansur.2025.102200","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102200"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295542","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":"Bone grafting for scaphoid nonunion with dry arthroscopy","authors":"Asgeir Amundsen ,&nbsp;Istvan Zoltan Rigo ,&nbsp;Preben Olsson Dovland ,&nbsp;Jan- Ragnar Haugstvedt","doi":"10.1016/j.hansur.2025.102204","DOIUrl":"10.1016/j.hansur.2025.102204","url":null,"abstract":"<div><div>From the time a scaphoid fracture occurs to the successful treatment of a nonunion, months and years have often passed, and the patient frequently has reduced wrist motion, grip strength, and wrist pain. Scaphoid nonunions can be a challenge for the wrist surgeon, and operations are undertaken in several ways. Technological advancements have led surgeons to be able to do minimally invasive procedures on the wrist that were not previously attempted, sparing the soft tissue envelope from surgical trauma. Arthroscopy can be a powerful tool for diagnosis, but it has evolved over the past decades into a tool for undertaking the whole surgical procedure or parts of the procedure as hybrid wrist surgery.</div><div>The purpose of this paper is to focus on the technique of dry arthroscopic bone grafting for scaphoid nonunion, aiming to produce consistent results with high union rates.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102204"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295541","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":"Functional and aesthetic outcomes after index pollicization using two different techniques in children with thumb hypoplasia – A comparative study","authors":"Karim Hachem ,&nbsp;Manon Bachy-Razzouk ,&nbsp;Coline Martinot-Lagarde ,&nbsp;Elie Saghbiny ,&nbsp;Frank Fitoussi","doi":"10.1016/j.hansur.2025.102221","DOIUrl":"10.1016/j.hansur.2025.102221","url":null,"abstract":"<div><h3>Background</h3><div>As several skin incision patterns have been described when performing index pollicization, it is currently difficult to know whether one incision is superior to another.</div></div><div><h3>Hypothesis</h3><div>Functional and aesthetic outcomes of two techniques of pollicization that differ in the incision pattern (Buck-Gramcko and Malek’s technique) were analyzed.</div></div><div><h3>Patients and methods</h3><div>Of 81 patients operated on between 1987 and 2021, 43 self-questionnaires were completed on 48 pollicized hands and 24 were reviewed for the study. Eighteen and 30 pollicizations were performed according to Buck Gramcko’s and Malek’s techniques, respectively.</div></div><div><h3>Results</h3><div>Following a functional analysis evaluation, no significant differences were observed between the two groups in terms of the appearance of the first commissure, active abduction of the neo-thumb, grip assessment, scar appearance and visibility, and neo-thumb girth. However, passive abduction of the thumb was better in the group operated on using Buck-Gramcko's technique at the last follow-up. Regardless of the technique used, patients were generally satisfied with the overall function, aesthetics, and daily use of the neo-thumb, as demonstrated by self-completed questionnaires.</div></div><div><h3>Conclusion</h3><div>This investigation demonstrated the superiority of Buck-Gramcko's technique in terms of passive abduction of the thumb. There was no impact on the function or aesthetics of the neo-thumb, and the results were comparable across the different techniques. The main prognostic factor requiring additional procedures involving opposition muscle transfer is the association with a radial club hand.</div></div><div><h3>Level of evidence</h3><div>Level III—Retrospective comparative study.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102221"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661406","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: Fractal geometry in wrist biomechanics: A preliminary study with implications for arthroplasty and surgery. Gorelick L, Oron A, Gannot G, Israeli R. Hand Surg Rehabil 2025:102203","authors":"Ziyue Xiang ,&nbsp;Shanlin Chen","doi":"10.1016/j.hansur.2025.102227","DOIUrl":"10.1016/j.hansur.2025.102227","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102227"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796496","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: Rein S, Hagert E. Nerve transfer of the median flexor pollicis brevis branch to the deep branch of the ulnar nerve for ulnar nerve palsy: a cadaveric feasibility study. Hand Surg Rehabil. 2025;44 (April (2)):102083","authors":"Alfio Luca Costa ,&nbsp;Bruno Battiston ,&nbsp;Paolo Titolo ,&nbsp;Mariarosaria Galeano ,&nbsp;Michele Rosario Colonna","doi":"10.1016/j.hansur.2025.102170","DOIUrl":"10.1016/j.hansur.2025.102170","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102170"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096558","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}