Hand Surgery & Rehabilitation最新文献

{"title":"Complications of first rib resection for thoracic outlet syndrome – A national registry study from Finland","authors":"Markus Pääkkönen ,&nbsp;Ville Kytö ,&nbsp;Jarmo Gunn","doi":"10.1016/j.hansur.2025.102199","DOIUrl":"10.1016/j.hansur.2025.102199","url":null,"abstract":"<div><div>Many studies have described the frequency of short-term complications in patients undergoing first rib resection for thoracic outlet syndrome (TOS). The rate of long-term complications is less well known. 699 patients that had undergone first rib resection for TOS during 2004–2018 were identified from the Care Register for Healthcare in Finland. The prevalence of complications within 30 days and 1 year was analyzed. The prevalence of complications within 30 days was 9.8%, and complications occurred in 18.8% of the cases within 1 year. The rate of vascular and neural complications increased from 5.9% and 0.7% within 30 days to 10.3% and 2.7% within 1 year, respectively. Only a slight increase was seen in the rate of pneumo/chylothorax or infection. A follow-up of at least 1 year is prudent to detect all complications in patients undergoing first rib resection for TOS.</div></div><div><h3>Level of evidence</h3><div>III (Retrospective cohort study).</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102199"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251551","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":"Combined radial closing-wedge osteotomy and ulnar shortening osteotomy for distal radius malunion","authors":"Arnaud Walch ,&nbsp;Sabine Pillot ,&nbsp;Thais Galissard ,&nbsp;Aram Gazarian ,&nbsp;Thibault Druel","doi":"10.1016/j.hansur.2025.102207","DOIUrl":"10.1016/j.hansur.2025.102207","url":null,"abstract":"<div><h3>Purpose</h3><div>Distal radius malunion alters wrist biomechanics, leading to pain, stiffness, and functional impairment. Various corrective osteotomy techniques exist. The aim of this study was to evaluate the functional outcomes of a combined radial closing-wedge osteotomy and ulnar shortening osteotomy in the treatment of distal radius malunions.</div></div><div><h3>Materials and Methods</h3><div>We retrospectively reviewed 20 patients who underwent combined radial closing-wedge osteotomy and ulnar shortening osteotomy for symptomatic distal radius malunions. Functional outcomes, grip strength, range of motion, and radiographic parameters were analyzed.</div></div><div><h3>Results</h3><div>Surgery significantly improved supination (20°–80°), flexion (40°–60°), extension (50°–65°), and grip strength (12 kg–22 kg). Ulnar variance correction was achieved. Complications occurred in four cases, with three requiring revision surgery.</div></div><div><h3>Discussion</h3><div>Combined radial closing-wedge osteotomy and ulnar shortening osteotomy effectively restores wrist function while avoiding graft-related complications. This approach provides an alternative to opening-wedge osteotomies for distal radius malunions.</div></div><div><h3>Level of Evidence</h3><div>IV.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102207"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304097","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":"Surface replacing proximal interphalangeal joint arthroplasty in patients with post-traumatic versus primary osteoarthritis","authors":"Helen Richter ,&nbsp;Miriam Marks ,&nbsp;Kei Mathis ,&nbsp;Daniel B. Herren ,&nbsp;Stephan Schindele","doi":"10.1016/j.hansur.2025.102172","DOIUrl":"10.1016/j.hansur.2025.102172","url":null,"abstract":"<div><h3>Objective</h3><div>The study compared clinical and patient-reported outcomes after proximal interphalangeal (PIP) joint surface replacement in patients with post-traumatic osteoarthritis (OA) and primary OA.</div></div><div><h3>Methods</h3><div><span>Data from a prospective registry of patients who underwent surface replacing PIP joint arthroplasty (CapFlex-PIP, KLS Martin, Germany) were analysed. The primary outcome was active range of motion (ROM) measured before surgery and at several times up to five years after surgery. Grip strength, the brief Michigan Hand Outcomes Questionnaire (MHQ) and pain during daily activities were also assessed. Using </span>propensity score matching, 22 patients with post-traumatic OA were matched to 110 patients with primary OA based on their preoperative (baseline) ROM. Between-group differences were analysed using the Mann-Whitney U test or Fisher’s exact test.