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Advances and Updates in Hand Surgery
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Advances and Updates in Hand Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 20 June 2025 | Viewed by 6539

Special Issue Editors

Dr. Sebastien Durand

E-Mail Website
Guest Editor
Department of Plastic, Reconstructive and Hand Surgery, University Hospital of Lausanne, CHUV, Lausanne, Switzerland
Interests: orthopedic and trauma surgery; hand surgery; surgery for the paralyzed; microsurgery
Prof. Dr. Wassim Raffoul

E-Mail Website
Guest Editor
Division of Plastic, Reconstructive and Aesthetic Surgery, CHUV, Lausanne University Hospital, Lausanne, Switzerland
Interests: aesthetic surgery; skin; wound care; burns; plastic and reconstructive surgery; wounds; wound healing

Special Issue Information

Dear Colleagues,

Hand surgery contains a very broad spectrum of procedures and comprises complex subspecialities. We will present the latest advances in the dynamic field of hand surgery in which worldwide efforts are made around the world to treat traumatic injuries and degenerative conditions of the hand that continue to lead to significant impairment and disability. This Special Issue offers a space with which to explore innovative technologies applied to hand surgery. We invite contributions of the newest innovations available to hand surgeons and studies about the effect of new technologies on hand surgery in terms of diagnosis, prognosis, and therapeutic.

Dr. Sebastien Durand
Prof. Dr. Wassim Raffoul
Guest Editors

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

  • hand surgery
  • walant technique
  • 3D imaging
  • hand ultrasonography
  • artificial intelligence

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

Published Papers (5 papers)

