Hand surgery & rehabilitation最新文献

{"title":"Influence of Screw Length, Diameter, and Immobilization on Percutaneous Scaphoid Fixation: A Retrospective Study of 249 Acute Scaphoid Fractures.","authors":"Jean-Baptiste de Villeneuve Bargemon, Emily Haynes Simmons, David Rakotondralay, Marie Witters, Lucas Audiffret, Camille Brenac, Rémy Dubian","doi":"10.1016/j.hansur.2026.102773","DOIUrl":"https://doi.org/10.1016/j.hansur.2026.102773","url":null,"abstract":"<p><strong>Introduction: </strong>Articular screw protrusion remains frequent after percutaneous fixation of acute scaphoid fractures and may be influenced by screw length and positioning. This study evaluated the influence of screw length, diameter, direction, and postoperative immobilization on fracture union and CT-detected articular protrusion.</p><p><strong>Hypothesis: </strong>Shorter screws are associated with a lower rate of CT-detected articular protrusion without an observed reduction in fracture union.</p><p><strong>Methods: </strong>This retrospective single-center study included 249 adults treated with percutaneous screw fixation for acute scaphoid fractures between 2017 and 2026. Fracture union and CT-detected articular protrusion on postoperative CT were the primary outcomes. Protrusion was defined as ≥1 mm beyond the osseous articular boundary. Screw length was primarily analyzed as a continuous variable, with an additional comparison between screws ≤20 mm and ≥22 mm. A screw-to-scaphoid length ratio was also calculated. Multivariable logistic regression was performed to identify factors associated with CT-detected articular protrusion.</p><p><strong>Results: </strong>Overall union was achieved in 232 cases (93.2%), whereas CT-detected articular protrusion was observed in 130 cases (52.2%). Protrusion was significantly less frequent with screws ≤20 mm than with screws ≥22 mm (25.9% vs 60.2%; p < 0.001), while union rates were similar (93.1% vs 93.2%; p = 1.000). Each 1-mm increase in screw length was independently associated with higher odds of CT-detected articular protrusion (OR 1.32; 95% CI 1.16-1.50; p < 0.001). Similarly, a higher screw-to-scaphoid length ratio was independently associated with protrusion (OR 1.73 per 0.10 increase; 95% CI 1.26-2.37; p < 0.001). Screw diameter, fixation direction, and postoperative immobilization duration were not significantly associated with union.</p><p><strong>Conclusion: </strong>In this retrospective cohort, shorter screws were associated with a substantially lower rate of CT-detected articular protrusion, while no lower union rate was observed. The association persisted after normalization of screw length to individual scaphoid length. These findings support considering shorter screw fixation when anatomy and fracture configuration allow, although prospective studies incorporating clinical outcomes are required to determine the clinical significance of CT-detected protrusion and the optimal screw length.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102773"},"PeriodicalIF":1.0,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: Synthetic dermal substitute as an extension of occlusive treatment for complex fingertip pulp defects. Rieussec C, Juan A, Mari R, Huttin G, Forli A. Hand Surg Rehabil. 2026 Aug; 45(4):102760.","authors":"Domenico Marrella, Philippe Liverneaux","doi":"10.1016/j.hansur.2026.102772","DOIUrl":"https://doi.org/10.1016/j.hansur.2026.102772","url":null,"abstract":"","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102772"},"PeriodicalIF":1.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148883039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term functional and aesthetic outcomes of the Joshi and Pho Flap for subtotal digital pulp reconstruction: A retrospective case series of 14 patients.","authors":"Rachel Le Dreau, Marine Aubey, Christophe Hulet, Gaëlle Maroteau, Isabelle Auquit-Auckbur","doi":"10.1016/j.hansur.2026.102766","DOIUrl":"https://doi.org/10.1016/j.hansur.2026.102766","url":null,"abstract":"<p><strong>Purpose: </strong>Fingertip injuries are very common and can lead to significant functional impairment or even loss of finger function. Techniques for pulp reconstruction often involve the use of flaps. The Joshi and Pho flap is a single-pedicle island flap. Our purpose was to evaluate the long-term functional and aesthetic outcomes of the Joshi and Pho flap in digital pulp reconstruction from 2010 to 2022 in a University Hospital.</p><p><strong>Methods: </strong>An observational retrospective single-center study included 14 patients who underwent Joshi and Pho flap reconstruction for subtotal pulp defects between 2010 and 2022, with a minimum follow-up of 12 months. The primary outcome was functional recovery assessed by the DASH score. Secondary outcomes included pain (VAS, DN4), joint mobility, sensibility (two-point discrimination, Semmes-Weinstein monofilament test), scar quality (POSAS scale, donor site morbidity), flap survival and complications.