</div></div><div><h3>Results</h3><div>After matching, the mean baseline ROM of 34° (95% confidence interval [CI]: 22 to 46) for post-traumatic OA patients and 38° (CI: 34 to 42) for primary OA patients were comparable. By one year, ROM improved significantly after PIP arthroplasty to 53° (CI: 45 to 61) and 59° (CI: 55 to 63) for post-traumatic and primary OA patients respectively, and there was no significant difference between groups (p = 0.103). Thereafter, ROM declined in a similar manner for both groups over the 5-year follow-up period. The brief MHQ score and grip strength at baseline and the 1-year follow-up were significantly higher in the post-traumatic OA group. Complications occurred in five post-traumatic OA patients (23%) and in 15 patients (14%) with primary OA (p = 0.327).</div></div><div><h3>Conclusion</h3><div>Proximal interphalangeal joint surface replacement arthroplasty for post-traumatic osteoarthritis significantly improved range of motion, and this trend was similar to that achieved for patients with primary osteoarthritis. As clinical and patient-reported outcomes also improved, we recommend this procedure for patients with post-traumatic osteoarthritis, but the potentially higher risk of complications and reoperations for post-traumatic osteoarthritis patients should be considered.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102172"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061034","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":"Limited palmar fasciectomy combined with Z-plasty for Dupuytren’s disease: A 56 cases review","authors":"Nathan Guez ,&nbsp;Octave Dhellemmes ,&nbsp;Alexandre Bazeli ,&nbsp;Francesco Monti ,&nbsp;Isabelle Auquit-Auckbur","doi":"10.1016/j.hansur.2025.102206","DOIUrl":"10.1016/j.hansur.2025.102206","url":null,"abstract":"<div><h3>Introduction</h3><div><span>Fasciectomy is the gold standard for treating palmodigital cords in Dupuytren's disease. When </span>flexion contracture predominates at the metacarpophalangeal (MCP) joint, a segmental aponeurectomy in the palm combined with a Z-plasty can be performed.</div><div>The primary objective of this study was to evaluate the improvement in MCP extension achieved by this limited procedure. The secondary objectives were to assess long-term complications and recurrence rates.</div></div><div><h3>Materials and methods</h3><div>A retrospective study was conducted on patients who underwent pure palmar segmental fasciectomy with Z-plasty between 2014 and 2023. Palmar fasciectomy was performed on patients with exclusive or predominant MCP Dupuytren's contracture. This local fasciectomy procedure achieved full MCP joint extension. One or more Z-plasties enabled tension-free wound closure. Patients were reviewed, and extension deficit, complications, and recurrence were noted.</div></div><div><h3>Results</h3><div>46 patients (56 operated rays) were reviewed, with a mean follow-up period of 26 months (range 10–60 months). The mean preoperative MCP extension deficit was 48.4°. At the final follow-up, the mean MCP contracture was 6.1°, representing an improvement rate of 87%. Eleven patients experienced recurrence, five developed complex regional pain syndrome<span> after surgery and one had neurapraxia that resolved spontaneously.</span></div></div><div><h3>Discussion</h3><div><span>Segmental palmar fasciectomy and Z-plasty demonstrated substantial improvement in MCP extension. Complications appear to be fewer than with extended palmo-digital fasciectomy, and the recurrence rate is lower than with collagenase or </span>fasciotomy.</div></div><div><h3>Conclusion</h3><div>Limited palmar fasciectomy combined with Z-plasty is a simple, safe and effective treatment option for patients with MCP flexion contracture as the predominant or exclusive manifestation of Dupuytren’s disease.