The Journal of hand surgery, European volume最新文献

{"title":"Surgical treatment of radial polydactyly: a review of the Congenital Upper Limb Differences (CoULD) registry.","authors":"Anna K Holten, Ann E Van Heest, Andrea S Bauer, Charles A Goldfarb, Suzanne E Steinman, Caroline H Hu","doi":"10.1177/17531934261459878","DOIUrl":"https://doi.org/10.1177/17531934261459878","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to explore the types of surgeries performed for radial polydactyly, complications and their associations with Wassel-Flatt classification types using a multi-centre prospective paediatric hand surgery registry.</p><p><strong>Methods: </strong>Patients with radial polydactyly in the Congenital Upper Limb Differences (CoULD) Registry who underwent surgery were reviewed for Wassel-Flatt classification, types of surgeries performed and complications.</p><p><strong>Results: </strong>A total of 247 extremities with radial polydactyly in 230 patients underwent surgical treatment at an average age of 1.4 years (ranging from 24 days to 8.4 years) for the index operation. The most common primary procedure was excision of the radial thumb with reconstruction of the dominant ulnar thumb (87%), followed by simple excision (7%). Thumbs classified as the hypoplastic subtype were more likely to undergo simple excision. The most common ancillary procedure was ligament reconstruction. Fifteen patients (7%) experienced 17 total complications including five thumbs requiring revision at an average of 3.6 years (range 2.5-4.3 years) after the first surgery.</p><p><strong>Conclusions: </strong>Excision of the radial thumb with reconstruction of the ulnar thumb is the most common procedure for patients undergoing surgical treatment for radial polydactyly, followed by simple excision of a hypoplastic polydactylous digit. Surgical complication rates for radial polydactyly surgery are low (7%) with a 2% reoperation rate at the 3 year follow-up.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"17531934261459878"},"PeriodicalIF":1.6,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564407","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":"Beyond the first year: Long-term outcome of shockwave therapy versus corticosteroid infiltration in the management of trigger finger.","authors":"Adrián H Suárez Cabañas, Margarita Ramírez Sánchez, Alberto Álvarez Jiménez, Milán Santana Bañolas, Jesús M González Martín, José M García Castellano","doi":"10.1177/17531934261466890","DOIUrl":"https://doi.org/10.1177/17531934261466890","url":null,"abstract":"<p><strong>Introduction: </strong>Trigger finger is a common tendinopathy with an increasing incidence in the aging and metabolically compromised populations. While corticosteroid infiltration (INF) remains the most frequently used conservative treatment, extracorporeal shock wave therapy (ESWT) is a non-invasive alternative with potential long-term benefits.</p><p><strong>Methods: </strong>A prospective, non-randomized comparative study was conducted including 42 patients with Quinnell grade II-III trigger finger. Patients were allocated sequentially to treatment with either ESWT (<i>n</i> = 21) or INF (<i>n</i> = 21). Outcomes were assessed at baseline, 6 months, 1 year and 2 years including pain, functional status, grip strength, Quinnell classification, Roles and Maudsley score, patient satisfaction and conversion to surgery.</p><p><strong>Results: </strong>At 6 months, outcomes were comparable between the groups across most assessed variables. Most of the patients in the ESWT group achieved substantial pain relief at 1 and 2 years. Functional outcomes differed between the groups at 1 year. Grip strength gains were maintained in the ESWT group. Patient satisfaction remained stable in the ESWT group and decreased in the INF group. Surgical conversion occurred less frequently in the ESWT group than in the INF group at 2 years.</p><p><strong>Conclusions: </strong>In this study, both ESWT and INF were associated with clinical improvement in patients with moderate trigger finger. Differences between treatments emerged at longer follow-up intervals, particularly in pain-related outcomes and rates of surgical conversion. These findings indicate that ESWT is a non-invasive treatment option associated with sustained clinical outcomes over time.</p><p><strong>Level of evidence: </strong>II.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"17531934261466890"},"PeriodicalIF":1.6,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564448","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":"Risk factors for nail dystrophy following distal phalangeal fractures of the hand.","authors":"Céline S Bratschi, Andreas Weber, Jan A Plock, Christin Kammerhofer, Thuan Ly, Flavien Mauler","doi":"10.1177/17531934261456220","DOIUrl":"https://doi.org/10.1177/17531934261456220","url":null,"abstract":"<p><strong>Introduction: </strong>Distal phalanx fractures are commonly associated with nail unit injuries and may cause long-term nail dystrophy. However, the risk factors associated with such deformities are poorly understood. In this study, we aimed to assess the potential risk factors for nail dystrophy after distal phalanx fractures.</p><p><strong>Methods: </strong>We conducted a retrospective review of adult patients with distal phalanx fractures treated at a single hand surgery centre between January 2015 and December 2019. The patients were followed up clinically and radiographically for at least 1 year after injury.</p><p><strong>Results: </strong>We included 112 patients with 128 distal phalanx fractures. Nail dystrophy developed in 50 fingers. The significant independent predictors of nail dystrophy included nail bed injury and nonunion. Nail bed suturing, fracture location, trauma type and dorsal rim incongruence were not independently associated with nail dystrophy using multivariate analysis.