Sep 28 – Oct 4, 2026 · 29 new studies, 10 reviews · Hand & Upper Extremity archive · All weeks
The new Hand & Upper Extremity research The Reduction sent the week of Sep 28 – Oct 4, 2026, with the week’s most recent reviews, each with a one-line summary.
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The Dorsal Lunate Dislocation: A Systematic Review and Case Series.
A three-case series plus systematic review of 20 rare dorsal lunate dislocations, mostly from high-energy trauma, supports closed reduction followed by fixation and ligament repair when indicated.
Midcarpal Ultra-wide Scapholunotriquetral Capsulo-ligamentoplasty (MUSCL) Procedure.
This describes the MUSCL arthroscopic technique for scapholunate instability, passing sutures directly through the midcarpal joint; in 68 patients, QuickDASH improved about 35 points at short-term follow-up with preserved motion.
In a 35-patient randomized trial, distal radius ORIF with local lidocaine/epinephrine and no tourniquet was safe, with modestly better early function and pain, similar blood loss and operative time, but slightly poorer visualization.
The Wind Off Test: A Novel Clinical Test for TFCC Tears.
The wind off test for TFCC tears was highly sensitive (92%) but had zero specificity in 79 arthroscopy patients, so it may screen but needs corroboration.
The Incidence and Risk Factors for Volar Shear Distal Radius Fractures at a Level 1 Trauma Center.
Volar shear distal radius fractures made up 8.5% of distal radius fractures at a level 1 trauma center, with high-energy injury mechanism and younger age as the key risk factors.
Clinical, Radiographical, and Arthroscopic Features of Dorsal Tears of the TFCC.
Dorsal-ulnar TFCC tears were frequently missed on MRI (accurately identified in only 14%) but consistently showed a positive dorsal hook test at arthroscopy, so persistent ulnar-sided pain warrants arthroscopic evaluation.
In 84 scaphoid nonunion surgeries, a higher postoperative height-to-length ratio predicted lower odds of union and worse DASH scores, supporting restoration of scaphoid morphology.
In 17 patients with advanced wrist cartilage lesions, arthroscopic dermal-matrix interposition cut pain and disability at about 28 months while preserving motion, with one conversion to arthrodesis.
After carpal tunnel release, non-tobacco nicotine dependence raised 90-day medical complications and ED visits versus controls, though fewer ED visits and revisions than tobacco users, supporting preoperative screening.
In a turkey zone II flexor tendon repair model, ablating vincular and tenocyte intrinsic healing elements did not worsen early motion, adhesions, or strength, suggesting extrinsic mechanisms dominate early healing.
In a retrospective study of 104 metacarpal shaft fractures, intramedullary screw fixation allowed the fastest return to full motion without more complications than plating or pinning.
After MLB's 2023 pitch clock, pitcher upper extremity injuries involved about 6 more recovery days and a greater share of elbow injuries, independent of rising fastball velocity.
In 105 brachial plexus reconstructions, panplexus injuries had graft-eligible C5 roots about as often as upper plexus injuries, and MRN predicted C5 graftability well (28 of 29), supporting routine exploration.
The Impact of Occupational Therapy on Patient Outcomes Following Total Wrist Arthroplasty.
After total wrist arthroplasty, specialized occupational therapy was linked to fewer complications than general therapy, while range of motion, reoperation rates, and costs were similar.
A ResNet50 transfer-learning model detected pediatric supracondylar fractures on radiographs with about 90% accuracy, statistically comparable to emergency physicians, but it missed nondisplaced Gartland I fractures and needs prospective validation.
In six infants with brachial plexus birth injuries, spinal accessory to musculocutaneous nerve transfer gave durable grade 4 or greater elbow flexion over about 12 years without costing trapezius strength.
The surgical value framework in hand surgery: a conceptual model for evaluating surgical pathways.
Proposes a Surgical Value Framework for comparing hand surgery pathways across clinical, patient experience, recovery, economic, and environmental domains, complementing rather than replacing patient-reported outcome measures.
For FDP zone 1 repairs, a nondrilling pull-out technique matched Bunnell's biomechanically and at 6 months functionally, with less early postoperative pain, while avoiding bone drilling.
MLB pitchers returning from a nonoperative forearm flexor strain had about 3 times the 1-year hazard of UCL surgery versus matched controls (9.8% vs 4.1%); longer recovery time was associated with lower risk, likely as a marker rather than protective.
In 150 open trigger finger releases, lower preoperative vitamin D independently predicted delayed wound healing (20% of patients) and poorer early hand function, though prospective confirmation is needed.
In a propensity-matched cohort, systemic amyloidosis was not associated with increased early complications or additional CTS-related care after carpal tunnel release.
