Hand Surgery & Rehabilitation最新文献

{"title":"Proximal ulna corticocancellous autograft for the repair of metacarpal defect following ballistic hand injury","authors":"Kyle Stump ,&nbsp;Lasya Sethi ,&nbsp;Alec Talsania ,&nbsp;Logan Sterling ,&nbsp;Bradley Wiekrykas","doi":"10.1016/j.hansur.2026.102599","DOIUrl":"10.1016/j.hansur.2026.102599","url":null,"abstract":"<div><div>Metacarpal defects following ballistic hand injuries are a devastating complication that can compromise hand function. Autologous bone grafting is the gold standard treatment of these osseous defects, most commonly utilizing the anterior iliac crest as the donor site. Alternatively, use of corticocancellous bone graft from the proximal ulna has been described, although with mixed clinical outcomes. Additionally, the upper limit of defect that can be repaired with this technique remains unknown. Herein we described the case a patient who sustained a partial extensor tendon injury and significant fourth metacarpal defect following ballistic injury who was subsequently treated with open reduction and internal fixation of the fourth metacarpal using a 2.5 cm corticocancellous bone graft harvested from the ipsilateral proximal ulna, in conjunction with primary extensor tendon repair. The patient achieved successful radiographic union of the corticocancellous graft and appropriate filling of the donor site with restoration of digit flexion and extension.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 2","pages":"Article 102599"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146204423","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":"Corrective cold ablation robot-guided laser osteotomies in wrist surgery: do we get what we planned? – A cadaver study","authors":"Maximilian Hofer ,&nbsp;Enrico Coppo ,&nbsp;Marta Morawska ,&nbsp;Florian M. Thieringer ,&nbsp;Philipp Honigmann","doi":"10.1016/j.hansur.2026.102626","DOIUrl":"10.1016/j.hansur.2026.102626","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study is to evaluate the accuracy of a cold ablation robot-guided laser osteotome in pre-clinical cadaver tests, performing shortening and lengthening osteotomies on the ulna and radius.</div></div><div><h3>Methods</h3><div>The osteotomies were performed using CARLO®, a miniaturised ablation laser. A total of 12 corrective laser osteotomies were performed on the distal metaphysis of the radius and ulna. These were planned on a 3D CT model specific to each patient prior to surgery. Pre- and postoperative CT scans were taken to compare the virtual surgical planning with the postoperative results and to demonstrate the accuracy of the cutting path.</div></div><div><h3>Results</h3><div>Accuracy measurements of the actual cutting path compared to the planned cut showed a mean deviation of 2.11 ± 0.73 mm in the osteotomies of the radii and 1.66 ± 0.29 mm on the ulnae. After fixation the radii revealed an average lengthening of 4.36 ± 0.58 mm (planned: 4.00 mm), while radial inclination was corrected by 10.55 ° ±1.02 (planned: 10.00 °). The ulnae showed an average shortening of 3.05 ± 0.28 mm (planned: 3.00 mm).</div></div><div><h3>Conclusion</h3><div>First cadaveric tests showed promising results concerning the resulting corrections of one and two plane osteotomies in wrist and forearm surgery. Compared to previously published results on corrective osteotomies of the radius and ulna, the resulting corrections were highly precise, matching the accuracy of current techniques. Future steps are stability testing of the osteosynthesis followed by certification and first use in patients.</div></div><div><h3>Level of evidence</h3><div>Therapeutic, Level 5.