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Medicina
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Advances in the Diagnosis and Treatment of Hand–Wrist Disorders
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Advances in the Diagnosis and Treatment of Hand–Wrist Disorders

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 25 February 2027 | Viewed by 1716

Editors

Dr. Danilo Donati

E-Mail Website
Guest Editor
Physical Therapy and Rehabilitation Unit, Policlinico di Modena, 41125 Modena, Italy
Interests: ultrasound diagnosis; rehabilitation; musculoskeletal imaging; interventional ultrasound; orthopedic
Special Issues, Collections and Topics in MDPI journals
Dr. Paolo Boccolari

E-Mail Website
Guest Editor Assistant
Physical Therapy and Rehabilitation Unit, Policlinico di Modena, 41125 Modena, Italy
Interests: hand and wrist rehabilitation

Special Issue Information

Dear Colleagues,

The hand–wrist region is an extremely complex and highly specialized anatomical and biomechanical system that is crucial for humans to interact with the sensible world. Due to its unique anatomical and functional peculiarities, this region is easily affected by countless degenerative pathologies and traumatic injuries. Both can cause modifications to structures, affecting their ability to fulfill their specific functions. Timely and specific medical and rehabilitative approaches can make the difference between a good functional recovery and a poor one. This issue of the journal aims to unify all clinical practices—from imaging evaluation to rehabilitation plans—that must be employed to achieve the ultimate goal. Therefore, we would like to collect articles that include the following:

  • Clinical and Diagnostic Evaluation.
  • Etiopathogenesis of Muscle, Tendon, and Joint Diseases.
  • Surgical Aspects in Hand Traumatology: from fractures to osteo-ligamentous lesions, primary and secondary tendon and nerve repairs, reconstructive microsurgery, and corrective interventions in rheumatological pathologies.
  • Conservative and Post-Operative Treatments in Hand–Wrist Trauma and Rheumatic Diseases.
  • Patient Reintegration into Normal Daily Life and Work Activities.
  • Prevention of Overuse Syndromes.

Dr. Danilo Donati
Guest Editor

Dr. Paolo Boccolari
Guest Editor Assistant

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 250 words) can be sent to the Editorial Office for assessment.

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-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly 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 2200 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 rehab
  • wrist rehab
  • hand surgery

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Published Papers (3 papers)