</p><p><strong>Results: </strong>The mean follow up duration was 78 month (min-max : 12-183). The mean DASH score was 22.16/100 (min-max: 5-45; SD: 11.9). Pain scores were low (VAS: 0.64 SD; DN4: 0.5 SD). DIP flexion was statistically reduced on the injured side (58 ° vs 63 °, p < 0.01), but the clinical relevance of this reduction was limited. Two-point discrimination averaged 5.4 mm and the mean Semmes-Weinstein monofilament test was 3,5 mm with 6 patients (43%) grade 6. POSAS scale were 13.9/60 (patient) and 17.7./50 (observer). No flap necrosis was observed. One infection led to secondary amputation. Donor-site morbidity was minimal with no case of hook deformation ou ungual dystrophy.</p><p><strong>Conclusion: </strong>The Joshi and Pho flap provides a durable and sensible coverage for subtotal digital pulp defects with satisfactory long-term function and aesthetic outcomes. It remains a valuable reconstructive option in hand surgery.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102766"},"PeriodicalIF":1.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Isometric deviation and forearm position on the Scapholunate Space - An in Vivo Ultrasound Study.","authors":"Grégory Mesplié, Benjamin Rey, Hugo Pelet","doi":"10.1016/j.hansur.2026.102770","DOIUrl":"https://doi.org/10.1016/j.hansur.2026.102770","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the in vivo effects of forearm rotation and selective isometric wrist muscle activation on the dorsal scapholunate (SL) interval using dynamic ultrasonography, and to determine whether previously described cadaveric biomechanical mechanisms are reproducible in healthy subjects.</p><p><strong>Methods: </strong>Twenty-four asymptomatic adults underwent ultrasonographic assessment of the dorsal SL interval under six experimental conditions combining forearm position (maximal pronation or maximal supination) and contraction state (rest, resisted isometric radial deviation, resisted isometric ulnar deviation). Measurements were obtained using a standardized dynamic ultrasound protocol. Intra-rater reliability was assessed using ICC(3,1). A 2 × 3 repeated-measures ANOVA with Bonferroni-adjusted planned contrasts was performed.</p><p><strong>Results: </strong>Ultrasound measurements demonstrated good-to-excellent reliability (ICC = 0.82-0.99). Significant main effects were identified for both forearm position (F(1,23) = 20.15, p < 0.001, η²p = 0.467) and contraction condition (F(1.32,30.37) = 140.40, p < 0.001, η²p = 0.86) on the dorsal SL interval. Resisted isometric radial deviation significantly decreased the SL interval compared with rest (p < 0.0001), whereas resisted isometric ulnar deviation significantly increased it (p < 0.0001). Maximal forearm supination resulted in significantly greater SL widening than maximal pronation (p = 0.0002). No significant interaction effect was observed between forearm position and contraction condition.</p><p><strong>Conclusion: </strong>Selective wrist muscle activation and forearm rotation significantly influence the dorsal SL interval in vivo. Radial deviation appears to exert a protective stabilizing effect on the SL complex, whereas ulnar deviation increases SL separation, likely through ECU-mediated intracarpal pronation. These findings support rehabilitation strategies emphasizing activation of intracarpal supinator muscles while minimizing ECU recruitment during conservative or postoperative management of SL instability.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102770"},"PeriodicalIF":1.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated extensor carpi radialis brevis avulsion fracture: successful fixation with two Kirschner wires.","authors":"Stéphane Méo, Benoît Pedeutour","doi":"10.1016/j.hansur.2026.102767","DOIUrl":"10.1016/j.hansur.2026.102767","url":null,"abstract":"","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102767"},"PeriodicalIF":1.0,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148858022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study of Elbow-Flexion Gain in Patients with Upper Brachial Plexus Injury Using the Oberlin Neurotization Technique versus Free Gracilis Muscle Transplantation Neurotized with an Ulnar Nerve Fascicle.","authors":"Antonio Isidoro de Sousa Neto, Fabio de França Urquiza, Álvaro Baik Cho, Raquel Bernardelli Iamaguchi, Leandro Yoshinobu Kiyohara, Marcelo Rosa de Rezende","doi":"10.1016/j.hansur.2026.102768","DOIUrl":"https://doi.org/10.1016/j.hansur.2026.102768","url":null,"abstract":"<p><strong>Introduction: </strong>There is a consensus in the literature regarding the excellent outcomes achieved with the Oberlin procedure for the treatment of upper brachial plexus injuries (C5-C6 and/or C7) in restoring elbow flexion. However, some limitations exist when this procedure is performed long after the initial trauma. An alternative is the free gracilis muscle transfer, using a fascicle of the ulnar nerve as the donor nerve. The aim of this study was to compare the Oberlin procedure and free functional gracilis muscle transfer in terms of elbow flexion strength recovery.</p><p><strong>Methods: </strong>A non-randomized retrospective cohort study was conducted comparing these two techniques in 69 patients with upper brachial plexus injuries, evaluating postoperative elbow flexion strength. The minimum follow-up period was 12 months.