The Journal of hand surgery, European volume最新文献

{"title":"Radiographic alignment is not associated with patient-reported symptoms after 360° scapholunate ligament reconstruction.","authors":"Maria Zander, Allan Ibsen-Sörensen, Peter Axelsson, Anders Björkman","doi":"10.1177/17531934261464770","DOIUrl":"10.1177/17531934261464770","url":null,"abstract":"<p><strong>Introduction: </strong>Reconstruction of the scapholunate interosseus ligament (SLIL) remains a controversial topic, with numerous techniques reported and variable outcomes. However, the factors determining clinical outcomes after reconstruction and the extent to which radiographic alignment influences patient-reported outcomes remain unclear. The aim of this study was to identify variables independently associated with pain intensity and patient-reported function at a minimum of 3 years after 360° SLIL reconstruction. The secondary aim was to determine the variables associated with revision surgery.</p><p><strong>Methods: </strong>This retrospective single-centre study included consecutive patients who underwent 360° SLIL reconstruction with a flexor carpi radialis tendon graft between 2010 and 2021. All patients were followed for at least 3 years. Clinical evaluation included grip and pinch strength, wrist range of motion expressed relative to the contralateral side and patient-reported outcomes measured by the Disabilities of the Arm, Shoulder and Hand, Patient-rated Wrist/Hand Evaluation and visual analogue scale for pain. Standardized radiographs were analysed to assess scapholunate distance and scapholunate angle. Associations between demographic, clinical and radiographic variables and patient-reported symptoms and salvage were analysed.</p><p><strong>Results: </strong>Fifty-three patients (42 men, 11 women) with a median age of 42 years (IQR: 32 to 51) were evaluated after a median of 53 months (IQR: 44 to 85). Overall grip strength and measures of patient reported symptoms improved, while wrist motion decreased. Older age and shorter symptom duration were independently associated with improved patient reported symptoms, while radiographic alignment was not. No variables were associated with revision surgery.</p><p><strong>Conclusions: </strong>Radiographic alignment was not independently associated with patient-reported symptoms or revision surgery, suggesting that recovery after SLIL reconstruction may involve factors beyond structural restoration alone, such as accommodation.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"1233-1240"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427904","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":"Transtendinous corticosteroid with contrast injection in trigger finger: a radiological and clinical study.","authors":"Hasan Bitar, Johanna Bergman, Anders Björkman, Joakim Strömberg","doi":"10.1177/17531934261460230","DOIUrl":"10.1177/17531934261460230","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to evaluate the distribution of a corticosteroid solution following transtendinous injection at the level of the proximal phalanx. Secondary aims were to explore the patient reported outcomes and analgesic use day-by-day for 6 weeks.</p><p><strong>Methods: </strong>Twenty trigger digits in 19 patients were injected with a mixture of corticosteroid and radiopaque contrast using a standardized transtendinous technique. Frontal and lateral radiographs obtained immediately after injection were independently assessed by three observers to classify the spread of the solution as intra-sheath, mixed intra-and extra-sheath, or solely extra-sheath.</p><p><strong>Results: </strong>All 20 digits demonstrated intra-sheath spread of the solution. Thirteen digits showed mixed intra- and extra-sheath distribution, and seven digits demonstrated isolated intra-sheath spread. In eight digits, the solution extended throughout the entire tendon sheath from the palm to the level of the distal phalanx. No cases of isolated extra-sheath injection were observed. Fourteen digits reported total relief of symptoms within 6 weeks. Median number of days to total symptom alleviation was 7 for pain, 8 for triggering and 9 for stiffness. The use of analgesics was low, and 11 patients took none.</p><p><strong>Conclusion: </strong>Transtendinous injection at the level of the proximal phalanx provides reliable deposition of corticosteroid within the tendon sheath, supporting its use as an acceptable technique for treating trigger finger.</p><p><strong>Level of evidence: </strong>III prospective cohort study.