Hand & Wrist – Pubmed Results

CONCLUSIONS: Wrist arthroscopy, while generally safe and effective, carries a risk of complications that can be mitigated with experience and adherence to meticulous surgical techniques. The study highlights the spectrum of complications encountered during wrist arthroscopy and emphasizes the importance of awareness and appropriate management of these events in clinical practice. Future prospective studies with larger sample sizes are needed to validate these findings and further refine the...

CONCLUSION: Delayed surgical intervention for selected open metacarpal and phalangeal fractures was not associated with increased rates of 30-day surgical site infection, readmission, reoperation, or overall complications. These findings suggest that carefully selected patients may be safely managed with modest delays to surgery when appropriate antibiotic administration, wound care, and follow-up are ensured.

Placement of a Resurfacing Capitate Pyrocarbon Implant (RCPI) after proximal row carpectomy represents a reliable option for patients with osteoarthritis of the capitate head. Methods: This is a retrospective study that evaluated clinically and radiologically 18 patients who underwent RCPI implantation, with a mean follow-up of 34 months. Results: The postoperative pain decreased significantly in all patients (from 6 to 2 on a scale of 1 to 10), and mobility and grip strength remained sufficient...

This study aimed to compare the clinical and functional outcomes of Kirschner wire (K-wire) fixation versus volar locking plate (VLP) fixation for intra-articular distal radius fractures (DRFs). It also aimed to identify key patient- and fracture-related factors that influence the choice of surgical technique and to evaluate the responsiveness of specific patient-reported outcome measures in assessing recovery. Methods: A total of 201 consecutive patients with Arbeitsgemeinschaft für...

CONCLUSIONS: Nutraceutical supplementation in addition to PEMF was associated with improved short-term outcomes; however, due to the absence of a non-PEMF control group, the independent effect of PEMF cannot be determined.

The authors examine 3 controversies in pediatric fracture management. The first is the use of point-of-care ultrasound versus radiography for buckle fractures. The second is the need for immobilization for stable distal radius fractures. The third is the role of using a cast or splint versus no immobilization in the management of toddler's fractures. Recent evidence supports potentially more minimalist approaches. The use of ultrasound, soft bandaging, and nonimmobilization can be as effective...

CONCLUSION: In this randomized controlled trial, MIPO under WALANT achieved functional, radiographic, and safety outcomes equivalent to conventional volar plate fixation. The statistically lower POD1 pain score in the MIPO group fell below the minimal clinically important difference, indicating no clinically significant difference in early postoperative pain between the two techniques; the only consistent advantages were smaller incisions and better cosmetic scores. MIPO under WALANT is...

CONCLUSION: PO-EBPT yielded superior functional outcomes compared with conservative treatment in patients with Doyle type 4B mallet fractures, as demonstrated by reduced extension lag, improved DIP joint flexion and higher rates of excellent Crawford scores.

CONCLUSION: Pediatric scaphoid fracture patient and fracture characteristics roughly mirrored adult populations. The occurrence of most nonunion diagnoses shortly after initial fracture diagnosis suggests that many patients with nonunion presented late to care.

Distal radius fractures in adults primarily occur in the elderly, in whom comorbidity, polypharmacy, dependency, and limited functional demands often coexist. Most patients have been managed non-surgically with casting. However, only a few trials with high evidence exist on comparing non-surgical and surgical treatments in the elderly. Given the heterogeneity of the aging population, a universal approach to treatment selection may not be feasible. This educational article aims to discuss the...

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: The primary objective is to assess the benefits and harms of partial wrist fusion compared with placebo or sham surgery in adults with non-inflammatory osteoarthritis of the wrist. Secondary objectives are to assess the benefits and harms of surgery, including but not limited to, proximal row carpectomy, total wrist arthroplasty, and wrist denervation, compared with placebo or sham surgery, any non-surgical...

Multimodal large language models (LLMs) that process text and images are increasingly discussed for medical imaging, yet their diagnostic performance on radiographs remains poorly characterized. We evaluated three commercially available multimodal LLMs (GPT-4o, Claude 3.5 Sonnet, Gemini 1.5 Pro) in a strict zero-shot setting for pediatric wrist fracture detection and compared them with a domain-trained Inception v3 convolutional neural network (CNN) on the same GRAZPEDWRI-DX dataset. We...

