Hand surgery & rehabilitation最新文献

{"title":"Response to \"Comment on: Simplified oral antibiotic regimen for pyogenic flexor tenosynovitis - What is the safety net after same-day discharge?\"","authors":"Nicolas Bigorre, Ewen Lataste","doi":"10.1016/j.hansur.2026.102808","DOIUrl":"10.1016/j.hansur.2026.102808","url":null,"abstract":"","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102808"},"PeriodicalIF":1.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149120824","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 \"Functional and aesthetic outcomes after index pollicization using two different techniques in children with thumb hypoplasia - A comparative study\" by K Hachem, M Bachy-Razzouk M, C Martinot-Lagarde, E Saghbiny, F Fitoussi. Hand Surg Rehabil. 2025;44(4):102221.","authors":"Nitin Jain","doi":"10.1016/j.hansur.2026.102810","DOIUrl":"https://doi.org/10.1016/j.hansur.2026.102810","url":null,"abstract":"","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102810"},"PeriodicalIF":1.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149120859","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":"A comparison of treatment outcomes of partial and complete radial collateral ligament tears of the index and long finger.","authors":"Liliane A Freundt, Ingmar W F Legerstee, Floris V Raasveld, Maximilian Mayrhofer-Schmid, Cameron Darnell, Hinne Rakhorst, Neal C Chen, Kyle R Eberlin","doi":"10.1016/j.hansur.2026.102807","DOIUrl":"10.1016/j.hansur.2026.102807","url":null,"abstract":"<p><strong>Background: </strong>The radial collateral ligament (RCL) is essential for metacarpophalangeal joint stability and plays a crucial part in pinch and grip strength of the index and long finger.</p><p><strong>Methods: </strong>This study compared treatment patterns and patient-reported outcomes for partial and complete RCL tears of the index and long finger. A database from six U.S. urban hospitals was reviewed for RCL injuries to the index or long finger between January 2004 and March 2022. Eligible patients were asked to complete the QuickDASH questionnaire. The injury-to-study inclusion interval showed a median of 5.7 years. Patients were classified according to initially intended treatment and definitive treatment. Nonoperative treatment failure was defined as conversion to surgery after initially intended nonoperative treatment.</p><p><strong>Results: </strong>Seventy-three patients with RCL injuries (46 index, 27 long finger) were included. Twenty-five of 46 (54%) index and eleven of 27 (41%) long finger injuries underwent surgical treatment. Of 66 patients eligible for QuickDASH assessment, 58% completed the questionnaire. Complete RCL tears treated nonoperatively had the highest median QuickDASH score (14, n = 5), and partial RCL tears treated nonoperatively had the lowest median QuickDASH score (0, n = 14). The ligament ruptured from the proximal metacarpal attachment in 33/44 (75%) of all cases. Conversion to surgery after initially intended nonoperative treatment occurred in six out of 12 (50%) complete RCL tears of the index finger and eight out of 15 (53%) of the long finger.</p><p><strong>Conclusion: </strong>Complete tears treated nonoperatively had higher median QuickDASH scores than complete RCL tears treated surgically, while partial tears treated nonoperatively had the lowest scores overall. Conversion to surgery after initially intended nonoperative treatment was ≥50% for complete RCL tears. Our descriptive findings are hypothesis-generating and suggest surgical treatment for complete RCL may be considered for shared decision-making in symptomatic patients with high functional demand, pending confirmation in larger, prospective studies.</p><p><strong>Level of evidence: </strong>Therapeutic III.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102807"},"PeriodicalIF":1.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077085","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":"Emergency hand surgery without interruption of antithrombotic therapy: postoperative bleeding risk.","authors":"Guillaume Davy, Corinne Dussaussoy, Nicolas Bigorre","doi":"10.1016/j.hansur.2026.102806","DOIUrl":"10.1016/j.hansur.2026.102806","url":null,"abstract":"<p><p>The perioperative management of antithrombotic therapy in hand surgery involves striking a delicate balance between the risk of thromboembolism associated with discontinuing treatment and a risk of bleeding that is generally low but sometimes a cause for concern in clinical practice. This issue is even