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 2","pages":"Article 102626"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313645","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":"Muscle-sparing dorsal approach for Bennett fracture osteosynthesis","authors":"Richard-Tobias Moeller ,&nbsp;Alice-Dorothee Eiserbeck ,&nbsp;Martin Mentzel ,&nbsp;Simon Bauknecht ,&nbsp;Sybille Marion Moeller ,&nbsp;Patricia Lang ,&nbsp;Maximilian Denzinger ,&nbsp;Alexander Eickhoff ,&nbsp;Daniel Vergote","doi":"10.1016/j.hansur.2026.102638","DOIUrl":"10.1016/j.hansur.2026.102638","url":null,"abstract":"<div><h3>Introduction</h3><div>Fractures of the first metacarpal base with partial involvement of the joint surface, known as Bennett fractures, are unstable due to static and dynamic forces. If closed reduction remains unsuccessful, an open procedure is indicated. The fracture is usually exposed via a radiopalmar approach according to Wagner to the trapeziometacarpal (TMC) joint with detachment of the thenar muscles. An alternative,muscle-sparing dorsal approach to the TMC joint and its long-term results in the treatment of Bennett fractures are described.</div></div><div><h3>Patients and methods</h3><div>Over a period of 15 years, a total of 53 patients with Bennett fractures were reduced via a dorsal approach and fixed with screw osteosynthesis. In a follow-up examination, the mobility and the strength development of the hand were compared with the healthy contralateral side. Subjective symptoms were assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and the German Thumb Disability Examination (TDX-G) questionnaire.</div></div><div><h3>Results</h3><div>8.2 years (±4.6; 2.2–16.7) after the accident, 33 patients (35.6 years ±16.5) were available for follow-up examination. Radial and palmar abduction were significantly reduced by 5% and 6%, respectively. No other significant measurable differences were found. The DASH score and TDX-G score were 4.6 and 5.7, respectively. A total of 4 complications occurred.</div></div><div><h3>Conclusion</h3><div>The dorsal, muscle-sparing approach to the TMC joint is an alternative to the radiopalmar approach for the treatment of Bennett fractures. In the long term, patients are little restricted in their everyday lives despite significant measurable restrictions in movement.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 2","pages":"Article 102638"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391172","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":"Association Between Early Opioid Prescribing and New Persistent Use After Distal Radius Fracture: A Retrospective Cohort Study","authors":"Eve R. Glenn,&nbsp;Grace Q. Chen,&nbsp;Indeevar R. Beeram,&nbsp;Dawn LaPorte","doi":"10.1016/j.hansur.2025.102535","DOIUrl":"10.1016/j.hansur.2025.102535","url":null,"abstract":"<div><h3>Purpose</h3><div>Distal radius fractures (DRFs) are common orthopaedic injuries often requiring surgical intervention. While opioids are frequently prescribed for postoperative pain, concerns regarding new persistent opioid use have emerged, particularly in opioid-naïve patients. This study examines whether early postoperative opioid prescribing increases the risk of new persistent opioid use following DRF surgery.</div></div><div><h3>Methods</h3><div>A retrospective cohort analysis was conducted using the TriNetX database. Opioid-naïve patients undergoing DRF surgery were stratified into opioid and no-opioid cohorts based on prescription within 30 days postoperatively. Propensity score matching was applied to adjust for confounding variables. The primary outcome was new persistent opioid use, while secondary outcomes included mortality, new mental health disorders, and persistent upper extremity pain from 90 days through one year postoperatively.</div></div><div><h3>Results</h3><div>Early opioid prescription was associated with a significantly higher risk of new persistent opioid use (4.2% vs. 1.4%), an increased rate of persistent forearm, hand, or finger pain (1.0% vs. 0.6%), and a higher incidence of wrist pain (5.8% vs. 3.8%) (all <em>p</em> &lt; 0.01). No significant differences in mortality or new mental health disorders were observed.</div></div><div><h3>Conclusions</h3><div>Early opioid prescribing following DRF surgery is significantly associated with new persistent opioid use and persistent upper extremity pain. These findings may highlight the need for judicious opioid use and alternative pain management strategies to reduce the risk of prolonged opioid utilization.</div></div><div><h3>Level of evidence</h3><div>Therapeutic, Level III.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 1","pages":"Article 102535"},"PeriodicalIF":1.