The Journal of hand surgery, European volume最新文献

{"title":"Short-to-medium-term outcomes of MAÏA® dual mobility CMC joint arthroplasty.","authors":"Debashis Dass, Rye Yap, Jefin Edakalathur, Manikandar Srinivas Cheruvu, Ibrahim Roushdi","doi":"10.1177/17531934251410360","DOIUrl":"10.1177/17531934251410360","url":null,"abstract":"<p><strong>Introduction: </strong>There is no consensus on the ideal surgical intervention for trapeziometacarpal joint arthritis. Although trapeziectomy has been the preferred procedure for several decades, trapeziometacarpal joint replacement has been gaining favour over several years owing to improvements in implant design. Dual mobility implants have been introduced to reduce the risk of dislocation associated with earlier single mobility versions. The aim of this study was to report the medium-term clinical outcomes of trapeziometacarpal joint replacement using the MAÏA^® dual mobility implant, from a single tertiary referral centre.</p><p><strong>Methods: </strong>This study included 106 patients with trapeziometacarpal joint osteoarthritis who received MAÏA^® dual mobility implants between 2017 and 2023. Patients were selected based on clinical and radiological criteria, with exclusions for inflammatory arthritis and STT joint involvement. Outcomes were assessed pre- and postoperatively using validated clinical scores, grip strength and radiographs at set intervals.</p><p><strong>Results: </strong>Patients were followed for an average of 53 months (IQR 20 to 58 months). The Brief Michigan score improved from 42 to 83, the pain score improved from 7 to 1, pinch strength improved from 2 to 4 kg and power grip improved from 14 to 22 kg. Two cups were revised owing to symptomatic loosening, while an additional two cups exhibited loosening but were not revised as both patients were asymptomatic. There were two intraoperative trapezium fractures. Survivorship of implants with maximum final follow-up of 6 years was 97% (IQR 20 to 58 months).</p><p><strong>Conclusions: </strong>The MAÏA^® dual mobility implant shows good improvement in pain, strength, mobility, and patient reported outcomes over the medium term, with no dislocations.</p><p><strong>Level of evidence: </strong>Therapeutic IV.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"623-629"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146204483","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":"Patterns of proximal interphalangeal joint dislocations.","authors":"Charles Bewsey, Grey Giddins","doi":"10.1177/17531934251405707","DOIUrl":"10.1177/17531934251405707","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to understand finger proximal interphalangeal joint (PIPJ) dislocations better by reviewing the demographics and biomechanics of a cohort of PIPJ dislocations.</p><p><strong>Methods: </strong>All cases of PIPJ dislocations presenting to our emergency department or neighbouring minor injury units over a 2 year period were reviewed. We recorded demographics, mechanism of injury, direction of the dislocation radiologically, concomitant injuries and rates of follow-up (FU).</p><p><strong>Results: </strong>There were 74 dislocations in 74 adults with a median age of 46 (range 14-87) years. Fifty-six (76%) were men and 18 (24%) were women. The dislocations were ulnar more than radial: little finger (43%), ring finger (34%), middle finger (15%) and index finger (8%). Amongst all 74 dislocations, 36 (49%) were dorso-ulnar, 30 (41%) dorsal, five (7%) ulnar, two volar and one dorso-radial. Six dislocations were open. Five of these were dorsal dislocations and five affected the index (three) and middle (two) fingers. The median number of FU appointments was two (range 0-21).</p><p><strong>Conclusion: </strong>Our findings suggest that PIPJ dislocations commonly affect two distinct populations: young men suffering little finger dislocations during sport and older patients sustaining middle finger dislocations after falling. Open dislocations are predominantly dorsal dislocations of the index and middle fingers. FU rates are very variable but suggest 20% of cases have prolonged symptoms.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"576-580"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013961","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":"Role of high-resolution dynamic ultrasonography in the evaluation of posterior interosseous nerve compression at radial tunnel: a prospective case-control study.","authors":"Sanjoth Basavaraj, Vinay Raju, Deepthi Paraj, Anil K Bhat, Ashwath Acharya","doi":"10.1177/17531934261443138","DOIUrl":"https://doi.org/10.1177/17531934261443138","url":null,"abstract":"<p><strong>Introduction: </strong>Radial tunnel syndrome is a dynamic compressive neuropathy of the posterior interosseous nerve often misdiagnosed as lateral epicondylitis. This study aimed to appraise the role of high-resolution dynamic ultrasonography in diagnosing radial tunnel syndrome by assessing nerve compression in different forearm positions.</p><p><strong>Methods: </strong>In this prospective case-control study, 28 patients with radial tunnel syndrome and 56 matched healthy volunteers underwent dynamic ultrasonography. The anteroposterior (AP) diameter and cross-sectional area (CSA) of the posterior interosseous nerve were measured proximal to the Arcade of Frohse and the AP diameter was measured within the tunnel in the pronated, neutral and supinated forearm positions. The measurements were compared with those of the volunteers and the unaffected side of the patients.