Hand & Wrist – Pubmed Results

CONCLUSION: Over 2 years, a considerable proportion of patients demonstrated radiographic progression. Progressors were especially those with erosive disease, more radiographic damage (most pronounced in younger females) and bone marrow lesions at baseline.

Foreign body granuloma of the phalanx is an exceptionally rare entity in pediatric populations. Herein, we present a case involving a 10-year-old male patient with a granuloma of the proximal phalanx of the right index finger, initially misinterpreted as an osteoid osteoma on magnetic resonance imaging. The lesion manifested as a progressively enlarging, painful swelling over five months, with no antecedent trauma reported. Surgical exploration revealed a plant thorn embedded within an...

CONCLUSIONS: In spite of a large number of clinical and radiological complications during follow-up, long-term functional results are good in this kind of wrist injuries.

CONCLUSIONS: The implantation of a stabilized partial scaphoid prosthesis does not significantly modify the movement pattern of a healthy wrist. Therefore, in the future it could be a viable alternative for the treatment of recalcitrant pathology of the carpal scaphoid.

Distal radius fractures are common injuries that every orthopedic surgeon must be able to treat effectively. Achieving good outcomes without surgery is complex: it requires proper maneuvers in the emergency department, follow-up visits with cast adjustments or replacements, and follow-up radiographs, often resulting in discomfort for the patient. Additionally, some specialists, especially younger ones, are drawn to the perceived ease and convenience of surgical procedures, which contributes to...

Distal radius fractures are common injuries that every orthopaedic surgeon must be able to treat effectively. Achieving good outcomes without surgery is complex: it requires proper manoeuvres in the emergency department, follow-up visits with cast adjustments or replacements, and follow-up radiographs, often resulting in discomfort for the patient. Additionally, some specialists, especially younger ones, are drawn to the perceived ease and convenience of surgical procedures, which contributes to...

CONCLUSIONS: The use of TMP in patients with trapeziometacarpal osteoarthritis has excellent short and medium-term results, regardless of STT involvement, so it should not be a contraindication for osteoarthritis at this level.

CONCLUSIONS: The use of TMP in patients with trapeziometacarpal osteoarthritis has excellent short and medium-term results, regardless of STT involvement, so it should not be a contraindication for osteoarthritis at this level.

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Volkmann's ischemic contracture is a disabling consequence of compartment syndrome, characterized by irreversible muscle and nerve damage leading to joint deformities and functional impairment. Traditional surgical approaches such as tendon lengthening, neurolysis, and free muscle transfer are often limited in severe cases, especially when soft tissue is compromised. This article reviews current treatment options, focusing on the Ilizarov circular frame as a minimally invasive alternative for...

CONCLUSIONS: The results regarding the prevalence of injuries among aerobic and artistic gymnasts at all levels of competition are significant. Gymnasts who exercise at highly competitive levels and are exposed to competitive environments are at increased risk for injury. Future research should be focused on implementation of consistent reporting methods.

CONCLUSION: Short-arm circular casting and volar splinting provide equivalent clinical and functional outcomes in the management of stable distal radius fractures. Given its ease of application and greater patient comfort, volar splinting can be considered a practical alternative in emergency department settings, particularly for selected patient populations.

CONCLUSIONS: Visual inspection of photos and videos to detect MCP and PIP joint effusions was poor at both the joint and person levels. Patients and rheumatologists should be aware of these limitations when conducting remote telehealth assessments.

CONCLUSION: This case highlights that, in carefully selected adolescents, proximal row carpectomy can achieve excellent outcomes, challenging traditional age-based and stage-based contraindications and emphasizing individualized, patient-centered surgical decision-making.

CONCLUSION: Older age, AO/OTA type C fractures, fracture displacement, dorsal metaphyseal comminuted fracture, prolonged operation time, low preoperative serum calcium level, and comorbid osteoporosis are the main risk factors for postoperative loss of reduction in patients with unstable distal radius fractures. The established predictive nomogram model enables clinicians to more accurately assess the risk of postoperative loss of reduction and provides valuable support for personalized...