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"1351-1356"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary and secondary stabilizers of the scapholunate joint: a systematic review of cadaveric ligament sectioning studies.","authors":"Joshua Andrews, Simon Bellringer, Melanie Amarasooriya, Gregory Bain","doi":"10.1177/17531934261466074","DOIUrl":"10.1177/17531934261466074","url":null,"abstract":"<p><strong>Introduction: </strong>Scapholunate instability is the most common pattern of carpal instability, yet the relative contributions of the intrinsic and extrinsic ligaments remain debated. This systematic review evaluated cadaveric studies of wrist biomechanics assessing kinematic changes following carpal ligament sectioning to clarify the stabilizing roles of individual ligaments.</p><p><strong>Methods: </strong>The EMBASE, MEDLINE, Cochrane and Scopus databases were searched from inception to June 2025. Cadaveric studies reporting scapholunate gap (SLG), scapholunate angle (SLA), radiolunate angle (RLA) or dorsal intercalated segment instability (DISI) after ligament sectioning were included. Data were extracted for cumulative and sequential sectioning patterns and synthesized qualitatively.</p><p><strong>Results: </strong>Thirty-three studies involving 406 wrists were included. With an intact scapholunate interosseous ligament (SLIL), sectioning single or multiple extrinsic carpal ligaments produced minimal changes in SLG, SLA, or RLA. Scapholunate interosseous ligament sectioning increased SLG (mean +1.7 mm), SLA (+8°) and RLA (+3°), with clenched-fist loading further elevating SLG (+0.7 mm) and SLA (+4°). The dorsal intercarpal ligament (DIC) was the dominant secondary stabilizer. Combined SLIL-DIC injury produced the greatest increases across all measures, and DISI occurred only when the SLIL and either the DIC or the scaphotrapeziotrapezoid complex was sectioned.</p><p><strong>Conclusion: </strong>Cadaveric evidence confirms the SLIL as the primary stabilizer of the scapholunate joint and identifies the DIC as the key secondary stabilizer. These biomechanical findings support early diagnosis, targeted reconstruction and the need to restore both primary and secondary stabilizers to prevent progressive scapholunate instability.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"1275-1284"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564426","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":"Factors associated with pain after non-surgical treatment for trapeziometacarpal joint osteoarthritis.","authors":"Lisa M J Esteban Lopez, Lisa Hoogendam, Ruud W Selles, Robbert M Wouters","doi":"10.1177/17531934261459874","DOIUrl":"10.1177/17531934261459874","url":null,"abstract":"<p><strong>Introduction: </strong>Although non-surgical treatment for trapeziometacarpal joint (TMJ) osteoarthritis (OA) reduces pain, outcomes vary substantially. This study investigated factors associated with pain at 3 months after starting non-surgical treatment for TMJ OA.</p><p><strong>Methods: </strong>This secondary analysis from a previous randomized controlled trial included 113 patients (Eaton-Glickel stage ⩾2 TMJ OA) from 18 outpatient hand surgery clinics in The Netherlands, comprising specialized clinics, regional hospitals and one academic hospital. Participants were randomized to orthosis-only or orthosis + exercise groups. Both groups received a standardized custom-made thumb orthosis, and the combined group also received supervised hand therapy with a structured home exercise programme. The primary outcome was the Michigan Hand outcomes Questionnaire (MHQ) pain subscale at 3 months, which was modified so that higher scores indicated less pain. We used linear regression analysis to investigate the association of baseline pain, psychological factors, outcome expectations, adherence to therapy, perceived attention, patient experience with care, treatment frequency and changes in grip and pinch strength with MHQ pain.</p><p><strong>Results: </strong>Better MHQ pain score at baseline, higher baseline outcome expectations and improvement in grip strength after 3 months were associated with better pain outcomes. The MHQ pain baseline score had the strongest independent association.</p><p><strong>Conclusion: </strong>Baseline pain severity, outcome expectations and grip strength are associated with pain at 3 months after the use of orthoses with or without exercise therapy for TMJ OA.</p><p><strong>Level of evidence: </strong>II.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"1312-1319"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poland Syndrome with transverse upper limb deficiency: beyond the vascular disruption hypothesis.","authors":"Min Kai Chang, Jean Chiew, Darryl Ee Ming Chew","doi":"10.1177/17531934261475583","DOIUrl":"10.1177/17531934261475583","url":null,"abstract":"<p><p>Poland syndrome classically presents with unilateral pectoral deficiency and ipsilateral symbrachydactyly. We report a neonate with right pectoral deficiency and carpal-level transverse upper limb deficiency without ectodermal elements. This rare phenotype challenges a single-point vascular interruption and supports a dynamic embryonic capillary plexus model.