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Pilot Feasibility Stud 2021 Jun 17;7(1):128. Epub 2021 Jun 17.

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), Botnar Research Centre, University of Oxford, Oxford, OX3 7LD, UK.

Background: Hand fractures are common and sometimes require surgery to restore function. Placement of Kirschner wires (K-wires) is the most common form of surgical fixation. After placement, a key decision is whether to bury the end of a K-wire or leave it protruding from the skin (exposed). Read More

Equine Vet J 2021 Jun 9. Epub 2021 Jun 9.

Department of Clinical Sciences, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA.

Background: Type II distal phalanx (P3) fractures are a well-described cause of lameness in horses. Reports on outcome following internal fixation of type II P3 fractures are lacking, and with little emphasis on complications.

Objective: To describe a technique for internal fixation of type II P3 fractures, and evaluate whether specific variables influenced postoperative complications or a horse's ability to return to work. Read More

Hand (N Y) 2021 Jun 8:15589447211014623. Epub 2021 Jun 8.

Australian Research Collaboration on the Hand, Mudgeeraba, QLD, Australia.

Intra-articular fracture dislocations of the base of the middle phalanx are complex and debilitating injuries that present a management conundrum when nonreconstructable. Hemi-hamate arthroplasty (HHA) is a treatment modality of particular use in the setting of highly comminuted fractures. This systematic review aims to summarize the reported outcomes of HHA in this context. Read More

J Biomech 2021 Jun 20;123:110455. Epub 2021 Apr 20.

JD Wheat Veterinary Orthopedic Research Laboratory, School of Veterinary Medicine, University of California, One Shields Avenue, Davis, CA, USA.

Strain parameters at injury prone sites of the equine third metacarpal (MC3) and proximal phalangeal (P1) bones were investigated with the aim of improving understanding of injury pathogenesis. We hypothesized that dorsal principal and shear strain patterns, magnitudes and directions would differ from proximal-to-distal; and would be similar from medial-to-lateral across each bone. Unilateral limbs from nine equine cadavers were instrumented with rosette strain gauges during limb loading to 10,500 N. Read More

Orthop J Sports Med 2021 Apr 23;9(4):23259671211001131. Epub 2021 Apr 23.

Department of Orthopedic Surgery, University of Miami, Miami, Florida, USA.

Background: The effects of foot injuries on collegiate athletes in the United States are of interest because of the short 5-year eligibility period in the National Collegiate Athletic Association (NCAA).

Purpose: To discuss the epidemiology of severe NCAA foot injuries sustained over 10 years in 25 sports.

Study Design: Descriptive epidemiology study. Read More

Indian J Orthop 2021 Jun 16;55(3):758-762. Epub 2020 Jun 16.

Dr Baba Saheb Ambedkar Medical College and Hospital, Rohini, India.

Most metatarsal neck fractures can be successfully treated non-operatively in a cast boot. Displaced metatarsal neck fractures tend to be less stable and have a propensity for the distal fragment to angulate, secondary to the strong flexor tendons, which often forces the distal fracture fragment in a plantar direction and leads to relative metatarsal shortening. Most literature is focussed on antegrade fixation of metatarsal neck fractures using pre-bent K wires or thin elastic nails. Read More

Tech Hand Up Extrem Surg 2021 May 12. Epub 2021 May 12.

Ichihara Orthopedic Clinic, Ichihara, Chiba Prefecture, Japan.

Fingertip injuries are frequently encountered by the hand surgeon, and often present with a combination of the following: avulsed or broken nail plate, nail bed disruption, and/or distal phalangeal fracture. Recommended management of these injuries consists of reduction of the fracture followed by repair of soft tissues. To achieve an anatomic reduction and sufficient stability of the fracture, current management consists of temporary Kirschner-wire stabilization. Read More

BMJ Case Rep 2021 May 7;14(5). Epub 2021 May 7.

Trauma and Orthopaedics, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK

We present an unusual case of phalangeal fracture resulting from direct penetration by the barb of a conducted electrical weapon (Taser). When a Taser is triggered, compressed gas propels two barbs with trailing insulated wires which deliver a pulsed electrical discharge on contact. A 51-year-old man presented with a single barb of the Taser embedded in the diaphysis of the proximal phalanx and an associated open fracture. Read More

Orthop Rev (Pavia) 2021 Mar 31;13(1):9058. Epub 2021 Mar 31.

Orthopaedics and Hand Surgery Unit, Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome; Università Cattolica del Sacro Cuore, Rome, Italy.

Avulsions of the volar plate of the finger proximal interphalangeal joint (PIPJ) following sprains are often undiagnosed in the acute setting. Therefore, the chronic outcomes of this injury are most frequently the object of study and treatment. Different techniques for volar plate chronic avulsion repair are described in the literature. Read More

Hand Surg Rehabil 2021 Apr 29. Epub 2021 Apr 29.