more critical in emergency situations, where the urgency of the procedure does not always allow for treatment to be adjusted in line with the standard protocols for elective surgery. The primary objective was to assess whether simple emergency hand surgery in patients on uninterrupted antithrombotic therapy was associated with an increased risk of postoperative local hemorrhagic events compared with elective carpal tunnel surgery. The secondary objective was to identify the factors associated with the occurrence of such an event. This was a prospective, observational, single-center study conducted between January 2024 and December 2025. The study included 390 patients on antithrombotic therapy who underwent either elective carpal tunnel surgery or simple emergency hand surgery, under peripheral nerve block or WALANT anesthesia. In the carpal tunnel control group, antiplatelet agents were continued, direct oral anticoagulants were discontinued in accordance with local protocol, and vitamin K antagonists were maintained or adjusted according to the INR. In the emergency group, treatments were neither discontinued nor modified. The primary endpoint was the occurrence, within 30 days of a postoperative local hemorrhagic event, classified as minor or clinically significant. Of the patients included, 241 were in the carpal tunnel group and 149 in the emergency group. Fifty-eight postoperative bleeding events were observed, representing 14.9% of the cohort, of which 57 were minor and 1 was clinically significant. No reoperation was required. The rate of bleeding events did not differ between the carpal tunnel group and the emergency group, at 14.5% and 15.4% respectively (p = 0.92). In exploratory multivariate analysis, the emergency setting was not associated with the occurrence of a bleeding event (adjusted OR 1.23; 95% CI 0.65-2.32; p = 0.52). In this single-center cohort, simple hand surgery performed as an emergency in patients on uninterrupted antithrombotic therapy was not associated with an increased risk of postoperative local bleeding compared with elective carpal tunnel surgery. The events observed were almost exclusively minor. These results suggest that prompt surgical management in an emergency setting may be considered without systematic deferral based solely on antithrombotic status, provided the procedure is simple and carries a low risk of bleeding.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102806"},"PeriodicalIF":1.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066785","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":"Acute herpes zoster-like eruption in a free flap after reconstruction of post-burn hand contracture: A case report.","authors":"Jong-Koo Lee, Jeong Tae Kim","doi":"10.1016/j.hansur.2026.102805","DOIUrl":"10.1016/j.hansur.2026.102805","url":null,"abstract":"<p><p>Herpes zoster involving transferred free-flap skin is rare, particularly during the immediate postoperative period. A 49-year-old man underwent release of severe post-burn contracture of the left hand and wrist and reconstruction with a lateral thoracic perforator free flap. Pruritus and erythema developed on the contralateral upper back on postoperative day (POD) 0, followed by a thoracic dermatomal vesicular eruption on POD 3 that was clinically diagnosed as herpes zoster. Intravenous acyclovir was initiated. On POD 6, morphologically similar vesicles appeared on the transferred flap, and distal partial flap necrosis subsequently demarcated. Herpes simplex virus testing was negative, but varicella-zoster virus testing was unavailable; therefore, involvement of the flap could not be virologically confirmed. This unusual temporal sequence highlights viral reactivation as a differential consideration when vesicular lesions appear during early free-flap monitoring, while standard assessment for vascular compromise must continue.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102805"},"PeriodicalIF":1.0,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009602","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":"Modern Nerve Surgery Applied to Biopsy Evaluation for Neuromuscular Disorders.","authors":"Aneri U Patel, Noah S Llaneras, Andrea Biaggi-Ondina, Michelle Seu, Erin L Langton, Susan E Mackinnon","doi":"10.1016/j.hansur.2026.102803","DOIUrl":"https://doi.org/10.1016/j.hansur.2026.102803","url":null,"abstract":"<p><strong>Purpose: </strong>Expendable nerves commonly used in nerve transfer surgery may serve as options for diagnosing peripheral neuropathies, potentially improving outcomes compared to traditional sural nerve biopsies. This study compares diagnostic utility of sural nerve biopsies versus other nerve biopsies and evaluates patient-reported postoperative pain following sural nerve biopsy with allograft reconstruction.