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Research

11 pages, 2567 KiB  
Article
Deep Learning in Scaphoid Nonunion Treatment
by Leyla Tümen, Fabian Medved, Katarzyna Rachunek-Medved, Yeaeun Han and Dominik Saul
J. Clin. Med. 2025, 14(6), 1850; https://doi.org/10.3390/jcm14061850 - 9 Mar 2025
Viewed by 1437
Abstract
Background/Objectives: Scaphoid fractures are notorious for a high rate of nonunion, resulting in chronic pain and impaired wrist function. The decision for surgical intervention often involves extensive imaging and prolonged conservative management, leading to delays in definitive treatment. The effectiveness of such [...] Read more.
Background/Objectives: Scaphoid fractures are notorious for a high rate of nonunion, resulting in chronic pain and impaired wrist function. The decision for surgical intervention often involves extensive imaging and prolonged conservative management, leading to delays in definitive treatment. The effectiveness of such treatment remains a subject of ongoing clinical debate, with no universally accepted predictive tool for surgical success. The objective of this study was to train a deep learning algorithm to reliably identify cases of nonunion with a high probability of subsequent union following operative revision. Methods: This study utilized a comprehensive database of 346 patients diagnosed with scaphoid nonunions, with preoperative and postoperative X-rays available for analysis. A classical logistic regression for clinical parameters was used, as well as a TensorFlow deep learning algorithm on X-rays. The latter was developed and applied to these imaging datasets to predict the likelihood of surgical success based solely on the preoperative anteroposterior (AP) X-ray view. The model was trained and validated over six epochs to optimize its predictive accuracy. Results: The logistic regression yielded an accuracy of 66.3% in predicting the surgical outcome based on patient parameters. The deep learning model demonstrated remarkable predictive accuracy, achieving a success rate of 93.6%, suggesting its potential as a reliable tool for guiding clinical decision-making in scaphoid nonunion management. Conclusions: The findings of this study indicate that the preoperative AP X-ray of a scaphoid nonunion provides sufficient information to predict the likelihood of surgical success when analyzed using our deep learning model. This approach has the potential to streamline decision-making and reduce reliance on extensive imaging and prolonged conservative treatment. Full article
(This article belongs to the Special Issue Advances and Updates in Hand Surgery)
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10 pages, 1409 KiB  
Article
Emerging Healthcare Trends in Prosthetic Treatment of Hand Osteoarthritis
by Andreas M. Siegmund, Marc Ruewe, Dominik Szymski, Rafael Loucas, Dmytro Oliinyk, Andrea Pagani, Cassandra Ecklmaier, Sebastian Geis, Alexandra M. Anker, Lukas Prantl and Silvan M. Klein
J. Clin. Med. 2025, 14(2), 573; https://doi.org/10.3390/jcm14020573 - 17 Jan 2025
Viewed by 651
Abstract
Background: For many years, advancements in hand joint replacement (JR) were relatively minor compared to those for large joints. However, the caution previously exercised due to high complication rates is gradually being replaced by the expanding use of JR therapies for small [...] Read more.
Background: For many years, advancements in hand joint replacement (JR) were relatively minor compared to those for large joints. However, the caution previously exercised due to high complication rates is gradually being replaced by the expanding use of JR therapies for small joints in the hand. Despite this progress, there is a lack of comprehensive data on the outcomes of hand JR and on the optimal infrastructure required to meet the growing demand for these therapies. Methods: This study examined trends and revision rates of JR for thumb carpometacarpal (CMC-1) and finger (MCP and PIP) joints in both inpatient and outpatient settings in Germany. Data from the Federal Statistical Office of Germany (Destatis) and the Central Institute for Statutory Health Insurance Physicians (ZI) were analyzed, focusing on the incidence, demographics, and outcomes of these procedures. Results: This study found a substantial national increase in prosthetic treatments specifically for CMC-1, with a 2.18-fold rise in the outpatient sector compared to a 1.65-fold increase in inpatient treatments. Despite this shift, 83.7% of JR procedures were still performed in an inpatient setting. Conclusions: The overall complication rates appear to be declining, suggesting that while the management of these procedures is shifting towards outpatient care, the quality remains stable. Full article
(This article belongs to the Special Issue Advances and Updates in Hand Surgery)
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9 pages, 2358 KiB  
Article
Characteristics and Therapy of Jersey Finger Type V Injuries at a Middle-European Level 1 Trauma Center—A Retrospective Data Analysis
by Paul Lennart Hoppe, Stephan Frenzel, Irena Krusche-Mandl, Gerhild Thalhammer, Stefan Hajdu and Gabriel Halát
J. Clin. Med. 2024, 13(21), 6540; https://doi.org/10.3390/jcm13216540 - 31 Oct 2024
Cited by 1 | Viewed by 1196
Abstract
Background/Objectives: Reports on type V FDP tendon avulsions and their treatment are rare. Furthermore, they are not always classified in a consistent manner in the literature. The purpose of our retrospective data analysis was to evaluate and present jersey finger type V [...] Read more.
