Search Our Scientific Publications & Authors

J Pediatr Orthop 2020 Jun 26. Epub 2020 Jun 26.

Children's Research Center, University Children's Hospital Zurich, Zurich Switzerland.

Plast Surg (Oakv) 2020 May 21;28(2):83-87. Epub 2020 May 21.

Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

This study describes a novel method of pin care with a Betadine-soaked alcohol pad in conjunction with immobilization to reduce pin site complications in hand fractures treated with exposed Kirschner wires (K-wires). We conducted a retrospective review of all phalangeal and metacarpal fractures from 2010 to 2016 treated with K-wire fixation, a Betadine-soaked alcohol pad, and immobilization in a well-moulded plaster cast. A total of 155 patients with metacarpal or phalangeal fractures were identified, of which 149 were included with 164 fractures treated with 217 exposed K-wires. Read More

J Hand Ther 2020 Jun 19. Epub 2020 Jun 19.

Physiotherapy Department, Perth Children's Hospital, Perth, Western Australia, Australia.

Study Design: This is a noninferior, single-blind, randomized controlled trial.

Introduction: Joint stiffness is common after plaster cast immobilization for simple phalanx and metacarpal fractures in children. The limited literature suggests this joint stiffness in children resolves without one-on-one therapy; however, without robust studies confirming that there is no detrimental effect from withdrawing treatment, many children are still referred. Read More

J Hand Surg Eur Vol 2020 Jul;45(6):547-559

Capio/CFR Hospital, Hellerup, Denmark.

In treating hand fractures, we have to make a proper decision about conservative treatment versus surgical intervention and decide on individual surgical methods. This article reviews recent publications, technical advances, and outcome measures in treating metacarpal fractures, phalangeal fractures, complex fractures of the proximal interphalangeal joints, bony mallet fingers, and fractures of the thumb. My personal preferences and considerations are presented. Read More

Plast Reconstr Surg Glob Open 2020 Mar 25;8(3):e2703. Epub 2020 Mar 25.

Section of Plastic Surgery, Department of Surgery, University of Calgary.

Pediatric hand fractures are common and approximately 10% require surgery.

Methods: This retrospective cohort study reports on hand fractures in a large pediatric population and identifies the characteristics and patterns of fractures that required surgical correction. A χ analysis was done to evaluate the association between individual fracture variables and surgery. Read More

J Hand Surg Am 2020 Jun 1. Epub 2020 Jun 1.

Faculty of Medicine, University of Cologne, Center for Orthopedic and Trauma Surgery, University Hospital, Cologne, Germany.

Purpose: The aim of this study was to compare several osteosynthesis techniques (intramedullary headless compression screws, T-plates, and Kirschner wires) for distal epiphyseal fractures of proximal phalanges in a human cadaveric model.

Methods: A total of 90 proximal phalanges from 30 specimens (index, ring, and middle fingers) were used for this study. After stripping off all soft tissue, a transverse distal epiphyseal fracture was simulated at the proximal phalanx. Read More

J Biol Regul Homeost Agents 2020 Mar-Apr;34(2):623-627

Department of Hand and Foot Surgery, The Affiliated Hospital of Qingdao University; Shandong, China.

Injury 2020 May 21. Epub 2020 May 21.

The Royal London Hospital, Barts Health NHS Trust. Electronic address:

Eur J Trauma Emerg Surg 2020 May 25. Epub 2020 May 25.

Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany.

Purpose: Despite the high number of patients with phalangeal fractures, evidence-based recommendations for the treatment of specific phalangeal fractures could not be concluded from the literature. The purpose of the present study was to assess current epidemiological data, classification of the fracture type, and mode of treatment.

Methods: This study presents a retrospective review of 261 patients with 283 phalangeal fractures ≥ 18 years of age who were treated in our level I trauma centre between 2017 and 2018. Read More

J Pediatr Orthop 2020 May 15. Epub 2020 May 15.

Department of Hand Surgery and Plastic and Reconstructive Surgery of the limbs La Timone University Hospital Assistance Publique Hôpitaux de Marseille, Marseille, France.

J Hand Surg Eur Vol 2020 Jul 5;45(6):601-607. Epub 2020 May 5.

Department of Orthopaedic Surgery, Cantonal Hospital Baden, Baden, Switzerland.

Osteosynthesis of metacarpal and phalangeal fractures with headless compression screws leads to a defect in the articular surface and possibly damage to the extensor tendons. This study aimed to quantify the articular surface defect and extensor tendon injuries after implant placement in cadaveric hands. Defect size was assessed with computed tomography. Read More

J Hand Surg Eur Vol 2020 Apr 26:1753193420918173. Epub 2020 Apr 26.

