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Clin Imaging 2021 May 6;76:235-246. Epub 2021 May 6.

Department of Musculoskeletal Radiology, Fleury Medicina e Saúde Higienópolis, Rua Mato Grosso 306, 1° Andar, Higienópolis, São Paulo, SP 01239-040, Brazil. Electronic address:

A Stener lesion is a displaced tear of the ulnar collateral ligament in the metacarpophalangeal joint of the thumb in which the adductor pollicis aponeurosis is positioned between the retracted ligament and the injury site, preventing natural healing. This lesion was first described in 1962, and since then, both radiologists and orthopedists have considered it important to treat surgically. Although this lesion was originally described in the thumb, this injury mechanism can occur in other joints of the hand, knee, and foot. Read More

J Hand Surg Asian Pac Vol 2021 Jun;26(2):158-165

Department of Hand Surgery, Plastic and Reconstructive Surgery, Centre Chirurgical Emile Gallé, Nancy University Hospital, Nancy, France.

The purpose of this retrospective study was to report and compare the outcomes of the MAIA prosthesis and trapeziectomy for trapeziometacarpal osteoarthritis. We included 92 consecutive patients (8 men, 84 women) with a mean age of 57 years (range 44-75 years) who underwent trapeziectomy (44 patients) or trapeziometacarpal joint replacement with a MAIA prosthesis (48 patients) for painful osteoarthritis. All patients were evaluated (pain, range of motion, strength, function, X-rays) by an independent examiner. Read More

J Hand Surg Asian Pac Vol 2021 Jun;26(2):245-264

Department of Surgery, Royal College of Surgeons, Dublin, Ireland.

Osteoarthritis of the thumb base is the second most prevalent arthritis of the hand. Management is primarily conservative, consisting of analgesia, splinting, physiotherapy, and steroid injections. Surgery is considered when conservative measures fail. Read More

J Orthop 2021 May-Jun;25:59-63. Epub 2021 Apr 1.

Department of Orthopaedic Surgery, Detroit Medical Center, Detroit, MI, 48201, USA.

Although rare, thumb Carpometacarpal (CMC) joint dislocations can have significant complications which impact hand function. Optimal management is crucial in restoring pinch and grasp strength, but no agreement exists regarding treatment due to a paucity of literature on this subject. Systematic review was conducted involving non-operative and operative management of the CMC joint. Read More

BMJ Mil Health 2021 Apr 29. Epub 2021 Apr 29.

Academic Department for Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK.

Introduction: The conflicts in Iraq and Afghanistan resulted in large numbers of personnel sustaining extremity injuries. In the context of polytrauma, partial hand amputation is often unrecorded. The aim of this work was to quantify the burden of upper limb (UL) amputation at any level occurring concurrently with a major (ankle and proximal) lower limb (LL) amputation. Read More

J Hand Surg Eur Vol 2021 Apr 22:17531934211010078. Epub 2021 Apr 22.

Department of Orthopaedic Surgery, KK Women's and Children's Hospital, Singapore, Republic of Singapore.

Metacarpal osteotomies are done to correct deviation deformity in thumb duplication. We describe a suture-only technique of metacarpal osteosynthesis, without using K-wires. Thirteen Flatt Type IV thumbs and five Wassel Type VII thumbs were reconstructed with this technique. Read More

Microsurgery 2021 Apr 20. Epub 2021 Apr 20.

Department of Plastic Reconstructive Aesthetic Surgery, Osmangazi University, Faculty of Medicine, ESKİŞEHİR, Turkey.

Background: The reverse posterior interosseous artery flap is useful for covering hand defects. However, its major drawback is the short pedicle that limits the reach of the flap up to the metacarpophalangeal level. The authors performed a new modification extending the distal reach of the flap by including the recurrent branch of the posterior interosseous artery and they aimed to present the results of reconstruction with this technique. Read More

Injury 2021 Mar 30. Epub 2021 Mar 30.

Emot Hospital 1418 sok No14 Kahramanlar. İzmir, Turkey.

