Hand & Upper Extremity Archive

SUMMARY: In 67 intra-articular distal humerus fractures, older patients had more distal transverse and more lateral longitudinal fracture lines, which may limit distal lateral fixation with a tab-equipped posterolateral plate.

SUMMARY: In a matched database cohort of over 91,000 patients, stage III-V CKD carried higher 30- and 90-day rates of skin infection, osteomyelitis, and sepsis after soft tissue hand surgery, though absolute rates stayed low.

SUMMARY: This review covers imaging of scapholunate ligament injuries, weighing radiographs, ultrasound, CT, and MRI against emerging dynamic modalities and AI tools, and stresses pairing imaging with clinical examination.

SUMMARY: This article reviews open and arthroscopic surgical approaches to the wrist, emphasizing the anatomy needed to choose safe exposure for managing wrist arthritis in young patients.

SUMMARY: Review of rehabilitation after flexor tendon repair, stressing the balance between protecting the repair and early controlled motion to limit adhesions, guided by healing phase and close surgeon-therapist communication.

SUMMARY: This review covers recognition and management of vasopressor-induced digital ischemia, from early warming, nitrates, botulinum toxin, and sympatholysis to distal amputation for established necrosis, noting weak supporting evidence.

SUMMARY: Review of perionychium anatomy and reconstructive options for chronic nail deformities after trauma, such as nonadherence, split nails, and hook nails, plus pincer nails and pigmented lesions, with the senior author's technical pearls.

SUMMARY: In 46 patients with zone II flexor tendon repairs using a cross-stitch epitendinal suture and early combined active/passive mobilization, there were two ruptures and good motion (DIP 63°, PIP 94° at 6 months).

SUMMARY: Scoping review of 163 free functional muscle transfers for Volkmann's ischemic contracture found a 96% success rate, mostly gracilis for finger flexion, but 34.6% needed later tenolysis or adhesiolysis.

SUMMARY: At about 21 years after hemi-hamate resurfacing for PIP fracture-dislocations, all 13 patients had radiographic PIP arthrosis but good-to-excellent outcome scores, stable grafts, and no revisions, supporting long-term durability.

SUMMARY: Among 1,597 hand and wrist fracture patients, incarcerated patients were first seen by specialists more often in clinic than the ED and completed fewer therapy visits, suggesting reduced access to timely care and rehabilitation.

SUMMARY: In 25 wrists, a freehand ulnar shortening osteotomy with interosseous wire plus locking plate achieved union in all cases (median 10 weeks) with improved pain and function and no specialized jigs needed.

SUMMARY: In this non-randomized study of 244 elderly distal radius fracture patients, daily vitamin C 500 mg for 3 months was associated with lower CRPS-I incidence (15.5% vs 35.2%), suggesting a cheap preventive option.

SUMMARY: In 33 distal humerus fractures fixed via the TRAP approach without postoperative immobilization, early passive motion at 48 hours gave acceptable function and preserved triceps strength, with no triceps rupture or implant failure.

SUMMARY: In mild to moderate cubital tunnel syndrome, corticosteroid injection, radiographic cervical spondylosis, and elbow osteoarthritis independently predicted failure of nonsurgical care, which may justify considering earlier surgery in such patients.

SUMMARY: In 35 surgically treated coronal shear fractures of the distal humerus, medial trochlear involvement on CT predicted worse elbow extension and more bone-related complications, which standard classifications missed, so it may help surgical planning.

SUMMARY: In patients over 70 with unstable Colles fractures, volar plating gave better radiographic alignment than casting, but functional outcomes were equivalent and casting had less pain and no complications, favoring nonoperative care.

SUMMARY: This review covers rehabilitation of elbow instability, emphasizing anatomy-based, surgeon-therapist coordinated programs that allow early motion within a safe arc while preserving joint stability.

SUMMARY: Review of the biologic rationale for synovectomy in the rheumatoid hand and wrist, its role in joint and tendon disease now that medical therapy has advanced, and what research is still needed.

SUMMARY: Narrative review finding machine learning, especially convolutional neural networks, diagnoses hand fractures with high accuracy (outperforming some clinicians), but limited external validation and workflow integration still constrain clinical adoption.

SUMMARY: Review of atypical radioscapholunate and lunotriquetral fusions, covering indications for pain relief and function, adjunct excisions to improve motion, and the benefits versus steep learning curve of arthroscopic technique.

SUMMARY: In 500 elbows with lateral epicondylitis, the resisted anterior drawer test showed 96% sensitivity and 82% specificity for MRI-defined lateral elbow instability, suggesting it is a useful screening maneuver pending prospective confirmation.

SUMMARY: Describes a surgical technique for rigid congenital clasped thumb in arthrogryposis, pairing a radially based index stiletto flap with growth-preserving MCP chondrodesis to open the web, resurface the volar thumb, and stabilize the joint.

SUMMARY: A low-cost drop-tower setup (about 947 euros) reliably produced distal radius fractures, mostly AO/OTA type C, in 15 tissue-intact full-length cadaveric forearms, offering a usable model for testing immobilization devices.

SUMMARY: In 88 young children followed about 9 years, latissimus dorsi (with or without teres major) transfer for brachial plexus birth injury durably improved shoulder abduction, external rotation, and flexion, with few revisions.

SUMMARY: In 70 healthy adults, optimal dynamometer grip span scaled with hand size in women, who need an adjusted span (hand size/5 + 1.5 cm), while men can use a fixed 5.5 cm.

SUMMARY: Overview of using foot tissues as donor sites for hand reconstruction, allowing missing fingers and structures to be rebuilt without taking healthy tissue from an already injured hand.

SUMMARY: Review of vascular imaging and interventional radiology options for hand and upper extremity vascular disorders, covering advantages, limitations, and indications to help hand surgeons choose studies and communicate with interventional radiologists.

SUMMARY: In this interim randomized trial of 101 patients, dorsal plating, lateral plating, and intramedullary screws gave similar motion and patient-reported outcomes for proximal phalangeal fractures, but dorsal plating had more major complications and longer surgery.

SUMMARY: In 417 distal radius fixations, single-shot regional blocks were associated with roughly 3 to 4 times higher risk of unscheduled pain-related health care use within three days, reflecting rebound pain.