Hand & Upper Extremity Archive

SUMMARY: This article reviews the column model and specific fixation techniques for achieving anatomic reduction of comminuted high-energy distal radius fractures.

SUMMARY: This narrative review proposes that developmental anatomical anomalies of the neonatal brachial plexus create a 'neurologic vulnerability' predisposing certain infants to Erb's palsy during delivery, suggesting decompression may complement nerve grafting.

SUMMARY: This article offers hand surgeons a practical framework and pearls for antiracist education and advocacy to reduce racial health care inequities in the field.

SUMMARY: This review outlines various open reduction and internal fixation approaches for proximal interphalangeal joint fractures, emphasizing fracture pattern/stability-guided treatment and setting realistic expectations for post-injury stiffness.

SUMMARY: Shifting soft tissue hand procedures from the OR to the procedure room substantially increases surgeon reimbursement and could save payers over $20 million per 1000 cases annually over 10 years.

SUMMARY: In nonagenarians undergoing distal radius fracture surgery, radiographic alignment was well maintained with acceptable complications (15%), though correlation between radiographic parameters and functional outcome was weak, supporting surgery as a safe option in selected elderly patients.

SUMMARY: A combined CNN and random forest AI model predicted hand surgeons' operative versus nonoperative recommendations for distal radius fractures with 87% accuracy using pre-reduction radiographs and clinical data, showing feasibility for point-of-care decision support.

SUMMARY: Long-term follow-up (30+ years) confirms the vascularized rib-cartilage-serratus Eve flap durably preserves metacarpal bone and joint space with high patient satisfaction, though it doesn't restore true joint motion.

SUMMARY: Cadaveric biomechanical testing showed dorsal angulation of malunited distal radius fractures shifts load onto the ulna, up to 67% with 45° tilt, explaining wrist disability.

SUMMARY: Review finds over three-quarters of primary flexor tendon repairs achieve good-to-excellent function, though rupture, adhesions, and stiffness remain key challenges to address.

SUMMARY: Electrocauterization of cyst remnants after ganglion excision showed a nonsignificant trend toward lower recurrence, with the best results seen when combined with tissue window excision, especially for dorsal cysts.

SUMMARY: In thumb CMC osteoarthritis, orthotic use improved pain and function at 3 months, but longer daily wear time was not independently associated with greater pain reduction.

SUMMARY: This review discusses evidence for leech therapy in managing venous congestion after digital replantation/revascularization and proposes a treatment algorithm for leech weaning, given the lack of consensus guidelines.

SUMMARY: Overview of hand surgery's 25-year evolution in Saudi Arabia, including specialized centers, fellowship training, and growing research contributions.

SUMMARY: Review highlights persistent gaps and noncompliance in hospital price transparency for hand procedures despite CMS rules, urging stronger enforcement and patient-cost dialogue.

SUMMARY: This review argues that locked intramedullary nailing is a viable alternative to plating for select forearm fractures, especially with comminution or soft tissue compromise, minimizing further tissue injury.

SUMMARY: This article explains the revised ACGME Hand Surgery Milestones 2.0, streamlining competencies and adding a supplemental guide to help programs assess fellows more clearly.

SUMMARY: This technical review covers essential positioning, anatomy, and portal placement principles for safe and effective elbow arthroscopy across its range of surgical indications.

SUMMARY: This review outlines sex-specific biologic and biomechanical factors underlying shoulder and elbow injuries in female athletes, an area less studied than other sex-based orthopaedic differences.

SUMMARY: This review outlines individualized management of rheumatoid thumb deformities—using Nalebuff's classification and tendon reconstruction, arthrodesis, or arthroplasty—based on joint involvement and disease activity.

SUMMARY: This review highlights the challenges of caring for uninsured hand surgery patients and argues for protecting safety-net hospitals and adapting individual practice patterns to improve access to care.

SUMMARY: This article provides practical guidance on camera settings, equipment, and editing software for producing high-quality educational surgical videos in hand and upper extremity surgery.

SUMMARY: This review outlines reconstructive (osteochondral graft-based) and salvage surgical options for proximal interphalangeal joint fracture dislocations and proposes an algorithm to guide surgeons in choosing between them.

SUMMARY: Cadaveric wrist kinematic testing confirms the scapholunate interosseous ligament is the primary scapholunate stabilizer, with dorsal radiocarpal, dorsal intercarpal, and scaphotrapezial ligaments serving secondary roles.

SUMMARY: A rare aneurysmal bone cyst of the distal phalanx was successfully treated with phalanx-preserving excision and curettage, achieving full range of motion and no recurrence at 4 years, supporting conservative management over amputation.

SUMMARY: Reverse shoulder arthroplasty improves functional hand-behind-back task performance by 6 months mainly through increased trunk/lumbar compensation and altered muscle activation, despite persistent internal rotation deficits.

SUMMARY: A decision-analytic model shows that whether adopting a new surgical technique (e.g., direct anterior hip approach) helps or harms patients depends heavily on the individual surgeon's case volume and learning curve, not just published outcomes.

SUMMARY: This review examines why evidence-based innovations spread slowly into hand surgery practice and highlights learning health systems as a way to speed adoption.

SUMMARY: This review outlines the pathoanatomy, biomechanics, and three phenotypes of Kienböck disease, emphasizing that multiple risk factors must converge to cause onset and progression.

SUMMARY: Field-sterility K-wire fixation of finger fractures with early pain-guided motion and removal at 2-4 weeks is safe, cheaper, and reduces stiffness without increasing infection or loss of reduction.