Introduction: The aim of this study is to present various hand reconstruction methods and provide technical notes regarding the treatment of mutilating hand injuries using free-tissue transfers from the foot and to investigate whether these transfers provide patients with a usable hand or not.

Patients And Methods: Ninety patients with mutilating hand injuries were included in the study. A total of 101 procedures were performed. Read More

Hand (N Y) 2021 Apr 9:15589447211003179. Epub 2021 Apr 9.

Royal North Shore Hospital, St Leonards, NSW, Australia.

Background: Reverse homodigital island flaps (RHIFs) are increasingly used to reconstruct traumatic fingertip injuries, but there is limited evidence on the efficacy of this technique. We performed a systematic review of the literature to establish the safety and functional outcomes of RHIF for traumatic fingertip injuries.

Methods: Electronic searches were performed using 3 databases (PubMed, Ovid Medline, Cochrane CENTRAL) from their date of inception to April 2020. Read More

Hand (N Y) 2021 Apr 8:15589447211003176. Epub 2021 Apr 8.

Washington University School of Medicine, St. Louis, MO, USA.

Background: Many surgical procedures have been described for the treatment of thumb carpometacarpal (CMC) joint osteoarthritis, with significant variation. To date, none has proven to be superior. The purpose of this study was to report long-term follow-up results of suture suspension arthroplasty (SSA). Read More

Hand Surg Rehabil 2021 Mar 31. Epub 2021 Mar 31.

Christine M. Kleinert Institute for Hand and Microsurgery, 225 Abraham Flexner Way, Louisville, KY 40202, USA. Electronic address:

This study aimed to compare the results of patients treated with a thumb carpometacarpal (CMC) suspension arthroplasty using an interference screw technique with patients that were treated by trapeziectomy and ligament reconstruction. A retrospective chart review was conducted of patients over 18 years old who required surgical treatment for thumb CMC joint arthritis treated by a single surgeon. Patients included in the study followed the same preoperative and postoperative protocol. Read More

Hand (N Y) 2021 Mar 31:1558944721994227. Epub 2021 Mar 31.

Rothman Institute of Thomas Jefferson University, Philadelphia, PA, USA.

Background: Thumb carpometacarpal (CMC) joint arthroplasty is a common procedure in the surgical management of symptomatic thumb basal joint arthritis. Following trapeziectomy, a number of suspensionplasty techniques are often used, but limited comparative evidence exists between these techniques. The central aim of this study was to prospectively compare the outcomes of 2 suspensionplasty techniques following trapeziectomy: suture button (TightRope) versus ligament reconstruction and tendon interposition (LRTI). Read More

J Plast Surg Hand Surg 2021 Mar 29:1-5. Epub 2021 Mar 29.

Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden.

Proximal migration of the thumb metacarpal has been suggested as a possible cause of remaining pain after trapeziectomy for trapeziometacarpal joint osteoarthritis. The aim of this study was to investigate if proximal migration after trapeziectomy is associated with a poorer long-term outcome in terms of pain and objective physical variables. We retrospectively examined 91 thumbs in 65 patients after a mean of 10 years following trapeziectomy with or without ligament reconstruction and tendon interposition. Read More

Folia Morphol (Warsz) 2021 Mar 29. Epub 2021 Mar 29.

Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, NY, United States.

Understanding anatomical variations, as well as, normal anatomy of the muscles and tendons of the hand is vital for successful clinical evaluation and surgery. A number of extensor muscle and tendon variations have been reported in the literature including duplication, triplication, and absence. We report a rare anatomical variation that includes bilateral absence of the extensor indicis (EI) muscles and bilateral duplication of the extensor digitorum (ED) tendon to the second digit in the forearm of an 83-year-old male cadaver during routine upper limbs dissection. Read More

Eur J Orthop Surg Traumatol 2021 Mar 25. Epub 2021 Mar 25.

Department of Orthopedic Surgery, Yamaguchi University School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan.

