Conflicts of interest in hand surgery: recognizing risks, navigating challenges and promoting integrity.

Conflicts of interest (COI) are pervasive in hand surgery, where clinical practice, research, and education intersect with industry. Beyond financial ties, COIs can be research-related, personal, social media-associated and royalty-based, influencing implant choice, study outcomes and educational content. Evidence shows that inaccurate disclosures remain common, with up to 81% of authors failing to report COIs correctly, while social media and mentorship reveal hidden biases. These conflicts risk undermining scientific integrity and patient trust. Mitigation requires a multi-level approach: full transparency in disclosures, adherence to social media guidelines, distancing from decision-making roles when conflicts exist, institutional COI registries, standardized journal policies and unbiased selection for conferences and leadership positions. Fostering a culture of integrity ensures collaboration with the industry and helps to advance innovation without compromising ethics or patient care.