The Journal of hand surgery, European volume最新文献

{"title":"Finger flexion after amputation through the proximal phalanx with and without flexor digitorum superficialis tenodesis.","authors":"Sebastian Leuschner, Kathleen Rätzer, Kemal Irga, Michael Geßner, Frank Siemers","doi":"10.1177/17531934261444260","DOIUrl":"https://doi.org/10.1177/17531934261444260","url":null,"abstract":"<p><strong>Introduction: </strong>Some authors have suggested that metacarpophalangeal joint (MCPJ) flexion is limited to 45° after finger amputation through the proximal phalanx. The aim of this study was to investigate if flexor digitorum superficialis (FDS) tenodesis improves MCPJ flexion.</p><p><strong>Methods: </strong>Patients who had had a FDS tenodesis between April 2022 and April 2023 were included in this study, and their outcomes were compared with patients who had received a conventional amputation between June 2018 and January 2023. All patients were invited to come to the hospital for follow-up to measure the MCPJ range of motion. Adverse events and pain were also assessed.</p><p><strong>Results: </strong>Twenty patients (25 fingers) without FDS tenodesis and 11 patients (13 fingers) with FDS tenodesis with a median follow-up of 21 (range 7-60) and 6 (range 2-12) months, respectively, were included in the study. Mean MCPJ flexion was 78° (SD 17, range 32-110) after conventional amputation and 86° (SD 8, range 70-95) after FDS tenodesis. Mean MCPJ extension was 6° (SD 9) in the conventional group and 7° (SD 6) in the FDS group. Adverse events were recorded in 20/25 fingers in the conventional group and 8/13 fingers in the FDS group. Pain was reported in 3/25 fingers after conventional amputation and 1/13 fingers after FDS tenodesis.</p><p><strong>Conclusion: </strong>The MCPJ flexion was almost normal after finger amputation through the proximal phalanx. While FDS tenodesis appeared to be safe, no advantage could be shown over conventional amputation. Owing to the lack of clinical benefit, we have abandoned the technique in our practice.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"17531934261444260"},"PeriodicalIF":1.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848275","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":"Surface alterations and chondrocyte activity in articular cartilage after monopolar radiofrequency treatment.","authors":"Thomas Schmid, Max von Schmeling, Sebastian Gehmert, Lukas Prantl, Marc Ruewe, Michaela Huber","doi":"10.1177/17531934261445820","DOIUrl":"https://doi.org/10.1177/17531934261445820","url":null,"abstract":"<p><strong>Introduction: </strong>Osteoarthritis is characterized by progressive degeneration of articular cartilage and impaired joint function. Arthroscopic monopolar radiofrequency energy chondroplasty enables minimally invasive smoothing of damaged cartilage surfaces, but there are concerns about chondrocyte viability under thermal stress, which is particularly critical in the wrist because of the thin cartilage layers and complex joint anatomy.</p><p><strong>Methods: </strong>In this <i>in vitro</i> study, porcine tibial plateau cartilage with simulated Outerbridge grade III degeneration was treated using six monopolar radiofrequency energy application protocols, including continuous or pulsed modes with single or double passes. Subchondral temperature was recorded, surface roughness was quantified by confocal laser scanning microscopy using the root-mean-square parameter and chondrocyte viability was assessed using live/dead and caspase 3/7 assays.</p><p><strong>Results: </strong>Subchondral temperatures remained below physiological core body temperature in all treatment groups. All radiofrequency energy protocols resulted in a clear reduction of surface roughness compared with degenerated control cartilage. The greatest smoothing effect was observed following a single pulsed application with longer activation intervals, although this also caused extensive chondrocyte death. Shorter pulsed application intervals produced moderate surface smoothing while preserving comparatively higher chondrocyte viability.</p><p><strong>Conclusion: </strong>Monopolar radiofrequency energy chondroplasty effectively reduces cartilage surface roughness but is associated with substantial chondrocyte loss regardless of the application protocol. Among the tested approaches, pulsed energy delivery with short activation intervals provided the most favourable balance between surface smoothing and cell preservation. However, the <i>in vivo</i> safety of this approach remains uncertain, particularly when applied to thin cartilage layers such as those in the wrist.