The radial artery is a vital access point for various cardiovascular and neurological interventions yet detailed morphometric studies in African populations are limited. This study aimed to investigate the radial artery dimensions in thirty adult body donors housed in the Department of Clinical Anatomy, University of KwaZulu-Natal, Durban, South Africa. The external and internal diameters, along with wall thickness of the radial artery, were measured at three anatomical sites viz. the point of...

Hand osteoarthritis is a leading cause of pain, disability, and reduced quality of life in older adults. Joint protection programs are recommended as a core component of self-management, but traditional delivery is limited by barriers to access. Digital programs can overcome these challenges for some people, but their reach and effectiveness depend on usability. We conducted a mixed methods usability study of a remotely delivered joint protection program designed for people with hand...

CONCLUSIONS: Circumferential block demonstrated superior pain control compared to hematoma block without compromising fracture alignment or increasing complications. Its broader periosteal innervation coverage and ease of administration suggest it may be a valuable alternative for pain management in distal radius fracture reduction. However, further studies with larger sample sizes and long-term functional assessments are warranted to confirm these findings.

CONCLUSION: All 4 treatments achieved acceptable outcomes, but with key trade-offs: Percutaneous Pinning had the best functional results but a higher infection risk. VLP provided better function and lower malunion rates than bracing. Splinting and bracing were effective conservative options, often yielding results similar to VLP, but were inferior in some specific measures. The findings suggest that a perfect anatomic repair is not always necessary for a good recovery. Ultimately, the choice of...

CONCLUSIONS: Early administration of DE after distal radius fracture surgery is safe and does not impair bone healing. Given the higher patient satisfaction and lower rate of adverse events, DE may be a favorable option for early osteoporosis management in the postoperative setting.

CONCLUSIONS: The findings of this study provide practical anatomical references for identifying the A1 and A2 pulleys using palmar skin creases, which may improve the safety and precision of percutaneous A1 pulley release while minimizing the risk of A2 pulley injury.

CONCLUSION: Although SCF has some advantages over CHF regarding joint ROM and clinical scores, no difference was found between the groups (clinically and radiologically). Both SCF and CHF combined with lunate excision seem to be effective in the treatment of advanced Kienböck's disease in the mid-term. Cite this article as: Sener İM, Ozturk T, Aldemir C, et al. Lunatum excision and limited intercarpal fusion in advanced Kienb.ck's disease: scaphocapitate versus capitohamate fusion. Acta Orthop...

Chondrosarcoma is a malignant tumor originating from cartilage-producing cells. Although rare in the hand, it is the most common primary malignant bone tumor in this location. We present a case of high-grade chondrosarcoma of the first metacarpal bone in an 85-year-old female, who presented with pain and severe limitation of hand function. Imaging studies initially suggested a giant cell bone tumor, and a tru-cut biopsy did not confirm chondrosarcoma. During the preoperative period, the tumor...

CONCLUSION: Palmar window dislocation technique for treating patients with osteoporotic distal radius fractures could effectively restore palmar inclination angle of radius. Combined with the implantation of artificial bone, it could effectively maintain the fracture reduction and reduce risk of re-displacement.

Distal radius fractures are one of the most common fractures with a growing incidence in the active and aging population. The classification of these fractures is complex due to continued improvements in our understanding of fracture patterns, their injury mechanisms, and resultant patterns of instability. This complexity has led to multiple classification systems that have not been updated with contemporary knowledge on distal radius fracture patterns and their respective treatments. We...

This study evaluated a novel implant for proximal interphalangeal (PIP) joint arthroplasty that we designed according to the principles of a logarithmic spiral. The design addresses the limitations of current implants that poorly replicate natural finger kinematics. Finite element analysis and cadaver studies, including biomechanical and kinematic analyses, were conducted. Results showed that our implant had consistent sliding displacement, maintained consistent articular surface spacing, and...

Scaphoid fractures are a common but frequently missed wrist injury. Patients classically present following a fall onto an outstretched hand, with pain and tenderness in the anatomical snuffbox. When missed, scaphoid fractures can have serious complications such as avascular necrosis of the scaphoid and scaphoid non-union advanced collapse. The British Society for Surgery of the Hand has recently published guidelines on the management of suspected scaphoid fractures. Initial management involves...

