Journal of Hand Surgery-American Volume最新文献

{"title":"The Likelihood of Future Dupuytren Disease Intervention After Initial Treatment in the Same Digit, Another Digit, and Contralateral Hand","authors":"Rayan El Bachaoui BSc,&nbsp;Ethan Cossu BS,&nbsp;Dafang Zhang MD,&nbsp;Brandon E. Earp MD,&nbsp;Philip E. Blazar MD","doi":"10.1016/j.jhsa.2026.05.004","DOIUrl":"10.1016/j.jhsa.2026.05.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Patients treated for Dupuytren contracture in one digit are at risk for future intervention in other digits or the contralateral hand. Identifying predictive factors can aid in patient counseling.</div></div><div><h3>Methods</h3><div>A single institutional database was queried for procedural codes for collagenase treatment or surgical fasciectomy. A total of 658 patients were identified in this query. Out of this cohort, 341 patients were eligible for inclusion. The cohort consists of 141 initially treated with fasciectomy and 200 initially treated with collagenase, between 2015 and 2019. The primary outcome was the need for subsequent treatment in the same digit, other digits of the same hand, or the contralateral hand. Predictor variables included demographics, medical history, and pretreatment contracture severity.</div></div><div><h3>Results</h3><div>At a mean follow-up of 5.3 years, 142 (42%) of patients underwent additional treatment. Revision procedures on the same digit occurred in 88 patients (26%) at a mean of 3.2 years, on another digit in the same hand in 35 patients (10%) at a mean of 3.6 years, and on the contralateral hand in 79 patients (23%) at a mean of 2.3 years. Procedure, multiple digits treated, and initial nontreated contracture are associated with subsequent procedures on the same digit. Younger age, active smoking, and initial nontreated contracture are associated with subsequent procedures on another digit in the same hand. Dominant hand was initially treated; initial nontreated contracture are associated with subsequent procedures on the contralateral hand.</div></div><div><h3>Conclusions</h3><div>Within 5 years of initial treatment for Dupuytren contracture in one digit, patients have over 40% likelihood of future intervention for contracture. Patients have approximately a 10% likelihood of future treatment on another digit in the same hand and nearly a 25% likelihood of future treatment in the contralateral hand. Key risk factors include age, multiple digits treated, smoking, and the presence of initially nontreated fingers, which should be incorporated into patient counseling.</div></div><div><h3>Type of study/level of evidence</h3><div>Prognostic III.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"51 10","pages":"Pages 1097-1106"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes After Treatment of Scaphoid Nonunion With Open Reduction Internal Fixation and Nonvascularized Autograft","authors":"Lynn Ann Forrester MD,&nbsp;Rafa Rahman MD,&nbsp;Raylin Xu MD,&nbsp;Michelle Carlson MD,&nbsp;Daniel Osei MD,&nbsp;Samir K. Trehan MD","doi":"10.1016/j.jhsa.2026.05.006","DOIUrl":"10.1016/j.jhsa.2026.05.006","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to assess outcomes after treatment of scaphoid nonunion with open reduction internal fixation and nonvascularized autograft (NVA).</div></div><div><h3>Methods</h3><div>This was a retrospective case series assessing all patients with scaphoid nonunions treated with open reduction internal fixation and NVA at a multispecialty orthopedic hospital from 2014 to 2024. Inclusion criteria were 12 weeks or greater from date of injury to date of surgery. Exclusion criteria were absence of postoperative CT scan or presence of additional local procedures. Radiographic healing was defined as 50% bridging bone on CT scan.</div></div><div><h3>Results</h3><div>Ninety-nine patients were included in this study: 45 patients were treated with cancellous only autograft (COA), 52 were treated with corticocancellous autograft (CCA), and 2 were treated with osteochondral autograft. Ninety-five percent of patients healed. Median time to healing was 81 days. On first postoperative CT, obtained at a median of 77 days after surgery, 75% of patients were healed. Eighty-nine percent of patients had bridging bone present on first CT; 99% of these patients went on to heal. Thirteen patients in this study had a prior attempt at surgical fixation at another institution; all healed after revision surgery. There were no significant differences in the odds of healing at any time point or the time to healing for patients treated with CCA versus COA.</div></div><div><h3>Conclusions</h3><div>Surgical treatment of scaphoid nonunion with NVA had a union rate of 95%. There were no significant differences in outcomes between patients treated with CCA and COA. Of patients who exhibited bridging bone on CT obtained at a median of 76 days after surgery, 99% went on to union. These findings support use of NVA for scaphoid nonunion and discourage the use of multiple postoperative CT scans to confirm healing.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic IV.