Hand Surgery & Rehabilitation最新文献

{"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}

{"title":"Influence of early postoperative worries and expectations on long-term outcomes in hand surgery patients","authors":"Tanne Bønnelykke Tromborg,&nbsp;Alice Ørts Hansen,&nbsp;Christian Færgemann","doi":"10.1016/j.hansur.2026.102738","DOIUrl":"10.1016/j.hansur.2026.102738","url":null,"abstract":"<div><h3>Purpose</h3><div>This retrospective study examines how patients’ expectations and their worries about surgical outcomes, worries about ability to work, and worries about quality of life three weeks post-surgery influence long-term outcomes after hand surgery.</div></div><div><h3>Methods</h3><div>We included 396 minor surgery (carpal tunnel surgery, fascia, bursae, tendon sheath, and ganglion cyst surgery) or major surgery (arthrodesis, prosthesis insertion, muscle and tendon surgeries in the hand and wrist) patients. Expectations and worries were assessed 3 weeks postoperatively. Patient-reported outcomes including pain, strength, sensibility, joint motion, and performance were measured 3 and 12 months postoperatively using VAS-scores, Quick-DASH scores.</div></div><div><h3>Results</h3><div>Overall, 270 (women 56.3%) patients underwent minor surgery and 126 (women 63.5%) underwent major surgery. Both minor and major surgery patients, who were worried three weeks postoperatively, had significantly worse self-rated outcome regarding pain, strength, joint motion, sensibility, and QDASH-scores after 3 and 12 months. In the group of minor surgery patients, the median VAS-scores and QDASH-scores were almost twice as high in the group of worried patients than in the group of not worried patients.</div></div><div><h3>Clinical relevance</h3><div>Postoperative expectations and worries correlate with long-term outcomes following hand surgery. Suggesting management of patient expectations and worries early in the postoperative period as a tool to improve long-term functional outcomes in both minor and major hand surgeries.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 4","pages":"Article 102738"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148595303","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":"Arthroscopically assisted temporary trans-articular headless screw fixation for perilunate injuries: A retrospective study","authors":"Gaetan Vanpoulle,&nbsp;Walter Klyce,&nbsp;Vincent Locquet,&nbsp;Florie Alech-Tournier,&nbsp;Lionel Erhard,&nbsp;Maxime Cievet-Bonfils,&nbsp;Marion Burnier","doi":"10.1016/j.hansur.2026.102739","DOIUrl":"10.1016/j.hansur.2026.102739","url":null,"abstract":"<div><h3>Background</h3><div>Perilunate injuries are rare high-energy wrist injuries whose open treatment carries a risk of capsular stiffness and carpal devascularisation. Arthroscopically assisted reduction with temporary fixation aims to limit this morbidity, and temporary trans-articular headless compression screws may provide more rigid scapholunate and lunotriquetral control than Kirschner wires. We asked what the mid-term clinical, radiographic and patient-reported outcomes of this technique are, using the contralateral wrist as a paired control, and whether they differ by injury pattern.</div></div><div><h3>Methods</h3><div>Retrospective single-centre study of 11 consecutive patients (10 men; mean age 37 years) with a closed perilunate dislocation (<em>n</em> = 7), trans-scaphoid perilunate fracture-dislocation (<em>n</em> = 3) or perilunate injury not dislocated (<em>n</em> = 1) treated between November 2015 and December 2020. All 11 were analysed by intention to treat; injured-versus-contralateral comparisons (Wilcoxon signed-rank test) were restricted to the 10 wrists that retained the index construct. Median follow-up was 47 months.</div></div><div><h3>Results</h3><div>One patient (9%) required four-corner fusion for scapholunate advanced collapse, and radiographic osteoarthritis was seen in 2/11 (18%). The flexion–extension arc (113° vs 132°, <em>p</em> = 0.002) and the scapholunate angle (60° vs 50°, <em>p</em> = 0.018) were significantly worse than the uninjured wrist; grip strength and radiolunate angle did not differ significantly. Median QuickDASH was 4.5 and median PRWE 7.</div></div><div><h3>Conclusion</h3><div>In selected closed, reducible perilunate injuries this technique gave good patient-reported outcomes and maintained carpal alignment in most patients, but flexion–extension and the scapholunate angle remained reduced relative to the uninjured wrist and one in eleven required salvage fusion. Comparative studies are needed before recommending it over open fixation.