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544613","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":"Response to the comment on: Left Hand, Right Hand: Understanding Laterality, Its Impact on Surgery, Durand S, Harder Y, Timoteo AD, Guttmann C, Mercier J, Jacques V. Hand Surg Rehabil. 2025, Oct, 44 (5), :102265. by Hafiz Abdul Mannan et al","authors":"Sébastien Durand","doi":"10.1016/j.hansur.2026.102569","DOIUrl":"10.1016/j.hansur.2026.102569","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 1","pages":"Article 102569"},"PeriodicalIF":1.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145961050","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":"Communicating branch between the dorsal branch of the palmar ulnar proper digital nerve and the palmar ulnar proper digital nerve of the little finger","authors":"Yoan-Kim De Almeida,&nbsp;Sylvie Collon","doi":"10.1016/j.hansur.2026.102573","DOIUrl":"10.1016/j.hansur.2026.102573","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 1","pages":"Article 102573"},"PeriodicalIF":1.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986139","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 burden of wrist joint dislocations: A nationwide 20-year analysis and review of incidence and injury mechanism","authors":"Timothy A. Reiad ,&nbsp;Peter V. Dinh ,&nbsp;Praneeth Tummala ,&nbsp;Jacob Glueck ,&nbsp;Ashley Rosenberg ,&nbsp;Carolyn Marquis ,&nbsp;Mitchell Solano ,&nbsp;Joseph A. Gil","doi":"10.1016/j.hansur.2026.102582","DOIUrl":"10.1016/j.hansur.2026.102582","url":null,"abstract":"<div><h3>Background</h3><div>Wrist dislocations are rare injuries that present substantial diagnostic challenges, yet large-scale epidemiological data on injury mechanisms and trends are limited. This study characterizes wrist dislocation epidemiology using nationally representative emergency department data from 2004 to 2023.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed using the National Electronic Injury Surveillance System (NEISS) database to estimate national wrist dislocation trends. Cases were identified by diagnosis and body part codes. Demographics, mechanisms, and annual incidence were examined. Trends were assessed using linear regression; group differences were assessed using Odds Ratios (OR) and Injury Proportion Ratios (IPR).</div></div><div><h3>Results</h3><div>Among 21,237 estimated cases (3.42/1,000,000 population), males accounted for 64.2% of dislocations, with a 4.38/1,000,000 incidence vs. 2.40/1,000,000 in females (<em>p</em> &lt; 0.001). Peak incidence was among ages 25–44 years (17.49 per 1,000,000 US population; male-to-female [M:F] IPR 3.59). Females demonstrated bimodal vulnerability: &lt;5 years (IPR 1.85) and ≥65 years (IPR 1.52). Athletic dislocations (19.7%) mainly involved males in football (16.0%) and snowboarding (12.8%). Non-athletic dislocations (80.3%) disproportionately affected females (OR 3.02) and individuals ≥50 years (OR 4.68), with home environments posing elevated risks (female OR 2.22).</div></div><div><h3>Conclusions</h3><div>This national analysis characterizes wrist dislocation epidemiology, revealing a stable incidence despite rising sports participation. Key demographic disparities were identified, including high-risk groups of young males (15–24) and females at bimodal age peaks (&lt;5 and ≥65 years). This descriptive epidemiological analysis provides a foundational baseline to inform future clinical research on management and outcomes within these specific populations.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 1","pages":"Article 102582"},"PeriodicalIF":1.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042211","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: Can artificial intelligence pass the written European Board of Hand Surgery exam? Mert S, Muir L, Fuchs B, Lucksch V, Vollbach FH, Haas-Lützenberger EM, et al. Hand Surg Rehabil 2025:102197","authors":"Ismail Sivri,&nbsp;Furkan Mehmet Ozden,&nbsp;Gamze Gul,&nbsp;Emre Kaygin,&nbsp;Tuncay Colak","doi":"10.1016/j.hansur.2026.102575","DOIUrl":"10.1016/j.hansur.2026.102575","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 1","pages":"Article 102575"},"PeriodicalIF":1.