</p><p><strong>Methods: </strong>A retrospective review of patients undergoing diagnostic sural or other nerve ± muscle biopsies at a quaternary referral center from January 2020 to July 2025 was conducted. Patient demographics, biopsy sites, and diagnostic outcomes were recorded. Chi-square test assessed association between biopsy site and diagnostic utility. Patients who underwent sural nerve biopsy were called at a median 706 (481, 1192) days after surgery regarding new pain at the biopsy site. Significance was set at p <  0.05.</p><p><strong>Results: </strong>Among 97 patients (57.7% male; median age 67 (58, 73) years), 108 nerves and 103 muscles were biopsied. Common non-sural nerve biopsies included the anterior interosseous nerve (AIN) (13.0%), palmar cutaneous nerve (3.7%), and nerve to flexor digitorum superficialis (3.7%). A confirmed diagnosis was noted by the referring neurologist in 77% of sural biopsies, 79% of AIN biopsies, and 94% other nerve biopsies (p =  0.308). Thirty-four out of 37 (91.9%) patients reported no new pain at the sural biopsy site.</p><p><strong>Conclusion: </strong>In this study, the diagnostic utility of sural nerve biopsies exceeds existing literature and compares to other nerve biopsies. Expendable nerves may serve dual roles as donors for nerve transfer and targets for diagnostic biopsy. Moreover, standardized allograft reconstruction may reduce postoperative pain.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102803"},"PeriodicalIF":1.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984439","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":"Compliance with thermoformed splint immobilization in fifth metacarpal fractures: Focus on punching injuries.","authors":"Erwan Le Hir, Nicolas Bigorre, Pierre Maincourt, Thomas Daoulas","doi":"10.1016/j.hansur.2026.102775","DOIUrl":"10.1016/j.hansur.2026.102775","url":null,"abstract":"<p><strong>Background: </strong>Fifth metacarpal fractures are frequently managed non-operatively with removable splint immobilization. Adherence to prescribed splint wear is variable, and patients injured by punching are often perceived as less adherent. This assumption has not been specifically evaluated. The primary objective was to compare splint adherence between punching and non-punching injuries.</p><p><strong>Methods: </strong>This prospective single-center observational study included 113 adults treated non-operatively for an isolated fifth metacarpal fracture between November 2023 and May 2025. All patients received a custom thermoformed splint and standardized instructions. Follow-up adherence was assessed with a study-specific, non-validated, self-administered questionnaire. Strict adherence was defined as patient-reported wear for the full prescribed duration. A secondary lenient definition classified discontinuation no more than one week before the prescribed end date as adherent. Follow-up analyses used complete cases only. Continuous and ordinal variables were compared with Mann-Whitney U tests when non-normal or ordinal, and categorical variables with Pearson chi-square or Fisher exact tests as appropriate.</p><p><strong>Results: </strong>Of 113 enrolled patients, 107 (94.7%) completed follow-up and 6 did not attend scheduled follow-up visits. Strict adherence was reported by 64 of 107 patients (59.8%). Adherence was 58.8% (30/51) after punching injuries and 60.7% (34/56) after non-punching injuries, an absolute difference of -1.9 percentage points (95% CI, -19.9 to 16.1; p = 0.84). With the lenient definition, adherence was 82.4% (42/51) and 83.9% (47/56), respectively (p = 0.83). In exploratory univariate analysis, strictly adherent patients were older than non-adherent patients (median 32.5 vs 26.0 years, p = 0.028); no other demographic or fracture-related characteristic differed significantly.</p><p><strong>Conclusion: </strong>In this cohort, no statistically significant difference in splint adherence was detected between punching and non-punching fifth metacarpal fractures. The confidence interval was wide, so these data do not establish equivalence and do not exclude a clinically relevant difference. Injury mechanism alone should therefore not be used to presume poor adherence. The absence of functional outcome assessment prevents conclusions about the clinical consequences of early splint discontinuation.