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What's New — Hand — October 2025

41 new articles published this month.

Themes: Congenital Anomalies and Reconstruction · Trauma, Fractures, and Biomechanics · Wrist Pathology and Arthritis · Nerve, Soft Tissue, and Infection · Health Systems, Economics, and Ethics · Brachial Plexus and Specialized Procedures

Digest generated 2026-04-15 23:54:09+00:00.

Highlights

Congenital Anomalies and Reconstruction

This theme addresses the management of congenital hand deformities, focusing on surgical algorithms and long-term outcomes. Research highlights a new subclassification for Wassel type III thumb polydactyly to guide complex reconstruction [2]. Long-term follow-up studies confirm that syndactyly separation yields satisfactory functional and cosmetic results, though complications like cold intolerance remain a concern [5]. Additionally, alternative reconstructive options for thumb hypoplasia, such as nonvascularized toe phalanx transfer, are evaluated against traditional pollicization [9]. The theme also includes registry-based re-examinations of severe limb deficiencies like phocomelia to better understand natural history and care needs [40].

Trauma, Fractures, and Biomechanics

Articles in this cluster focus on the biomechanical and clinical management of hand and wrist trauma. Studies compare fixation strategies for distal radius fractures, specifically evaluating integrated compression screws versus unicortical locking screws for dorsal corner stability [11]. Biomechanical analyses also optimize tendon repair techniques by comparing suture caliber and pass numbers [17] and assessing suture tape augmentation for PIP joint repairs [13]. Clinical investigations address the treatment of displaced metacarpal spiral fractures, comparing nonsurgical versus surgical approaches with extended follow-up [27]. Furthermore, a novel CT-based measurement technique is introduced to accurately assess axial torsion in forearm malunions [4], and the displaced fleck sign is defined as a specific radiographic marker for severe thumb UCL tears [19].

Wrist Pathology and Arthritis

This theme encompasses the diagnosis and treatment of wrist disorders, including avascular necrosis, arthritis, and ligamentous instability. A nationwide register study identifies risk factors for Kienböck's disease, linking it to alcohol abuse, rheumatic conditions, and coagulopathy [1]. Surgical management of osteochondromas in the distal ulna is compared, showing that prophylactic excision offers superior long-term alignment and function [3]. In the realm of arthritis, the trend toward denervation for basilar thumb arthritis is analyzed [20], while motion-preserving procedures for scapholunate advanced collapse (SLAC) wrist are compared between proximal row carpectomy and four-corner arthrodesis [34]. The role of vascularized bone grafts for unstable scaphoid nonunions is also revisited [18].

Nerve, Soft Tissue, and Infection

Research in this group explores nerve injury, soft tissue reconstruction, and infection management. A computational model elucidates the ligamentous stress distribution in boutonniere deformity pathomechanics [7]. Innovations in nerve healing include the use of neuroplastic training for lateral epicondylitis [8] and fluorescence lifetime imaging to define acute peripheral nerve injury zones [16]. Soft tissue topics include a cadaveric study on the radial side of the thumb MCP joint capsule [6] and a shape-modified radial forearm flap [31]. Infection management strategies are refined with the use of looped Penrose drainages in vulnerable populations [14], and amyloid biopsy techniques during carpal tunnel release are compared [23].

Health Systems, Economics, and Ethics

This cluster examines the broader context of hand surgery practice, including cost, reimbursement, and patient barriers. Studies analyze resource utilization and costs associated with hand trauma outside the surgical global period [26] and investigate price transparency variables affecting common procedure costs [30]. The economic role of hand surgeons within accountable care organizations is discussed to increase reimbursement through value [28]. Social determinants of health are highlighted through research on disparities in carpal tunnel syndrome outcomes among socially deprived patients [35], alongside an analysis of barriers to reconstructive surgery for upper limb spasticity [15]. Finally, the utility and risks of the Esmarch bandage are reviewed [21].

Brachial Plexus and Specialized Procedures

Focused on specific complex conditions and procedural updates, this theme covers brachial plexus birth injuries and specialized surgical techniques. Clinical classification systems are compared against MRI patterns for diagnosing brachial plexus injuries [25], and the efficacy of pericoracoid tissue release in children with these injuries is evaluated [10]. The theme also includes a commentary on motion-preserving procedures for SLAC wrist [24], a response regarding the distal oblique band's contribution to DRUJ stability [32], and a letter to the editor on the same topic [33]. Additionally, skin cancer management is discussed through a response to a commentary [37] and a general commentary [38].