</p><p><strong>Results: </strong>With regard to elbow flexion recovery, there was no statistically significant difference in the proportion of good results (M4 strength) between the two groups (60.4% for the Oberlin group and 61.9% for the free gracilis group). When subdividing the Oberlin group according to the maximum time interval between injury and surgery (≤6, ≤9, and ≤12 months), the rates of good results (M4) were 65.2%, 60.4%, and 58.3%, respectively. No statistically significant differences were found either among these subgroups or between any of them and the free muscle transfer group.</p><p><strong>Conclusion: </strong>The Oberlin procedure provides elbow flexion strength comparable to that achieved with free functional muscle transfer when performed within 12 months after the initial brachial plexus injury.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102768"},"PeriodicalIF":1.0,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The control of movement in the hand and the response to injury.","authors":"Daniel J Brown, Sharon Gillespie, Graham Cheung","doi":"10.1016/j.hansur.2026.102765","DOIUrl":"10.1016/j.hansur.2026.102765","url":null,"abstract":"<p><p>Hand movements involve the synchronous activation of up to 40 muscles moving up to 20 joints in 27 planes. With a near infinite possible combination of movements in the wrist and hand, control of this movement needs to be incredibly complicated, yet it is automatic and autonomous. The control of these movements is simplified by breaking down the common movements into smaller groups of movement, or synergies, that accomplish everyday tasks. The control of these synergies of hand movement is coordinated within the brainstem and spinal cord, not the sensorimotor cortex, and indeed conscious attempt at control can disrupt, rather than improve, these pathways. This paper is a comprehensive review of the various anatomical, biomechanical, neuroscience and psychological literature concerning this subject and explains the normal movement of the hand, the normal control of this movement and how these movements and control mechanisms are affected by injury and surgery.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102765"},"PeriodicalIF":1.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of hand and upper extremity surgery in patients with or at risk for lymphedema: A systematic review.","authors":"David Jann, Alexander Lunger, Maurizio Calcagni, Inga S Besmens","doi":"10.1016/j.hansur.2026.102764","DOIUrl":"10.1016/j.hansur.2026.102764","url":null,"abstract":"<p><strong>Background: </strong>Surgical procedures in patients with or at risk for lymphedema are often discouraged. This systematic review evaluates the safety of hand and upper extremity surgery in this population.</p><p><strong>Methods: </strong>A systematic review was conducted according to PRISMA guidelines. MEDLINE, Embase, Web of Science, and the Cochrane Library were searched. Studies reporting outcomes following hand or upper extremity surgery in patients with preexisting or at-risk lymphedema were included. Primary outcomes were new-onset or worsening lymphedema; secondary outcomes included complications and tourniquet use. A qualitative synthesis was performed.</p><p><strong>Results: </strong>Eight studies comprising 407 patients were included, of whom 95 had documented preexisting lymphedema; seven studies were retrospective and one was a prospective nonrandomized cohort. New-onset lymphedema was rare, and no consistent signal of permanent worsening was observed, although the overall certainty of evidence was very low. Transient postoperative swelling and minor complications were reported. One prospective cohort directly compared tourniquet-assisted with non-tourniquet surgery and found no clear difference in postoperative lymphedema, but it was underpowered and events were rare.</p><p><strong>Conclusion: </strong>Available very-low-certainty evidence does not demonstrate a consistent signal of permanent lymphedema progression after short-duration elective hand surgery, such as carpal tunnel release. These findings support an individualized, indication-based approach to surgical decision-making, rather than routine avoidance of indicated procedures in the affected limb.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102764"},"PeriodicalIF":1.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revision of failed Rubis II prostheses with a dual-mobility Touch implant.","authors":"Alix Dessirier, Oussama Abcha, Emmanuel Mimran, Mirdad Moughabghab, Nicolas Lebeau","doi":"10.1016/j.hansur.2026.102763","DOIUrl":"10.1016/j.hansur.2026.102763","url":null,"abstract":"<p><strong>Objectives: </strong>Trapeziometacarpal osteoarthritis is the most prevalent upper limb arthropathy. Total joint arthroplasty has established itself as a trapezium-preserving alternative to trapeziectomy, but single-mobility implants carry a significant risk of dislocation. When revision is required, conversion to a dual-mobility implant is an appealing option, yet no published series has specifically evaluated the outcomes of this procedure. This study aimed to assess implant survival, functional outcomes and complications after revision trapeziometacarpal arthroplasty by conversion from the single-mobility Rubis II prosthesis to the dual-mobility Touch prosthesis.