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What's New — Hand — June 2026

23 new articles published this month.

Themes: Thumb Osteoarthritis and Arthrodesis · Wrist Ligament and Scaphoid Pathology · Congenital Anomalies and Complex Reconstruction · Tendon Injuries and Soft Tissue Disorders · Nerve Compression and Transplantation Outcomes · Sports Injuries and Surgical Philosophy

Digest generated 2026-07-10 03:23:23+00:00.

Highlights

Thumb Osteoarthritis and Arthrodesis

Recent literature addresses the management of thumb carpometacarpal (CMC) and metacarpophalangeal (MCP) joint pathologies. Non-surgical factors influencing pain in trapeziometacarpal (TMJ) osteoarthritis were analyzed, highlighting variability in outcomes with orthosis and exercise [3]. Surgical interventions include trapeziectomy with suspensionplasty, where preoperative passive MCP hyperextension was evaluated as a predictor of mechanical failure [16]. Additionally, thumb MCP arthrodesis outcomes were compared across various fixation methods, revealing no significant difference in functional results between plate, screw, or K-wire techniques [8]. These studies collectively inform decision-making for both conservative and operative management of degenerative thumb conditions [3, 8, 16].

Wrist Ligament and Scaphoid Pathology

This theme encompasses surgical management of chronic wrist instability and scaphoid nonunions. Chronic scapholunate Geissler grade 3C lesions were treated with modified Viegas capsuloplasty, demonstrating preserved motion and low pain at long-term follow-up [7]. Scaphoid nonunions managed with open reduction internal fixation and nonvascularized autograft showed high healing rates, with cancellous and corticocancellous grafts performing comparably [18]. Furthermore, biomechanical studies evaluated intramedullary screw fixation for distal metacarpal fractures, assessing stability in simulated active motion models to address concerns regarding hardware incursion and fragment loss [14]. These articles provide evidence for joint-preserving ligament repairs and reliable fixation strategies for scaphoid and metacarpal injuries [7, 14, 18].

Congenital Anomalies and Complex Reconstruction

Articles in this theme focus on congenital hand anomalies and complex reconstructive techniques. Radial polydactyly management is discussed, advocating for a unifying approach that addresses soft-tissue imbalance and bony deviation beyond simple excision [2]. Type B ulnar polydactyly treatment outcomes were reviewed, noting high parental satisfaction across ligation and excision methods [9]. Upper limb reconstruction in arthrogryposis multiplex congenita was synthesized into an evidence-informed algorithm covering shoulder to thumb interventions [20]. Additionally, thin posteromedial thigh free flaps were utilized for hand coverage, offering a viable alternative to thicker conventional flaps with acceptable donor site morbidity [22]. These studies highlight nuanced surgical planning for congenital and reconstructive challenges [2, 9, 20, 22].

Tendon Injuries and Soft Tissue Disorders

This cluster covers specific tendon avulsions and soft tissue contractures. Jersey finger fractures (types 3-5) were treated with buttress plating, a technique designed to prevent bone fragment disruption while managing hardware removal rates [12]. Dupuytren disease recurrence was analyzed, identifying predictors for future interventions in the same digit, other digits, or the contralateral hand after initial fasciectomy or collagenase treatment [19]. Clenched fist syndrome, a rare psychosomatic condition, was reviewed to clarify diagnostic criteria and management strategies amidst inconsistent literature [23]. These articles address both traumatic tendon injuries and chronic soft tissue conditions requiring specialized surgical or medical intervention [12, 19, 23].

Nerve Compression and Transplantation Outcomes

Research in this theme examines carpal tunnel syndrome progression and hand transplantation recovery. The incidence and timing of contralateral carpal tunnel release were assessed in patients undergoing initial unilateral surgery, with 42% requiring subsequent contralateral intervention over ten years [21]. Hand and upper-extremity transplantation outcomes were quantified over the first decade post-transplant, detailing improvements in sensory function, grip strength, and psychosocial health scores [17]. These studies provide long-term data on the natural history of nerve compression disorders and the functional trajectory of complex transplant recipients [17, 21].