</div></div><div><h3>Level of evidence</h3><div>IV (retrospective case series).</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 4","pages":"Article 102739"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586418","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":"Cross-cultural adaptation and validation in French of the cold intolerance symptom severity (CISS) questionnaire and potential work exposure scale (PWES) in patients with hand pathologies","authors":"Michel Konzelmann,&nbsp;Philippe Vuistiner,&nbsp;Cyrille Burrus,&nbsp;François Luthi,&nbsp;Bertrand Léger","doi":"10.1016/j.hansur.2026.102687","DOIUrl":"10.1016/j.hansur.2026.102687","url":null,"abstract":"<div><h3>Background</h3><div>Cold intolerance is frequent after hand injuries and is the worst long-lasting problem that negatively affects other impairments in some patients. Two questionnaires are available to assess cold intolerance (CISS, PWES), but not in French. This study aimed to translate, cross-culturally adapt, and validate these questionnaires in French.</div></div><div><h3>Methods</h3><div>Population: outpatient and hospitalized patients between 2019 and 2024.</div><div>Translation, back translation, cross-cultural adaptation according to standard guidelines.</div><div>Ten experts evaluated the preliminary French versions for content validity.</div><div>Preliminary French versions were administered to 30 patients.</div><div>Final French versions to 70 patients for validation: internal consistency, test–retest reliability, construct validity, and floor or ceiling effect.</div></div><div><h3>Results</h3><div>Translation, back translation, and cross-cultural adaptation were easy with only minor changes.</div><div>Preliminary French versions well accepted by patients, and all 10 experts rated content validity very good.</div><div>Internal consistency was good: Cronbach α was 0.90 (95% CI [0.87−0.92]) for CISS; 0.80 (95% CI [0.65−0.95]) for PWES.</div><div>Factor analysis revealed one factor for each questionnaire.</div><div>Construct validity was good, 100% of our hypotheses were confirmed for CISS and 75% for PWES.</div><div>Test–retest reliability was excellent: 0.94 (95% CI [0.91−0.96]) for CISS; 0.90 (95% CI [0.78−0.95]) for PWES.</div><div>No floor or ceiling effects for either questionnaire.</div></div><div><h3>Conclusion</h3><div>Both questionnaires have good psychometric properties F-CISS could be used with confidence and had to be validated in other populations. For the PWES, due to small sample used for validation, we consider these results as preliminary and need to be confirmed on a larger sample.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 4","pages":"Article 102687"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990442","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":"Scaphoid nonunion in Schernberg zones II–III: Arthroscopy versus open radial approach","authors":"Emilie Renoud-Grappin,&nbsp;Flore-Anne Lecoq,&nbsp;Ludovic Ardouin,&nbsp;Marc Leroy,&nbsp;Victor Lestienne,&nbsp;Philippe Bellemère","doi":"10.1016/j.hansur.2026.102698","DOIUrl":"10.1016/j.hansur.2026.102698","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare arthroscopic versus open radial-approach management of scaphoid nonunion in Schernberg zones 2 and 3, with respect to radiographic union and functional recovery.</div></div><div><h3>Methods</h3><div>Retrospective cohort study of 54 consecutive patients treated for scaphoid nonunion in zones 2–3 over two years: 23 by arthroscopy and 31 via an open radial approach. Primary outcome was consolidation rate on imaging. Secondary outcomes were clinical and functional recovery recorded at follow-up; 22 patients underwent standardized clinical evaluation.</div></div><div><h3>Results</h3><div>Overall consolidation rate was 81% (44/54). Consolidation occurred in 21/23 (91%) arthroscopy patients and 23/31 (74%) open‑approach patients. Among the 22 patients with clinical assessment, those treated arthroscopically showed superior functional scores and range-of-motion measures. Differences did not reach statistical significance.</div></div><div><h3>Conclusion</h3><div>In this series, arthroscopic treatment of scaphoid nonunion in Schernberg zones 2–3 was associated with a higher observed consolidation rate and better functional outcomes compared with the open radial approach, although differences were not statistically significant. Arthroscopy appears to be a promising option for these nonunions and warrants further study in larger, prospective trials.