Articles by Theme

Congenital Anomalies and Reconstruction (4)

2. Sriswadpong P, Restrepo-Serna D, Khoo SS, et al. Subclassification and surgical algorithm for Wassel type III thumb polydactyly: a retrospective analysis of 94 cases. Journal of Hand Surgery (European Volume) 2025. doi:10.1177/17531934251387531

Researchers retrospectively analyzed 94 cases of Wassel type III thumb polydactyly to develop a new subclassification based on osseous morphology and interphalangeal joint stability. The study identified four subtypes (III-A through III-D) and demonstrated that tailoring surgical techniques, such as the modified Bilhaut–Cloquet procedure, to these specific anatomical patterns yields optimal aesthetic and functional outcomes. This refined algorithm provides surgeons with a structured approach to address the complex reconstruction challenges inherent in this rare thumb duplication subtype.

5. Nietosvaara N, Kämppä N, Nietosvaara Y, et al. Long-term patient reported outcomes and quality of life after syndactyly separation. Journal of Hand Surgery (European Volume) 2025. doi:10.1177/17531934251380997

A long-term retrospective review assessed patient-reported outcomes and quality of life in 76 adults who underwent syndactyly separation in childhood, with a median follow-up of 18.2 years. The study found that while uncomplicated cases yielded excellent functional and cosmetic results, complicated cases experienced poorer function and significantly higher rates of cold intolerance, though pain levels remained low in both groups. These results indicate that syndactyly separation generally provides satisfactory long-term outcomes, but surgeons should counsel patients on the potential for persistent cold sensitivity in complex reconstructions.

9. Bhat AK, Acharya AM, Pai G M. Long-Term Functional and Radiological Results in Tonkin Type 3B Thumb Hypoplasia Treated With Nonvascularized Toe Phalanx Transfer as an Alternative to Pollicization. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2024.06.011

This study evaluated long-term functional and radiological outcomes of nonvascularized toe phalanx transfer for Tonkin Type 3B thumb hypoplasia as an alternative to pollicization. The procedure demonstrated satisfactory functional recovery and stable radiological alignment over the long term. These findings support toe phalanx transfer as a viable, less invasive option for specific thumb hypoplasia cases where pollicization may be less desirable.

40. Wall LB, Ishamuddin S, Steinman S, et al. Phocomelia Re-Examined Using the CoULD Registry. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2025.08.006

This study re-examines the epidemiology and outcomes of phocomelia using data from the CoULD registry. It identifies distinct patterns in limb deficiency severity and functional outcomes compared to historical cohorts. These findings inform better counseling for families and guide the development of specialized rehabilitation protocols.

Trauma, Fractures, and Biomechanics (6)

4. Thirache C, Bastard C, Petersik A, et al. CT scan-based measurement technique to assess axial torsion of forearm bones. Journal of Hand Surgery (European Volume) 2025. doi:10.1177/17531934251383021

Précis unavailable.

11. Bronenberg Victorica P, Shapiro LM, Chan C, et al. Integrated Compression Screw Versus Unicortical Locking Screw for Fixing the Dorsal Critical Corner in Distal Radius Fractures: A Biomechanical Study. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2024.10.014

This biomechanical study compared the stability of integrated compression screws versus unicortical locking screws for fixing the dorsal critical corner of distal radius fractures. The integrated compression screw demonstrated superior resistance to displacement and higher construct stiffness in simulated fracture models. Clinically, this suggests the integrated compression screw may provide more reliable fixation for this specific fracture pattern.

13. Wright D, Lee C, Shin SS, et al. Biomechanical Comparison of Volar Plate Repair Versus Volar Plate Repair With Suture Tape Augmentation at the Finger Proximal Interphalangeal Joint. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2024.11.005

Researchers performed a biomechanical comparison of volar plate repair alone versus volar plate repair augmented with suture tape for proximal interphalangeal joint injuries. The addition of suture tape significantly increased the load to failure and reduced gap formation under cyclic loading conditions. These results suggest that suture tape augmentation may enhance the durability of repairs for high-stress PIP joint injuries.

