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What's New — Hand — July 2026

21 new articles published this month.

Themes: Trapeziometacarpal Arthroplasty Outcomes · Distal Radius and Scaphoid Fracture Management · Trigger Finger and Tendon Pathology · Nerve Injuries and Anatomical Variants · Perioperative Care and Surgical History

Digest generated 2026-08-04 16:01:13+00:00.

Highlights

Trapeziometacarpal Arthroplasty Outcomes

Recent literature critically evaluates the long-term performance and patient satisfaction of trapeziometacarpal (TMJ) arthroplasty. Herren et al. [3] identified determinants of satisfaction five years post-dual-mobility implant, while Stilling et al. [9] utilized radiostereometry to assess cup fixation and survival in 484 Moovis implants, highlighting aseptic loosening as a primary failure mode. These clinical findings are contextualized by Herren and Marks [6], who respond to calls for routine implant retrieval, advocating for broader responsible innovation frameworks beyond mere failure analysis. Together, these studies underscore the importance of rigorous long-term surveillance and understanding failure mechanisms to improve TMJ arthroplasty outcomes.

Distal Radius and Scaphoid Fracture Management

This theme addresses contemporary management strategies for distal radius and scaphoid fractures. Turan et al. [12] found that preserving pronator quadratus integrity after anterior plating correlates with improved grip strength, though motion scores remain similar. Assafiri et al. [15] demonstrated that dedicated day-case pathways significantly reduce length of stay for distal radius surgeries without increasing complications. Regarding scaphoid fractures, Zhang et al. [16] emulated the SWIFFT trial using Chinese EHR data, comparing surgical fixation to cast immobilization for bicortical waist fractures. Kamrani et al. [10] also contributed a minimally invasive technique for Kienböck’s disease involving capitate shortening, reflecting ongoing innovations in carpal pathology management.

Trigger Finger and Tendon Pathology

Articles in this cluster focus on the diagnosis, treatment, and surgical nuances of trigger finger and related tendon conditions. Suárez Cabañas et al. [4] compared shockwave therapy versus corticosteroid infiltration, noting superior long-term pain relief with shockwave therapy. Magtoto et al. [18] described a stepwise surgical approach for persistent triggering distal to the A2 pulley, a challenging scenario. Additionally, Woo et al. [2] investigated subtendinous connective tissue restraints affecting extension in vascularized toe joint transfers, a procedure often utilized for complex tendon and joint reconstruction. These studies highlight both conservative and advanced surgical options for tendon disorders.

Nerve Injuries and Anatomical Variants

This theme encompasses studies on nerve compression, surgical safety, and anatomical variations. Karadağ et al. [1] evaluated surgical outcomes for neuropathies caused by benign soft tissue tumors, showing significant functional improvement post-excision. Vhanda and Arenas-Prat [8] highlighted a proximal origin transligamentous recurrent motor branch of the median nerve, warning of a new danger zone during carpal tunnel release. Furthermore, Zander et al. [14] found that radiographic alignment after scapholunate ligament reconstruction did not correlate with patient-reported symptoms, suggesting clinical outcomes may depend on factors beyond simple anatomical restoration. These articles emphasize the need for anatomical awareness and careful patient counseling.

Perioperative Care and Surgical History

The final theme covers perioperative management considerations and historical perspectives in hand surgery. Song et al. [19] reviewed current concepts regarding patients taking GLP-1 receptor agonists, noting limited evidence of increased complications despite theoretical aspiration risks. Koehler and Ayhan [17] provided an update on Wide-Awake Local Anesthesia No Tourniquet (WALANT) techniques, reflecting evolving anesthesia practices. Finally, Little [20] reviewed a biography of Dr. Sterling Bunnell, honoring the founding father of modern hand surgery. These articles address the broader clinical context, including patient comorbidities, anesthesia choices, and the historical evolution of the specialty.

Articles by Theme

Trapeziometacarpal Arthroplasty Outcomes (3)

3. Herren DB, Mathis KH, Schindele S, et al. Determinants of patient satisfaction 5 years after dual-mobility trapeziometacarpal joint implant arthroplasty. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261468204

This registry-based study identified determinants of patient satisfaction five years after dual-mobility trapeziometacarpal joint implant arthroplasty. Higher satisfaction was significantly associated with lower pain levels and better hand function scores at the five-year mark. These results highlight the importance of long-term pain management and functional preservation in achieving sustained patient satisfaction after this procedure.

6. Herren DB, Marks M. Response to ‘Learning from Charnley: implant retrieval in modern hand surgery’. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261467264

This response letter agrees with the need for implant retrieval and failure analysis in hand surgery, framing it within the broader context of responsible innovation. The authors caution against pseudo-innovation that introduces technologies without sufficient evidence or understanding of long-term consequences. This perspective emphasizes the ethical responsibility of surgeons to ensure new implant technologies are rigorously evaluated before widespread adoption.