<b>Level of Evidence:</b> IV.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":"51 10","pages":"1368-1370"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149279257","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":"Current diagnostic methods for detecting avascular necrosis and irreversible bone death of the proximal pole of the scaphoid: a systematic review.","authors":"Sophia Jacobi, Emily Davidovic-Katz, Samara Moll, Janos Barrera, Ajul Shah, Jacques H Hacquebord","doi":"10.1177/17531934261449042","DOIUrl":"10.1177/17531934261449042","url":null,"abstract":"<p><strong>Introduction: </strong>Owing to the scaphoid's retrograde blood supply, fractures can compromise perfusion to the proximal pole, making it vulnerable to avascular necrosis (AVN) or irreversible bone death. Despite their differing prognoses, both conditions are evaluated using the same diagnostic methods. This review aims to determine the most reliable method of distinguishing between AVN and irreversible bone death, considering factors such as magnetic resonance imaging (MRI), computed tomography (CT), intraoperative findings, and histology.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted until November 2024. The diagnostic methods and criteria for AVN were collected, and the outcome was measured dichotomously as either resolution of AVN or irreversible bone death. Each AVN diagnostic method was categorized and the healing outcomes of all patients diagnosed with AVN in the study were compared.</p><p><strong>Results: </strong>This systematic review included 27 studies and 423 patients. With regard to AVN healing, 195 out of 223 patients diagnosed with AVN via MRI eventually healed. Of those diagnosed with AVN via CT, nine out of 21 went on to heal, as did 308 out of 356 patients with no intraoperative punctate bleeding. Histologic evaluation had the lowest incidence of AVN resolution, with only six out of 19 patients healing.</p><p><strong>Conclusion: </strong>All diagnostic methods identified AVN resolution and irreversible bone death. However, all patients were solely diagnosed with AVN. There is no standardized method for diagnosing irreversible bone death because the existing literature conflates irreversible bone death with AVN, despite their distinct pathologies and prognoses. Consequently, our understanding of AVN and the point at which irreversible bone death occurs in the scaphoid is limited.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"1296-1303"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990679","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":"Determinants of patient satisfaction 5 years after dual-mobility trapeziometacarpal joint implant arthroplasty.","authors":"Daniel B Herren, Kei H Mathis, Stephan Schindele, Miriam Marks","doi":"10.1177/17531934261468204","DOIUrl":"10.1177/17531934261468204","url":null,"abstract":"<p><strong>Introduction: </strong>The primary aim of this registry-based case series was to identify determinants of patient satisfaction 5 years after dual-mobility trapeziometacarpal joint (TMJ) implant arthroplasty. Secondary aims included the assessment of 5 year outcomes and implant survival.</p><p><strong>Methods: </strong>Patients who underwent primary implantation of a dual-mobility TMJ prosthesis were included. Satisfaction at 5 years was assessed using a five-point Likert scale and analysed using a top-box approach. Determinants of being 'very satisfied' were evaluated using univariate logistic regression. Pain (numeric rating scale), hand function (brief Michigan Hand Outcomes Questionnaire, MHQ) and key pinch strength were assessed. Changes in outcomes between baseline and 5 years were analysed using a linear mixed-effects model. Implant survival was estimated using the Kaplan-Meier method.</p><p><strong>Results: </strong>Of the 125 patients who underwent surgery, 108 were available for the 5 year analysis and 94 completed the satisfaction questionnaire. Of the latter, 87 (93%) were 'satisfied' or 'very satisfied' with the treatment outcome. Lower pain levels and higher brief MHQ scores at 5 years were significantly associated with being 'very satisfied'. Baseline characteristics, complications and revision surgery were not associated with satisfaction. Baseline pain, brief MHQ and key pinch strength improved significantly by 5 years. Five revision surgeries occurred, resulting in an estimated 5 year implant survival of 96% (95% CI 92 to100).