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"17531934261445820"},"PeriodicalIF":1.6,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848153","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":"Role of one- versus two-screw fixation of scaphoid fractures in contributing to nonunion and delayed union.","authors":"Crystal Jing, Christian F Zirbes, Julia E Ralph, John Mwangi, Tyler S Pidgeon, Warren C Hammert","doi":"10.1177/17531934261445802","DOIUrl":"https://doi.org/10.1177/17531934261445802","url":null,"abstract":"<p><strong>Introduction: </strong>Displaced scaphoid fractures warrant surgical fixation to mitigate the risk of nonunion or malunion. We hypothesized that two-screw fixation would result in higher rates of union at shorter times.</p><p><strong>Methods: </strong>We retrospectively reviewed data of patients who presented with scaphoid fractures and underwent surgical fixation between 1 January 2013 and 30 November 2024. Patients were propensity score matched using demographics and Herbert classification as covariates.</p><p><strong>Results: </strong>After propensity score matching, 92 patients were identified, 47 receiving one screw and 45 receiving two screws. At 6 months after surgery, wrist extension was significantly greater in the one-screw cohort than in the two-screw cohort (71.0°, standard deviation (SD) 10.7° vs. 56.2°, SD 20.5°, <i>p</i> = 0.03); all other range of motion variables were similar between the cohorts at this timepoint. Visual analogue scale scores postoperatively significantly improved compared with preoperatively for both cohorts (<i>p</i> < 0.001 for both). Patients in the one-screw cohort showed significant improvements in Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference (PI) and Physical Function scores after surgery as compared with before surgery. The PROMIS PI scores in the two-screw cohort also showed significant differences after and before surgery. Rates of nonunion, time to union and hardware complications did not show statistically significant differences between the one- and two-screw cohorts.</p><p><strong>Conclusion: </strong>In this study, we reject our hypothesis as two screws were similar to one-screw fixation for rates of healing and outcomes.</p><p><strong>Level of evidence: </strong>III, case-control study.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"17531934261445802"},"PeriodicalIF":1.6,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848305","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":"Anatomic predisposition and neurologic vulnerability to brachial plexus birth injury: a contemporary narrative review.","authors":"Hugo Oh Beaumont, Akira Wiberg, Hazel Brown, Tom J Quick","doi":"10.1177/17531934261443088","DOIUrl":"https://doi.org/10.1177/17531934261443088","url":null,"abstract":"<p><p>Erb's palsy, or brachial plexus birth injury (BPBI), is an injury sustained at birth to a vulnerable nervous system which even with the best care leaves many children with permanent impairments, growth retardation and pain. Established risk factors include maternal diabetes, increased foetal weight, shoulder dystocia and instrumental delivery. Yet these variables do not reliably predict which individual children will sustain injury. We propose an additional, largely neglected factor: developmental anatomical predisposition of the neonatal brachial plexus, with anomalies similar to those implicated in neurogenic thoracic outlet syndrome (nTOS) later in life. These include cervical ribs, aberrant scalene attachments and variant plexus branching - each capable of narrowing the supraclavicular corridor and concentrating mechanical strain during delivery. Such anatomical variants may lower the injury threshold and confer a 'neurologic vulnerability' when exposed to the forces of delivery. This may help explain why some infants sustain injury under normal obstetric conditions while others do not. We further propose that neonatal BPBI and adolescent nTOS represent distinct phenotypic expressions of a shared anatomical vulnerability, with a patterned molecular basis involving <i>Hox</i> gene regulation of axial skeletal patterning during embryogenesis. These insights carry direct clinical implications: in neonates undergoing brachial plexus exploration, recognition and decompression of anatomical compression may complement or replace standard nerve grafting strategies. We outline a research agenda including anatomical phenotyping, familial screening, biomarkers and prospective cohort studies to quantify this predisposition and integrate it into peripartum decision-making alongside conventional risk factors.<b>Level of Evidence:</b> Level V.