9. Stilling M, B Hansen T, Thillemann JK. A five-year radiostereometry study of cup fixation and implant survival in 484 Moovis trapeziometacarpal arthroplasties. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261459885

This study evaluated the fixation and survival of 484 Moovis trapeziometacarpal implants using radiostereometry and clinical outcomes over five to nine years. The findings demonstrated minimal cup migration and high implant survival rates, indicating stable long-term fixation. These results support the Moovis cup as a reliable option for trapeziometacarpal arthroplasty with low risk of aseptic loosening.

Distal Radius and Scaphoid Fracture Management (4)

10. Kamrani RS, Baroutkoub M, Kamrani S, et al. Treatment of Kienböck’s disease with capitate shortening and retrograde intermetacarpal screw fixation. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261460278

The authors describe a minimally invasive technique for treating Kienböck’s disease involving capitate shortening osteotomy and retrograde intermetacarpal screw fixation. This approach offers advantages such as reduced soft-tissue exposure and more central screw placement within the capitate. It provides a viable surgical alternative for managing this condition with potentially improved technical precision.

12. Turan K, Muratoğlu OG, Ergun T, et al. Integrity of pronator quadratus repair and grip strength after anterior plating of distal radial fractures. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261464018

The study examined the relationship between pronator quadratus repair integrity and functional outcomes after anterior plating of distal radial fractures. Preserved repair integrity was associated with greater grip strength at one year, although wrist motion and patient-reported scores remained similar. This suggests that while the repair aids grip strength, its overall functional contribution may be limited.

15. Assafiri I, HK Nam R, El-Mubarak A, et al. The impact of introducing a dedicated day case hand centre on the operative management of distal radial fractures. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261464419

This retrospective service assessment evaluated the impact of introducing a dedicated day case hand centre on the operative management of distal radial fractures. The implementation significantly increased same-day discharge rates from 66.4% to 98.3% and reduced mean length of stay from 19.4 to 6.6 hours without increasing complications. These findings suggest that dedicated day case pathways can substantially alleviate acute hospital bed pressure while maintaining safe surgical outcomes.

16. Zhang W, Yi C, Wu P, et al. Surgical Fixation Versus Cast Immobilization for Adults With Bicortical Scaphoid Fractures: A Target Trial Emulation of the SWIFFT Trial. Journal of the American Academy of Orthopaedic Surgeons 2026. doi:10.5435/jaaos-d-26-00386

This target trial emulation used Chinese electronic health record data to compare surgical fixation versus cast immobilization for bicortical scaphoid fractures. The results showed no notable difference in functional outcomes (DASH scores) between the two treatment groups at 52 weeks. These findings align with the UK-based SWIFFT trial, suggesting similar treatment effects across different populations.

Trigger Finger and Tendon Pathology (3)

2. Woo SJ, Lee C, Huang R, et al. The effect of subtendinous connective tissue restraints on extension of the vascularized toe joint transfer: a propensity score-matched comparison. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261459371

This propensity score-matched study compared vascularized toe joint transfers with and without dissection of subtendinous connective tissue restraints to assess their impact on extension lag. The results indicated that releasing this tissue improves extension without compromising perfusion or other functional outcomes. Clinically, this technique offers a viable method to enhance the functional results of toe joint transfers for destructive finger injuries.

4. Suárez Cabañas AH, Ramírez Sánchez M, Álvarez Jiménez A, et al. Beyond the first year: Long-term outcome of shockwave therapy versus corticosteroid infiltration in the management of trigger finger. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261466890

This prospective comparative study evaluated the long-term outcomes of extracorporeal shock wave therapy versus corticosteroid infiltration for trigger finger management. While short-term outcomes were comparable, shock wave therapy demonstrated superior long-term pain relief, maintained grip strength, and higher sustained patient satisfaction compared to corticosteroids. These findings support shock wave therapy as a durable non-invasive alternative for managing trigger finger.

18. Magtoto IJ, Sakamoto S, Hattori Y. Stepwise surgical approach for triggering distally to the A2 pulley after A1 pulley release. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261460239

The authors describe a stepwise surgical approach involving A1 pulley release, flexor digitorum superficialis slip excision, and flexor tenoplasty to treat persistent trigger finger distal to the A2 pulley. This technique successfully resolved symptoms in five fingers across four patients who had failed initial A1 pulley release. The study suggests this multi-step method is a viable salvage option for complex, distal trigger finger cases.

Nerve Injuries and Anatomical Variants (3)

1. Karadağ Z, Akkaya A, Özyaman O, et al. Surgical outcomes of upper extremity neuropathies caused by benign soft tissue tumours. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261470311

This retrospective study evaluated surgical excision outcomes for upper extremity neuropathies caused by benign soft tissue tumours in 34 patients. Postoperative assessments revealed significant improvements in functional scores and pain levels, although preoperative motor neuropathy, larger tumour volume, and diabetes were associated with worse outcomes. These findings suggest that while surgery is generally effective, specific patient and tumour characteristics should be considered when counselling regarding prognosis.

8. Vhanda J, Arenas-Prat J. Proximal origin transligamentous recurrent motor branch of the median nerve: implications for surgical safety. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261468580

This case report describes an anomalous recurrent motor branch of the median nerve with a proximal origin that traverses the transverse carpal ligament. The authors recommend a deliberate ulnar-sided and proximal-to-distal ligament division technique during carpal tunnel release to avoid injury to this variant. This anatomical variation highlights the need for heightened surgical awareness to prevent iatrogenic nerve damage.