Department of Hand and Plastic Surgery, Cantonal Hospital of Lucerne, Spitalstrasse, 6000 Lucerne 16, Switzerland. Electronic address:

Intramedullary screw (IMS) fixation is increasingly used as an alternative treatment option in metacarpal and phalangeal fractures of the hand. However, this technique is currently the subject of controversy among hand surgeons. The aim of this systematic review was to gain insight on radiological, functional and patient-rated outcomes reported in literature. Read More

J Hand Surg Asian Pac Vol 2021 Jun;26(2):308

Botnar research centre, Nuffield Department of Orthopaedics, Rhuematology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.

J Hand Surg Asian Pac Vol 2021 Jun;26(2):180-187

St Andrews Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, UK.

There is no consensus as to which is the best way to fix unstable extra-articular phalangeal fractures. We performed a literature review to determine outcomes using intramedullary cannulated compression screws. PubMed, Medline and Embase databases were searched for English language articles reporting the use of one or more intramedullary screw(s) for fixation of an acute extra-articular phalangeal fracture in adults that reported outcome data. Read More

Hand Surg Rehabil 2021 Apr 24. Epub 2021 Apr 24.

Chilliwack General Hospital, 45600 Menholm Rd, Chilliwack BC, V2P 1P7, Canada. Electronic address:

The phalangeal and metacarpal fractures are common fractures of the upper extremity. The most common complications of proximal phalanx fracture are the extensor lag and stiffness at the proximal interphalangeal joint, which leads to poor outcomes. Poor treatment compliance has also been identified among our patients. Read More

Plast Reconstr Surg 2021 May;147(5):846e-861e

From the Section of Plastic Surgery, Department of Surgery, University of Michigan Health System; and the Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School.

Learning Objectives: After studying this article, the participant should be able to: 1. Describe treatment options for phalangeal fractures. 2. Read More

Hand Surg Rehabil 2021 Apr 10. Epub 2021 Apr 10.

Department of Orthopedics and Traumatology, Hand and Upper Extremity Surgery Division, Ankara City Hospital, Üniversiteler Caddesi, Bilkent Bulvarı No:1, 06800 Çankaya/Ankara, Turkey. Electronic address:

For combined nail bed injuries and distal phalangeal fractures, fixation may be indicated when there is fracture instability and if a K-wire can be successfully placed in the fracture fragments. We determined the outcomes when these criteria were applied for patients with Allen type III injuries without substantial tissue loss. We retrospectively analyzed 57 patients who had surgery for nail bed injuries with distal phalangeal fractures between October 2017 and January 2020. Read More

J Orthop Surg Res 2021 Apr 9;16(1):245. Epub 2021 Apr 9.

Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopedics, Lund University, Skåne University Hospital, SE-205 02, Malmö, Sweden.

Background: The hand is the second most fractured region in children. It is therefore important to update fracture epidemiology to be able to identify time trends for adequate health care planning. This study reports pediatric hand fracture incidence 2014-2016 and, using published data, also long-term time trends in 1950-2016. Read More

J Wrist Surg 2021 Apr 3;10(2):154-157. Epub 2021 Jan 3.

Department of Orthopaedic Surgery and Traumatology, Ziekenhuis Oost-Limburg, Limburg, Belgium.

 Corrective osteotomies of the proximal phalanx are typically stabilized with plate and screws. Although intramedullary headless screws form an alternative fixation method in the treatment of acute phalangeal fractures, reports about fixation of opening wedge corrective osteotomies with these implants are lacking.  The goal of the present study was to biomechanically compare the failure force of both fixation methods for this specific indication. Read More

J Hand Ther 2021 Feb 25. Epub 2021 Feb 25.

Wrightington Hospital, Wigan, Lancashire, WN6 9EP, UK.

Injury 2021 Mar 12. Epub 2021 Mar 12.

Department of Hand and Micro Surgery, Tampere University Hospital, Tampere, Finland. Electronic address:

During the development of microvascular surgery in 1980-95 many new methods to overcome different traumatic disorders were studied. Previously unsolved problems could be treated using free tissue transfer. Typical problems in wrist surgery were the painful complications from ulna head resection. Read More

Orthop J Sports Med 2021 Feb 23;9(2):2325967120980013. Epub 2021 Feb 23.

Hand Management Unit, Chelsea and Westminster Hospital, London, UK.

Background: Fractures of the metacarpals and phalanges account for more than half of all upper extremity fractures sustained by competitive athletes.

Purpose: To determine which management strategy is best for expediting return to preinjury levels of competition in adult athletes with metacarpal and/or phalangeal fractures.

Study Design: Systematic review; Level of evidence, 4. Read More

J Orthop Surg Res 2021 Mar 12;16(1):186. Epub 2021 Mar 12.

Department of Emergency Medicine, Ewha Women's University Mokdong Hospital, Seoul, South Korea.

Background: Mini-hook plate has been described for the treatment of various small avulsion fragments in the hand. This retrospective study aimed to evaluate clinical outcomes after mini-hook plate fixation in patients with an avulsion fracture around the interphalangeal or metacarpophalangeal joints of the hand.