</p><p><strong>Results: </strong>An increase in the AP diameter in both the pronation and neutral forearm positions, as well as a larger CSA during forearm pronation, was observed proximal to the Arcade of Frohse in patients compared with volunteers. The increase in the AP diameter within the radial tunnel was significant in all three forearm positions. Comparison of the affected and unaffected sides revealed posterior interosseous nerve compression, with an increased AP diameter in the neutral forearm position. Twenty-five patients who were recalcitrant to non-operative treatment underwent surgical decompression and the Arcade of Frohse was the most common site of compression. At the 12 month follow-up, 24 patients achieved excellent to good results.</p><p><strong>Conclusion: </strong>Dynamic ultrasonographic assessment of changes in the AP diameter and CSA is an effective diagnostic tool for identifying radial tunnel syndrome. Although the Arcade of Frohse is the primary site of compression, it is crucial to address all compression structures in the radial tunnel during surgery.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"17531934261443138"},"PeriodicalIF":1.6,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793922","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":"Long-term outcomes of selective adductor muscle release for House type 1 thumb-in-palm deformity in cerebral palsy.","authors":"Okyar Altas, Emre Meriç, Gaye Torna, Bora Edim Akalın, Hayri Ömer Berkoz, Atakan Aydın","doi":"10.1177/17531934261438309","DOIUrl":"https://doi.org/10.1177/17531934261438309","url":null,"abstract":"<p><strong>Introduction: </strong>This study retrospectively assessed the long-term outcomes of surgical treatment for House type 1 thumb-in-palm deformities in 25 patients with spastic hemiplegic cerebral palsy.</p><p><strong>Methods: </strong>The study included 25 patients (mean age: 12.8 years) who met the inclusion criteria. The surgical technique involved the release of spastic thumb adductors, enhancement of thumb abduction and extension and stabilization of the first metacarpophalangeal joint. Patients wore a below-elbow palmar splint with the first phalanx in abduction for 6 weeks, followed by static splinting between weeks 6 and 8, dynamic splinting and rehabilitation between weeks 8 and 16 and night splinting until month 6. The Manual Ability Classification System (MACS) scores and fine and gross grasping abilities were measured and compared with those on the contralateral side.</p><p><strong>Results: </strong>The mean follow-up period was 8.8 years. The MACS score decreased from 2.72 preoperatively to 1.56 in the long term. Marked improvements in grasping ability were observed: key-pinch improved by 19%, tip-to-pinch by 19.2%, triple-pinch by 19.5% and gross grasping by 37%.</p><p><strong>Conclusion: </strong>This study suggests that surgical treatment can improve long-term functional outcomes of thumb-in-palm deformities in patients with cerebral palsy.<b>Level of evidence:</b> III, Therapeutic.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"17531934261438309"},"PeriodicalIF":1.6,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793779","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":"https://doi.org/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":"17531934261441532"},"PeriodicalIF":1.6,"publicationDate":"2026-04-24","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":"Radial polydactyly and thumb hypoplasia: retrospective analysis of clinical presentations and a proposed surgical strategy.","authors":"Wentao Yu, Chunhua Yin, Wei Liu, Papat Sriswadpong, Guang Yang, Xiaofang Shen","doi":"10.1177/17531934261441493","DOIUrl":"https://doi.org/10.1177/17531934261441493","url":null,"abstract":"<p><strong>Introduction: </strong>Although radial polydactyly is a common congenital hand malformation, its co-occurrence with thumb hypoplasia is rare, as the two are seen as opposite ends of a developmental spectrum. Radial polydactyly with thumb hypoplasia poses a significant diagnostic challenge, often leading to under-recognition and -treatment of the hypoplastic component. This study reviews our experience with the comprehensive management of this complex association.</p><p><strong>Methods: </strong>This retrospective study reviewed 13 cases (11 males) with a mean age of 28.2 months. Radial polydactyly with thumb hypoplasia cases that presented between 2017 and 2024 were reviewed. All patients underwent a tailored surgical strategy based on the Wassel classification and Blauth grade of hypoplasia in either single or two-stage procedures.</p><p><strong>Results: </strong>The majority of patients were classified as Wassel VII, and the most common thumb hypoplasia grading was Blauth II. At follow-up (13-88 months), reconstructed thumbs exhibited favourable aesthetics and functional opposition. Using the Japanese Society for Surgery of the Hand ratings, four patients were rated excellent, seven were rated good, and two were rated fair. Kapandji scores ranged from 6 to 9.</p><p><strong>Conclusion: </strong>Optimal outcomes in preaxial polydactyly require a high index of suspicion for potential thumb hypoplasia, even in its subtle forms. A comprehensive surgical plan that integrates the correction of both anomalies is fundamental to achieving reliable functional and aesthetic outcomes.</p><p><strong>Type of study/level of evidence: </strong>Therapeutic IV.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"17531934261441493"},"PeriodicalIF":1.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793943","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":"Re: Tang JB, Lalonde D, Fernandes CH, Sadek AF, Besmens IS. The IFSSH consensus and current guidelines on flexor tendon repairs and reconstruction. <i>Journal of Hand Surgery (European Volume)</i> 2026; 51(2): 127-138. doi:10.1177/17531934251404821.","authors":"Louis Tremblais","doi":"10.1177/17531934261439728","DOIUrl":"https://doi.org/10.1177/17531934261439728","url":null,"abstract":"","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"17531934261439728"},"PeriodicalIF":1.