Sports Injuries and Surgical Philosophy

This theme includes return-to-play data for athletes and broader surgical principles. Baseball players undergoing hook of hamate excision were reviewed, with systematic analysis of return-to-play rates and complications [6]. Implant retrieval principles from Charnley were applied to modern hand surgery, emphasizing the importance of analyzing failure mechanisms in trapeziometacarpal arthroplasty [1]. Additionally, a bibliometric analysis explored interdisciplinary collaboration in hand surgery research over four decades, highlighting the field's multidisciplinary nature [5]. These articles bridge specific sports medicine outcomes with overarching themes of innovation, failure analysis, and academic collaboration [1, 5, 6].

Articles by Theme

Thumb Osteoarthritis and Arthrodesis (3)

3. Esteban Lopez LMJ, Hoogendam L, Selles RW, et al. Factors associated with pain after non-surgical treatment for trapeziometacarpal joint osteoarthritis. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261459874

This secondary analysis of a randomized controlled trial identified baseline pain, psychological factors, and adherence to therapy as significant predictors of pain outcomes at three months following non-surgical treatment for trapeziometacarpal joint osteoarthritis. The study highlights that patient-reported outcomes vary substantially and are influenced by both clinical and psychosocial variables. These findings suggest that personalized management strategies addressing these factors may optimize non-surgical care.

8. Henriquez AR, Varney CR, Mwangi J, et al. Fixation method does not influence functional outcomes after thumb metacarpophalangeal arthrodesis. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261457024

This retrospective study found no significant difference in range of motion, pain scores, or patient-reported outcomes among various fixation methods for thumb metacarpophalangeal arthrodesis. While complication rates were similar across techniques, the need for hardware removal varied depending on the fixation type used. These results suggest that surgeons can select fixation methods based on preference or specific case factors without compromising functional results.

16. Smetana B, Wrightson D, Harold R, et al. Thumb Metacarpophalangeal Hyperextension in Patients Undergoing Basilar Thumb Joint Suspensionplasty: Are Preoperative Passive Measurements Predictive of Failure?. The Journal of Hand Surgery 2026. doi:10.1016/j.jhsa.2026.05.002

This prospective study evaluated whether preoperative passive metacarpophalangeal (MCP) joint hyperextension predicts failure in patients undergoing basilar thumb joint suspensionplasty without concurrent stabilization. The results showed no statistically significant difference in postoperative mechanical or patient-reported outcomes between patients with less than 30° and those with 30° or more of hyperextension. This suggests that preoperative passive MCP hyperextension may not be a reliable predictor of surgical failure in this context.

Wrist Ligament and Scaphoid Pathology (3)

7. Gravina D, Portoghese A, Maggi B, et al. Use of modified Viegas capsuloplasty for chronic scapholunate Geissler 3C lesions: long-term follow-up on 338 patients. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261454878

This long-term retrospective study of 338 patients demonstrates that modified Viegas dorsal capsuloplasty provides satisfactory functional outcomes and preserves wrist motion for chronic Geissler grade 3C scapholunate injuries. Most patients, including those in high-demand activities, returned to their previous activity levels with low residual pain and infrequent complications. The findings support this joint-preserving technique as a viable long-term solution for this challenging ligament injury.

14. Tarabochia M, Lindsey S, Agarwal R, et al. Intramedullary Screw Fixation of Distal Metacarpal Fractures: A Biomechanical Study. The Journal of Hand Surgery 2026. doi:10.1016/j.jhsa.2025.10.013

This biomechanical study assessed the stability of intramedullary headless compression screw fixation for progressively distal metacarpal osteotomies using a cadaveric model. The results indicated that fixation stability decreases as the osteotomy site moves closer to the metacarpal head cartilage. These findings highlight the risk of hardware incursion and loss of fixation in very distal fractures.