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102206"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487499","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":"High-resolution ultrasonography for extensor digiti minimi tendinopathy diagnosis","authors":"Hilmi Berkan Abacıoğlu,&nbsp;Berkay Yalçınkaya,&nbsp;Ahmet Furkan Çolak,&nbsp;Levent Özçakar","doi":"10.1016/j.hansur.2025.102209","DOIUrl":"10.1016/j.hansur.2025.102209","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102209"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512859","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":"A progressive learning strategy for flexor tendon repair for young surgeons","authors":"Nicolas Bigorre ,&nbsp;Thomas Daoulas","doi":"10.1016/j.hansur.2025.102173","DOIUrl":"10.1016/j.hansur.2025.102173","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102173"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096534","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":"Transfer of the long head of triceps branch to the anterior division of the axillary nerve for deltoid reanimation: Anterior or posterior approach? An anatomical study","authors":"Jean-Noël Goubier ,&nbsp;Tanguy Perraudin ,&nbsp;Camille Echalier","doi":"10.1016/j.hansur.2025.102211","DOIUrl":"10.1016/j.hansur.2025.102211","url":null,"abstract":"<div><div>Transferring the long head of the triceps nerve to the axillary nerve<span><span> is a widely used technique for restoring abduction and elevation of the shoulder in adults with partial brachial plexus lesions<span>. This procedure can be performed using either an anterior (axillary) or a posterior approach. This anatomical study aimed to compare the distance between the microsurgical<span> suture of the nerve transfer and the axillary nerve's entry into the middle and anterior deltoid, to determine which approach provides the shortest nerve </span></span></span>regrowth path.</span></div><div>The anatomical study was carried out on 12 subjects (i.e. 24 shoulders). For each subject, the transfer of the long portion of the triceps nerve to the anterior division of the axillary nerve was simulated. The microsurgical suture area was marked on the axillary nerve using stitches or clips. The nerve was then dissected and released until it entered the middle and anterior bundles of the deltoid via a lateral trans-deltoid route. The nerve was then cut flush with the muscle and recovered via the axillary route on ten shoulders (five right, five left) and via the posterior route on ten shoulders (five right, five left). The distance between the marker and the end of the axillary nerve was measured. The time taken to locate the teres minor branch after locating the axillary nerve through the anterior and posterior approaches was also noted.</div><div>On average, the distance between the suture and the nerve's entry into the deltoid was 74 mm for the anterior approach (ranging from 65 to 80 mm), and 62.4 mm for the posterior approach (ranging from 38 to 69 mm). There was a significant difference in length between the two approaches. The teres minor branch was located more quickly with the anterior approach (average time: 4 min, range 2−6 min) than with the posterior approach (average time: 18.1 min, range 16−21 min). This difference was significant (p &lt; 0.05).</div><div>In a nerve transfer, the distance between the suture and the recipient muscle affects the time taken for reinnervation<span><span> and therefore the outcome, given the progressive degradation of the motor end plates from the initial lesion. This study shows that the distance is significantly shorter via the posterior route. Reinnervation of the </span>deltoid muscle should therefore be faster and of better quality via this route. These results must be confirmed by a clinical study.</span></div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102211"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531960","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":"What long-term prospects for hand surgery education?","authors":"Nicolas Bigorre,&nbsp;Thomas Daoulas,&nbsp;Stéphane Guero","doi":"10.1016/j.hansur.2025.102218","DOIUrl":"10.1016/j.hansur.2025.102218","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 4","pages":"Article 102218"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621554","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":"Five-to-8-year prospective follow-up of 61 Touch® trapeziometacarpal prostheses","authors":"Cyril Falaise,&nbsp;Sandrine Boulat","doi":"10.1016/j.hansur.2025.102167","DOIUrl":"10.1016/j.hansur.2025.102167","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to evaluate the clinical and radiologic outcomes of the first patients who received a dual-mobility trapeziometacarpal prosthesis in our centre, for first carpometacarpal joint osteoarthritis, with a minimum 5-year follow-up.