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"51 10","pages":"Pages 1078-1083"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148207109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Generalized Joint Hypermobility a Risk Factor in the Development of Wrist Ganglion Cysts? A Retrospective Case-Control Study","authors":"Volkan Özel MD,&nbsp;İbrahim Halil Demir MD,&nbsp;Tuğrul Yıldırım MD","doi":"10.1016/j.jhsa.2026.05.007","DOIUrl":"10.1016/j.jhsa.2026.05.007","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to evaluate the association between ganglion cysts and generalized joint hypermobility and to identify potential independent risk factors.</div></div><div><h3>Methods</h3><div>In this retrospective case-control study, a total of 972 participants were included, comprising 243 patients diagnosed with ganglion cysts and 729 controls. Demographic characteristics, body mass index, occupational category, regular physical activity, and Beighton scores were recorded. Generalized joint hypermobility was defined as a Beighton score ≥4. Risk factors were analyzed using univariate and multivariate logistic regression models.</div></div><div><h3>Results</h3><div>There were no significant differences between the groups in terms of age (<em>P</em> = .185), sex (<em>P</em> = .629), body mass index (<em>P</em> = .412), or regular physical activity (<em>P</em> = .423). The proportion of individuals engaged in manual occupations was significantly higher in the ganglion cyst group compared to controls (<em>P</em> = .005). The mean Beighton score was significantly greater in patients with ganglion cysts and the prevalence of hypermobility was 64% in the ganglion group compared with 19% in controls. In multivariate analysis, hypermobility (adjusted OR, 7.1; 95% CI: 5.1–9.9) and manual occupation (adjusted OR, 1.4; 95% CI: 1.0–1.9) were identified as independent risk factors. A significant positive trend was observed across Beighton score categories.</div></div><div><h3>Conclusions</h3><div>Generalized joint hypermobility seems to be a strong and independent risk factor for the development of ganglion cysts. The risk increases substantially with greater severity of hypermobility. These findings suggest that intrinsic connective tissue characteristics may play a key role in the pathogenesis of ganglion cysts.</div></div><div><h3>Type of study/level of evidence</h3><div>Aetiology (risk factors) III.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"51 10","pages":"Pages 1107-1114"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treating Pregnant/Postpartum Patients in Hand Surgery Clinic: Answers to Common Questions that Every Hand Surgeon Should Know.","authors":"Amy K Fenoglio, Shannon L Son, Rebecca Milman, Sarah E Sibbel","doi":"10.1016/j.jhsa.2026.08.005","DOIUrl":"https://doi.org/10.1016/j.jhsa.2026.08.005","url":null,"abstract":"<p><p>Musculoskeletal complaints of the hand and upper-extremity are a common occurrence in pregnancy. From a surgeon perspective, caring for hand surgery patients in the pregnancy setting requires additional attention to ensure the safety of both the pregnant patient and the fetus or neonate. Many hand surgeons are less familiar with the nuanced care that may be required for this particular population. Pregnant patients frequently have questions regarding treatment plans with respect to fetal development risks, radiation safety thresholds, medical imaging considerations, and medication management. This article helps to summarize important topics related to pregnant/postpartum care and serves to address common clinical questions that may arise when providing nonsurgical care for the pregnant patient in the hand clinic setting.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intramedullary Fixation for Short and Long Oblique Metacarpal Fractures: A Biomechanical Analysis","authors":"Dang-Huy Do MD,&nbsp;Angel Valencia MD,&nbsp;Scott Oishi MD,&nbsp;Douglas Sammer MD,&nbsp;Daniel Koehler MD","doi":"10.1016/j.jhsa.2025.12.017","DOIUrl":"10.1016/j.jhsa.2025.12.017","url":null,"abstract":"<div><h3>Purpose</h3><div>To the best of our knowledge, no prior biomechanical study has determined how much fracture obliquity can be tolerated with intramedullary screw fixation. The purpose of this study was to compare the stiffness, load to failure, and fracture gapping of intramedullary fixation for oblique metacarpal fractures.</div></div><div><h3>Methods</h3><div>Forty-five metacarpal sawbones were divided into three fracture pattern treatment groups: transverse, short oblique, and long oblique. Fourth-generation sawbones models were used, which have been validated to simulate cortical bone strength and modulus. Osteotomies (0°, 30°, and 60°) were made through the shaft of each metacarpal to simulate fracture patterns, corresponding to each treatment group. Each metacarpal was reduced and fixed with a retrograde 3.5 × 52 mm intramedullary screw. Each construct was cycled under a cantilever bending force at a 45° angle to simulate physiologic loading and then loaded to failure. Stiffness, load to failure, and fracture gapping were measured and compared.</div></div><div><h3>Results</h3><div>There was no difference in the load to failure or stiffness among the three groups. The mean load to failure for the transverse, short oblique, and long oblique fractures was 222.0, 260.3, and 249.7 N, respectively, while the mean stiffness was 78.2, 78.3, and 72.2 MPa, respectively. Long oblique fractures had less gapping than short oblique and transverse fracture constructs following load removal. There was no difference in gapping between the short oblique and transverse fracture constructs. The mean fracture gapping for the transverse, short oblique, and long oblique fractures was 5.0, 3.3, and 0.6 mm, respectively.