Hospital Santa Casa de Porto, Alegre, Brazil.

J Hand Surg Am 2020 Apr 20. Epub 2020 Apr 20.

Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore; Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address:

Purpose: Displaced pediatric phalangeal neck fractures are regarded as unstable, and hence, surgical fixation is traditionally recommended. In our experience, some patients with displaced fractures treated nonsurgically healed with a good clinical outcome and no further displacement. We studied the outcome of displaced phalangeal neck fractures treated nonsurgically with attention to the change in fracture displacement over time and hypothesized that displaced phalangeal neck fractures can be treated nonsurgically with maintenance of acceptable radiological parameters. Read More

J Hand Surg Asian Pac Vol 2020 Jun;25(2):219-225

Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.

The rotational malalignment in proximal phalanx fracture is unacceptable. Authors attempted to describe clinical and radiographic outcomes as well as complications after open reduction and internal fixation with screw only or plate for phalangeal fractures accompanied by rotational malalignment. Authors conducted a retrospective review of 46 patients who had been treated between Jan. Read More

J Orthop 2020 Nov-Dec;22:100-103. Epub 2020 Mar 26.

Cricket Australia, 60 Jolimont St, Jolimont, VIC, Australia.

Introduction: Hand fractures are one of the most common injuries sustained whilst playing cricket. Further research is required to inform future clinical management and risk-reduction strategies.

Methods: This retrospective cohort study reviewed all cases of hand fractures in elite Australian cricket players over a three-year period. Read More

Cureus 2020 Feb 19;12(2):e7039. Epub 2020 Feb 19.

Anaesthesia, DHQ Khanewal, Khanewale, PAK.

Introduction Metacarpal and phalangeal fractures are common upper limb fractures due to direct blows, axial loading, and torsional loading injuries. The universal goal in treating all fractures for the patient to achieve normal motion, but the ideal technique for stabilization is still debated. For internal fixation, Kirschner wires (K-wires) or miniplates can be used, and each carries certain advantages. Read More

J Hand Ther 2020 Mar 9. Epub 2020 Mar 9.

Occupational Therapy Department, Southern Health and Social Care Trust, Armagh, Northern Ireland, UK. Electronic address:

J Hand Surg Am 2020 Jul 10;45(7):645-649. Epub 2020 Mar 10.

Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA; Rothman Institute of Orthopedics, Philadelphia, PA.

Radio-frequency identification (RFID) technology uses an antenna to respond to an incoming signal by sending an outgoing message. This technology has been in use for over 50 years and is common in daily activities such as tapping a credit card to a reader, swiping an ID badge to open a door, paying highway tolls, and operating keyless entry cars. This technology can be implanted, such as in the microchips used to identify domestic pets. Read More

Ann R Coll Surg Engl 2020 Mar 11. Epub 2020 Mar 11.

Nuffield Orthopaedic Centre, Oxford, UK.

Clin Sports Med 2020 Apr;39(2):401-422

Department of Orthopaedic Surgery, Duke University Medical Center, 4709 Creekstone Drive, Durham, NC 27703, USA.

Metacarpal and phalangeal fractures are common injuries in athletes and occur frequently in contact and ball-handling sports. They usually result after direct hits from other players or athletic equipment. The fractures often are minimally displaced and require a short period of immobilization followed by early range of motion for expeditious return to play. Read More

J Plast Reconstr Aesthet Surg 2020 Jun 18;73(6):1174-1205. Epub 2020 Feb 18.

Queen Victoria Hospital NHS Foundation Trust. Plastic Surgery Department. Holtye Road, East Grinstead. RH19 3DZ, United Kingdom.

Chin Med J (Engl) 2020 Mar(6):657-663

Department of Hand Surgery, Beijing Jishuitan Hospital, Beijing 100035, China.

Background: Mallet fracture is avulsion of the terminal extensor tendon from the base of the distal phalangeal bone with a bony fragment. This study was performed to evaluate the anatomical characteristics of mallet fractures, investigate a new mallet fracture classification system using anatomical and imaging methods, and discuss the treatment schemes for different types of mallet fracture.

Methods: Sixty-four fresh cadaveric fingers were divided into four groups, and models of different types of mallet fracture with distal interphalangeal joint instability were established by dissecting 25%, 50%, 75%, and 100% of the bilateral collateral ligaments. Read More

Z Orthop Unfall 2020 Feb 13;158(1):111-131. Epub 2020 Feb 13.

