State of the Art in Hand Surgery

Special Issue Editors


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Guest Editor
Department of Traumatology, Orthopaedics and Hand Surgery, Poznań University of Medical Sciences, 61-545 Poznań, Poland
Interests: nerve surgery; congenital hand; hand surgery

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Guest Editor Assistant
Department of Traumatology, Orthopaedics and Hand Surgery, Poznań University of Medical Sciences, 28 Czerwca 1956 r. Street, No. 135/147, 61-545 Poznań, Poland
Interests: nerve; congenital abnormalities; hand surgery, shoulder, wrist; traumatology; nerve reconstruction

Special Issue Information

Dear Colleagues,

Hand surgery is fast-developing specialty connecting surgeons of different specialties and hand therpists. From the very beginning, there was a high demand for the scientific justification of the solutions and procedures used to treat our patients. On the other hand, through the determination of the pioneers and their followers, we can offer predictable treatment for most hand conditions despite the lack of hard evidence.

THe state of the art can be interpreted in different ways. I am happy to open and lead this Special Issue and to include both review papers summarizing actual knowledge and practice but also research manuscripts that investigate our present work or new ideas. It is a perfect combination of what we already know and do and also what we could do in a better way, including criticism, which is so important to further development.

We invite you to contribute, as we all need good science in the background of our daily practice.

Prof. Dr. Leszek Romanowski
Guest Editor

Dr. Piotr Czarnecki
Guest Editor Assistant

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Keywords

  • hand surgery
  • nerve surgery
  • state-of-the-art
  • hand therapy
  • tendons
  • thumb arthritis
  • hand fractures

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Published Papers (2 papers)

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Research

10 pages, 984 KiB  
Article
Three-Dimensional-Planned Patient-Specific Guides for Scaphoid Reconstruction: A Comparative Study of Primary and Revision Nonunion Cases
by Michael A. Wirth, Mauro Maniglio, Benedikt C. Jochum, Sylvano Mania, Ladislav Nagy, Andreas Schweizer and Lisa Reissner
J. Clin. Med. 2025, 14(6), 2082; https://doi.org/10.3390/jcm14062082 - 19 Mar 2025
Viewed by 353
Abstract
Background: Scaphoid reconstruction after an established non- or malunion is challenging and recent developments have shown the feasibility to reconstruct it with 3D-planned and -printed patient-specific instrumentation. Methods: Our study compared the clinical outcome of computer assisted 3D-reconstructions of the scaphoid using patient-specific [...] Read more.
Background: Scaphoid reconstruction after an established non- or malunion is challenging and recent developments have shown the feasibility to reconstruct it with 3D-planned and -printed patient-specific instrumentation. Methods: Our study compared the clinical outcome of computer assisted 3D-reconstructions of the scaphoid using patient-specific guides for primary and revision reconstructions of scaphoid nonunion regarding clinical outcome. Therefore, 39 patients with primary scaphoid nonunion or malunion and 15 patients with nonunion or malunion after a previous operative treatment were treated with patient-specific guides and followed up for a mean of 10.5 months. The consolidation was assessed with a CT-scan, and the time to consolidation was recorded. Pain level, satisfaction, wrist range of motion, and grip strength were measured and compared. Results: The wrist range of motion and grip strength of the two groups were similar, except for the wrist extension, which was significantly reduced in the revision group. Consolidation was observed in 36/39 patients (92%) in the primary group and in 13/15 patients (87%) in the revision group. Our results showed similar clinical results postoperatively between primary reconstructions and revision surgery. Conclusions: The use of 3D-planned and -printed patient-specific instrumentation proves to be similarly effective in revision surgeries for the reconstruction of the scaphoid as it is in primary surgeries. Full article
(This article belongs to the Special Issue State of the Art in Hand Surgery)
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12 pages, 5235 KiB  
Article
Results of the Nerve Transfers and Secondary Procedures to Restore Shoulder and Elbow Function in Traumatic Upper Brachial Plexus Palsy
by Piotr Czarnecki, Michał Górecki and Leszek Romanowski
J. Clin. Med. 2024, 13(23), 7396; https://doi.org/10.3390/jcm13237396 - 4 Dec 2024
Viewed by 1189
Abstract
Background: Damage to the upper trunk of the brachial plexus, often caused by high-energy trauma, leads to significant functional impairment of the upper limb. This injury primarily affects the C5 and C6 roots, resulting in paralysis of muscles critical for shoulder and elbow [...] Read more.
Background: Damage to the upper trunk of the brachial plexus, often caused by high-energy trauma, leads to significant functional impairment of the upper limb. This injury primarily affects the C5 and C6 roots, resulting in paralysis of muscles critical for shoulder and elbow function. If spontaneous nerve regeneration does not occur within 3–6 months post-injury, surgical intervention, including nerve transfers, is recommended to restore function. Methods: This study evaluates long-term outcomes of nerve transfer surgeries performed between 2013 and 2023 on 16 adult patients with post-traumatic brachial plexus injuries. The most common cause of injury was motorcycle accidents. Nerve transfers targeted shoulder and elbow function restoration, including transfer of the accessory nerve to the suprascapular nerve, the radial nerve branch to the long or medial head of the triceps brachii to the axillary nerve, or the transfer of motor fascicles of the ulnar and median nerves (double Oberlin) to the brachialis and biceps brachii motor nerves. Results: Postoperative results showed varying degrees of functional recovery. In the shoulder, most patients achieved stabilization and partial restoration of active movement, with average flexion up to 92° and abduction up to 78°. In the elbow, full flexion with M4 strength was achieved in 64% of patients. In both the shoulder and the elbow, double nerve transfers yield better long-term outcomes than single transfers. Secondary procedures, such as tendon transfers, were required in some cases to improve limb strength. Conclusions: The study concludes that nerve transfers offer reliable outcomes in restoring upper limb function, although additional surgeries may be necessary in certain cases. Full article
(This article belongs to the Special Issue State of the Art in Hand Surgery)
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