The Journal of hand surgery, European volume最新文献

{"title":"Closed reduction technique for complex dorsal metacarpophalangeal dislocation in children.","authors":"Jhon F Castañeda, Diego F Rincón, Erika Ojeda","doi":"10.1177/17531934261473762","DOIUrl":"10.1177/17531934261473762","url":null,"abstract":"<p><p>Complex dorsal metacarpophalangeal joint dislocation of the index finger (Kaplan dislocation) is uncommon in children. This study evaluates a closed reduction technique using hyperextension, rotation and ulnar deviation in 16 pediatric patients.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"1371-1373"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922483","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":"Optimal location for bone grafting from the olecranon.","authors":"Andreas Weber, Corinna Grau, Christopher Gaffney, Ines Unterfrauner, Lisa Reissner","doi":"10.1177/17531934261480422","DOIUrl":"https://doi.org/10.1177/17531934261480422","url":null,"abstract":"<p><p>Computed tomography of 305 healthy forearms showed that the highest cancellous bone density is 1 cm distal to the olecranon tip, decreasing distally. This site appears optimal for proximal ulna bone graft harvesting in hand and reconstructive orthopaedic surgery.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":"51 10","pages":"1374-1375"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149279268","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":"Permanent hand motor deficit and failure of elbow flexion recovery following Oberlin nerve transfer: a retrospective case series.","authors":"Erica M Cavalli, Elisa Rosanda, Jayme A Bertelli","doi":"10.1177/17531934261441532","DOIUrl":"10.1177/17531934261441532","url":null,"abstract":"<p><strong>Introduction: </strong>The Oberlin nerve transfer is widely used to restore elbow flexion after brachial plexus injury. However, donor-site morbidity, particularly permanent motor deficit, has been rarely reported. This retrospective case series describes permanent donor-site morbidity following the Oberlin procedure and explores its association with poor elbow flexion outcomes.</p><p><strong>Methods: </strong>Nine patients (mean age, 38 years) with upper-type brachial plexus paralysis, including seven C5-C8 injuries, were referred to a tertiary centre after undergoing a primary Oberlin transfer at external institutions. All patients described immediate hand paralysis and/or failure of elbow flexion recovery after the surgery. Patients were reassessed at a mean follow-up of 27 months (range, 9-48). Outcome measures included assessment of hand motor deficits, grip strength and elbow flexion recovery using the Medical Research Council scale.</p><p><strong>Results: </strong>Six of nine patients failed to achieve functional elbow flexion (M0, <i>n</i> = 4; M2, <i>n</i> = 2). Eight patients had ulnar nerve involvement, most commonly paralysis of the first dorsal interosseous muscle (<i>n</i> = 7) and clawing deformity (<i>n</i> = 6). One patient exhibited isolated anterior interosseous nerve paralysis. Mean grip strength was markedly reduced, averaging 14 kg compared with reported normal values of 30-50 kg.</p><p><strong>Conclusions: </strong>The frequent association between irreversible hand weakness and unsatisfactory elbow flexion recovery highlights the limited functional reserve of donor nerves in selected clinical scenarios. These findings emphasize careful patient selection and microsurgical expertise in Oberlin transfers.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"1336-1341"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793760","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":"Intraoperative electrodiagnostic testing as a decision-making tool for neonatal brachial plexus palsy: a scoping review.","authors":"Michael J Albdewi, Martijn Ja Malessy, Yamaan S Saadeh","doi":"10.1177/17531934261478357","DOIUrl":"10.1177/17531934261478357","url":null,"abstract":"<p><strong>Introduction: </strong>Neonatal brachial plexus palsy causes upper extremity paralysis owing to birth-related brachial plexus injury. Although intraoperative electrodiagnostic techniques are routinely used to guide nerve repair in adult brachial plexus surgery, their utility in neonatal cases remains unclear. This scoping review examines whether intraoperative electrodiagnosis aids surgical decision-making, particularly in distinguishing cases amenable to neurolysis, from those that may benefit from nerve reconstruction.</p><p><strong>Methods: </strong>In adherence to PRISMA guidelines, a systematic review of literature was conducted using PubMed, Embase and Scopus databases. Nine relevant studies were identified, eight retrospective and one prospective, that evaluated intraoperative electrodiagnostic modalities such as nerve action potentials, somatosensory evoked potentials, motor evoked potentials, compound muscle action potentials and electromyography in neonatal brachial plexus palsy surgery.</p><p><strong>Results: </strong>All studies evaluated infants undergoing surgery for poor early functional recovery. Substantial heterogeneity existed in strategies of using intraoperative electrodiagnosis to guide clinical decision-making. Several studies used the presence of nerve action potentials, compound muscle action potentials or muscle contraction with stimulation to pursue neurolysis, whereas absent responses prompted neuroma resection and grafting. Meaningful follow-up data was only available from one study, this suggesting improved functional outcomes and fewer secondary operations in patients undergoing nerve resection and grafting compared with neurolysis alone.</p><p><strong>Conclusion: </strong>Intraoperative electrodiagnosis may offer limited value in neonatal brachial plexus palsy surgery, but there is insufficient evidence to reach robust conclusions. There is a need for standardized diagnostic methods and further prospective studies to improve outcomes.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"1342-1350"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842596","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":"Dynamic imaging and wrist biomechanics: a narrative review.","authors":"Ziyue Xiang, Shijie Jia, Shanlin Chen","doi":"10.1177/17531934261452068","DOIUrl":"10.1177/17531934261452068","url":null,"abstract":"<p><strong>Introduction: </strong>The wrist is a complex joint with tightly coupled intercarpal kinematics that remain difficult to interpret clinically. Traditional models, derived from static imaging and cadaveric studies, treat the wrist as a three-dimensional structure. However, wrist biomechanics is inherently dynamic, emerging from interactions across motion phases, loading conditions and functional tasks. Current limitations contribute to under-recognition of clinically relevant instability.