Metacarpal and phalangeal fractures are the second most frequent fractures of the upper extremity. Treatment goal is to restore the function of the injured hand. Due to better understanding of anatomy and biomechanics as well as the development of locking and low-profile implants for osteosynthesis of such fractures, there is a growing safety when choosing the operative treatment for the correct indication. Read More

Tech Hand Up Extrem Surg 2020 Feb 7. Epub 2020 Feb 7.

Curtis National Hand Center, Baltimore, MD.

Comminuted intra-articular phalanx fractures are complicated injuries often treated with external fixation. The ideal external fixation system should be affordable, readily available, adaptable, and easy to use. The use of dynamic external fixation has advanced the care of these injuries but can be difficult to implement. Read More

Hand (N Y) 2020 Feb 10:1558944719900565. Epub 2020 Feb 10.

Mayo Clinic, Rochester, MN, USA.

The frequency, pattern, and treatment of pediatric hand fractures are rarely reported. We sought to review our institution's experience in the management of pediatric hand fractures. : A retrospective review of children and adolescents (younger than 18 years) treated for hand fractures between January 1990 and June 2017 was preformed. Read More

Instr Course Lect 2019 ;68:415-426

Each year, a hand fracture is diagnosed in 24.2 of 100,000 children in Canada. Hand injuries are the most common fractures in children, making up approximately one fifth of all pediatric fractures. Read More

Ortop Traumatol Rehabil 2019 Jun;21(3):181-185

University Hospital of Wales, UK.

Background: Fractures of the hand are the most common fractures in the skeletal system and phalangeal fractures constitute about 46% of all hand fractures. Operative treatment of unstable phalangeal fractures should aim at anatomic fracture reduction and stable fixation that allows early mobilization of the affected finger's joints . This study evaluates the results of fixation of unstable shaft fractures of finger proximal or middle phalanges using a non-spanning external minifixator. Read More

Injury 2020 Mar 25;51(3):774-778. Epub 2020 Jan 25.

Tianjin First Center Hospital, Fukang Road No. 24, Nankai District, Tianjin, 300192, China.

Objective: To investigate effect of double button plate fixation in the treatment of inferior patella fracture METHODS: Patients with inferior pole of patella fracture were treated with double button plate fixation. The perioperative and postoperative outcomes of MPIF with those of KWIF patients with metacarpal and phalangeal fractures were included.

Results: The average operation and hospital stay time was 55 min and 8 days respectively. Read More

J Hand Surg Eur Vol 2020 Jul 20;45(6):582-587. Epub 2020 Jan 20.

Department of Hand Surgery, Nara Medical University, Kashihara, Japan.

We prospectively assessed clinical and radiological outcomes of locking plate fixation in treating unstable fractures in 11 metacarpals, 15 proximal phalanges, and eight middle phalanges in 34 consecutive patients from October 2011 to December 2016. Median length of follow-up was 14 months (range 12-24). The motion of finger joints, bony union, and complication rates were recorded. Read More

BMC Musculoskelet Disord 2020 Jan 7;21(1):12. Epub 2020 Jan 7.

Department of General Practice, Erasmus MC University Medical Center Rotterdam, Room NA1911 PO Box 2040, 3000, CA, Rotterdam, the Netherlands.

Background: The standard diagnostic work-up for hand and wrist fractures consists of history taking, physical examination and imaging if needed, but the supporting evidence for this work-up is limited. The purpose of this study was to systematically examine the diagnostic accuracy of tests for hand and wrist fractures.

Methods: A systematic search for relevant studies was performed. Read More

Malays Orthop J 2019 Nov;13(3):69-71

Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore.

Distal phalanx fractures of the toes are common injuries. The majority of them are treated conservatively with good outcome. We present the case of a painful non-union fracture of the distal phalanx of the 4th toe in a 60-year-old female patient with symphalangism of the 4th and 5th toes. Read More

Hand Surg Rehabil 2020 Apr 23;39(2):136. Epub 2019 Dec 23.

Department of Hand Surgery, SOS hand, University Hospital of Strasbourg, FMTS, University of Strasbourg, Icube CNRS 7357, 1, avenue Molière, 67000 Strasbourg, France. Electronic address:

J Hand Surg Eur Vol 2020 Jul 16;45(6):560-566. Epub 2019 Dec 16.

Orthopaedic Surgery Department, Minia University Hospital, Minia, Egypt.

