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Med Phys 2022 Jun 26. Epub 2022 Jun 26.

Department of Radiology, Mayo Clinic, Rochester, MN, 55905.

Background: A common rule of thumb for object detection is the Rose criterion, which states that a signal must be five standard deviations above background to be detectable to a human observer. The validity of the Rose criterion in CT imaging is limited due to the presence of correlated noise. Recent reconstruction and denoising methodologies are also able to restore apparent image quality in very noisy conditions, and the ultimate limits of these methodologies are not yet known. Read More

J Plast Surg Hand Surg 2022 Jun 20:1-7. Epub 2022 Jun 20.

Hand Surgery Department, The Second Hospital of Tangshan, Tangshan, P.R. China.

Reconstruction of degloving injury or amputation of distal thumb with no indication of replantation has always been a challenging problem for hand surgeons. In this study, a reverse homodigital dorsal wraparound flap innervated by the dorsal digital nerve was devised to repair degloving injury or amputation of distal thumb in 20 consecutive cases. In nine cases of thumb amputation, we skeletonized the phalanxes of the amputated part as a free cortical bone with Kirschner wires. Read More

J Orthop Surg (Hong Kong) 2022 May-Aug;30(2):10225536221103301

Department of Orthopaedic Surgery, Faculty of Medicine, 26782The University of Tokyo, Tokyo, Japan.

Background: Ligament reconstruction and tendon interposition (LRTI) is currently the most performed procedure for osteoarthritis (OA) of the thumb carpometacarpal (CMC) joint. In general, satisfactory outcomes are expected, although some patients complain of residual pain after LRTI. The objective of this study is to determine the factors associated with residual pain. Read More

Plast Reconstr Surg Glob Open 2022 Jun 14;10(6):e4385. Epub 2022 Jun 14.

Dermatology and Plastic Surgery Institute, Cleveland Clinic Foundation, Cleveland, Ohio.

Background: Traumatic thumb amputation can have devastating effects on residual hand function. When replantation is not possible, thumb reconstruction is often performed in a delayed manner and may require multiple stages. Furthermore, reconstruction techniques often require microsurgical skills and equipment, which are not readily available at all institutions. Read More

BMJ Case Rep 2022 06 16;15(6). Epub 2022 Jun 16.

Plastic Surgery, Mid Essex Hospital Services NHS Trust, Chelmsford, Essex, UK.

Hand Surg Rehabil 2022 Jun 11. Epub 2022 Jun 11.

Department of Anatomy, Nancy University, University of Lorraine, 9 Avenue de la Forêt de Haye, 54500 Vandœuvre-lès-Nancy, France. Electronic address:

Index pollicization in severe thumb hypoplasia or aplasia in children or for the reconstruction of a mutilated thumb in adults is a rare and technically demanding procedure. Weakness of the new thumb is routinely reported after index pollicization. An inappropriate position of the first dorsal interosseous muscle (FDIM) can partly explain this strength deficit. Read More

Tech Hand Up Extrem Surg 2022 Apr 5. Epub 2022 Apr 5.

Hand Surgery Center, National Hospital Organization Murayama Medical Center, Tokyo, Japan.

Thumb carpometacarpal (CMC) joint instability is thought to be a debilitating disorder and, if left untreated, develops joint persistent synovitis and osteoarthritis. In this study, we report a novel surgical technique reconstructing the anterior oblique ligament, the dorsoradial ligament, and the intermetacarpal ligament simultaneously using both the transverse carpal ligament, and the palmaris longus tendon. Six patients with a mean age of 44 years showing no osteoarthritic changes by the radiographical examination underwent our anatomical three ligaments reconstruction for persistent painful thumb CMC joint instability. Read More

J Orthop Sci 2022 Jun 8. Epub 2022 Jun 8.

Department of Orthopaedic Surgery, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.