Background/Objectives: Reports on type V FDP tendon avulsions and their treatment are rare. Furthermore, they are not always classified in a consistent manner in the literature. The purpose of our retrospective data analysis was to evaluate and present jersey finger type V injury characteristics, primary radiological findings, treatment options and subsequent patient outcomes, as well as potential complications. Methods: We reviewed all patients treated for a fracture of the distal phalanx at an academic Level 1 trauma center over a period of 19 years. By reviewing the patients’ charts and their initial X-rays, we identified 44 patients with injuries matching the criteria for classification as jersey finger type Va and type Vb. All clinical records and radiologic images were reviewed to gather data on the mechanism of trauma, injury characteristics, type of treatment and subsequent outcomes in both subtypes. Results: Direct blows represented the most common mechanism of trauma, accounting for 23 cases. Among 44 jersey finger type V injuries, 31 showed minor displacement and were treated conservatively with a good outcome. Six patients undergoing surgery showed a poor outcome, except for one. Conclusions: Jersey finger type V differs considerably from the remaining types of jersey finger injuries regarding the predominant trauma mechanism. Therefore, its inclusion in this classification should be reevaluated. Established surgical techniques for refixation did not show a satisfying outcome, thus the implementation of alternative surgical techniques seems advisable when better therapeutic results are sought. Full article
(This article belongs to the Special Issue Advances and Updates in Hand Surgery)
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12 pages, 3649 KiB  
Article
The Impact of Pronator Quadratus Origin Release on the Clinical Outcomes of Scaphoid Nonunion Patients Treated with Pronator Quadratus Pedicled Bone Grafts
by Ahmed Majid Heydar and Mustafa Kürklü
J. Clin. Med. 2024, 13(17), 5157; https://doi.org/10.3390/jcm13175157 - 30 Aug 2024
Viewed by 1063
Abstract
Background/Objectives: A pronator quadratus pedicled bone graft (PQPBG) is a distal radius volar vascularized bone graft used not only for avascular necrosis of the lunate but also for scaphoid nonunion. Despite its potency and its possession of a muscular shield, this vascularized [...] Read more.
Background/Objectives: A pronator quadratus pedicled bone graft (PQPBG) is a distal radius volar vascularized bone graft used not only for avascular necrosis of the lunate but also for scaphoid nonunion. Despite its potency and its possession of a muscular shield, this vascularized graft has a disadvantage in that the potential shortness of the muscular leash may limit the distal transfer of the bone graft. Releasing of the pronator quadratus (PQ) ulnar origin was used to enhance the distal mobility of the graft. We aimed to investigate the effect of a PQ release on the surgical outcomes of scaphoid nonunions that were operated on with the PQPBG technique. Methods: Patients with scaphoid nonunion that were treated with PQPBG from 2009 to 2020 were reviewed. Patient demographic characteristics, surgical notes, physical examinations, and radiological evaluation data were collected. Wrist range of motion, grip strength, modified Mayo wrist score, and Quick-DASH score were used to evaluate the outcomes. The included patients were divided into two groups based on the origin release status of their PQ, i.e., with and without release. Results: This study included 37 patients, 17 of whom underwent a PQ release and 20 of whom did not. The failure rates for the two groups were one and four patients, respectively, and there was no significant difference between them (p = 0.11). The postoperative mean wrist extension in the patients with a PQ release was significantly greater than that in the patients without a release (43.5 ± 6.8 vs. 36.5 ± 7.7, p = 0.0038). Although wrist flexion, ulnar deviation, radial deviation, mean outcome assessment scores, and grip strength were greater in the patients with a PQ release than in those without, no statistically significant intergroup differences were observed (p > 0.05). Conclusions: The PQPBG technique is a viable option for achieving bony union in patients with scaphoid nonunion, but it results in the postoperative restriction of wrist extension. PQ release during a graft transfer may have a favorable effect on both bone union and clinical outcomes. Full article
(This article belongs to the Special Issue Advances and Updates in Hand Surgery)
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7 pages, 3496 KiB  
Article
New Insights into Boxer’s Knuckle Injury of the Little Finger
by Sébastien Durand, Thierry Christen, Jean-Baptiste Ledoux and Romain Baillot
J. Clin. Med. 2024, 13(1), 46; https://doi.org/10.3390/jcm13010046 - 21 Dec 2023
Viewed by 1307
Abstract
Background: The original description of boxer’s knuckle injury of the fifth ray mentions that the injury occurs between the extensor digitorum communis (EDC) and the extensor digiti minimi (EDM). Subsequent reports claim similar findings. Anatomical studies show that the EDC of the fifth [...] Read more.
Background: The original description of boxer’s knuckle injury of the fifth ray mentions that the injury occurs between the extensor digitorum communis (EDC) and the extensor digiti minimi (EDM). Subsequent reports claim similar findings. Anatomical studies show that the EDC of the fifth ray is absent in most patients, while the EDM is generally composed of two slips. We present a modification of the current description of boxer’s knuckle injury of the little finger based on the correlation between advanced preoperative 3D imaging and intraoperative findings. Methods: Five patients were investigated preoperatively using high-resolution ultrasound and 3D tendon reconstruction-based MR arthrography. Surgical exploration identified the lesion site relative to the EDM and EDC. Results: All patients had two slips of the EDM and no EDC to the fifth ray. The injury appeared as a longitudinal tear of the EDM between its two slips. The mean gap was 7.8 mm (range 4.5–10 mm) on the pathological side vs. 1.3 mm (range 1–2 mm) on the healthy contralateral side. Conclusions: We believe that previous descriptions of boxer’s knuckle of the fifth ray are inaccurate. High-resolution ultrasound and 3D reconstructions based on MR arthrography are reliable diagnostic tools allowing to locate the injury with precision. Full article
(This article belongs to the Special Issue Advances and Updates in Hand Surgery)
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