The aim of this study was to compare two joint sparing Kirschner-wire fixation techniques for displaced proximal phalangeal neck fractures. Forty-six patients with proximal phalangeal neck fractures managed by either percutaneous antegrade flexible intramedullary nailing (Group I) or crossed Kirschner-wires (Group II) were recruited for a randomized prospective comparative study. Clinical and radiological assessment of all patients was done in addition to the Kang scoring system, Disability of Arm, Shoulder and Hand score and total active motion. Read More

J Int Med Res 2019 Dec 11:300060519887264. Epub 2019 Dec 11.

Tianjin First Center Hospital, Nankai District, Tianjin, China.

Objective: To conduct a meta-analysis to show the associations of perioperative and postoperative outcomes of mini-plate internal fixation (MPIF) versus Kirschner wire internal fixation (KWIF) for treating metacarpal and phalangeal fractures.

Methods: A literature search was performed in PubMed, Web of Science, Cochrane Library, and Embase from the earliest date of data collection to April 2018. Studies that compared perioperative and postoperative outcomes of MPIF with those of KWIF in patients with metacarpal and phalangeal fractures were included. Read More

J Small Anim Pract 2020 Jan 28;61(1):46-50. Epub 2019 Nov 28.

Hospital for Small Animals, Royal (Dick) School of Veterinary Studies and Roslin Institute, Midlothian, EH25 9RG, Scotland.

Objectives: To describe the incidence, aetiology, characteristics, assessment, management and outcome of long-bone fractures in rabbits presenting to a single institution.

Materials And Methods: Medical records of pet rabbits diagnosed with long-bone fractures over a 12-year period were analysed. Patient signalment, fracture aetiology, fracture location, fracture description, time from fracture occurrence to veterinary presentation, fixation method, postoperative complications, clinical outcome and follow-up were recorded. Read More

J Hand Surg Asian Pac Vol 2019 Dec;24(4):462-468

Macquarie University, Faculty of Medicine and Health Sciences, North Ryde, Australia.

The purpose of this study was to determine whether baseline characteristics predict outcomes twelve weeks after open reduction and internal fixation of proximal phalangeal fracture. A cohort of patients (n = 48, mean 35 years; SD 11) commencing outpatient rehabilitation within one week of surgery were reviewed. Outcomes of interest were active PIP extension; active total range of motion; pain at rest; comprehensive pain; strength; and hand use (reported difficulty performing specific activities such as turning a door handle, as well as usual activities including housework and recreation) at twelve weeks. Read More

J Hand Surg Eur Vol 2020 Feb 22;45(2):126-130. Epub 2019 Oct 22.

Department of Plastic and Reconstructive Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.

We performed a prospective, observational study using a non-surgical, conservative protocol with immediate mobilization for the treatment of 101 isolated stable or initially unstable proximal phalangeal fractures. The patients were evaluated at the time of discharge from therapy treatment, mean 7 weeks (range 3-15) after conservative treatment. These patients achieved a median proximal interphalangeal joint extension of -4° (IQR 0, -8), a mean total active motion of 253° (SD 20) and minimal pain. Read More

Clin Endocrinol (Oxf) 2019 12 6;91(6):743-749. Epub 2019 Nov 6.

Reproductive Medicine Unit, University College London Hospitals, London, UK.

Objective: Women with early-onset oestrogen deficiency are at risk of reduced bone mineral density (BMD). We sought to assess fracture history and BMD in women with Turner syndrome (TS) and premature ovarian insufficiency (POI).

Design: A cross-sectional observational study. Read More

Arch Acad Emerg Med 2019 15;7(1):e51. Epub 2019 Sep 15.

Department of Emergency Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Foot (Edinb) 2019 Sep 20;40:105-108. Epub 2019 Aug 20.

Foot and Ankle Surgery, Instituto de Ortopedia Jaime Slullitel, San Luis 2435, Rosario, Santa Fe, Argentina.

Reports of isolated avulsion fracture of the distal phalanx of the hallux that comprise the functionality of the extensor hallucis longus tendon (EHL) are scarce and treatment for such injury has only been described in isolated single case reports. Two patients with an unstable avulsion fracture of the distal phalanx treated with reinsertion of the EHL with a Mini ThigthRope® system are presented in this paper. Two patients whom suffered an extreme plantarflexion mechanism sought attention in our clinic. Read More

J Hand Surg Am 2020 Apr 2;45(4):327-334. Epub 2019 Oct 2.

Department of Surgery, St. Antonius Ziekenhuis, Nieuwegein, The Netherlands.