In children with both-bone forearm fractures, lower vitamin D levels were linked to delayed radiographic union, while high-dose vitamin D supplementation improved healing rates and scores.
Comparing 20 homodigital adipofascial reverse flaps versus 20 dermal substitute reconstructions for fingertip loss, the flap gave better sensory recovery and faster return to work, while dermal substitutes preserved donor sites with good cosmesis.
A Novel Flexor Tendon Reconstruction Technique in Children: A Potential Solution for a Rare Problem.
In a cadaveric study of nine pediatric digits, a novel palmaris longus-to-FDP anchor construct for two-stage flexor tendon reconstruction showed acceptable elongation, though anchor pullout from soft pediatric bone was the main failure mode.
In this randomized trial of 59 patients with recurrent Dupuytren contracture, fasciectomy and collagenase gave similar 2-year extension outcomes, but surgery carried more severe adverse events and early functional worsening.
Salvage Arthrodesis after Failed Trapeziometacarpal Total Joint Replacement: A Technical Note.
In three patients with failed trapeziometacarpal total joint replacements, salvage arthrodesis with an interposed iliac crest graft healed in all cases with satisfied patients, suggesting an option for high-demand patients, pending larger studies.
Scaffold Fixation of Multi-Fragmented Intra-Articular Distal Radius Fractures.
In 87 patients with multi-fragmented distal radius fractures, combining volar locking plates with a dorsal bone clamp ('scaffold fixation') restored motion and maintained radiocarpal alignment regardless of dorsal ulnar corner screw purchase or fragment size.
Repairing unstable ECU tendons with a retrograde posterior interosseous artery fascial flap significantly improved strength, DASH, PRWE, and pain scores with no recurrent instability in this small case series.
Change in Carpal Height as Related to Outcomes of Total Wrist Arthroplasty.
In this Level III study of 49 total wrist arthroplasties, postoperative radiographic carpal height/alignment changes did not predict clinical outcome, suggesting soft-tissue balance matters more than bony geometry restoration.
Magnetic Resonance Neurography of Sports-Related Peripheral Nerve Injuries of the Shoulder Region.
Narrative review of how MR neurography complements exam and electrodiagnostics in localizing sports-related shoulder nerve injuries, including brachial plexus trauma, thoracic outlet syndrome, axillary nerve stretch, and postsurgical nerve problems.
The Role of Traditional Limb Salvage and Finger Replantation in the Era of Bionic Reconstruction.
This review argues replantation still beats revision amputation for thumb, multiple-digit, and distal single-digit amputations, and for distal forearm amputations, with bionic reconstruction a possible alternative when replanted hands function poorly.
Structural balance restoration in complex forearm problems using 3D technology.
Describes a surgeon-engineer 3D imaging, planning, and printing workflow for restoring bone and soft-tissue balance in complex forearm malunions and deformities.
Arthroscopic Treatment of Thumb Carpometacarpal Joint Arthritis.
Review of arthroscopic treatment for thumb CMC arthritis, covering interventions, outcomes, and remaining challenges, given no consensus on the best surgical approach after nonoperative care fails.
Current evidence on non-surgical therapies for Dupuytren's disease: A clinical review.
This clinical review of nonsurgical Dupuytren's treatments (collagenase, needle aponeurotomy, radiotherapy, pharmacologic agents, rehabilitation) finds they are less invasive but vary in durability, with higher recurrence than surgery, so treatment should be individualized.
Radial Styloidectomy: Open Versus Arthroscopic.
Reviews radial styloidectomy for radioscaphoid arthritis and impingement, comparing open access with arthroscopic technique, which offers better visualization and helps preserve the radioscaphocapitate ligament to avoid instability and ulnar carpal translation.
A European Delphi consensus of seven hand surgeons recommends surgical management of trapeziometacarpal periprosthetic infections, with debridement and neck exchange for acute cases, trapeziectomy as salvage, and six weeks of antibiotics.
The IFSSH consensus and current guidelines on flexor tendon repairs and reconstruction.
This 2025 IFSSH consensus recommends strong six-strand repairs with early active motion for primary flexor tendon repair and outlines one-stage versus staged grafting approaches for secondary reconstruction.
Expanding Indications for Temporary Dorsal Wrist Spanning Plate Fixation.
This review covers the history, expanding indications, and technique of temporary dorsal wrist spanning plate fixation, a versatile option for distal radius fractures and other carpal conditions despite requiring a second procedure for removal.
Current clinical tests and imaging for diagnosing DRUJ instability remain subjective or limited, highlighting the need for better quantifiable diagnostic tools.
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