18. Forrester LA, Rahman R, Xu R, et al. Outcomes After Treatment of Scaphoid Nonunion With Open Reduction Internal Fixation and Nonvascularized Autograft. The Journal of Hand Surgery 2026. doi:10.1016/j.jhsa.2026.05.006

This retrospective case series evaluated 99 patients treated for scaphoid nonunion with open reduction internal fixation and nonvascularized autograft, achieving a 95% healing rate. The study found that early radiographic evidence of bridging bone on postoperative CT strongly predicted final union. This suggests that early CT imaging can serve as a reliable prognostic indicator for surgical success in this population.

Congenital Anomalies and Complex Reconstruction (4)

2. Xiaofei T, Lam WL, Chen S. Radial polydactyly: towards a unifying approach for surgical management. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261455208

The authors propose a simplified two-group classification for radial polydactyly that integrates soft-tissue anomalies and axial deviation, addressing limitations of traditional systems like Wassel–Flatt. This framework aims to guide surgical planning for complex cases where standard excision or Bilhaut–Cloquet procedures may yield suboptimal aesthetic or functional results. The approach seeks to improve outcomes by better accounting for the specific anatomical challenges of each patient.

9. ten Berge S, Nieuwdorp N, Burger E, et al. Shared decision making in the treatment of type B ulnar polydactyly: a systematic review and meta-analysis on parental satisfaction and complications. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261447693

This systematic review and meta-analysis evaluated treatment outcomes and parental satisfaction for type B ulnar polydactyly across various surgical techniques. The study found that excision under local anesthesia yielded significantly higher parental satisfaction regarding outcomes and aesthetics compared to suture ligation or excision under general anesthesia. These findings support local anesthesia excision as a preferred option to enhance patient-centered care and satisfaction.

20. Jose Jerome JT, Surendran G, Thirumagal K. Upper Limb Reconstruction in Arthrogryposis Multiplex Congenita: A Systematic Review. The Journal of Hand Surgery 2026. doi:10.1016/j.jhsa.2026.05.010

Précis unavailable.

22. Chim H. Ultrasound-Assisted Thin Posteromedial Thigh Free Flap for Coverage of Hand and Upper-Extremity Wounds. The Journal of Hand Surgery 2026. doi:10.1016/j.jhsa.2026.05.016

Précis unavailable.

Tendon Injuries and Soft Tissue Disorders (3)

12. Kümbüloğlu ÖF, Altuntas Y, Demirkale İ. Buttress Plating for Type 3-4-5 Jersey Finger Fractures: Without Bone Fragment Disruption and With a Challenging Rate of Hardware Removal–A Case Series. The Journal of Hand Surgery 2026. doi:10.1016/j.jhsa.2025.07.038

Précis unavailable.

19. El Bachaoui R, Cossu E, Zhang D, et al. The Likelihood of Future Dupuytren Disease Intervention After Initial Treatment in the Same Digit, Another Digit, and Contralateral Hand. The Journal of Hand Surgery 2026. doi:10.1016/j.jhsa.2026.05.004

Précis unavailable.

23. Zeller NP, Cohen JM, Ma S, et al. The Diagnosis and Management of Clenched Fist Syndrome. The Journal of Hand Surgery 2026. doi:10.1016/j.jhsa.2026.05.011

Précis unavailable.

Nerve Compression and Transplantation Outcomes (2)

17. Mordukhovich I, Roncagli C, Hoffner N, et al. Timeline of Functional Recovery Following Hand and Upper-Extremity Transplantation. The Journal of Hand Surgery 2026. doi:10.1016/j.jhsa.2026.05.003

This systematic review quantified functional recovery trends in 97 hand and upper-extremity transplantation patients over the first decade post-surgery. Distal transplants demonstrated superior power grip recovery compared to proximal ones, while sensory and pinch strengths showed variable but generally positive trajectories. These findings provide clinicians with evidence-based timelines for setting realistic patient expectations regarding motor and sensory restoration.

21. Toma L, Gold RM, Cossu E, et al. Incidence, Timing, and Predictors of Staged Contralateral Carpal Tunnel Release at Minimum Ten-Year Follow-Up from Unilateral Surgery. The Journal of Hand Surgery 2026. doi:10.1016/j.jhsa.2026.05.012

Précis unavailable.