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"17531934261443088"},"PeriodicalIF":1.6,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825348","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":"Editorial. The simplicity and complexity of carpal tunnel syndrome.","authors":"Jane E McEachan","doi":"10.1177/17531934261433793","DOIUrl":"https://doi.org/10.1177/17531934261433793","url":null,"abstract":"","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":"51 5","pages":"548-549"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793878","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":"Arthroscopic resection of dorsal wrist ganglions with or without midcarpal exploration.","authors":"Kun-Han Lee, Hui-Kuang Huang, Hsuan-Hsiao Ma, Yi-Chao Huang, Jung-Pan Wang","doi":"10.1177/17531934251405730","DOIUrl":"10.1177/17531934251405730","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to compare a radiocarpal approach with or without a midcarpal exploration to determine outcomes and incidence of recurrences following arthroscopic excision of dorsal wrist ganglions.</p><p><strong>Methods: </strong>This retrospective study included 39 patients who underwent arthroscopic excision of dorsal wrist ganglions with a radiocarpal approach alone and 32 patients who received radiocarpal excision with midcarpal exploration. Outcomes assessed at 1 year follow-up included Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores, pain relief, patient satisfaction, complications and recurrence. Pre- and postoperative MRI images were used to classify the ganglions into four types based on their origin and location. Postoperative MRI was performed in cases of suspected recurrence.</p><p><strong>Results: </strong>One year postoperatively, QuickDASH scores, pain relief and patient satisfaction were similar in both groups. Complications were minimal and comparable between groups. Recurrence occurred in seven patients in the radiocarpal excision group and in one patient who underwent radiocarpal excision with midcarpal exploration. Magnetic resonance imaging analysis of the eight recurrences revealed five type 2 lesions (midcarpal), one type 3 lesion (radiocarpal) and two type 4 lesions (combined radiocarpal and midcarpal), indicating that seven of eight recurrences involved the midcarpal joint.</p><p><strong>Conclusion: </strong>Routine midcarpal joint exploration during arthroscopic excision of dorsal wrist ganglions appeared to reduce recurrence at 1 year without negatively impacting patient outcomes.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"581-588"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145759074","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":"Magnetic resonance imaging for detecting root avulsions in brachial plexus birth injuries.","authors":"Claire M Hardie, Chiraag Karia, Ryckie G Wade, Jeannette K Kraft, Rob Bains, Grainne Bourke","doi":"10.1177/17531934251406957","DOIUrl":"10.1177/17531934251406957","url":null,"abstract":"<p><strong>Introduction: </strong>We assessed the diagnostic accuracy of 3T magnetic resonance imaging in comparison with surgical exploration for detecting root avulsion in brachial plexus birth injuries.</p><p><strong>Methods: </strong>This retrospective cohort study describes a consecutive series of 18 infants with brachial plexus birth injuries born between January 2019 and May 2024 who had a surgical exploration of the plexus preceded by magnetic resonance imaging under the same general anaesthetic.</p><p><strong>Results: </strong>The overall diagnostic accuracy of magnetic resonance imaging for detecting root avulsion(s) of C5-T1 was 68%, with 67% sensitivity and 92% specificity. It has a 'good' diagnostic accuracy for detection of root avulsion, although only a 'sufficient' sensitivity.</p><p><strong>Conclusion: </strong>Although useful, magnetic resonance imaging in its current form cannot be solely relied upon for clinical decision-making in brachial plexus birth injuries.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"589-596"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835884","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":"Clinical presentations of macrodactyly in adults vs. children: a descriptive analysis.","authors":"S Raja Sabapathy, Monusha Mohan","doi":"10.1177/17531934251409593","DOIUrl":"10.1177/17531934251409593","url":null,"abstract":"<p><strong>Introduction: </strong>Macrodactyly of the hand is an uncommon anomaly. There are few studies looking at late presentation or adults with macrodactyly. This study specifically aims to describe the presentation and surgical management of adult macrodactyly and to compare these findings with those in children, highlighting the distinct challenges associated with late presentation.