</p><p><strong>Methods: </strong>This narrative review summarizes representative studies from the past 10-15 years, with emphasis on <i>in vivo</i> dynamic imaging studies reporting quantitative kinematic outcomes. Four modalities (4D-CT, biplanar videoradiography, four-dimensional magnetic resonance imaging and motion capture) were evaluated in terms of kinematic findings and clinical utility, with findings organized by substructure.</p><p><strong>Results: </strong>Dynamic imaging demonstrates that wrist kinematics are phase-, load- and task-dependent. Abnormalities such as scapholunate instability may only become apparent during specific phases of motion or under physiological loading. 4D-CT currently provides the most accessible <i>in vivo</i> assessment of intercarpal coordination, while biplanar videoradiography offers high-precision kinematic analysis in controlled settings. Motion capture characterizes task-dependent wrist motion for functional activities but lacks intercarpal resolution, whereas four-dimensional magnetic resonance imaging offers potential for integrating soft-tissue behaviour, although current applications remain limited.</p><p><strong>Conclusion: </strong>Dynamic imaging shows that wrist instability arises from abnormal motion patterns rather than a static structural abnormality. Rather than competing, these modalities provide complementary, structure-specific insights. This framework supports clinical interpretation of wrist instability and guides appropriate technique selection. However, clinical interpretation will require further standardized protocols and clinically validated thresholds.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"1378-1385"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140221","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":"Four-finger reconstruction with ten toes preservation: 5-year follow-up.","authors":"Qiu Shenqiang, Sun Jun, Wang Zengtao","doi":"10.1177/17531934261476751","DOIUrl":"10.1177/17531934261476751","url":null,"abstract":"<p><p>Multi-digit defects are difficult to reconstruct. A 25-year-old man underwent staged four-finger reconstructions using composite flaps and iliac grafts. Good functional and aesthetic outcomes were achieved with preservation of all toes. This represents a novel and effective reconstructive strategy.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"1365-1367"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809627","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":"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":"1285-1295"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","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":"CORRIGENDUM to \"Upper Limb Triplication with Radial Dimelia\".","authors":"","doi":"10.1177/17531934261489953","DOIUrl":"https://doi.org/10.1177/17531934261489953","url":null,"abstract":"","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":"51 10","pages":"1386"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149279275","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":"Extended medial cutaneous nerve of the forearm harvest during brachial plexus exploration and repair.","authors":"Bipin A Ghanghurde, Anand R Dugad, Mukund Thatte","doi":"10.1177/17531934261477009","DOIUrl":"https://doi.org/10.1177/17531934261477009","url":null,"abstract":"<p><p>The medial cutaneous nerve of the forearm can provide substantial graft length for brachial plexus reconstruction. We describe a technique for extended harvest, increasing graft length while maintaining low morbidity and simplifying reconstruction, particularly in obstetric but also traumatic plexus injuries.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":"51 10","pages":"1363-1364"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149279305","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":"Systematic characterization of flexor tendon and tendon sheath malposition in proximal phalangeal thumb polydactyly.","authors":"Susumu Saito, Aiko Makino, Naoki Morimoto","doi":"10.1177/17531934261445800","DOIUrl":"10.1177/17531934261445800","url":null,"abstract":"<p><strong>Introduction: </strong>The diverse morphology of proximal phalangeal thumb polydactyly complicates a systematic understanding of soft tissue abnormalities associated with postoperative zigzag deformity. This study aimed to characterize intraoperative anatomical abnormalities of the flexor pollicis longus tendon and its sheath using the concept of the <i>duplication range</i>.</p><p><strong>Methods: </strong>Patients with proximal phalangeal thumb duplication who underwent primary surgery and had high-quality intraoperative records with images of tendon and sheath anatomy were included. Duplicated thumbs were classified as articulated/bony-connected or non-articulated types according to the articulation and developmental status of the radial thumb component and were further stratified based on the duplication range. Fibrous structures bridging the radial and ulnar thumbs overlying the flexor pollicis longus tendons were defined as aberrant pulleys. Displacement of the flexor pollicis tendon insertion was assessed relative to the palmar longitudinal midline.</p><p><strong>Results: </strong>Consistent anatomical patterns were observed within each duplication range. Skin levels 1 (mid-distal phalanx) to 2 (interphalangeal joint) were associated with marked displacement of the flexor pollicis longus tendon insertion, whereas skin level 2.5 (distal third of the proximal phalanx) showed moderate displacement. In contrast, the insertion was near normal at skin level 3 (mid-proximal phalanx). Across duplication ranges and developmental types, tendon sheaths demonstrated eccentrically displaced attachments on the proximal phalanx.</p><p><strong>Conclusion: </strong>The duplication range offers a practical framework for systematically understanding malposition of the flexor pollicis longus tendon and tendon sheath in proximal phalangeal thumb polydactyly and may facilitate preoperative risk stratification and surgical planning for tendon centralization and pulley reconstruction.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"1328-1335"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147871148","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}