CONCLUSIONS: This study found that postmenopausal women who received non-operative treatment or had osteopenia on DXA are less likely to initiate or maintain osteoporosis evaluation and management following DRF. Clinicians need to emphasize osteoporosis evaluation and treatment adherence, particularly in these patients following DRF.

CONCLUSION: Injury to the interosseous intercarpal ligaments causing diastasis of carpal bones is rare in patients with a scaphoid waist fracture displaced by ≤ 2 mm. Treatment of the fracture with a cast or surgical fixation, without additional imaging or intervention for a potential ligament injury, appears adequate for most fractures. If there are ligament injuries not identified with standard imaging, they do not seem to progress.

CONCLUSION: Timely operative management, tailored to dislocation type and obstructing anatomy, is essential. The dorsal approach optimizes MCP mobility, disability reduction, and athletic recovery, whereas the volar approach enhances grip strength. These complementary outcomes underscore the importance of individualized surgical selection and structured rehabilitation.

CONCLUSION: The lift technique using a fixed-angle volar plate is a reliable and effective method for intraoperative correction of volar tilt in dorsally displaced distal radius fractures. The technique provides a valuable alternative, particularly in cases where manual reduction fails to achieve sufficient volar tilt restoration.

Guyon's canal syndrome is an uncommon distal ulnar neuropathy caused by compression within the wrist. We report a case of delayed ulnar nerve entrapment secondary to post-traumatic fibrosis, diagnosed nine years after wrist injury and surgery. High-resolution ultrasonography demonstrated focal nerve compression within Guyon's canal adjacent to fibrotic tissue. The patient presented with chronic sensory deficits and hypothenar atrophy. Conservative treatment led to partial symptom control. This...

INTRODUCTION: Accurate bone age assessment (BAA) is essential for diagnosing and managing pediatric endocrine and growth disorders, as it reflects biological maturity beyond chronological age. The widely used Greulich-Pyle (GP) method estimates bone age by visually comparing full-hand radiographs with standardised reference images. Although widely used, this technique-and most automated systems based on it-assumes uniform skeletal maturation across the hand. In practice, however, skeletal...

RATIONALE: Rice body synovitis is a rare benign synovial disorder with an insidious onset and nonspecific clinical features that often lead to diagnostic uncertainty or delay.

CONCLUSIONS: These findings suggest that isolated USO effectively treats UIS with concurrent DRUJ instability and achieves satisfactory clinical outcomes without the need for simultaneous TFCC repair.

Background: Thumb metacarpophalangeal (MCP) collateral ligament injuries are common and can be debilitating, with prolonged recovery and functional limitation of the injured hand. The aim of this study is to identify potential demographic differences between patients treated operatively and nonoperatively and identify trends in the surgical management of thumb MCP ligament injuries in New York (NY) State. Methods: Using the Statewide Planning and Research Cooperative System (SPARCS) database and...

Background: Our objective is to compare clinical, radiographic and complication-related outcomes between two non-autologous implants - Mini TightRope^(®) and Microlink™ - used in suspensionplasty following open trapeziectomy for thumb carpometacarpal joint arthritis. Methods: We retrospectively analysed 77 patients (41 Mini TightRope^(®), 36 Microlink™) treated between 2017 and 2021 with a minimum follow-up of 36 months. All surgeries were performed by the same experienced hand surgeon using a...

Background: Neglected dorsal subluxation of the proximal interphalangeal joint (PIPJ) results in significant compromise of hand function. Operations like volar plate arthroplasty, hemihamate arthroplasty and joint fusions have been described to treat them. However, all are open procedures and technically demanding. Dynamic external fixation has been used as a treatment for acute injuries. There is a paucity of literature on the use of static external fixation in the treatment of neglected PIPJ...

Vertical locking of the thumb metacarpophalangeal joint (MCPJ) is a very rare condition characterised by a flexion deformity at the MCPJ, accompanied by preserved interphalangeal joint motion. Most reported cases are associated with trauma in young adults, and degenerative causes, especially in the thumb, have not been documented. We present a case of a 52-year-old woman with a several-year history of intermittent locking of the left thumb in flexion, initially self-reducible, later requiring...