Acupuncture is generally considered safe; however, inadequate aseptic technique may result in infections involving the skin, soft tissue, bone, or joints. Gram-negative bacilli causing hand infections are uncommon and may present diagnostic and therapeutic challenges, particularly when multiple digits are involved. A 73-year-old woman developed progressive pain, swelling, and functional limitation of the right third and left fifth fingers approximately 1 month after acupuncture. Imaging...

CONCLUSIONS: The combination of hematoma block with median nerve and superficial branch of the radial nerve block was associated with lower digital pain during distal radius fracture reduction compared with isolated hematoma block, without increasing complications. Female sex, obesity, and baseline psychiatric or chronic analgesic medication use were associated with higher pain perception in exploratory analyses. RETROSPECTIVELY REGISTERED CLINICAL TRIAL (18TH SEPTEMBER 2025):...

CONCLUSION: Age older than 60 years and increasing prereduction ulnar positive variance demonstrated high certainty associations with loss of distal radius reduction from available multivariable analyses. Further well-designed prognosis studies are needed to better delineate the predictors of loss of reduction with nonoperative management of distal radius fractures.

CONCLUSION: CMC 1 arthrodesis demonstrates good long-term results with significant pain relief and high patient satisfaction. Mobility compensation and near-complete strength restoration were observed. Adjacent joint arthrosis occurred but remained largely asymptomatic. The use of cancellous bone grafting and compression screws is strongly recommended to reduce non-union risk. Arthrodesis proves a reliable surgical option, particularly for patients with high strength requirements.

This study reviews literature on corrective osteotomies without bone grafting for malunion of distal radius fractures (MDRF). A systematic review was performed on the treatment of MDRF without bone graft. The primary functional outcome measures were time to radiological union, Disabilities of the Arm, Shoulder, and Hand (DASH) scores, Visual Analogue Scale (VAS) scores, Mayo Wrist scores, grip strength, and range of motion (ROM) at final follow-up. A total of 285 patients across 11 studies met...

CONCLUSION: Surgeons who perform distal radius fracture fixation infrequently may benefit from focused strategies to support maintenance of procedural proficiency including continuing professional development and enhanced surgical training. At a systems level, the lower risk of complications observed among surgeons performing at least 20 procedures per year have implications for training programs, ongoing competence frameworks, and health-system planning, particularly in settings where referral...

CONCLUSION: In patients with acute tendinous mallet finger, percutaneous IM Kirschner wire DIP joint transfixation provides superior extension control and higher functional success rates compared with conservative treatment. Although pin configuration does not significantly influence functional outcomes, it affects patient comfort and the complication profile. Treatment decisions should therefore be individualized based on patient compliance and functional expectations.

The objective of this study is to compare the clinical and radiological outcomes of conservative vs. surgical management in pediatric patients with Salter-Harris types I and II distal radius fractures who experienced loss of reduction following initial closed reduction. This retrospective matched cohort study included pediatric patients under 16 years of age treated for Salter-Harris types I and II distal radius fractures with documented loss of reduction. Patients were matched based on age,...

CONCLUSIONS: Coronal hamate body fractures with CMC instability frequently presented as dorsal oblique patterns following punching injuries and were commonly associated with fourth metacarpal base fractures. Open reduction with multiple small-diameter screw fixation through K-wire tracts, combined with supplementary K-wire stabilization, was feasible and provided favorable clinical outcomes. Favorable outcomes were generally observed when anatomical reduction was achieved within 3 weeks after...

The cellular basis for site-specific inflammation remains unclear. In human fingers, proximal interphalangeal (PIP) joints are preferentially affected by inflammatory arthritis, whereas distal interphalangeal joints are spared, providing a model to investigate the predilection of inflammation to distinct sites. Here we combine single-cell RNA sequencing, imaging and X-ray tomography to examine cellular composition, spatial organization and structure of finger joints during fetal development. PIP...

CONCLUSIONS: Both open and arthroscopic foveal TFCC repair can improve function, pain, motion, grip strength, and distal radioulnar joint stability, but current comparative evidence does not demonstrate clear superiority of either technique. Because the available evidence is limited to a small number of non-randomized studies with substantial heterogeneity and low certainty, the absence of statistically significant differences should be interpreted cautiously and should not be considered...

CONCLUSION: Across fixation strategies for intraarticular distal radius fractures, no single construct demonstrated radiographic superiority at final follow-up, although volar plating was associated with greater flexion and extension at final follow-up. These findings underscore the importance of tailoring fixation strategy to fracture pattern and patient-specific factors when managing complex distal radius fractures.