Sports Injuries and Surgical Philosophy (3)

1. Phillips JR, Tucker K, Timperley J, et al. Learning from Charnley: implant retrieval in modern hand surgery. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261452468

The authors advocate for the systematic retrieval and analysis of failed hand implants, drawing parallels to Sir John Charnley’s rigorous approach in hip arthroplasty. They emphasize that responsible innovation in trapeziometacarpal joint surgery requires structured evaluation and the willingness to discontinue ineffective devices. This perspective underscores the need for critical outcome assessment to drive safe advancements in modern hand surgery.

5. Ghetti EM, Scarlato C, Caimi E, et al. Specialty representation and interdisciplinary collaboration in hand surgery research over four decades. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261453314

A bibliometric analysis of hand surgery publications from 1980 to 2025 reveals that orthopaedic surgery is the most frequent specialty, followed by hand surgery units and plastic surgery. The study characterizes patterns of interdisciplinary collaboration, showing that while clinical care is multidisciplinary, academic contributions remain dominated by surgical specialties. These findings provide insight into the evolving academic landscape and collaborative dynamics within the field.

6. Adio AA, Morato Surio J, Halgas B, et al. Return to Play After Hook of Hamate Excision in Baseball Players: A Systematic Review. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261452783

This systematic review of 624 baseball players found that hook of hamate excision results in high return-to-play rates (weighted mean 90.7%) with a median time to return of 10 weeks. The procedure demonstrates reliable outcomes for athletes requiring expedited recovery after failed nonoperative treatment. These data support excision as an effective surgical option for restoring function in this specific athletic population.

4. Morrell N, Kelley NH, Pidgeon TS. Management of Metacarpal and Phalangeal Fracture Malunions. Journal of the American Academy of Orthopaedic Surgeons 2026. doi:10.5435/jaaos-d-26-00068

The article reviews the management of metacarpal and phalangeal fracture malunions, noting that while the hand can adapt to some misalignment, surgical correction often improves function. It highlights contemporary innovations such as preoperative software-assisted planning and 3D-printed cut guides as valuable tools for addressing complex coronal, sagittal, and axial deformities. These technologies make the correction of difficult malunions more approachable and precise.

10. Translateur TR. Thoughts At Hand. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.26.00439

This article presents a poetic reflection on the surgeon's mindset and the intricate anatomical structures encountered during hand surgery. It emphasizes the importance of focused intention, deep anatomical knowledge, and the profound responsibility inherent in shaping hand function. The piece serves as a meditative reminder of the skill and care required in surgical practice.

11. Sahu D, Garg J, Thakur P, et al. Correspondence- Isolated NF140 Seropositivity in Autoimmune Nodopathy: A Caution in Clinical Interpretation. Annals of Indian Academy of Neurology 2026. doi:10.4103/aian.aian_43_26

This correspondence highlights the limitations of interpreting isolated NF140 seropositivity in autoimmune nodopathy due to small subgroup sizes lacking statistical utility. The text also details scaphoid fracture outcomes, noting delayed unions and avascular necrosis rates associated with different cast types and injury mechanisms. It cautions against overinterpreting clinical data from small samples and notes the impracticality of analyzing results by specific fall mechanisms.

13. Unknown Author. Journal CME Instructions. The Journal of Hand Surgery 2026. doi:10.1016/s0363-5023(26)00338-2

This document outlines the continuing medical education (CME) instructions for the Journal of Hand Surgery, detailing program objectives and format. It specifies that participants must read selected articles and answer related questions correctly to earn CME credits. The guidelines ensure that hand surgeons can affirm their knowledge and apply clinical data to patient care.

15. Farlow MC, Price B, Robinson V, et al. Recycling Implementation in Wide-Awake Local Anesthesia No Tourniquet Hand Surgery. The Journal of Hand Surgery 2026. doi:10.1016/j.jhsa.2026.04.015

This prospective study quantified waste reduction achieved by implementing a recycling program in a wide-awake local anesthesia no tourniquet (WALANT) procedure room. The intervention successfully separated recyclable materials from total waste, identifying key contributors to procedural waste. The findings support recycling initiatives as an effective strategy for reducing the environmental impact of WALANT surgeries.

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