</div></div><div><h3>Conclusions</h3><div>Intramedullary fixation for simulated short oblique and long oblique metacarpal fracture patterns provides similar stability when compared to transverse fracture fixation.</div></div><div><h3>Clinical relevance</h3><div>Intramedullary fixation of oblique metacarpal fractures may be able to achieve adequate fixation, regardless of fracture obliquity.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"51 10","pages":"Pages 1085.e1-1085.e7"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146069023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic Treatment of Wrist Chondral Lesions Using Interposition Arthroplasty With Acellular Dermal Matrix: A Case Series and Surgical Technique.","authors":"Pedro J Delgado, Ricardo Kaempf, Alfonso Prada, Victor Trivino, Paula Fischer","doi":"10.1016/j.jhsa.2026.08.010","DOIUrl":"https://doi.org/10.1016/j.jhsa.2026.08.010","url":null,"abstract":"<p><strong>Purpose: </strong>Focal chondral lesions of the wrist are a frequent cause of pain and, despite their high incidence, there are no well-defined criteria for their treatment. For advanced focal chondral lesions (Outerbridge IV), treatment remains challenging. Although salvage procedures, such as arthrodesis provide reliable pain relief, joint-preserving techniques, have gained increasing interest in carefully selected patients because they may preserve wrist motion while delaying irreversible salvage surgery.</p><p><strong>Methods: </strong>We describe the surgical technique and the clinical and functional outcomes of a prospective case series of 17 patients with wrist osteoarthritis treated with arthroscopic interposition arthroplasty using an acellular dermal allograft.</p><p><strong>Results: </strong>The mean follow-up was 28 (12-78) months. Disabilities of the Arm, Shoulder, and Hand improved from 54.1 to 13.4 and pain (visual analog scale) from 6.8 to 2.1. Range of motion was preserved, with mean wrist flexion changed from 53° to 49° and extension from 48° to 45°. There was one case of radial sensory nerve neurapraxia with spontaneous resolution, one case of anchor removal, and one case of conversion to wrist arthrodesis.</p><p><strong>Conclusions: </strong>Arthroscopic interposition using acellular dermal matrix may represent a promising joint-preserving option to more aggressive salvage procedures for the treatment of wrist chondral lesions, providing pain relief and functional improvement without precluding or compromising future procedures.</p><p><strong>Type of study/level of evidence: </strong>Therapeutic IV.</p>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Ethics of Hand Transplants in Non-Immunocompromised Children","authors":"Jaclyn T. Mauch MD, MBE,&nbsp;Leah M. Gudex MD,&nbsp;Casey J. Humbyrd MD, MBE,&nbsp;Ines C. Lin MD, MSE,&nbsp;Christian J. Vercler MD, MBE","doi":"10.1016/j.jhsa.2026.02.008","DOIUrl":"10.1016/j.jhsa.2026.02.008","url":null,"abstract":"<div><div>Although hand transplantation in the adult population is increasingly recognized as an acceptable reconstructive treatment, the ethical trade-offs of performing hand transplants in the pediatric population require closer scrutiny. This analysis applies the concepts of the best interest standard, the Harm Principle, and protections for vulnerable populations to weigh the risks and benefits of immunocompetent pediatric hand transplantation. As only two pediatric hand transplants have been performed to date, much of the outcome data has been extrapolated from the adult population. Such comparisons are problematic given differences in physiology, psychosocial development, adherence, and increased risks of lifelong immunosuppression—including infection, organ failure, and early mortality. Given these uncertainties and our current ethical analysis, immunocompetent pediatric hand transplantation remains ethically impermissible outside of rigorously designed and transparent clinical trials.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"51 10","pages":"Pages 1117-1123"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147619119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Talk Through the Hand: Upper-Extremity Injury and Surgical Considerations in Sign Language Users","authors":"Sarah A. Uriarte BS,&nbsp;Jason Nguyen BS,&nbsp;Ali Mansour BS,&nbsp;Elijah M. Persad MD,&nbsp;Vinay Rao MD, MPH,&nbsp;Reena A. Bhatt MD","doi":"10.1016/j.jhsa.2026.02.024","DOIUrl":"10.1016/j.jhsa.2026.02.024","url":null,"abstract":"<div><div>Sign language is a predominant form of nonverbal communication in the United States with 7 million signers nationally, one million of which are deaf or hard-of-hearing. This population is particularly vulnerable to impaired communication when confronting upper-extremity impairment resulting from extensive long-term use in their communication. Given the high importance of adequate upper-extremity mobility for sign language users, hand surgeons must carefully choose the appropriate treatment modalities to minimize disruptions in this population’s ability to communicate in their daily lives. This article provides important background and clinical considerations when working with such patients.