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102775"},"PeriodicalIF":1.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972655","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":"Destructive Mycobacterium marinum Osteoarticular Infection of the Third Metacarpophalangeal Joint in an Aquarium Hobbyist.","authors":"Rares-Marius Teodorescu, Marie-Cecile Sapa, Louis Barthel, Dimitri Giannikas, David Montoya-Faivre, Alexis Pereira","doi":"10.1016/j.hansur.2026.102777","DOIUrl":"10.1016/j.hansur.2026.102777","url":null,"abstract":"","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102777"},"PeriodicalIF":1.0,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957681","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":"Educational interventions in hand and upper extremity surgery: a scoping review.","authors":"Henry Wang, Koorosh Kashanian, Yibo Li","doi":"10.1016/j.hansur.2026.102776","DOIUrl":"10.1016/j.hansur.2026.102776","url":null,"abstract":"<p><strong>Introduction: </strong>Hand and upper extremity surgery is increasingly performed in ambulatory settings, placing greater responsibility on patients to manage their postoperative recovery. While the readability of patient education materials has been studied, the formats used and their impact on postoperative outcomes have not been comprehensively synthesized.</p><p><strong>Methods: </strong>A literature search of PubMed and Web of Science was conducted for eligible studies published between 2015 and 2025 that included patients undergoing or being considered for upper extremity surgery and who received an educational intervention.</p><p><strong>Results: </strong>Fourteen studies were included, comprising 1981 participants (52.9 ± 7.5 years old). Common procedures included carpal tunnel release, trigger finger release, and distal radius fracture fixation. Educational interventions varied in format (handouts, videos, digital tools, verbal instruction) and timing (preoperative, postoperative, or day of surgery), with several studies using multimodal approaches. Patient education had no consistent impacts on objective functional recovery metrics but instead was associated with improved patient satisfaction and comprehension, reduced opioid use, and fewer unplanned healthcare encounters. As a result, patient education may have its largest impacts on behavioral changes rather than biomechanical recovery, optimizing decision-making but not directly accelerating patient healing.</p><p><strong>Conclusion: </strong>These findings support the integration of structured education into perioperative care and highlight the need for comparative studies evaluating optimal timing and delivery strategies.</p><p><strong>Level of evidence: </strong>V.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102776"},"PeriodicalIF":1.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932269","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":"Pisi-palmaris muscle: An anatomical study of a novel hypothenar muscle variant.","authors":"Maya Jarolem, Bill Frank","doi":"10.1016/j.hansur.2026.102774","DOIUrl":"10.1016/j.hansur.2026.102774","url":null,"abstract":"<p><p>The presence of anomalous muscles in the hand are present in around 22-35% of individuals, leading to potential clinical implications. During a routine cadaveric dissection of a 72 year old male, a unique hypothenar muscle variant was identified: the pisi-palmaris muscle. Detailed dissection and literature review determined the origin, insertion, and relationships of the muscle. The pisi-palmaris originated from the pisiform bone, deep to the tendon of the flexor carpi ulnaris and the volar carpal ligament, and inserted onto the transverse carpal ligament, merging with fibers of the abductor and flexor digiti minimi muscles. Based on its distinguishing anatomical features, we believe this muscle represents a previously unreported anatomical variant. Given its proximity to the ulnar nerve within Guyon's canal, this variant may contribute to ulnar nerve compression. Recognizing its presence may decrease the risk of diagnostic error or iatrogenic injury during nonoperative interventions or surgical decompression and improve patient outcomes and guide treatment. LEVEL OF EVIDENCE: V.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102774"},"PeriodicalIF":1.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922371","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}