Background: Trapeziectomy with ligament reconstruction and tendon interposition (LRTI) is currently the most popular technique for treating primary osteoarthritis of the thumb carpometacarpal joint. However, reduced trapezial height has sometimes been reported after LRTI. Longer immobilization and delayed rehabilitation times are also problematic. Read More

J Biol Regul Homeost Agents 2020 Sep-Oct;34(5 Suppl. 1):39-44. IORS Special Issue on Orthopedics

Department of Public Health, Section of Orthopaedic Surgery, "Federico II" University, Naples, Italy.

The aim of this systematic review was to analyze the failure rates among different trapeziometacarpal interposition implants used to treat thumb basal joint osteoarthritis. We searched Medline (PubMed), Web of Science and Scopus databases, to identify articles reporting on thumb interpositional arthroplasty, in English literature. We excluded studies with less than 35 cases and with a follow-up shorter than 24 months. Read More

Hand Surg Rehabil 2021 Jun 5;40(3):231-234. Epub 2021 Mar 5.

Hôpital Privé Paul D'Égine, 4 Avenue Marx Dormoy, 94500 Champigny-sur-Marne, France. Electronic address:

Isometric ligament reconstruction with two graft limbs is used for chronic ligament injuries. Our technique facilitates proper tensioning. It is described in thumb metacarpophalangeal joint ulnar collateral ligament reconstruction. Read More

Plast Reconstr Surg Glob Open 2021 Feb 17;9(2):e3434. Epub 2021 Feb 17.

Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.

Distal thumb injuries are common in high construction load regions, and it is a challenging task for the plastic surgeon to find the optimum choice that preserves thumb length and provides a sensory substitute to the lost tissue. Introducing first dorsal metacarpal artery flap has solved the dilemma. One drawback is that the flap is susceptible to distal necrosis, which can happen because of tight tunneling or insufficient venous drainage. Read More

Hand (N Y) 2021 Mar 7:1558944721998003. Epub 2021 Mar 7.

University of California, Los Angeles, USA.

Isolated third toe-to-thumb transfers have been rarely reported and none in the pediatric population. We describe a third toe-to-thumb transfer for reconstruction of a congenital hypoplastic thumb with excellent functional results and no morbidity in the donor foot. Read More

Ann Plast Surg 2021 Mar 5. Epub 2021 Mar 5.

From the College of Medicine Division of Plastic Surgery, Medical University of South Carolina Ralph H Johnson Veterans Affairs Medical Center, Charleston, SC.

Background: Thumb basal arthritis (TBA) is a common form of arthritis characterized by wearing away of cartilage in the crarpometacarpal joint at the base of the thumb. The purpose of the study was to analyze cost trends of the 2 common surgical treatments options: ligament reconstruction/tendon interposition (LRTI) and trapeziectomy/hematoma distraction arthroplasty (THDA).

Methods: The Vizient Clinical Data/Resource Manager electronic database was reviewed for the 3 treatment procedures of TBA from January 1, 2016, to December 31, 2019. Read More

Hand Surg Rehabil 2021 Jun 1;40(3):309-313. Epub 2021 Mar 1.

Karadeniz Technical University, School of Medicine, Orthopedic and Traumatology Department, Farabi Cd. No: 66, 61080 Ortahisar/Trabzon, Turkey.

Ligament reconstruction and tendon interposition (LRTI) procedures for trapeziometacarpal osteoarthritis aim to prevent proximal metacarpal migration to improve thumb function. We sought to evaluate the effect of the remaining trapezial space on outcomes after trapeziectomy with LRTI. Forty-seven patients were included in this study. Read More

BMJ Case Rep 2021 Mar 3;14(3). Epub 2021 Mar 3.

Department of Pediatrics, All India Institute of Medical Sciences Jodphur, Jodhpur, India.

A 2-month-old boy presented to us with bilateral microtia, left lower motor neuron facial palsy, micrognathia, hemivertebra, bifid rib, bifid thumb and absent/hypoplastic right-sided depressor anguli oris. He had bilateral external auditory canal atresia, although response to loud sound was present. Brain stem evoked response audiometry (BERA) was advised at 3 months of age. Read More

Unfallchirurg 2021 Apr 3;124(4):294-302. Epub 2021 Mar 3.

Klinik für Hand‑, Plastische und Rekonstruktive Chirurgie, BG Klinik Ludwigshafen, Ludwigshafen, Deutschland.