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 4","pages":"Article 102698"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152589","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":"Simplified oral antibiotic regimen for pyogenic flexor tenosynovitis","authors":"Ewen Lataste,&nbsp;Jérôme Jeudy,&nbsp;Bruno Cesari,&nbsp;Nicolas Bigorre","doi":"10.1016/j.hansur.2026.102724","DOIUrl":"10.1016/j.hansur.2026.102724","url":null,"abstract":"<div><h3>Introduction</h3><div>Pyogenic flexor tenosynovitis is a common, potentially serious hand infection. Although initial management is surgical, postoperative antibiotic strategies vary. We evaluated a protocol combining minimally invasive surgical irrigation with a short (7–10 day) course of oral antibiotics, reporting infection control and functional outcomes at six months.</div></div><div><h3>Patients and methods</h3><div>In this prospective observational cohort, consecutive patients treated for pyogenic flexor tenosynovitis between 2 November 2022, and 30 October 2024 were managed as outpatients or with brief hospital stays. The standardized protocol comprised minimally invasive lavage followed by a single oral antibiotic course (median 8 days). Primary endpoints were treatment failure and functional status at six months (Patient-Rated Wrist Evaluation, PRWE). We analysed failure rates, predictors of failure, and determinants of functional outcome.</div></div><div><h3>Results</h3><div>One hundred and forty-eight patients were included; 93% were treated on an outpatient basis. All received postoperative oral antibiotics, predominantly amoxicillin–clavulanate (96%); median duration was 8 days. Overall failure rate was 6.8%. Stage IIB phlegmon was independently associated with treatment failure (p = 0.033). At six months, 86 patients were reassessed: 74% had PRWE ≤ 10, consistent with minimal or no functional impairment. Higher phlegmon stage (p = 0.032), longer treatment delay (p = 0.013), and occurrence of treatment failure (p = 0.011) were significantly associated with worse functional outcome.</div></div><div><h3>Conclusion</h3><div>For stage I and IIA pyogenic flexor tenosynovitis, outpatient management combining minimally invasive surgical lavage and a one-week oral antibiotic regimen appears safe and effective. Patients with stage IIB disease have higher failure risk and may require an adapted approach.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 4","pages":"Article 102724"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364550","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":"Hyperselective neurectomy: current status and future perspectives","authors":"Caroline Leclercq","doi":"10.1016/j.hansur.2026.102728","DOIUrl":"10.1016/j.hansur.2026.102728","url":null,"abstract":"<div><div>Surgery has a limited place in the treatment of spasticity of the upper limb. It is only one element of the rehabilitative care, together with physiotherapy, splinting, occupational therapy and pharmacological treatment as needed. Surgical decisions are best made with the patient and family by a multidisciplinary team including all the involved specialists.</div><div>Upper limb deformity and impairment in spasticity is a complex association of spasticity itself, and of resulting muscle/ joint contracture and weakness / paralysis. Each component must be treated simultaneously for a durable result. Therefore, nerve procedures, including hyperselective neurectomy, are rarely performed in isolation.</div><div>Selective (or partial) neurectomy, which consists in resecting only part of the motor rami for each of the involved muscles, was introduced in the early 1900 but was not widely spread until popularized by Brunelli (1980, 1983). The technique of hyperselective neurectomy, by which the motor rami are interrupted at their point of entry into the muscle, allows durable reduction of hypertonia without loss of muscle strength, and thus improvement of balance, with a low morbidity rate. Precise knowledge of the anatomy of motor nerve branches and their variations is critical in order to plan these procedures properly.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 ","pages":"Article 102728"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148383459","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 spastic upper limb","authors":"Yves Allieu","doi":"10.1016/j.hansur.2026.102721","DOIUrl":"10.1016/j.hansur.2026.102721","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 ","pages":"Article 102721"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364539","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}