Purpose: Multiple methods exist to surgically fix unstable phalangeal fractures. Whereas these methods have different rates of complications or reoperation, it is not known whether these differences lead to changes in patient reported outcome. We compared patient-reported outcomes measures and complications of Kirschner wire (K-wire), lag-screw and plate fixation of proximal phalanx fractures (excluding the thumb). Read More

Hand (N Y) 2019 Sep 13:1558944719873144. Epub 2019 Sep 13.

Hospital Universitari Vall d'Hebron, Barcelona, Spain.

Several techniques have been described for treating metacarpal and phalangeal fractures. We sought to compare the 3 techniques most frequently used for extra-articular metacarpal and phalangeal fractures: plate screw (PS), Kirschner wire (KW), and retrograde intramedullary screw (RIS) fixation. We aimed to determine whether using an RIS provides better clinical outcomes than using either a PS or a KW fixation. Read More

Hand Surg Rehabil 2019 10 6;38(5):302-306. Epub 2019 Aug 6.

Department of Orthopedic Surgery, Juntendo University, Tokyo, Japan.

External fixators are an effective treatment option for comminuted or unstable phalangeal fractures. We developed a new linked-wire type of external fixator (the Ichi-Fixator) for finger phalangeal fractures, which enables fine adjustment of the fixation under fluoroscopy guidance either in a static way or with distraction through small screws inside the fixator. This technique was designed to improve on the stability and rigidity of conventional percutaneous Kirchner wire fixation. Read More

J Orthop Surg Res 2019 Jul 12;14(1):213. Epub 2019 Jul 12.

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

Background: The aim of this study was to describe hand fracture epidemiology/etiology in city children and describe time trend during six decades.

Patients And Methods: A single hospital serves the entire city population of 271,271 (year 2005). Through the hospital medical and radiological archives, we collected epidemiology and etiology data concerning pediatric (age < 16 years) hand fractures in city residents, treated during 2005-2006. Read More

J Orthop Surg Res 2019 Jul 12;14(1):212. Epub 2019 Jul 12.

Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro, 173-beon-gil, Bundang-gu, Seungnam, 13620, Republic of Korea.

Background: The aims of this study were to propose a novel implant design for the proximal interphalangeal joint (PIPJ) of the hand using a rolling contact joint (RCJ) mechanism and to derive an optimal implant design based on human PIPJ kinematics.

Methods: In total, 10 participants with normal PIPJs were enrolled in this study. True lateral finger radiographs were obtained in 10° increments from 0º (full extension) to 120° flexion of PIPJ. Read More

Saudi Med J 2019 Jul;40(7):732-736

College of Medicine, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, Kingdom of Saudi Arabia. E-mail.

Objectives: To examine the epidemiology of hand fractures including common bones affected, causes, interventions, outcomes, and complications. Methods: This retrospective records-based study included patients who were admitted to King Saud Medical City, Riyadh, Kingdom of Saudi Arabia, with traumatic metacarpal or phalangeal fractures between January 2016 and September 2017. Carpal fractures, wrist fractures, and all pathological fractures were excluded. Read More

Injury 2019 Aug 22;50(8):1423-1428. Epub 2019 Jun 22.

University of Edinburgh, Edinburgh, United Kingdom.

There has been very limited analysis of the relationship between obesity and fractures in the orthopaedic literature. It has been established for some years that underweight individuals are at greater risk of proximal femoral fractures but recently there has been interest in the susceptibility of obese post-menopausal females to fracture. We have undertaken an analysis of 4886 adult patients who presented with a fracture and had their BMI assessed. Read More

Hand (N Y) 2019 Jun 17:1558944719855443. Epub 2019 Jun 17.

2 Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, USA.

To describe the rate and predictors of pathologic fractures in benign neoplasms of the finger, as variables from prediction models for pathologic fractures of the long bones of the extremities are not necessarily applicable to the bones of the hand. In this retrospective chart review, 69 histologically confirmed neoplasms affecting the bones of the fingers, 49 phalanges and 20 metacarpals, were identified in patients presenting at 2 urban hospitals over a 24-year period. Different variables were studied as possible predictors of pathologic fractures. Read More

J Endocrinol Invest 2019 Nov 24;42(11):1337-1343. Epub 2019 May 24.

Department of Clinical and Experimental Medicine, University Hospital of Messina, Via C. Valeria, 98125, Messina, Italy.

Purpose: Aromatase inhibitors (AIs) represent the first-line adjuvant therapy for hormone receptor-positive breast cancer (BC) women. AIs have been associated with an increased rate of fractures. The aim of our study was to investigate trabecular bone score (TBS) and bone quantitative ultrasound (QUS) measurements as bone quality surrogates in AIs users. Read More