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Hand Surgery: Clinical Advances and Practice Updates
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Hand Surgery: Clinical Advances and Practice Updates

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Plastic, Reconstructive and Aesthetic Surgery/Aesthetic Medicine".

Deadline for manuscript submissions: closed (31 July 2025) | Viewed by 766

Special Issue Editor

Dr. Guy Rubin

E-Mail Website
Guest Editor
Orthopedic Department, Emek Medical Center, Afula 1834111, Israel
Interests: hand surgery; elbow surgery; orthopedic surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Hand surgery utilizes and incorporates diverse techniques from orthopedics, plastic surgery, and microvascular surgery. Hand surgeons treat fractures of the hand and upper extremity, tendon repairs, tendon transfers, and reconstruction following traumatic injuries and burn injuries to the hand. Corrections of hand deformities and contractures and congenital defects are some of the most common procedures performed. Hand surgery also utilizes the microsurgical reconstruction of amputated digits and limbs, the repair and reconstruction of soft tissue and bone, and nerve reconstruction. Hand surgeons also treat sport injuries with advanced techniques such as arthroscopy and ligament reconstructions.

Advances in hand surgery over the last decade include the use of nerve allografts and nerve transfers, improvements in fracture fixation, and the use of minimally invasive techniques such as arthroscopy and wide-awake hand surgery. Joint replacements have replaced joint fusions and allow for the preservation of motion.

The aim of this Special Issue is to address new advances in the growing field of hand surgery.

Dr. Guy Rubin
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • trauma
  • mallet
  • burn
  • nerve
  • tendon

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

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10 pages, 1380 KB  
Article
Aesthetic Reconstruction of Fingertip Defect Using Second Toe Pulp Free Flap
by Soyeon Jung, Sodam Yi, Seungjun Lee and Seokchan Eun
J. Clin. Med. 2025, 14(16), 5855; https://doi.org/10.3390/jcm14165855 - 19 Aug 2025
Viewed by 360
Abstract
Background: Varioaus methods are available to address fingertip injuries, which are becoming increasingly common. Coverage should ideally involve both functional and aesthetic improvements. The second toe pulp-free flap is useful because of its similarity to the fingertips in shape, texture, and sensation. Herein, [...] Read more.
Background: Varioaus methods are available to address fingertip injuries, which are becoming increasingly common. Coverage should ideally involve both functional and aesthetic improvements. The second toe pulp-free flap is useful because of its similarity to the fingertips in shape, texture, and sensation. Herein, we present our clinical experience and surgical methods for fingertip defect reconstruction using second toe pulp-free flaps. Materials and Methods: Between April 2022 and May 2023, 13 toe pulp-free flaps were used to reconstruct fingertip defects. The average patient age was 50.1 years (range, 35–67 years), and nine of the 13 patients were male. Nine patients were injured on the right hand, and four on the left hand. After complete debridement, a toe-pulp flap was harvested with a teardrop from the ipsilateral side. The cases included the reconstruction of four index fingers, seven middle fingers, and two little fingers. Functional and aesthetic assessments were performed postoperatively. Results: All flaps survived completely, with no partial necrosis. The average flap size was 1.5 × 2 cm (range, 0.8 × 1.5 to 2.0 × 3.0 cm). None of the patients had functional impairments. No emergency surgeries were required during the follow-up period. The median follow-up period was 28 months, and the median duration of surgery was 119 min (range, 100–140 min). The average static two-point discrimination score for the injured finger pulp was 3.7 mm (range, 2–5 mm), the Quick Dash score was 3.4 (range, 2.3–4.2), and the Vancouver scar scale was 1.5 (range, 0–2). Conclusions: The toe pulp-free flap is the optimal choice for surgical treatment of fingertip defects and injuries, with excellent functional and cosmetic results. Full article
(This article belongs to the Special Issue Hand Surgery: Clinical Advances and Practice Updates)
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Review

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11 pages, 617 KB  
Review
Wide-Awake Local Anesthesia with No Tourniquet (WALANT) Carpal Tunnel Release in the Clinic: A Clinical Practice Update
by T. Hunter Stocker-Downing, Rebecca McAllister, Sean Chan, Ian Mullikin and Kevin Krul
J. Clin. Med. 2025, 14(18), 6407; https://doi.org/10.3390/jcm14186407 - 11 Sep 2025
Viewed by 21
Abstract
Background: Wide-awake local anesthesia with no tourniquet (WALANT) carpal tunnel release (CTR), performed in the clinic setting, has emerged as a safe, efficient, and cost-effective alternative to traditional operating room (OR)-based decompression. With increasing adoption in clinic settings, WALANT CTR offers the potential [...] Read more.
Background: Wide-awake local anesthesia with no tourniquet (WALANT) carpal tunnel release (CTR), performed in the clinic setting, has emerged as a safe, efficient, and cost-effective alternative to traditional operating room (OR)-based decompression. With increasing adoption in clinic settings, WALANT CTR offers the potential to improve access, reduce costs, and maintain excellent patient outcomes. Purpose: This clinical practice update provides an evidence-based summary of clinic-based WALANT CTR, including patient selection, procedural setup, safety profile, cost implications, and system-level considerations for implementation. Recent Findings: Multiple prospective and retrospective studies confirm the safety of WALANT CTR in the clinic setting, with complication rates comparable to OR-based procedures and no increase in surgical-site infections when field sterility is used. Cost analyses report a 70–85% reduction in facility costs per operative case, and patient satisfaction remains consistently high, even among those with anxiety disorders or psychiatric conditions. Adjunctive interventions such as virtual reality technology devices and noise-canceling headphones further enhance the awake surgical experience. Institutional adoption remains variable, with barriers including sterility concerns, billing uncertainty, and credentialing logistics. This clinical update offers detailed, practical guidance on implementing WALANT CTR for surgeons and staff, covering scheduling, staff training, clinical integration, billing, and compliance considerations. Summary: Clinic-based WALANT CTR is a high-value, patient-centered approach supported by a growing body of literature. With appropriate patient selection, streamlined workflows, and institutional support, this model can optimize surgical care delivery in both resource-rich and limited environments. Full article
(This article belongs to the Special Issue Hand Surgery: Clinical Advances and Practice Updates)
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