</p><p><strong>Material and methods: </strong>A single-centre retrospective study was conducted at the Centre Hospitalier de Saint-Quentin, including all consecutive patients who underwent revision trapeziometacarpal arthroplasty by conversion to the Touch prosthesis between 2019 and 2025, with a minimum follow-up of six months. Functional outcomes were assessed using the QuickDASH and Patient-Rated Wrist Evaluation (PRWE) scores; pain was evaluated using a visual analogue scale (VAS). Complications and reoperations were recorded for all 30 cases. Implant survival without reoperation was estimated using Kaplan-Meier analysis.</p><p><strong>Results: </strong>Thirty cases were included. Functional analysis was performed in 18 cases with available functional follow-up data (four excluded after secondary prosthesis removal, eight with missing data). Mean QuickDASH was 30.3 ± 26.2 and mean PRWE was 26.5 ± 23.5. VAS at rest was low (mean 0.9, median 0). Complications occurred in six cases (20.0%), comprising five mechanical complications (16.7%) and one persistent pain without reoperation (3.3%). Reoperation was required in five cases (16.7%), of which three occurred within four months. Kaplan-Meier survival without reoperation was 86.7% (95% CI: 68.3-94.8 %) at one year and 83.3% (95% CI: 64.5-92.7 %) at two years.</p><p><strong>Conclusion: </strong>Revision trapeziometacarpal arthroplasty by conversion from a single-mobility Rubis II prosthesis to a dual-mobility Touch prosthesis is a feasible salvage option, achieving satisfactory functional outcomes, near-complete rest pain relief, and an implant survival without reoperation of 83.3% at two years.</p><p><strong>Level of evidence: </strong>IV (retrospective observational study).</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102763"},"PeriodicalIF":1.0,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disease-modifying antirheumatic drugs for hand osteoarthritis: A systematic review and network meta-analysis.","authors":"Pei Dong, Qianle Zhao, Bo Yang, Wulin Kang, Puwei Yuan","doi":"10.1016/j.hansur.2026.102762","DOIUrl":"10.1016/j.hansur.2026.102762","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To compare the symptomatic efficacy, safety, and exploratory structural evidence of disease-modifying antirheumatic drug therapies in patients with hand osteoarthritis, with particular attention to inflammatory and erosive phenotypes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We searched PubMed, Web of Science, Embase, the Cochrane Library, ClinicalTrials.gov, and the Chinese Clinical Trial Registry from inception to 12 March 2026 for randomized controlled trials evaluating disease-modifying antirheumatic drug therapies in hand osteoarthritis. Eligible trials included patients with general, inflammatory, erosive, or thumb-base hand osteoarthritis, while studies involving rheumatoid arthritis or other inflammatory arthritides were excluded. Interventions were classified as conventional synthetic or biologic disease-modifying antirheumatic drugs. Pain intensity and hand function were considered primary clinical outcomes. Inflammatory symptom-related outcomes, including swollen and painful joint counts and stiffness, were analysed separately. Treatment-emergent adverse events and serious adverse events were primary safety outcomes, while imaging and biomarker outcomes were treated as exploratory evidence related to potential structural disease modification. A frequentist network meta-analysis was performed. Continuous outcomes were summarized as standardized mean differences and dichotomous outcomes as odds ratios, both with 95% confidence intervals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Twelve randomized controlled trials involving 1317 participants and seven active disease-modifying antirheumatic drug therapies were included. Methotrexate and hydroxychloroquine were classified as conventional synthetic disease-modifying antirheumatic drugs, whereas adalimumab, etanercept, tocilizumab, lutikizumab, and otilimab were classified as biologic disease-modifying antirheumatic drugs. No eligible trial of a targeted synthetic disease-modifying antirheumatic drug was identified. For pain intensity outcomes, etanercept and tocilizumab were associated with lower long-term visual analogue scale pain than placebo, whereas no intervention showed consistent improvement in hand function. For inflammatory symptom-related outcomes, tocilizumab showed a short-term reduction in painful and swollen joint counts, and adalimumab reduced swollen joint counts in some analyses. However, these findings were outcome-specific, time-dependent, and largely based on sparse, placebo-centred networks. No clear differences were detected in overall treatment-emergent adverse events or serious adverse events, but safety evidence was limited by small sample sizes, short exposure durations, and inconsistent adverse-event reporting. Imaging and biomarker outcomes were heterogeneous and insufficient for quantitative synthesis across most endpoints.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Current randomized evidence does not support the routine use of disease-modifying antirheumati","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102762"},"PeriodicalIF":1.0,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}