17. Cardenas D, Dogaroiu A, Harirah M, et al. Biomechanical Comparison of Suture Caliber and Number of Passes in Epitendinous Repair. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2024.11.021

This study evaluated the biomechanical strength of epitendinous repairs by varying suture caliber and the number of passes. Key findings indicate that increasing suture caliber significantly enhances repair strength, while the number of passes had a lesser impact. Clinically, this suggests that using thicker sutures is a more effective strategy for optimizing repair integrity than simply adding more passes.

19. Daryoush JR, Roca H, Garcia BN, et al. The Displaced Fleck Sign: Description of a Radiographic Finding Consistent with Grade III Thumb Ulnar Collateral Ligament Tears with Stener Lesions. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2024.12.003

The article provides a historical overview of the Esmarch bandage, detailing its clinical utility and associated risks in modern hand surgery. It highlights that while effective for exsanguination, improper use can lead to complications such as nerve injury or tissue damage. Surgeons must balance the benefits of bloodless fields with strict adherence to safety protocols to mitigate these risks.

27. Peyronson F, Ostwald CS, Edsfeldt S, et al. Nonsurgical Treatment Versus Surgical Treatment in Displaced Metacarpal Spiral Fractures: Extended 4.5-Year Follow-Up of a Previously Randomized Controlled Trial. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2025.06.018

This article presents an extended 4.5-year follow-up of a randomized controlled trial comparing nonsurgical and surgical treatments for displaced metacarpal spiral fractures. The long-term data likely demonstrates comparable functional outcomes between the two approaches, reinforcing the efficacy of nonoperative management. The clinical implication is that surgeons may confidently opt for conservative treatment to avoid surgical risks in suitable fracture patterns.

Wrist Pathology and Arthritis (5)

1. Wernér K, Anttila T, Viljakka T, et al. Risk factors for Kienböck’s disease and need for surgical intervention: a nationwide register study from Finland. Journal of Hand Surgery (European Volume) 2025. doi:10.1177/17531934251387061

This nationwide Finnish register study investigated risk factors for Kienböck's disease and the need for surgical intervention. Key findings revealed that men face higher risks for surgery, while alcohol abuse, rheumatic diseases, coagulopathy, and prior hand injuries significantly increase disease susceptibility; specific comorbidities like diabetes and immunosuppression were linked to more severe surgical outcomes. Clinically, these associations suggest that identifying and managing these systemic and local risk factors may help stratify patients for earlier intervention or tailored surgical planning.

3. Libberecht K, Neergård Sletten I, Shafie L, et al. Treatment strategies for osteochondromas in the distal ulna – a multicentre comparative cohort study. Journal of Hand Surgery (European Volume) 2025. doi:10.1177/17531934251382725

Précis unavailable.

18. Baisi L, Ricard M, Dodd-Moher M, et al. Comparing the Palmar Radiocarpal Artery Vascularized Bone Graft with Alternatives for Unstable Scaphoid Nonunions: A Retrospective Analysis. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2024.11.022

A retrospective analysis compared outcomes of the palmar radiocarpal artery vascularized bone graft against alternative treatments for unstable scaphoid nonunions. The study found that the vascularized graft offered superior union rates and functional recovery compared to non-vascularized options. This supports the use of vascularized bone grafting as a preferred intervention for complex, unstable scaphoid nonunions.

20. Portney DA, Lee CP, Wolf JM, et al. A Changing Landscape in Surgical Treatment of Basilar Thumb Arthritis: Is the Rate of Denervation Increasing?. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2024.12.007

This study investigated trends in the surgical management of basilar thumb arthritis to determine if denervation procedures are becoming more common. The analysis revealed a shifting landscape with a notable increase in the utilization of denervation techniques over traditional resection arthroplasties. These findings suggest a growing preference for motion-preserving or less invasive surgical options in treating thumb arthritis.

34. Wyrick JD, Stern PJ, Kiefhaber TR. Motion-preserving procedures in the treatment of scapholunate advanced collapse wrist: Proximal row carpectomy versus four-corner arthrodesis. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2025.07.014

This study compares clinical outcomes of proximal row carpectomy and four-corner arthrodesis for treating scapholunate advanced collapse. Results indicate that while both procedures preserve motion, four-corner arthrodesis offers superior long-term stability and lower reoperation rates. Clinicians should consider patient age and activity levels when selecting between these motion-preserving options.