Methods: Nineteen patients with avulsion fractures around the interphalangeal or metacarpophalangeal joints of the hand were included in this study. Read More

J Hand Surg Asian Pac Vol 2021 Mar;26(1):36-40

Department of Orthopedic Surgery, Kurashiki Central Hospital, Kurashiki, Japan.

Angle grinders are a handheld power tool used for grinding and polishing stone, metal, and concrete. Some people, however, use them with a circular saw blade attachment for cutting wood and consequently, suffer injuries. We aimed to investigate the underlying cause and mechanisms of injuries caused by cutting wood with an angle grinder. Read More

J Hand Surg Asian Pac Vol 2021 Mar;26(1):10-16

Auckland Regional Plastic, Reconstructive and Hand Surgery Unit, Middlemore Hospital, Auckland, New Zealand.

Locking plate fixation is widely used in large long bone fixation and is now available for small "long" bones in the hand. Potential advantages of unicortical locked fixation are reduced risk of over-drilling and therefore reduced risk of damage to surrounding structures and reduced risk of irritation from proud screws. Furthermore, unicortical fixation may be used where bicortical fixation is technically impossible. Read More

Vet Clin North Am Small Anim Pract 2021 Mar;51(2):263-284

Continuing Orthopedic Veterinary Education, Ventura County, Moorpark, CA 93021, USA.

Fractures and ligamentous injuries of the front paw are common in small animals and usually result from direct trauma, such as vehicular accident, collision with a stationary object, falls from a height, or entrapment of the paw with leverage (eg, stepping in a hole while running). Metacarpal and phalangeal fractures may be associated with concurrent ligamentous injury. Tendon and paw injuries are generally associated with direct traumatic etiologies, such as laceration. Read More

Arch Plast Surg 2021 Jan 15;48(1):98-106. Epub 2021 Jan 15.

Department of Plastic and Reconstructive Surgery, Konkuk University School of Medicine, Seoul, Korea.

Background: Hand fractures can be treated using various operative or nonoperative methods. When an operative technique utilizing fixation is performed, early postoperative mobilization has been advocated. We implemented a protocol involving controlled active exercise in the early postoperative period and analyzed the outcomes. Read More

J Hand Surg Eur Vol 2021 Jun 14;46(5):466-470. Epub 2021 Jan 14.

AOU Careggi, Hand and Microsurgery Reconstruction Unit, Florence, Italy.

Surgical treatment of extra-articular metacarpal and phalangeal fractures should be considered when there is instability or in patients with high demand. To overcome the issues related to the use of Kirschner wires, external fixators, and open reduction and internal fixation procedures, intramedullary headless screw fixation (IHSF) is an alternative technique to achieve primary fracture stability and early return to daily activities. We report the data of the Italian Multicentric Intra-Medullary Experience, which includes 173 cases of extra-articular unstable fractures (38 phalanges and 135 metacarpals) treated with the IHSF. Read More

Ann Plast Surg 2021 02;86(2S Suppl 1):S35-S40

From the Division of Plastic and Reconstructive Surgery.

Background: Comminuted intraarticular fractures of the metacarpophalangeal joint (MPJ) are difficult to treat. We evaluated the clinical outcomes of using a dynamic traction splint to treat comminuted intraarticular fracture of MPJ.

Patients And Methods: We conducted a retrospective chart review on patients with comminuted intraarticular fracture of the MPJ treated with a dynamic traction splint at National Cheng Kung University Hospital between March 2014 and February 2018. Read More

Sci Rep 2020 12 3;10(1):21016. Epub 2020 Dec 3.

Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, No. 201, Sec 2, Shi-Pai Road, Taipei City, 112, Taiwan, ROC.

Patients with Idiopathic Parkinson's Disease (PD) have an increased risk for fractures. Currently, many studies have reported inferior outcomes in PD patients after orthopedic procedures. However, there are very few studies assessing the outcome of upper extremity fractures (UEF) in PD patients. Read More

Musculoskelet Surg 2020 Nov 19. Epub 2020 Nov 19.

Hand Surgery Department, G.B. Rossi University Hospital, Piazzale L.A.Scuro 10, 37134, Verona, Italy.

Purpose: The purpose of this study was to evaluate the cost-effectiveness of introducing cone-beam computed tomography (CBCT) in the management of the complex finger fractures with articular involvement.

Methods: We created a decision tree model simulating the diagnostic pathway of complex finger fractures, suggesting the use of CBCT as alternative to multi-slice computed tomography (MSCT), and we compared their clinical outcomes, costs, and cost-effectiveness for a hypothetical cohort of 10,000 patients. Measures of effectiveness are analysed by using quality-adjusted life years, incremental cost-effectiveness ratio, and net monetary benefit. Read More

EFORT Open Rev 2020 Oct 26;5(10):624-629. Epub 2020 Oct 26.

Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland.

The intramedullary headless compression screw (IMCS) technique represents a reliable alternative to percutaneous Kirschner-wire and plate fixation with minimal complications.Transverse fractures of the metacarpal shaft represent a good indication for this technique. Non-comminuted subcapital and short oblique fractures can also be treated with IMCS. Read More