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Research

12 pages, 2456 KB  
Article
Differential Surgery on the Rheumatoid Wrist: Patient Satisfaction and Clinical Outcome
by Christoph Biehl, Madita Biehl and Lotta Biehl
Medicina 2026, 62(7), 1400; https://doi.org/10.3390/medicina62071400 - 20 Jul 2026
Viewed by 298
Abstract
Background and Objectives: The wrist is one of the most common sites of rheumatic disease. Based on the graded deformities of Larsen et al., surgery has been adapted to minimize harm while maximizing benefit to the individual. This study aims to survey [...] Read more.
Background and Objectives: The wrist is one of the most common sites of rheumatic disease. Based on the graded deformities of Larsen et al., surgery has been adapted to minimize harm while maximizing benefit to the individual. This study aims to survey the institutional experience, describing functional outcomes and patient satisfaction across several surgical approaches, without formal statistical comparison. Materials and Methods: The studies and results presented here are from one center specialized in rheumaorthopedic surgery and reflect the above concepts. The studies cover a broad spectrum of surgical techniques, which were categorized according to the Larsen stages of wrist destruction. All studies were retrospective or retrospective-like, and follow-up data were analyzed collectively. The primary endpoints were functional outcome scales and patient satisfaction, supplemented by pain relief, as well as strength and range of motion. The assessment utilized, amongst others, the QuickDASH, FFbH and Clayton score, as well as appropriate patient-reported measures such as ADL and SF-36. Radiological follow-ups were classified according to the Larsen–Dale–Eek classification; for endoprostheses/arthrodesis, carpal height was determined according to Youme. Results: Significant improvements in the Clayton score (consistently greater postoperatively than preoperatively) are evident for several procedures, particularly MPW® (+37 points) and APW® (+28 points). Postoperative reductions in VAS pain scores are marked for most procedures, e.g., MPW® from 7 to 1.8. The revision rates for most procedures are around 10–13% during the follow-up periods. In addition, the tendon and soft tissue functions of the hand(s) play critical roles in these PROMs. Conclusions: The studies present the results and limitations of surgical treatment for rheumatic wrists in the prebiological era. The results of individual studies need to be examined more closely to better assess the potential and limitations of surgery for patients. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Treatment of Hand–Wrist Disorders)
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13 pages, 6317 KB  
Article
The Impact of COVID-19-Related Restrictions on the Incidence of Diaphyseal and Distal Forearm Fractures: A Retrospective Analysis
by Katja Brabec, Nicola Stringari, Manuel Gahleitner, Paul Michael Schwarz, Sandra Feldler, Simon Kargl, Tobias Gotterbarm, Lorenz Pisecky and Matthias Holzbauer
Medicina 2026, 62(5), 966; https://doi.org/10.3390/medicina62050966 - 15 May 2026
Viewed by 468
Abstract
Background and Objectives: Pediatric forearm fractures are among the most common childhood injuries. COVID-19-related societal restrictions, including school closures and suspension of sports activities, altered children’s daily routines and may have influenced injury patterns. This study aimed to evaluate whether periods of [...] Read more.
Background and Objectives: Pediatric forearm fractures are among the most common childhood injuries. COVID-19-related societal restrictions, including school closures and suspension of sports activities, altered children’s daily routines and may have influenced injury patterns. This study aimed to evaluate whether periods of stricter COVID-19 restrictions were associated with changes in the incidence of pediatric distal and diaphyseal forearm fractures after accounting for seasonal variation and long-term temporal trends. Materials and Methods: This retrospective observational time-series study analyzed pediatric patients aged 0–17 years who underwent forearm radiography between January 2018 and June 2023 at a tertiary pediatric trauma center. Cases with radiologically confirmed distal or diaphyseal forearm fractures or epiphyseal injuries were included. Monthly fracture counts were analyzed using generalized linear models with logarithmic link functions. Exposure variables included a COVID-19 restriction index based on governmental measures and a binary pandemic indicator. Seasonal variation and long-term temporal trends were included as covariates. Results: A total of 5702 forearm radiographs were identified, of which 4041 trauma-related presentations met the inclusion criteria. Among these, 2014 children had confirmed forearm fractures. Boys accounted for 61% of cases, and the median age was 9 years (IQR 5). Most fractures were treated conservatively (88%). The most frequent injury mechanisms included soccer-related injuries (9.6%) and bicycle falls (7.3%). In regression analyses adjusted for seasonal variation and temporal trends, neither the COVID-19 restriction index (IRR 1.01, 95% CI 0.87–1.17; p = 0.95) nor the pandemic period indicator (IRR 0.99, 95% CI 0.37–2.65; p = 0.98) was significantly associated with monthly fracture counts. The wide confidence interval of the pandemic indicator reflects limited statistical precision and suggests that both clinically relevant decreases and increases in fracture incidence cannot be excluded. Conclusions: No sustained long-term changes in the incidence or injury patterns of pediatric forearm fractures were observed during the COVID-19 pandemic. Temporary fluctuations during early lockdown phases were not independently associated with governmental restrictions after adjustment for seasonal variability and long-term trends. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Treatment of Hand–Wrist Disorders)
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12 pages, 634 KB  
Article
Comprehensive Hand Evaluation Form: Feasibility of Merging the Most Common Hand-Specific Patient-Reported Outcome Measures
by Matthias Holzbauer, Stefan Mathias Froschauer, Bernhard Oellinger, Paul Michael Schwarz, Sandra Feldler, Julian Alexander Mihalic and Tobias Gotterbarm
Medicina 2026, 62(5), 929; https://doi.org/10.3390/medicina62050929 - 10 May 2026
Viewed by 492
Abstract
Background and Objectives: Patient-reported outcome measures (PROMs) are essential for evaluating outcomes in hand surgery, but the broad range of available instruments complicates selection and increases patient burden due to overlapping content. The Disabilities of the Arm, Shoulder and Hand (DASH), Michigan [...] Read more.
Background and Objectives: Patient-reported outcome measures (PROMs) are essential for evaluating outcomes in hand surgery, but the broad range of available instruments complicates selection and increases patient burden due to overlapping content. The Disabilities of the Arm, Shoulder and Hand (DASH), Michigan Hand Outcomes Questionnaire (MHQ), and Patient-Rated Wrist/Hand Evaluation (PRWHE) are the most frequently used PROMs. This study aimed to develop a merged instrument, the Comprehensive Hand Evaluation Form (CHEF), and to test whether CHEF-derived scores are equivalent to the original questionnaires. A secondary objective was to assess equivalence between pain ratings using an 11-item numeric rating scale (NRS) and a visual analogue scale (VAS). Materials and Methods: In this prospective study, adults with chronic atraumatic hand or wrist conditions completed the CHEF in the outpatient clinic and, three days later, the original DASH-G, MHQ-G, and PRWHE-G by mail. Equivalence was evaluated using two one-sided tests with margins set at half the minimal clinically important difference. Completion times were recorded. Results: Of the 100 patients, 57 could be included in the final analysis. Equivalence between CHEF-derived and original scores was demonstrated for PRWHE-G (mean difference −2.0; 90% CI −4.4 to 0.4 within ±7). Equivalence was not demonstrated for DASH-G (mean difference −3.5; 90% CI −5.7 to −1.3; margin ±5) or MHQ-G (mean difference 13.3; 90% CI 10.6 to 15.9; margin ±4.5). Thus, equivalence was achieved for one of three instruments. CHEF completion time was significantly shorter than the combined original questionnaires (median 10 vs. 15 min; p < 0.0001). For pain assessment, equivalence between the numeric rating scale and the visual analogue scale was observed at rest but not during activity. Conclusions: CHEF reduced completion time but achieved score equivalence only for PRWHE-G. These findings suggest that integrated PROM approaches may reduce burden, but do not consistently preserve equivalence across instruments. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Treatment of Hand–Wrist Disorders)
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