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793881","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":"Performance and reliability of large language models on the European Board of Hand Surgery examination: a multi-model evaluation study.","authors":"Ibrahim Güler, Lindsay Muir, Gerrit Grieb, Philipp Moog, Armin Kraus, Henrik Stelling","doi":"10.1177/17531934261436305","DOIUrl":"https://doi.org/10.1177/17531934261436305","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence (AI) has demonstrated transformative potential in medical education and assessment, with large language models achieving competitive results across multiple high-stakes examinations. In this study, we evaluated the performance and inter-run reliability of 10 widely adopted large language models (LLMs) on the European Board of Hand Surgery written examination.</p><p><strong>Methods: </strong>Ten LLMs were assessed on the complete 300-item European Board of Hand Surgery written examination using standardized zero-shot prompting. The models included five proprietary systems (GPT-5 Pro, Claude Sonnet 4.5, Gemini 2.5 Pro, Grok-4 and ERNIE 4.5 Turbo) and five open-source architectures (DeepSeek V3.2, Qwen3 Max, Mistral Medium 3.1, Llama 3.3 and Falcon H1). Each LLM completed five independent runs, producing 15000 answers analysed for mean accuracy, 95% confidence intervals and inter-run reliability using Cohen's kappa (<i>κ</i>).</p><p><strong>Results: </strong>Mean accuracy across the LLMs ranged from 72 to 85%, corresponding to total European Board of Hand Surgery scores between 131 and 211 points. Seven of the 10 LLMs reached or exceeded the illustrative pass threshold of 75%, equivalent to 150 of 300 points. Proprietary systems showed consistently higher mean accuracy than open-source systems. The highest-performing LLM (GPT-5 Pro) achieved 85% accuracy with a 95% confidence interval of 84 to 86% and a mean inter-run reliability measured by Cohen's <i>κ</i> of 0.739. The overall reliability across the LLMs was 0.821.</p><p><strong>Conclusions: </strong>Contemporary LLMs show robust and reproducible performance on a complex surgical certification examination, with proprietary architectures tending to outperform open-source counterparts. Although several models reached or exceeded an illustrative pass threshold, persistent gaps in subspecialty knowledge remain such as congenital anomalies and complex reconstructions. Therefore, LLMs may assist in structured learning and examination preparation but require specialist oversight and remain unsuitable for independent subspecialty decision-making.</p><p><strong>Level of evidence: </strong>Not applicable.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"17531934261436305"},"PeriodicalIF":1.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793831","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":"Reply.","authors":"Donald Lalonde, Jin Bo Tang","doi":"10.1177/17531934261439728#sub1-17531934261439728","DOIUrl":"https://doi.org/10.1177/17531934261439728#sub1-17531934261439728","url":null,"abstract":"","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"17531934261439728"},"PeriodicalIF":1.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793912","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":"Restoring rotational balance of the paediatric forearm: lessons from post-traumatic malunion.","authors":"Filip Stockmans, Joost Colaris","doi":"10.1177/17531934261438706","DOIUrl":"https://doi.org/10.1177/17531934261438706","url":null,"abstract":"<p><strong>Introduction: </strong>Post-traumatic malunion of paediatric forearm fractures may lead to impairment of pronation and supination. Treatment decisions are traditionally based on radiographic alignment, although functional limitations do not always correlate with deformity on plain radiographs. Understanding the interaction between bony deformity, soft tissue contracture and growth related remodelling is essential for restoring rotational balance of the forearm.Current concepts:Impaired forearm rotation may result from angular or rotational malalignment, loss of the radial bow or soft tissue contracture. Two-dimensional radiographic measurements do not accurately predict functional impairment. Growth-related remodelling can substantially improve both alignment and rotation over time, particularly in younger children and fractures near active growth plates. Physiotherapy and splinting may address soft tissue restrictions. In persistent cases, three-dimensional analysis and patient-specific instrumentation allow more accurate correction of deformity and improved restoration of forearm rotation. Increasing evidence suggests that functional improvement depends not only on anatomical correction but also on restoring the balance between radius, ulna and interosseous membrane.</p><p><strong>Clinical implications: </strong>Management of post-traumatic forearm malunion should focus on restoring rotational balance rather than correcting deformity alone. Patient-specific evaluation that considers both anatomical deformity and soft tissue constraints may help guide treatment and optimize functional outcomes.</p>","PeriodicalId":94237,"journal":{"name":"The Journal of hand surgery, European volume","volume":" ","pages":"17531934261438706"},"PeriodicalIF":1.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147725187","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}