14. Zander M, Ibsen-Sörensen A, Axelsson P, et al. Radiographic alignment is not associated with patient-reported symptoms after 360° scapholunate ligament reconstruction. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261464770

This retrospective study investigated whether radiographic alignment correlates with patient-reported symptoms after 360° scapholunate ligament reconstruction. The analysis found no association between radiographic alignment and patient-reported pain or function at a minimum of three years follow-up. This suggests that radiographic success may not directly predict clinical outcomes in these patients.

Perioperative Care and Surgical History (3)

17. Koehler SM, Ayhan E. What’s New in Wide-Awake Local Anesthesia No Tourniquet (WALANT) Hand Surgery?. Journal of Hand Surgery Global Online 2026. doi:10.1016/j.jhsg.2026.101033

This narrative review synthesizes recent evidence on Wide-Awake Local Anesthesia No Tourniquet (WALANT) across six thematic domains, including comparative outcomes, pediatric use, and environmental impact. The authors highlight that WALANT offers noninferior functional results and complication rates compared to traditional anesthesia while enhancing value-based care and sustainability. These findings support the continued expansion and adoption of WALANT in contemporary hand surgery practice.

19. Song EY, Melton MS, Hammert W, et al. Current Concepts in Perioperative Guidance and Outcomes in Hand Surgery Patients Taking Glucagon-Like Peptide-1 Receptor Agonists. The Journal of Hand Surgery 2026. doi:10.1016/j.jhsa.2026.05.008

This review examines perioperative management for hand surgery patients taking glucagon-like peptide-1 receptor agonists (GLP-1 RAs), addressing concerns regarding delayed gastric emptying and aspiration risk. Current evidence indicates no notable increase in postoperative complications, though optimal medication management and effects on wound healing remain areas of uncertainty. Surgeons are advised to understand the pharmacology and emerging data to guide clinical decision-making for this growing patient population.

20. Little KJ. Dr. Sterling Bunnell: From Son of the Gold Rush to Founding Father of Hand Surgery. The Journal of Hand Surgery 2026. doi:10.1016/j.jhsa.2026.04.002

This book review evaluates a biography of Dr. Sterling Bunnell, highlighting how his upbringing in post-Gold Rush California shaped his character and contributions to modern hand surgery. The authors praise the text for effectively situating Bunnell’s career within the historical context of the late 19th and early 20th centuries. The review concludes that the biography is a readable and informative resource for surgeons, trainees, and medical history enthusiasts.

5. Holten AK, Van Heest AE, Bauer AS, et al. Surgical treatment of radial polydactyly: a review of the Congenital Upper Limb Differences (CoULD) registry. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261459878

This review of the CoULD registry analyzed surgical treatments and complications for radial polydactyly in 230 patients. The most common procedure was excision of the radial thumb with reconstruction of the ulnar thumb, with a low overall complication rate. These data provide evidence-based guidance on surgical approaches and highlight the importance of ligament reconstruction in optimizing outcomes.

7. Bratschi CS, Weber A, Plock JA, et al. Risk factors for nail dystrophy following distal phalangeal fractures of the hand. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261456220

This retrospective study identified nail bed injury and fracture nonunion as significant independent risk factors for nail dystrophy following distal phalangeal fractures. Other factors such as nail bed suturing, fracture location, and trauma type were not independently associated with dystrophy in multivariate analysis. These findings underscore the critical importance of meticulous management of nail bed injuries and fracture stability to prevent long-term nail deformities.

11. Coquelet C, Chantelot C, Saab M. Outcomes of open dorsal proximal interphalangeal joint dislocations. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261464365

This study assessed outcomes for 25 open dorsal proximal interphalangeal joint dislocations treated without palmar plate reinsertion. While stiffness was frequent, no residual dorsal instability was observed in the patients. These findings suggest that routine palmar plate reinsertion may not be necessary for these injuries.

13. Rooth A, Kaminskaite V, Furniss D. Dupuytren’s disease: a state-of-the-art review. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261463402

This review provides a state-of-the-art overview of Dupuytren’s disease, covering its epidemiology, risk factors, and pathogenesis. It summarizes current non-surgical and surgical corrective options while discussing future directions for early-stage treatment. The article highlights that existing management techniques are primarily corrective rather than addressing the underlying biological mechanisms.

21. Kuno H, Zenke Y, Sakai A. An Anatomical Equivalence Study of the Capitate and the Second Metatarsal Head as a Donor for Lunocapitate Articular Reconstruction. The Journal of Hand Surgery 2026. doi:10.1016/j.jhsa.2026.05.001

This anatomical equivalence study compared the capitate and second metatarsal head to assess the suitability of the latter as a donor for lunocapitate articular reconstruction. Measurements demonstrated equivalence in head width and radius of curvature, with three-dimensional analysis confirming close surface congruity. These findings support the use of the second metatarsal head as a viable autograft option for reconstructing the lunocapitate joint.

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