An aneurysmal bone cyst (ABC) is classified as a benign osteoclastic giant cell-rich tumour. We report a case of a 48-year-old male patient with a solid variant ABC involving the trapezoid bone. We chose to fill the defect with bone cement after curettage. At the 12-month follow-up, the patient remained recurrence-free with satisfactory hand function. Carpal bone tumours are rare and typically benign, with malignant and metastatic lesions being extremely uncommon. We were unable to find any...

Background: Emergency department (ED) utilisation after surgery is a potentially preventable complication and a focus of health system improvement programmes. Understanding whether mean area income is a risk factor for increased ED utilisation can guide how resources are deployed to reduce unnecessary utilisation. In this study, we tested whether there is an association between mean area income and ED utilisation after hand surgery. Methods: Using a national administrative claims database, we...

The 4-corner and 3-corner fusions are established treatments for scapholunate and scaphoid nonunion advanced collapse arthritis, effectively alleviating pain while maintaining partial mobility. Traditionally performed via open techniques, advancements in arthroscopy now allow for minimally invasive approaches that may prove to reduce complications and accelerate recovery. Various fixation methods, including compression screws, dorsal plates, staples, and Kirschner wires influence stability and...

Radial styloidectomy (RS) is a surgical procedure used to address radioscaphoid arthritis and radioscaphoid impingement. It involves removing the distal portion of the radial styloid to relieve pressure on the radioscaphoid joint. The procedure can be performed open or arthroscopically. Open RS provides direct access but can be more invasive, while arthroscopic RS offers better visualization and preservation of volar radiocarpal ligaments such as the radioscaphocapitate (RSC). The key challenge...

Proximal row carpectomy (PRC) is a workhorse surgical procedure used to treat degenerative and traumatic wrist conditions to preserve wrist range of motion. Various modifications of grafts have been used to expand indications. As minimally invasive arthroscopic options become increasingly popular, the use of the wrist arthroscope as a possible adjunct to perform PRC has also come under scrutiny. While it has the potential advantages of minimal soft tissue injury with faster postoperative...

Although radioscapholunate (RSL) and lunotriquetral (LT) fusions are less commonly performed than other limited carpal fusions, they can relieve pain, correct deformity, and restore function for appropriately selected patients with wrist arthritis or instability. Distal scaphoid excision and triquetrum excision may improve range of motion in patients undergoing RSL fusion. Although complete LT coalitions are often asymptomatic, LT fusion may be considered to eliminate motion at the...

Wrist hemiarthroplasty is a surgical technique involving partial arthroplasty of the radiocarpal joint. Depending on the pathology the surgeon is treating, the surgery can be radial-sided, radial-sided with a proximal row carpectomy, or carpal sided. The rationale for performing a wrist hemiarthroplasty is to avoid complications associated with total wrist arthroplasty. This may be a better option for younger, more active patients to avoid complications and lifelong activity restrictions...

This comprehensive review discusses wrist arthritis in young patients while discussing the evolution of wrist arthroplasty and its use in this population. Here, we emphasize the challenges of managing arthritis in a high-demand, younger population and review historical to modern implant designs, including their benefits, complications, and outcomes. Ultimately, while modern implants show improved outcomes, long-term success in younger patients remains uncertain, necessitating cautious patient...

Total wrist arthrodesis or fusion (TWF) is a complex procedure that is indicated for advanced wrist arthritis. It is indicated for the management of advanced rheumatoid arthritis and posttraumatic arthritis such as scapholunate advanced collapse or scaphoid nonunion advanced collapse. At the expense of wrist motion, it provides adequate pain relief and therefore, patients should be carefully selected. Multiple techniques have been described through both open and arthroscopic approaches. In this...

An important challenge in the management of thumb carpometacarpal (CMC) joint arthritis is determining the most appropriate surgical approach for any given clinical scenario, once non-operative treatment has been exhausted. The variety of surgical procedures available highlights the fact that there is no general consensus on the optimal surgical treatment of this condition. With the advancement in wrist arthroscopy, the use of arthroscopic-assisted treatment for basilar joint arthritis has...

The surgical management of wrist arthritis in a young patient requires a detailed understanding of wrist anatomy and thoughtful surgical approach. The carpus can be accessed through open and arthroscopic techniques, allowing both visualization and assessment of volar and dorsal wrist anatomy. The chosen approach is guided by the pathology and exposure required to safely perform the necessary procedures.