Background: This study was performed to assess the clinical and radiographic results at a minimum of 2 years after ligament reconstruction suspension arthroplasty (LRSA) that comprised full trapeziectomy and suspensionplasty using the palmaris longus tendon and the Mini TightRope (Arthrex, Naples, FL) for advanced thumb carpometacarpal arthritis.

Methods: We clinically and radiographically evaluated 26 thumbs in 26 patients who had undergone LRSA at least 2 years previously. The mean follow-up period was 35. Read More

Plast Reconstr Surg Glob Open 2022 Jun 6;10(6):e4358. Epub 2022 Jun 6.

Division of Plastic Surgery, Saint Louis University School of Medicine, St. Louis, Mo.

The serratus anterior-rib composite flap is a well described and versatile flap used for reconstruction in a variety of anatomical regions. However, reconstruction of a thumb defect using this flap has not been well described since first mentioned in the literature by the Buncke et al group 20 years ago. The authors describe the use of this technique for thumb reconstruction in a complex defect from a gunshot wound. Read More

Front Neurol 2022 20;13:857363. Epub 2022 May 20.

Department of Neurology and Clinical Neurophysiology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands.

Bilateral cleft hand syndrome is a rare congenital malformation with complex anatomy. Previous reports have mainly focused on the description of bone and soft tissue abnormalities, but information about innervation is scarce. Knowledge of the peripheral nerve anatomy is helpful for surgical treatment, optimizing the reconstruction, and preventing iatrogenic damage. Read More

Hand (N Y) 2022 Jun 6:15589447221096705. Epub 2022 Jun 6.

Division of Plastic Surgery, University of British Columbia, Vancouver, Canada.

Traumatic thumb injuries often result in significant functional disability. With segmental bone loss, reconstructive options include antibiotic cement with delayed bone graft, revision amputation with webspace deepening, metacarpal distraction osteogenesis, index pollicization, bone flap, and free toe transfer. We present a case of a subtotal thumb amputation just distal to the metacarpal phalangeal joint resulting in loss of both soft tissue and a segmental bone defect of the proximal and distal phalanx. Read More

Handchir Mikrochir Plast Chir 2022 Jun 1;54(3):244-252. Epub 2022 Jun 1.

AZ Monica Hospital.

Osteoarthritis of the carpometacarpal joint of the thumb ( CMC-1) is a common problem and many patients will seek medical attention and may eventually need surgical treatment. As no treatment option has shown consistent superiority, a variety of surgical procedures have been proposed. In this review paper we present our algorithm for the approach of symptomatic CMC-1 osteoarthritis, supported by scientific evidence and our personal experience. Read More

Bull Hosp Jt Dis (2013) 2022 Jun;80(2):122-128

A retrospective review was conducted of 500 consecutive patients who underwent surgery for complete collateral ligament ruptures of their thumb metacarpophalangeal (MP) joints comprising 362 ulnar collateral and 138 radial collateral ligaments. Complete rupture was confirmed in all cases at surgery. When surgery was carried out within 3 weeks of the injury, reinsertion of the ligament was pos- sible in 98% of cases. Read More

Hand (N Y) 2022 May 30:15589447221092060. Epub 2022 May 30.

Department of Orthopedic Surgery, Mount Sinai Beth Israel Hospital, New York City, NY, USA.

Background: Although hand surgeons usually concur that arthroplasty is indicated for disabling basal joint arthritis, controversy persists regarding the preferred surgical methods. This article describes a novel technique of trapezial excisional arthroplasty with partial trapezoidectomy and abductor pollicis longus (APL) dual ligament reconstruction, and reports the long-term results of 150 cases. Based on this experience, we hypothesize that this technique is a reliably effective and durable surgical option for basal joint arthritis. Read More

J Orthop Case Rep 2022 Jan;12(1):41-44

Department of Orthopaedics, "Panagiotis and Aglaia Kyriakou" Athens General Children's Hospital, Athens, Greece.