The proximal interphalangeal joint is a central structure in the function and biomechanics of the hand and finger flexion. It has unique anatomical characteristics that influence its normal function and is affected by multiple pathologies that can markedly alter its architecture and function. This narrative literature review correlates basic sciences, clinical practice, and surgical management, focusing on two treatment options that sacrifice the joint: arthroplasty and arthrodesis. The aim is...

CONCLUSIONS: This nationwide 11-year analysis demonstrates that wrist arthroscopy in South Korea has steadily increased, with a growing trend toward complex reconstructive procedures. Despite regional variation, no income-based disparity was observed, and overall complication rates remained low, although postoperative infection was observed somewhat more frequently than reported after larger-joint arthroscopy, supporting both the accessibility and safety of wrist arthroscopy in routine clinical...

Distal radius fractures (DRFs) are one of the most common orthopaedic injuries seen in the Accident and Emergency (A&E) Department, accounting for 17% of all fractures. They are associated with significant morbidity, with substantial economic and societal costs due to the high incidence of these injuries. Initial management of displaced fractures consists of prompt reduction of the fracture in A&E and application of a moulded plaster cast to hold the fracture. However, there is currently no...

Video platforms are major sources of health information; however, the accuracy of musculoskeletal content is uncertain. Triangular fibrocartilage complex (TFCC) injury is common, and many patients seek guidance online. The present study aims to evaluate TFCC-related videos on Bilibili and TikTok to measure dissemination, quality, and reliability, and to identify features associated with higher-quality content. This study conducted a systematic screening and assessment of videos related to the...

CONCLUSION: Fracture prevention was effective in reducing the risk of a second fracture. Notable differences were observed by first fracture type, treatment being ineffective for hip fractures. Furthermore, treatment coverage must be increased in order to reap the full benefits of secondary prevention at a population level.

RATIONALE: Surgery is used to treat persistent pain and dysfunction due to osteoarthritis at the base of the thumb, when conservative management is no longer effective. This is an update of a Cochrane review first published in 2005.

Background and Objectives: Dupuytren's disease (DD) most commonly affects the palm and metacarpophalangeal/proximal interphalangeal joints; distal digital involvement at the distal interphalangeal joint (DIPJ) is uncommon and incompletely characterised. This systematic review summarises reported cases of DD involving the DIPJ, with or without proximal interphalangeal joint (PIPJ) involvement, focusing on clinical patterns, management, and reported outcomes. Materials and Methods: A systematic...

CONCLUSION: Patients treated with volar plate fixation demonstrated more pronounced subclinical ultrasonographic and electrophysiological median nerve alterations compared with those treated conservatively with cast immobilization. However, given the retrospective and non-randomized design, these findings should be interpreted as associative rather than causal. Combined ultrasonographic and electrophysiological assessment may be useful for detecting early median nerve involvement and guiding...

Rupture of the extensor pollicis longus (EPL) tendon is a recognised complication after distal radius fracture (DRF) that leads to loss of active thumb extension. Transfer of the extensor indicis proprius (EIP) tendon to the EPL is one of the most common reconstructive procedures, but prospective outcome data are limited. This study evaluated functional and patient-reported outcomes after EIP-to-EPL tendon transfer exclusively in patients with EPL rupture secondary to DRF. Thirty consecutive...

INTRODUCTION: We evaluated construct validity of a 3D-printed displaced, unstable distal radius fracture (DRF) model for closed reduction and percutaneous pinning (CRPP). We hypothesized that clinical DRF experience levels would correlate with performance metrics during model CRPP.

INTRODUCTION: Trapeziometacarpal osteoarthritis (TMO) is among the most prevalent forms of upper extremity osteoarthritis. It is frequently associated with significant levels of pain and disability, particularly among ageing women. The typical care pathway for TMO relies on non-surgical approaches for up to 2 years, before surgery is considered. One of the most common non-surgical approaches is an intra-articular cortisone injection. However, these are not universally recommended due to their...

CONCLUSION: Isolated scaphoidectomy for type II SLAC and SNAC wrist is a reliable and simple surgical procedure which could be proposed only after careful patient selection. This procedure has maintained a high level of satisfaction at long-term follow-up despite the radiological deterioration. It is far less invasive and requires a shorter time of functional recovery than Four Corner Fusion and Proximal Row Carpectomy in elderly or low-demanding patients with good pain relief. In case of...