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"51 10","pages":"Pages 1124-1131"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, Timing, and Predictors of Staged Contralateral Carpal Tunnel Release at Minimum Ten-Year Follow-Up from Unilateral Surgery","authors":"Luna Toma,&nbsp;Rose Meng Gold BS,&nbsp;Ethan Cossu BS,&nbsp;Leah Demetri MD,&nbsp;Brandon E. Earp MD,&nbsp;Philip E. Blazar MD,&nbsp;Dafang Zhang MD","doi":"10.1016/j.jhsa.2026.05.012","DOIUrl":"10.1016/j.jhsa.2026.05.012","url":null,"abstract":"<div><h3>Purpose</h3><div>Carpal tunnel syndrome is one of the most prevalent upper-extremity disorders. It may present unilaterally, bilaterally, or on the contralateral hand at a subsequent time to initial carpal tunnel release (CTR). We aimed to assess the incidence, timing, and factors associated with contralateral CTR at the time of an index unilateral surgery.</div></div><div><h3>Methods</h3><div>We performed a retrospective chart review of 1,291 primary unilateral CTR surgeries performed from 2008 to 2013 with a minimum follow-up period of 10 years within our integrated health network. In total, 742 (58%) patients met our inclusion criteria. We conducted bivariate analyses to assess for risk factors associated with contralateral CTR. Odds ratios were calculated for variables with significant results. A Kaplan–Meier curve was generated to depict the overall cumulative rate of contralateral CTR-free survival.</div></div><div><h3>Results</h3><div>Of the 742 patients included, 314 patients (42%) underwent contralateral CTR surgery at a median of 10.6 months (IQR 4.2 months to 2.7 years) after primary surgery. The incidence of contralateral CTR after 1, 2, 5, and 10 years is 22%, 26%, 34%, and 40%, respectively. The strongest predictor was the presence of contralateral carpal tunnel syndrome symptoms at the time of index surgery (odds ratio [OR] 7.2, <em>P</em> &lt; .05). Other significant risk factors included preoperative contralateral electrodiagnostic study severity (OR 1.43 per unit increase, <em>P</em> &lt; .001) and a concurrent diagnosis of trigger finger (OR 1.80, <em>P</em> &lt; .05). Black race was associated with significantly lower odds of contralateral surgery (OR 0.44, <em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>The incidence of contralateral CTR surgery is substantial over long-term follow-up. The observed association among trigger finger, Black race, and contralateral CTR warrants further research. Our findings help to inform preoperative counseling for patients undergoing unilateral CTR.</div></div><div><h3>Type of study/level of evidence</h3><div>Prognostic III.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"51 10","pages":"Pages 1087-1094"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Anatomical Equivalence Study of the Capitate and the Second Metatarsal Head as a Donor for Lunocapitate Articular Reconstruction","authors":"Hayato Kuno MD,&nbsp;Yukichi Zenke MD, PhD,&nbsp;Akinori Sakai MD, PhD","doi":"10.1016/j.jhsa.2026.05.001","DOIUrl":"10.1016/j.jhsa.2026.05.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the anatomical equivalence of the proximal articular surface of the capitate and the second metatarsal head as potential donor–recipient surfaces for lunocapitate reconstruction.</div></div><div><h3>Methods</h3><div>Ten capitates and 10 second metatarsals were excised from the bilateral hands and feet of five cadaver specimens. Frontal and sagittal photographs were obtained for each specimen, and articular parameters, including head width, length, thickness, and radius of curvature, were measured using standardized two-dimensional analysis. Morphological equivalence was assessed using paired two one-sided tests with predefined equivalence margins. Sagittal analysis included both radial and ulnar views, as well as crossed-orientation comparisons to simulate nonipsilateral grafting conditions. Three-dimensional surface analysis of a representative specimen was conducted for qualitative validation.</div></div><div><h3>Results</h3><div>Equivalence was demonstrated for head width in the frontal view. In sagittal analyses, the radius of curvature consistently met equivalence criteria across both ipsilateral and crossed-orientation comparisons. Three-dimensional analysis demonstrated close overall surface congruity after rigid registration, supporting the two-dimensional findings.</div></div><div><h3>Conclusions</h3><div>Critical articular parameters, specifically head width and radius of curvature, demonstrated robust anatomical equivalence between the proximal articular surface of the capitate and the second metatarsal head across multiple orientations. These findings provide an anatomical rationale for considering the second metatarsal head as a donor for lunocapitate reconstruction.</div></div><div><h3>Clinical relevance</h3><div>Anatomical equivalence of articular geometry, particularly curvature, supports rational donor-site selection for capitate reconstruction when preservation of joint congruity is prioritized.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"51 10","pages":"Pages 1115.e1-1115.e8"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}