Introduction: Monteggia injuries are relatively rare in the pediatric population. They can be missed leading to complications arising from a chronic radial head dislocation. There is limited information about their proper management in the literature. Read More

Medicine (Baltimore) 2022 May 20;101(20):e29043. Epub 2022 May 20.

Affiliated Dongguan Hospital, Southern Medical University, Dongguan, Guangdong Province, China.

Rationale: Thumb function is one of the most fundamental components of hand function, and a vast majority of hand functions are derived from thumb motion. Injury of the thumb interphalangeal joint has a tremendous impact on the function of the thumb, and damage to the thumb interphalangeal joint (IPJ) caused by trauma is usually accompanied by dislocation of the surrounding skin; therefore, it is particularly important to restore the thumb anatomy and skin coverage.

Patient Concerns: A 41-year-old woman presented with IPJ disfigurement accompanied by a local skin defect caused by machine compression of her right thumb. Read More

J Hand Surg Glob Online 2022 May 27;4(3):141-146. Epub 2022 Mar 27.

Department of Orthopaedic Surgery, Geisinger Commonwealth School of Medicine, Geisinger Musculoskeletal Institute, Danville, PA.

Purpose: To assess patient satisfaction and functional outcomes of primary suture anchor repair with local soft tissue advancement for both acute and chronic thumb ulnar collateral ligament (UCL) injuries.

Methods: We retrospectively reviewed patient charts who had undergone operative UCL repair between 2006 and 2013. Patients who had more than 8 weeks between the time of injury and surgery were classified as having chronic injuries. Read More

J Coll Physicians Surg Pak 2022 May;32(5):685-687

Department of Upper Limb and Hand Surgery, 521 Hospital of Norinco Group, Shaanxi, China.

The aim of this study was to investigate the feasibility of transferring the free flow-through dorsoulnar perforator flap to reconstruct severely injured fingers. From January 2015 to March 2019, 16 patients, 16 thumb or fingers volar partial defects concomitant with segmental digital arterial defects, were included in this study. The flow-through dorsoulnar perforator flaps were used to repair the finger wounds and reconstruct digit arteries. Read More

Orthop Surg 2022 Jun 7;14(6):1019-1033. Epub 2022 May 7.

Unit of Lecco, CNR ICMATE, National Research Council, Lecco, Italy.

Digital trauma amputations and digital agenesis strongly affect the functionality and aesthetic appearance of the hand. Autologous reconstruction is the gold standard of treatment. Unfortunately, microsurgical options and transplantation procedures are not possible for patients who present contraindications or refuse to undergo transplantation from the toe (e. Read More

J Plast Reconstr Aesthet Surg 2022 Feb 26. Epub 2022 Feb 26.

Department of Orthopaedics, Children's Hospital of Chongqing Medical University, Yuzhong District Zhongshan 2 road 136#, Chongqing 400014, China. Electronic address:

Background: The Bilhaut-Cloquet technique is the preferred surgical method for thumb polydactyly with symmetrical caliber and osseous components. However, the traditional Bilhaut-Cloquet technique has many esthetic and functional complications. In this study, we aimed to investigate an effective modified Bilhaut-Cloquet procedure for Wassel type IV thumb duplication. Read More

Hand Clin 2022 May;38(2):269-279

University of Texas Medical Branch, 301 University Boulevard, McCullough 6.124, Galveston, TX 77555, USA. Electronic address:

Isolated dislocations of thumb CMC joints are rare injuries with serious functional implications. Patients suffering these injuries will have decreased pinch and grip strength. A high-energy, axially directed force on a flexed thumb typically causes dislocation. Read More

Hand Clin 2022 May;38(2):261-268

Hand Surgery, University Hopsital Southampton, Southampton SO16 6YD, UK.