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991920","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 recovery and patient-reported outcomes after total wrist arthrodesis: A decade-long follow-up","authors":"Mohamad Khaled Ghannam ,&nbsp;Victor Rutka ,&nbsp;Louis Ducharne ,&nbsp;Gaetan Vanpoulle ,&nbsp;Christophe Gaillard ,&nbsp;Laurent Mathieu ,&nbsp;Aram Gazarian ,&nbsp;Arnaud Walch ,&nbsp;Thibault Druel","doi":"10.1016/j.hansur.2025.102536","DOIUrl":"10.1016/j.hansur.2025.102536","url":null,"abstract":"<div><h3>Introduction</h3><div>Total wrist arthrodesis (TWA) is a definitive treatment for advanced wrist pathology. This study aimed to evaluate patient-reported outcomes (PROMs), persistent complaints, and quality of life after TWA at a minimal one year of follow-up.</div></div><div><h3>Methods</h3><div>A multicenter retrospective cohort of 28 patients who underwent dorsal plate TWA between 2009 and 2022 was analyzed. The primary outcome was the Overall Subjective Self-Assessment (OSSA) including a specific analysis of patients’ complaints. Secondary outcomes included QuickDASH, PRWE, VAS, SF-36, grip strength, and satisfaction.</div></div><div><h3>Results</h3><div>Mean follow-up was 116 months. OSSA averaged 5/10, with reduced mobility as the main complaint. Patients reported low pain levels (mean VAS 2). Grip strength was 55% of the contralateral side. Despite functional limitations (mean QuickDASH and PRWE: 42), satisfaction was high (mean 8/10). The SF-36 physical score was lower than the general population, but mental health was preserved, regardless of the etiology for TWA.</div></div><div><h3>Conclusion</h3><div>While OSSA revealed moderate score due to immobility, overall acceptance and adaptation post-TWA were high. Preoperative counseling is essential to align expectations with outcomes.</div></div><div><h3>Level of evidence</h3><div>IV.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 1","pages":"Article 102536"},"PeriodicalIF":1.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535143","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":"Corrective osteotomy of a malunion of the distal radius using a spanning plate in an older patient","authors":"Alienor De Bue ,&nbsp;Lucas Audiffret ,&nbsp;Najib Kachouh ,&nbsp;Jean-Baptiste de Villeneuve Bargemon","doi":"10.1016/j.hansur.2025.102537","DOIUrl":"10.1016/j.hansur.2025.102537","url":null,"abstract":"<div><h3>Introduction</h3><div>Distal radius malunions in older patients represent a therapeutic challenge due to osteoporotic bone quality and the need to preserve autonomy. Spanning plates, which are widely used in complex distal radius fractures, allow immediate weight-bearing, but their use in corrective osteotomies has not been reported.</div></div><div><h3>Case report</h3><div>We report the case of a 77-year-old right-handed female patient, dependent on a cane, who presented with a distal radius malunion 3 months after conservative management of a displaced fracture. The deformity resulted in severe functional impairment and loss of independence. Considering her frailty and scheduled tibiotalar arthrodesis, a corrective osteotomy of the distal radius with an autologous bone graft and fixation using a dorsal spanning plate was performed during the same procedure. This strategy allowed for the patients to use a cane immediately after the procedure. Rehabilitation was initiated early, leading to full recovery of finger flexion within 11 days. Five months after plate removal, the patient presented 50 ° flexion, 50 ° extension, and a grip strength of 12 kg; showed complete pain resolution; and had a QuickDASH score of 18.18.</div></div><div><h3>Conclusion</h3><div>This case highlights the potential use of spanning plates as a temporary fixation method for distal radius corrective osteotomy in frail older patients. This technique allows weight-bearing immediately after surgery, thus preserving autonomy while providing satisfactory functional and radiological outcomes.</div></div><div><h3>Level of evidence</h3><div>4.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"45 1","pages":"Article 102537"},"PeriodicalIF":1.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145590521","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}