Background: Due to various functional impairments after primary extensor tendon repair or lack of treatment, secondary tendon reconstruction is often required. Anatomical considerations, the outcome of the injury and its treatment and the patients' individual demands on the function of the hand affect the choice of the procedure.

Objective: Description of techniques for secondary reconstruction after extensor tendon injury in zones V-VII. Read More

Unfallchirurg 2021 Apr 3;124(4):287-293. Epub 2021 Mar 3.

Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland.

Extensor tendon injuries of the thumb include lesions of the tendons of the extensor pollicis longus, extensor pollicis brevis and abductor pollicis longus muscles. The latter is practically only affected in open injuries. Open injuries require a tendon reconstruction by suture followed by immobilization in the distal and an adequate aftercare depending on the zone of injury. Read More

Arch Orthop Trauma Surg 2021 Mar 1. Epub 2021 Mar 1.

Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Yanagido 1-1, Gifu, 501-1194, Japan.

Introduction: Trapeziometacarpal osteoarthritis sometimes results in hyperextension of the thumb metacarpophalangeal (MCP) joint, which could negatively impact outcomes following trapeziectomy with ligament reconstruction and tendon interposition (LRTI) arthroplasty. Although algorithms on performing trapeziectomy with LRTI for the management of this deformity are available, they lack clear evidence. Here, we investigate the function of the thumb MCP joint after trapeziectomy with LTRI and whether this procedure alone corrects preoperative MCP hyperextension, and also analyze clinical factors correlated with MCP hyperextension post-surgery. Read More

J Plast Reconstr Aesthet Surg 2021 Jan 10. Epub 2021 Jan 10.

Department of Hand and Foot Microsurgery, Guigang City People's Hospital, No.1 Zhongshan ZhongLu, Guigang, Guangxi Zhuang Autonomous Region 537100, China. Electronic address:

Background: Computed tomography angiography (CTA) has become a widely used imaging modality in vascular surgery. The first web arterial branches of the foot are significant for surgical planning of the donor site for thumb reconstruction.

Methods: We retrospectively analysed 30 thumb reconstructions with free second toe/great toe wrap-around flap transfer, performed between January 2016 and January 2019. Read More

Hand Surg Rehabil 2021 Jun 22;40(3):211-223. Epub 2021 Feb 22.

Service d'Orthopédie, de Traumatologie, de Chirurgie Plastique et assistance Main CHU Jean Minjoz, Boulevard Fleming, 25000 Besançon, France.

Scaphotrapeziotrapezoid osteoarthritis (STT OA) is common and often associated with thumb basal joint arthritis. Pain at the base of the thumb on the volar aspect and during resisted extension is characteristic of symptomatic STT OA. If conservative treatment fails, surgical treatment may be offered. Read More

J Reconstr Microsurg 2021 Feb 17. Epub 2021 Feb 17.

Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts.

Background:  Digital transfer for hand reconstruction in children with cleft hand and foot differences present unique challenges with anomalous anatomy and rare opportunities to dramatically improve function of one- or two-digit hands.

Methods:  Medical records were reviewed for patients with cleft hand and foot treated at two pediatric institutions between 1996 and 2018. Hospital records, clinical photographs, radiographs, and alginate molds were available on all patients. Read More

Microsurgery 2021 May 13;41(4):393-395. Epub 2021 Feb 13.

Pediatric Upper Limb and Microsurgery, Barcelona University Children Hospital HM Nens, Barcelona, Spain.

Tech Hand Up Extrem Surg 2021 Feb 2. Epub 2021 Feb 2.

Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, Bangkok Department of Orthopaedics, Kasemrad Chachoengsao Hospital, Chachoengsao, Thailand.

Vascularized toe joint transfer can be an alternative treatment for children who have hypoplastic thumb with unstable carpometacarpal joint and refuse thumb ablation with index pollicization. This procedure can reconstruct a 5-digit hand with stable thumb for opposition. As the viable epiphyseal plate is included in this transfer, the potential for future growth can be expected from this type of reconstruction. Read More