The use of mathematical modelling in hand surgery.

Consistent explanations of hand and wrist anatomy, how it relates to function and leads to dysfunction, remain elusive. Recent research using new capabilities in computer-aided and three-dimensional (3D) modelling with mathematical tools have advanced our understanding in areas where conventional understanding does not align with clinical observation. Translating the complex biomechanical and clinical realities into mathematical models of the hand and upper limb, however, poses significant challenges; yet when successful, these models can provide answers to questions difficult to address in two-dimensional analyses. Mathematical tools can also measure forces across joints, mark fracture planes in comminuted fractures, enabling the virtual reduction of fractures, and analyse the properties of denervated muscles. High mathematical quality data, when validated carefully, facilitate the creation of models that can be used to provide new general information in hand surgery as well as the potential to personalize patient care.