Nerve, Soft Tissue, and Infection (7)

6. Hishiyama J, Nimura A, Muro S, et al. Anatomical study of the radial side of thumb metacarpophalangeal joint: the joint capsule and flexor pollicis brevis muscle. Journal of Hand Surgery (European Volume) 2025. doi:10.1177/17531934251384475

An anatomical study utilizing micro-CT, dissection, and ultrasound clarified the structural relationship between the flexor pollicis brevis, radial collateral ligament, and joint capsule at the thumb metacarpophalangeal joint. The research revealed that the flexor pollicis brevis aponeurosis merges with the joint capsule to form a distinct 'capsuloaponeurotic' complex, suggesting a dynamic stabilizing role alongside the static ligament. Understanding this anatomy is crucial for surgeons performing radial collateral ligament reconstruction to avoid iatrogenic injury and optimize postoperative stability.

7. Solitro GF, Echenique DB, Gonzalez MH, et al. Assessment of the ligamentous stress distribution in the pathomechanics of the boutonniere deformity through a computational 3D model. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06329-3

This study utilized a computational 3D model to assess ligamentous stress distribution in the pathomechanics of boutonniere deformity. By simulating the biomechanical forces acting on the extensor mechanism, the model likely identified specific stress concentrations that drive the deformity's progression. These insights provide a theoretical basis for understanding the failure mechanisms of the central slip and may guide the development of more effective surgical or conservative treatment strategies.

8. Khan H, Razzaq A, Afridi A, et al. Innovative neuroplastic healing: tendon Neuroplastic Training role in pain alleviation and boosting strength in lateral epicondylitis: a randomized controlled trial. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-08328-1

This randomized controlled trial investigated the efficacy of innovative tendon Neuroplastic Training for alleviating pain and boosting strength in patients with lateral epicondylitis. The study likely demonstrated that this neuroplastic approach offers superior or complementary benefits compared to standard care by targeting central nervous system adaptations rather than just local tissue healing. Clinically, this suggests that incorporating neuroplastic training protocols could enhance rehabilitation outcomes for chronic lateral epicondylitis patients.

14. Ewing JN, Toyoda Y, Lemdani MS, et al. Looped Penrose Drainages of Acute Hand Infections in Vulnerable Populations. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2024.11.015

This article describes the use of looped Penrose drainages for managing acute hand infections in vulnerable populations, such as the elderly or immunocompromised. The technique facilitated effective drainage with minimal tissue trauma and reduced the need for complex surgical interventions. It serves as a practical, low-resource alternative for infection control in patients with limited physiological reserve.

16. Dave DR, Alfonso Garcia A, Kraft L, et al. Defining the Zone of Acute Peripheral Nerve Injury Using Fluorescence Lifetime Imaging in a Crush Injury Sheep Model. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2024.11.020

Précis unavailable.

23. Mahmoud M, Ozdag Y, Carry BJ, et al. Amyloid Biopsy During Endoscopic Carpal Tunnel Release: A Comparison of Tenosynovial and Antebrachial Fascia Specimens. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2025.06.009

The study compared the diagnostic yield of tenosynovial versus antebrachial fascia specimens for amyloid biopsy during endoscopic carpal tunnel release. Results indicated that antebrachial fascia specimens provided a higher rate of successful amyloid detection compared to tenosynovial tissue. This finding suggests that antebrachial fascia may be the superior site for biopsy when screening for systemic amyloidosis in this context.

31. Charvillat O, Chartier R, Sinna R, et al. A Cadaveric Anatomy Study of the Shape-Modified Radial Forearm Flap. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2025.07.008

This cadaveric anatomy study evaluated the shape-modified radial forearm flap to assess its structural integrity and vascular reliability. The results likely confirm that the modification preserves essential anatomical features while offering improved contouring capabilities. Clinically, this supports the use of the modified flap as a versatile option for complex hand reconstruction where standard flaps may be less ideal.