</div></div><div><h3>Patients and methods</h3><div>Fifty-seven patients received a total trapeziometacarpal ball-and-socket arthroplasty with the Touch® prosthesis for severe arthritis and one for significant laxity. Four patients underwent bilateral surgery. One was lost of follow-up and three died during the study. Function was assessed before surgery and at one, 3, 5 and 10-years follow-up visits. Visual analog scale for pain, active thumb range of motion, including Kapandji’s score, key-pinch grip strength and patients’ satisfaction outcomes were recorded by an independent observer. Standardized radiographs were obtained to assess osteolysis, loosening, and subsidence.</div></div><div><h3>Results</h3><div>Patients were followed for an average of 6.5 years (5–8.8). Pain decreased from 7.3 to 0.4, range of motion increased, and key grip strength improved from 67% to 102% of the contralateral side. Metacarpophalangeal hyperextension was present in 26 thumbs (46%) before surgery (5 severe, more than 30°), and in 19 thumbs (33%) at follow-up. Z-deformity was reported in 13 cases (23%) preoperatively and in 2 cases (4%) postoperatively. At maximum follow-up, radiographs showed minor osteolysis in 4 cases (7%) around the trapezium component and in 7 cases (12%) around the metacarpal component. One revision (2%) was required for cup loosening 7 years after surgery. All patients were satisfied or very satisfied with the treatment.</div></div><div><h3>Conclusions</h3><div>This prospective study of 61 Touch® dual mobility prostheses confirms that this implant is a safe and effective treatment option for trapeziometacarpal osteoarthritis in the short and medium term. Continued follow-up is necessary to assess the long-term outcomes of this arthroplasty.</div></div><div><h3>Level of evidence</h3><div>II.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 3","pages":"Article 102167"},"PeriodicalIF":0.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096577","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":"Ultrasound-guided trigger finger release with a minimally invasive knife: A retrospective analysis of 297 releases","authors":"Michiel Cromheecke ,&nbsp;Sebastiaan Bogaert ,&nbsp;Mathieu Dejonghe ,&nbsp;Pieter-Bastiaan De Keyzer ,&nbsp;Olivier Mares ,&nbsp;Jean Goubau ,&nbsp;Jean-Michel Cognet","doi":"10.1016/j.hansur.2025.102081","DOIUrl":"10.1016/j.hansur.2025.102081","url":null,"abstract":"<div><div>Trigger finger, or stenosing tenovaginitis, is a common condition characterized by impaired flexor tendon sliding due to thickening of the A1 pulley. While open surgical release remains the gold standard for the treatment of persistent trigger finger, there is increasing interest in minimally invasive ultrasound-guided techniques to improve precision and outcomes.</div><div>The purpose of this study is to evaluate the outcomes, safety, and complications associated with ultrasound-guided trigger finger release using a minimally invasive surgical knife.</div><div>We performed a retrospective analysis of 297 trigger finger releases performed on 238 patients between April 2021 and December 2023. All procedures were performed on the long fingers, excluding the thumb, using ultrasound guidance under WALANT or regional anesthesia. Patients were evaluated at 6 weeks and 3 months postoperatively for symptom resolution, complications, and functional recovery.</div><div>The procedure achieved a 100% success rate for complete release of the A1 pulley with no major complications or iatrogenic damage such as tendon or neurovascular injury. Minor complications, such as temporary postoperative loss of motion or localized pain, occurred in 33 cases (11.1%) and all resolved with conservative management by the three-month follow-up. Importantly, only one procedure required conversion to open surgery due to intraoperative uncertainty, where full release was confirmed.</div><div>Ultrasound-guided minimally invasive trigger finger release is a safe and effective technique. It provides precise release with a low risk of complications or iatrogenic damage. As ultrasound technology advances and availability increases, this technique has the potential to become a reliable and patient-friendly alternative to classic open methods.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 ","pages":"Article 102081"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967655","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}