</p><p><strong>Conclusion: </strong>Nail bed injury and nonunion of the distal phalanx fracture significantly increased the risk of post-traumatic nail dystrophy. These findings underscore the importance of careful assessment and management of nail bed injuries and fracture healing when treating distal phalanx fractures.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"17531934261456220"},"PeriodicalIF":1.6,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551947","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":"Proximal origin transligamentous recurrent motor branch of the median nerve: implications for surgical safety.","authors":"Jabez Vhanda, Joan Arenas-Prat","doi":"10.1177/17531934261468580","DOIUrl":"https://doi.org/10.1177/17531934261468580","url":null,"abstract":"<p><p>An anomalous motor branch of the median nerve with proximal origin and traversing the transverse carpal ligament was encountered during carpal tunnel release, which could create an additional proximal danger zone. We recommend deliberate ulnar-sided and proximal to distal ligament division to minimize risk of damage to anatomic variants of the median nerve.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"17531934261468580"},"PeriodicalIF":1.6,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551921","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 five-year radiostereometry study of cup fixation and implant survival in 484 Moovis trapeziometacarpal arthroplasties.","authors":"Maiken Stilling, Torben B Hansen, Janni K Thillemann","doi":"10.1177/17531934261459885","DOIUrl":"https://doi.org/10.1177/17531934261459885","url":null,"abstract":"<p><strong>Introduction: </strong>The primary cause of revision of trapeziometacarpal arthroplasty limiting the implant survival has been aseptic cup loosening. Radiostereometry is a precise method to evaluate implant migration as a surrogate marker for aseptic implant loosening and later revision. The aim of this prospective single-centre cross-sectional cohort study was to evaluate fixation of trapeziometacarpal cups using radiostereometry, report clinical and patient reported outcomes at 5 year follow-up, and assess the complications and survival rate of the Moovis cup with up to 9 years of follow-up.</p><p><strong>Methods: </strong>Four-hundred and eighty-four conical press-fit dual-mobility Moovis trapeziometacarpal implants were inserted in 407 patients, with a mean age of 59 years (range 43-80). Tantalum beads were inserted in the trapezium during index surgery. Radiostereometric images at 3 weeks, 3 months, 1 year, 2 years and 5 years after the index surgery were used to measure cup migration. Clinical and patient reported outcomes were recorded for 5 years. The cumulative implant survival until 9 years was analysed using the Kaplan-Meier method.</p><p><strong>Results: </strong>Cup migration was 0.28 mm (95% CI: 0.25 to 0.32 mm) total translation at the 3 month follow-up and remained stable until the 5 year follow-up. Females had 0.15 mm (95% CI: 0.06 to 0.24 mm) more cup migration (total translation) than males at the 5 year follow-up. Grip strength, resting and activity pain, and Quick DASH score showed clinically relevant improvement at 1 year and remained stable until the 5 year follow-up. Medium-term patient satisfaction was 96%, and willingness to repeat the procedure was 96%. The 9 year cumulative implant survival rate was 98% for cup removal owing to aseptic loosening and 87% for removal/exchange of any implant component.</p><p><strong>Conclusion: </strong>Stable cup fixation and high patient satisfaction until 5 years combined with good 9 year survivorship for Moovis press-fit cups favour its use in the treatment of trapeziometacarpal osteoarthritis. Although these results cannot be directly extrapolated to other trapezial cups, they suggest that similar press-fit conical trapezial cup designs may also provide good fixation and favourable clinical outcomes in the treatment of painful trapeziometacarpal joint osteoarthritis, in patients between the ages of 40 and 80 years.</p><p><strong>Level of evidence: </strong>Level II.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"17531934261459885"},"PeriodicalIF":1.6,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148552004","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":"Hysteresis in dynamic wrist kinematics: a 4DCT comparison between healthy and scapholunate ligament-injured wrists.","authors":"Hanne S Vries, Maranda Haenen, Brigitte van der Heijden","doi":"10.1177/17531934261468199","DOIUrl":"https://doi.org/10.1177/17531934261468199","url":null,"abstract":"<p><p>This study showed that hysteresis was greater in wrists with scapholunate ligament injury than in healthy wrists for scapholunate angle, distance during radioulnar deviation and distance during flexion-extension, suggesting that 4DCT-derived hysteresis may provide a dynamic marker of carpal instability.<b>Level of evidence:</b> III.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"17531934261468199"},"PeriodicalIF":1.6,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451189","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 impact of introducing a dedicated day case hand centre on the operative management of distal radial fractures.","authors":"Ibrahim Assafiri, Ronald Hk Nam, Ahmed El-Mubarak, Yaseen I Mohammed, Munnan Al-Najjim, Akshay Malhotra","doi":"10.1177/17531934261464419","DOIUrl":"https://doi.org/10.1177/17531934261464419","url":null,"abstract":"<p><strong>Introduction: </strong>The operative management of distal radial fractures commonly requires inpatient admission, increasing the pressure on acute hospital capacity. Dedicated day case pathways and regional anaesthesia can reduce the length of stay but evidence remains limited.