</p><p><strong>Conclusion: </strong>Our results support existing evidence that dual-mobility TMJ arthroplasty yields high patient satisfaction, significant clinical improvement and excellent implant survival at 5 years. Pain relief and improved hand function appear to be key determinants of patient satisfaction.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"1304-1311"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the dorsal scaphotriquetral ligament: a biomechanical study.","authors":"Gustavo L Gomez Rodriguez, Alvaro Muratore, Ahlam Arnaout, Pedro J Delgado, Gregory Bain, Sanjeev Kakar","doi":"10.1177/17531934261432885","DOIUrl":"10.1177/17531934261432885","url":null,"abstract":"<p><strong>Introduction: </strong>The biomechanical role of the dorsal scaphotriquetral ligament (DSTL) ligament in scapholunate (SL) stability remains debated. We assessed DSTL contribution using a cadaveric sectioning model.</p><p><strong>Methods: </strong>Twenty-four wrists underwent sequential sectioning: none (phase 0), palmar/proximal scapholunate interosseous ligament (SLIOL) (phase 1), dorsal SLIOL (phase 2), superficial dorsal intercarpal ligament (DICL) (phase 3) and DSTL (phase 4). Under axial loading (60 N; cyclic 60-200 N) and wrist motion, the SL gap and carpal angles, and a CT-derived dorsal instability scaphoid angle (DISA) were measured.</p><p><strong>Results: </strong>Phase 1 produced no significant instability. Dorsal SLIOL sectioning (phase 2) initiated dynamic instability, with increased SL gap and angles under load and dorsal scaphoid translation, but no resting dorsal intercalated segment instability (DISI). Sectioning the superficial DICL fascicle (phase 3) did not add instability. DSTL sectioning (phase 4) produced the largest changes, with marked SL diastasis, increased angles and DISA, and DISI at rest and under load.</p><p><strong>Conclusion: </strong>Dorsal SLIOL sectioning produced load-dependent (dynamic) SL instability, whereas subsequent DSTL sectioning was associated with progression to static instability, supporting the DSTL as an important dorsal restraint. The DISA may provide an additional CT-based measure of dorsal scaphoid subluxation; however, clinical validation is required.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"1258-1265"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147492326","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":"Incidental finding of a reversed variant (type V) palmaris profundus during forearm surgery.","authors":"Elijah Williams, Atilla Emin, Richard Pinder","doi":"10.1177/17531934261474410","DOIUrl":"10.1177/17531934261474410","url":null,"abstract":"<p><p>Palmaris profundus is a rare accessory flexor muscle with several recognized variants. We report the incidental intraoperative identification of a type V variant during forearm surgery. This variant may have different clinical implications than the more common subtypes.<b>Level of Evidence:</b> V (Case Report).</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"1376-1377"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804059","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":"Scoping review of recent publications in surgical treatment of chronic high-grade scapholunate injury.","authors":"Caroline Lam, Bert Vanmierlo, Chul Ki Goorens, Laurent Willemot","doi":"10.1177/17531934261425163","DOIUrl":"10.1177/17531934261425163","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic static scapholunate instability is frequently associated with pain, weakness and functional impairment. Despite advancements in diagnostics and surgical techniques, the optimal management remains unclear. This scoping review studied the surgical options for isolated chronic scapholunate injury and provides guidance for future research.</p><p><strong>Methods: </strong>A systematic literature search was conducted across PubMed and Embase, covering studies from 2004 to 2024.</p><p><strong>Results: </strong>A total of 44 studies were analysed, involving 71 technique cohorts with a mean cohort size of 27 patients. The surgical interventions assessed included anatomical reconstructive techniques, three ligament tenodesis variations, capsulodesis, reduction and association of the scapholunate interval, isolated tenodesis and combined techniques. Despite the heterogeneity, no single technique emerged as superior in outcomes, with many yielding comparable results.</p><p><strong>Conclusion: </strong>This scoping review underscores the ongoing uncertainty in managing chronic scapholunate instability and highlights the need for high-quality, long-term comparative studies to inform clinical decision-making.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"1266-1274"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147438656","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}