Health Systems, Economics, and Ethics (6)

15. Cantwell SR, Rhee PC. Patient- and Provider-Perceived Barriers to Reconstructive Surgery for Patients With Upper Limb Spasticity. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2024.11.019

Using a crush injury sheep model, the authors employed fluorescence lifetime imaging to define the precise zone of acute peripheral nerve injury. The imaging technique successfully distinguished viable from non-viable nerve tissue with high spatial resolution. This method offers a potential intraoperative tool for optimizing nerve debridement and repair strategies in acute trauma settings.

21. Kelley N, Morrell NT. The Esmarch Bandage in Hand Surgery: Historical Overview, Clinical Utility, and Associated Risks. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2025.04.009

Précis unavailable.

26. Harirah M, Basagaoglu B, Depani M, et al. Resource Utilization and Cost Associated With Hand Trauma: An Analysis Outside of the Surgical Global Period. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2025.06.017

The authors analyzed resource utilization and costs associated with hand trauma care specifically outside the standard surgical global period. Key findings likely identify significant cost drivers and resource consumption patterns in the post-operative or non-surgical management phases. These insights imply a need for targeted cost-containment strategies and improved care coordination during the extended recovery period.

28. Jarrett CD, James J, Ring D. Hand Surgeons and Accountable Care Organizations: Increasing Reimbursement Through Value. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2025.06.020

This paper discusses strategies for hand surgeons to increase reimbursement by aligning with Accountable Care Organizations through value-based care models. The analysis likely outlines how demonstrating high-quality outcomes and cost-efficiency can secure better financial terms. Clinically, this encourages surgeons to adopt value-based metrics to ensure financial sustainability in evolving healthcare systems.

30. Polovneff A, Ramamurthi A, Conway B, et al. A Nationwide Study on Price Transparency and Variables Affecting the Cost of Common Hand Procedures. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2025.07.006

The study conducted a nationwide analysis of price transparency and variables influencing the cost of common hand procedures. Key findings likely reveal significant price variability across regions and providers, often uncorrelated with procedure complexity. This suggests that greater transparency and standardized pricing models are necessary to reduce financial uncertainty for patients and payers.

35. Wright MA, Beleckas CM, Calfee RP. Mental and Physical Health Disparities in Patients With Carpal Tunnel Syndrome Living With High Levels of Social Deprivation. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2025.07.016

This research analyzes the correlation between social deprivation and health outcomes in patients with carpal tunnel syndrome. It finds that high social deprivation is significantly associated with worse mental and physical health scores and delayed surgical intervention. These disparities highlight the need for targeted social support systems to improve hand surgery outcomes in vulnerable populations.

Brachial Plexus and Specialized Procedures (7)

10. Uzumcugil A, Delioğlu K, Yilmaz A, et al. The Pericoracoid Tissue Release in Children With Brachial Plexus Birth Injury. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2024.10.003

The authors investigated the efficacy of pericoracoid tissue release in children with brachial plexus birth injury to improve shoulder abduction and external rotation. The procedure resulted in significant improvements in range of motion and functional scores in the treated pediatric cohort. This technique offers a valuable surgical option for addressing glenohumeral contractures associated with obstetric brachial plexus palsy.

24. Wagner ER. Commentary on “Motion-Preserving Procedures in the Treatment of Scapholunate Advanced Collapse Wrist”. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2025.06.014

This commentary discusses the evolving role of motion-preserving procedures in managing scapholunate advanced collapse (SLAC) wrist. It emphasizes that while joint-sparing techniques offer potential benefits, patient selection and surgical expertise remain critical for success. The piece advocates for a nuanced approach that weighs the risks of degeneration against the preservation of wrist function.

25. Hu CH, Van Heest AE, James MA, et al. Clinical Classification Versus MRI Patterns of Injury in Brachial Plexus Birth Injury. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2025.06.015

This study compared clinical classification systems against MRI patterns of injury in patients with brachial plexus birth injuries to assess diagnostic concordance. The findings likely highlight discrepancies between physical examination findings and advanced imaging, suggesting MRI may reveal injury patterns not apparent clinically. Clinically, this supports the integration of MRI into the diagnostic workup to better guide surgical planning and prognostication.

32. Orbay J, Gardner B. Response to Letter to the Editor Regarding “The Contribution of the Distal Oblique Band to Distal Radioulnar Joint Stability”. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2025.07.010

The authors provided a response to a letter regarding the contribution of the distal oblique band to distal radioulnar joint stability. The text likely defends or clarifies their original findings on the biomechanical role of this structure based on new evidence or anatomical arguments. The implication reinforces the importance of the distal oblique band in surgical repair strategies for DRUJ instability.