Distal radius fractures are among the most prevalent fractures, accounting for approximately 17% of all fractures treated. Given the high prevalence of these fractures, particularly in the older adults population, determining the optimal treatment approach is of utmost clinical importance. While previous research has highlighted both the advantages and drawbacks of surgical and conservative treatment strategies, there remains a lack of consensus regarding which approach yields superior outcomes...

This study aimed to identify independent risk factors associated with poor wrist function recovery 6 months after internal fixation of distal radius fractures (DRF) and develop machine learning models for early risk prediction. This retrospective study included 328 patients who underwent internal fixation for DRF at our hospital between January 2022 and June 2025. Wrist function was evaluated using the Cooney Wrist Score at 6 months postoperatively. Poor recovery was defined as a Cooney score...

CONCLUSION: Radial entry ESIN is associated with a low rate of predominantly transient neurological complications. Entry point positioning and patient age appear to influence the risk of SBRN injury. Based on our data and the available literature, the radial approach represents a safe and clinically favorable option for ESIN of pediatric radius fractures.

CONCLUSION: Proximal phalangeal base fracture-dislocations with partial-articular bone loss pose reconstructive challenges. We present a rare case of proximal phalangeal base articular reconstruction using distal tibial osteochondral allograft.

This study aimed to review the postoperative outcomes of surgical treatment options for wrist ganglion cysts and perform a meta-analysis comparing the 2 most common techniques: open and arthroscopic resection. We searched PubMed, Embase, Web of Science, and Cochrane Library databases for articles that compared the clinical outcomes of patients who underwent arthroscopic or open resection of the wrist ganglion. After screening, we identified two randomized controlled trials and four retrospective...

CONCLUSION: This case series demonstrates that split hamate fracture can achieve excellent functional and radiological outcomes with surgical treatment, while also highlighting specific challenges in surgical approach and osteosynthesis.

CONCLUSION: Radiographic improvement consistent with damage repair is not infrequent in PsA. Concomitant treatment with biologic DMARDs and MTX is a predictor of slower radiographic progression and damage repair.

Condylar stress fracture of the third metacarpal bone (MC3) in Thoroughbred racehorses is a common catastrophic injury, and identification of horses at heightened risk remains subjective. Standing computed tomography (sCT) is a practical screening tool that enables patient-specific finite element analysis (FEA) of the distal MC3 and prediction of subchondral bone strain, as a potential objective classifier of racehorses at heightened risk. The goal of this study was to compare two independently...

Hand osteoarthritis (HOA) is a common musculoskeletal condition characterized by joint pain and structural changes; however, the role of systemic inflammation in its pathogenesis remains unclear. This retrospective case-control study aimed to evaluate both traditional and novel systemic inflammatory markers in patients with HOA and to examine their associations with Kellgren-Lawrence grade and erosive disease. A total of 175 patients with HOA and 94 age- and sex-matched controls were included....

Hominin forelimbs have evolved from primarily locomotive to manipulative appendages over approximately 6 million years. As such, hand functions in fossil hominins and the Pan-Homo last common ancestor (LCA) are intensely debated, with carpal morphology central to this debate. However, owing to their irregular and challenging shapes, few studies have comprehensively quantified carpal morphology. We analyse the overall carpal morphology of anthropoids, including fossil hominins, using spherical...

CONCLUSION: The modified Henry approach preserving the FCR tendon sheath significantly improves early postoperative pain relief and functional recovery, with sustained benefits in pain and grip strength up to 12 months. This technique does not increase surgical difficulty, reduces complication risk, and follows the ERAS principle, showing high clinical value.

CONCLUSION: Conclusions: The change in the post-fracture care system from a traditional to a self-monitoring has shown great effectiveness and safety for patients. This improved the work of the hand clinic, improved patients' access, increased satisfaction and reduced costs.

CONCLUSIONS: The crutch-bend modification of retrograde ESIN was associated with improved postoperative radiographic alignment in this retrospective cohort. Whether this translates into clinically meaningful advantages remains uncertain and requires further investigation in larger prospective studies.

This paper describes motion assessment in young adults (YA) and older adults (OA) during the use of an upper limb rehabilitation robot (ULRR). An experimental protocol was proposed to collect kinematic and surface electromyographic (sEMG) data from 20 participants. The protocol included the use of the ULRR along with an interface to execute standardized wrist movements randomly (flexion, extension, radial deviation, and ulnar deviation) at fixed intervals. For the sEMG, representative features...