</p><p><strong>Methods: </strong>A retrospective service assessment was carried out at a large multisite NHS trust. Consecutive adults undergoing operative fixation of isolated distal radial fractures were identified across two control periods (2018-2019 and 2021-2022) and a post-implementation period following the introduction of the North Midlands Hand Centre (NMHC) (2023-2024). The primary outcomes were same-day discharge, length of stay and postoperative complications. Secondary outcomes included anaesthetic technique, hand surgeon involvement and bed-day utilization.</p><p><strong>Results: </strong>A total of 243 patients were included (Control n = 125; NMHC <i>n</i> = 118), with comparable baseline characteristics. Following NMHC implementation, same-day discharge increased from 66.4% to 98.3% (<i>p</i> < 0.001) and the mean length of stay decreased from 19.4 to 6.6 h (<i>p</i> < 0.001). The mean bed-day utilization per patient fell from 0.69 to 0.06, corresponding to an estimated reduction of approximately 74 inpatient bed-days over 1 year. The use of regional anaesthesia increased from 20.0 to 93.2% (<i>p</i> < 0.001) and hand surgeon involvement increased from 70.4 to 97.5% (<i>p</i> < 0.001). Overall complication rates remained stable (17.6 vs. 13.6%, <i>p</i> = 0.5).</p><p><strong>Conclusion: </strong>A bespoke day case pathway in a clean-air theatre for distal radial fracture fixation was associated with improved perioperative efficiency without increased complications.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"17531934261464419"},"PeriodicalIF":1.6,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148393192","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 flexor digitorum superficialis tendon rupture following intratendinous steroid injection: a case report.","authors":"Sathya Vamsi Krishna, Sanjna Das","doi":"10.1177/17531934251409637","DOIUrl":"10.1177/17531934251409637","url":null,"abstract":"<p><p>This report presents a rare case of flexor digitorum superficialis tendon rupture following intratendinous steroid injection, which caused a fixed proximal interphalangeal joint flexion deformity in a 45-year-old man. Surgical correction required complete release of the flexor digitorum superficialis insertion.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"947-948"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168592","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":"Hemihamate arthroplasty for dorsal fracture-dislocation of the proximal interphalangeal joint with palmar articular surface loss.","authors":"George Jm Hourston, Adrian J Chojnowski","doi":"10.1177/17531934261418526","DOIUrl":"10.1177/17531934261418526","url":null,"abstract":"<p><p>Eighteen patients with a proximal interphalangeal joint fracture-dislocation involving at least half of the palmar articular surface were treated with hemihamate arthroplasty, achieving a mean of 70° flexion at 14 months. This technique is an effective option for complex injuries.<b>Level of Evidence:</b> IV.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"949-950"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168640","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":"Characteristics of extensor indicis and index extensor digitorum during finger extension: an electromyographic and kinematic study.","authors":"Shota Date, Nanako Nakamae, Hiroshi Kurumadani, Runa Kamikawa, Kazuya Kurauchi, Toru Sunagawa","doi":"10.1177/17531934261416296","DOIUrl":"10.1177/17531934261416296","url":null,"abstract":"<p><strong>Introduction: </strong>Functional differences between the extensor indicis proprius and extensor digitorum communis of the index finger remain poorly understood. We quantified these functional differences by measuring metacarpophalangeal joint angles and muscle activities during extension tasks.</p><p><strong>Methods: </strong>Fifteen healthy participants performed index metacarpophalangeal joint extension under two conditions: a single-finger extension task, primarily activating the extensor indicis proprius; and a four-finger extension task, extending all four fingers, primarily activating the index extensor digitorum communis. Joint kinematics were recorded using a three-dimensional motion analysis system, and muscle activities were measured via surface electromyography.</p><p><strong>Results: </strong>During the single-finger extension task, electromyography showed significantly higher extensor indicis proprius than index extensor digitorum communis activity. In contrast, there was higher index extensor digitorum communis activity during the four-finger extension task. Angle waveforms of the index metacarpophalangeal joint showed comparable flexion/extension patterns between the single-finger extension task and four-finger extension task, but greater adduction (mean 14° vs. 1°) and less internal rotation (-1° vs. 5°) were observed in the single-finger extension task compared with the four-finger extension task, indicating that the extensor indicis proprius has an adduction and external rotation action on this joint.</p><p><strong>Conclusion: </strong>These findings suggest that anatomical differences between the extensor indicis proprius and index extensor digitorum communis underlie their distinct kinematic roles, and that index finger adduction/abduction and rotation may be altered following extensor indicis proprius tendon transfer.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"910-918"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168501","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}