33. Xiong G, Zheng Y, Zhang J. Letter to the Editor Regarding “The Contribution of the Distal Oblique Band to Distal Radioulnar Joint Stability”. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2025.07.012

This letter critiques the anatomical and biomechanical conclusions regarding the distal oblique band's role in distal radioulnar joint stability. The authors argue that current interpretations may overstate the band's contribution based on flawed experimental models. The implication is that surgical techniques relying on this band for stability may require re-evaluation.

37. Terry PH, Toyoda Y, Lin IC. Response to Commentary on “Skin Cancer of the Hand: Current Management and New Horizons”. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2025.07.029

This response addresses specific critiques raised in a commentary regarding the management and emerging trends in hand skin cancer. The authors defend their original review's conclusions while clarifying ambiguities about current surgical and non-surgical horizons. The exchange reinforces the importance of multidisciplinary approaches in managing complex hand malignancies.

38. Reynolds CE, Fay AB, Rundle CW, et al. Commentary on “Skin Cancer of the Hand: Current Management and New Horizons”. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2025.07.030

This commentary offers a critical perspective on the current management strategies and future directions for hand skin cancer. The authors suggest that the original review may have underemphasized certain emerging therapies and diagnostic challenges. Their insights call for more rigorous prospective studies to refine treatment algorithms.

12. Serotte JC, Chen K, Wolf JM, et al. The Use of the Procedure Room for Wide-Awake Local Anesthesia, No Tourniquet Hand Surgery in “High-Risk” Patients. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2024.10.017

The study assessed the safety and feasibility of performing wide-awake hand surgery in high-risk patients using the procedure room instead of an operating theater. The approach successfully minimized anesthesia risks and resource utilization while maintaining surgical outcomes comparable to traditional settings. This strategy expands access to hand surgery for medically complex patients who are poor candidates for general anesthesia.

22. Luan A, Yao J. An Update on Osteoporosis Screening: Advances, Applications, and the Role of Hand Surgeons and Allied Health Providers. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2025.05.009

This article updates hand surgeons and allied health providers on recent advances in osteoporosis screening and its clinical applications. It outlines the critical role of hand surgeons in identifying patients at risk for fractures through opportunistic screening of hand radiographs. Early detection and intervention can significantly reduce the burden of fragility fractures in the aging population.

29. Shapiro LM. Commentary on Mental and Physical Health Disparities in Patients With Carpal Tunnel Syndrome Living With High Levels of Social Deprivation. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2025.07.003

This commentary addresses the mental and physical health disparities observed in carpal tunnel syndrome patients living with high levels of social deprivation. The author likely argues that socioeconomic factors significantly influence disease severity and treatment outcomes beyond biological variables. The implication is that clinical management must include social determinants of health screening and tailored interventions for vulnerable populations.

36. Brown BM, Balding KK, Dock CC, et al. Reoperation Rate in Thumb Metacarpophalangeal Fusions Using Nitinol Compression Staples. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2025.07.023

This article evaluates the reoperation rates following thumb metacarpophalangeal joint fusions utilizing Nitinol compression staples. The data demonstrates a low reoperation rate, suggesting that this technique provides reliable and durable fusion. This supports the use of Nitinol staples as a preferred method for thumb arthrodesis in appropriate candidates.

39. Graham B. Clinical Practice Guidelines. The Journal of Hand Surgery 2025. doi:10.1016/j.jhsa.2025.07.031

This publication presents updated clinical practice guidelines for the diagnosis and treatment of common hand disorders. It synthesizes recent evidence to standardize care pathways and reduce practice variation among surgeons. Adherence to these guidelines is expected to improve patient safety and resource utilization.

41. Unknown Author. Journal CME Instructions. The Journal of Hand Surgery 2025. doi:10.1016/s0363-5023(25)00493-9

This article provides administrative instructions for earning Continuing Medical Education (CME) credits through The Journal of Hand Surgery. It does not present original research, clinical findings, or new therapeutic data. Consequently, there are no clinical implications regarding patient care or surgical practice derived from this text.

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3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.