Hypermobility of the first CMC joint may adversely affect hand function and may lead to osteoarthritis later in life. It presents more commonly in younger women with generalized joint hypermobility or postmenopausal women with early stages of arthritis. It may follow trauma and deletive surgical interventions. Read More

Hand Clin 2022 May;38(2):249-259

Department of Surgery, Section of Plastic Surgery, University of Michigan Medical School, University of Michigan, 2130 Taubman Center, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0340, USA. Electronic address:

Revision thumb carpometacarpal (CMC) arthroplasty alleviates persistent pain and instability after nonimplant or implant CMC arthroplasty. Metacarpal subsidence onto the scaphoid causing impingement, missed diagnosis such as scaphotrapezoid arthritis, and metacarpophalangeal hyperextension are common causes of failed CMC arthroplasty. Literature shows that revision CMC arthroplasty has satisfactory outcomes. Read More

Hand Clin 2022 May;38(2):217-230

IM2S, Clinique de Chirurgie orthopédique et traumatologique de Monaco, 11 avenue d'Ostende 98000, Monaco.

Thumb carpometacarpal implant arthroplasty aims to preserve thumb length and motion and to provide pain relief and functional recovery after a short postoperative time. For several decades, implant arthroplasty has been performed with total trapeziometacarpal joint prosthesis using the concept of "ball-and-socket" joint. More recently, pyrocarbon implants used as hemiarthroplasty or interposition arthroplasty have been proposed. Read More

Hand Clin 2022 May;38(2):207-215

Department of Orthopaedic Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267-0212, USA; Department of Sports Medicine, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267-0212, USA.

The trapeziometacarpal joint is the site that most commonly develops arthritis in the hand. Although optimal treatment requires careful consideration of history, physical examination, radiographs, and functional goals, many patients ultimately undergo surgical intervention. Several described techniques and approaches are highlighted in this article, especially pertaining to carpometacarpal arthroplasty with ligament reconstruction and tendon interposition. Read More

Hand Clin 2022 May;38(2):199-205

Medical College of Wisconsin, 1155 North Mayfair Road, Wauwatosa, WI 53226, USA.

Osteoarthritis of the first carpometacarpal joint is common. When nonoperative measures fail, surgery may provide long-term pain relief. There are many surgical options in the management of carpometacarpal joint arthritis. Read More

Hand Clin 2022 May;38(2):169-181

Plastic Surgery Boutique, 2601 SW 37th Ave Suite 804, Miami, FL 33133, USA.

Trapezium resection with or without tendon suspension arthroplasty has been considered the gold standard surgical treatment for thumb carpometacarpal joint osteoarthritis (CMCJ OA). However, the removal of the trapezium may result in subsidence or shortening of the first metacarpal axis. Resection may also lead to reduced pinch strength and thumb instability. Read More

Neurosurgery 2022 Apr 25. Epub 2022 Apr 25.

Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.

Background: In patients with C7-T1 brachial plexus avulsions, complete loss of hand function is commonly seen. However, the reconstruction of hand function is difficult.

Objective: To report the outcomes of hand function recovery after combined nerve and tendon transfers in C7-T1 brachial plexus injury. Read More

Plast Reconstr Surg Glob Open 2022 Apr 13;10(4):e4254. Epub 2022 Apr 13.

Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, N.C.

Many approaches to CMC arthroplasty have been described for treatment of advanced arthritis, yet there is no consensus on the "best" operation. Implantable hardware is increasingly utilized for metacarpal suspension, but few hardware-mediated complications have been documented. Here we present the case of a 69-year-old man with insidious-onset median neuropathy following ligament reconstruction and tendon interposition for CMC arthritis, utilizing interference screw fixation. Read More

J Orthop Sci 2022 Apr 13. Epub 2022 Apr 13.

Department of Orthopaedic Surgery, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.

Background: Management of metacarpophalangeal (MCP) hyperextension deformity in thumb carpometacarpal (CMC) joint arthritis is challenging. It remains unclear how the preoperative MCP joint angle affects the outcomes. The present study aimed to clarify the associations between postoperative MCP hyperextension deformity and outcomes, and to determine the preoperative MCP joint angle that can predict poor outcomes. Read More