</p><p><strong>Methods: </strong>This is a retrospective study of 13 adults (18 years or older) and 19 children with macrodactyly of the upper limb who underwent surgery in a 13 year period. Clinical features including radiographic findings, number and types of surgeries were compared between adults and children.</p><p><strong>Results: </strong>Common reasons for presentation in adulthood were carpal tunnel syndrome and functional impairment. Radiographs of adults showed exostoses, arthritis, bony fusions and angulation deformities. The mean number of surgeries that children underwent was almost double that of adults. The average number of debulking procedures per patient was significantly more in children including soft tissue resection, osteotomy and reconstructive surgeries. Amputations were slightly more common in adults. Carpal tunnel syndrome or trigger fingers were seen only in adults.</p><p><strong>Conclusion: </strong>Adults and paediatric patients with macrodactyly seek treatment for different reasons. Presentation in childhood often results in multiple debulking stages or reconstructive attempts. In adults, surgery is often for improving function and usually single staged. Untreated, long-term progression of joint changes can lead to pain and disability. Recognition of these symptoms can guide treatment in older patients or prevent age-related changes in younger populations.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"611-616"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013988","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":"Cartilage damage in patients with scapholunate lesions: arthroscopic prevalence, location and associated clinical factors.","authors":"L van Wijk, J S Teunissen, R Feitz, Epa van der Heijden, Ser Hovius","doi":"10.1177/17531934251407799","DOIUrl":"10.1177/17531934251407799","url":null,"abstract":"<p><strong>Introduction: </strong>Scapholunate ligament (SLL) injuries can lead to instability and osteoarthritis through stages of scapholunate dissociation and scapholunate advanced collapse. Although cartilage damage is traditionally seen as a late finding, recent evidence suggests that it may occur earlier. This study aimed to assess the prevalence and distribution of cartilage damage in patients with isolated SLL lesions confirmed by arthroscopy and to explore associated sociodemographic and clinical factors.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted in patients with arthroscopically confirmed SLL lesions. Baseline demographics, injury duration, and Patient Rated Wrist Hand Evaluation (PRWHE) scores were routinely collected prior to arthroscopy. Arthroscopic findings documented cartilage damage at the scaphoid (fossa), capitate, lunate (fossa), hamate and triquetrum. Prevalence was analysed descriptively, and associations were tested using univariate logistic regression.</p><p><strong>Results: </strong>Of 226 included patients, 33.2% showed cartilage damage, most commonly affecting the scaphoid and scaphoid fossa. Damage was present across all Geissler grades, including patients without prior fractures. It was more frequent in older males, those with Geissler IV lesions, prior wrist fractures and those less likely to report a clear traumatic event. No association was found with symptom duration, dominant hand, occupation or PRWHE scores.</p><p><strong>Conclusion: </strong>The presence of cartilage damage across all Geissler grades challenges the idea that it is a late-stage finding. These results support the need for a revised classification system that integrates both ligament and cartilage pathology to enable more tailored treatment strategies for scapholunate ligament injuries.</p><p><strong>Level of evidence: </strong>Level III (Cohort study).</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"597-603"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222608","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":"Four-week splint with early mobilization protocol for the management of bony mallet injuries.","authors":"Guy Rubin, Uri Diego Mano, Ravit Shay, David Rothem","doi":"10.1177/17531934251382017","DOIUrl":"10.1177/17531934251382017","url":null,"abstract":"<p><p>Bony mallet injuries are usually treated with 6 weeks of continuous splinting. This retrospective study found that 4 weeks of immobilization followed by staged withdrawal achieved outcomes equivalent to those for 6 weeks, suggesting that shorter treatment is as effective for acute cases.<b>Level of evidence:</b> IV.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"636-638"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607988","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}