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Current Trends in Hand Surgery
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Current Trends in Hand Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 28 April 2026 | Viewed by 2651

Special Issue Editors

Dr. Alexandre Kaempfen

E-Mail Website
Guest Editor
Department of Plastic and Hand Surgery, University Hospital of Basel, 4031 Basel, Switzerland
Interests: bone tissue engineering; paediatric hand surgery; minimally invasive hand surgery; microsurgical reconstruction
Dr. Florian Frueh

E-Mail Website
Guest Editor
Department of Plastic Surgery and Hand Surgery, Cantonal Hospital Aarau, Aarau, Switzerland
Interests: microsurgical reconstruction; peripheral nerve surgery; brachial plexus surgery; nerve transfer; mangled hand; replantation

Special Issue Information

Dear Colleagues,

Practitioners in hand surgery strive for excellence and have transformed this field in small increments over recent years. These changes show a trend towards minimally invasive procedures for common pathologies, which increase patient comfort and minimise side effects. Examples include arthroscopic and sonography-controlled procedures or customized small free tissue transfers. Currently, well-trained hand surgeons are applying orthopaedic, plastic, and microsurgical techniques and conservative treatments to improve outcomes. We invite researchers and clinicians to contribute to this Special Issue and share the latest developments in the reconstruction and improvement of hand functions.

Dr. Alexandre Kaempfen
Dr. Florian Frueh
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • microsurgery
  • minimally invasive
  • arthroscopy
  • sonography
  • nerve surgery
  • joint replacement

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Published Papers (3 papers)

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Research

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11 pages, 631 KB  
Article
The Role of Preoperative Antibiotics in Osteosynthesis of the Hand and Wrist: A Retrospective Analysis
by Anja Hunziker, Ilja Kaech, Brigitta Gahl, Konrad Mende, Dirk J. Schaefer and Alexandre Kaempfen
J. Clin. Med. 2025, 14(24), 8877; https://doi.org/10.3390/jcm14248877 - 15 Dec 2025
Viewed by 469
Abstract
Background: Preventing postoperative infections in hand surgery is an important factor for achieving sustainable results of surgical procedures. To prevent infections, especially when implants are used, preoperative prophylactic antibiotics are applied in adherence to predominantly national guidelines, which are not specifically tailored [...] Read more.
Background: Preventing postoperative infections in hand surgery is an important factor for achieving sustainable results of surgical procedures. To prevent infections, especially when implants are used, preoperative prophylactic antibiotics are applied in adherence to predominantly national guidelines, which are not specifically tailored to hand surgery. However, several studies related to elective soft tissue hand surgery indicate that the preoperative use of antibiotics does not reduce the incidence of postoperative infections. Evidence regarding their efficacy in osteosynthesis of the hand and wrist remains limited. Methods: In this retrospective study, we analyzed 542 adult patients who underwent hand or wrist osteosynthesis between 2016 and 2019 at our university center. They were enrolled in an antibiotic treatment group and a control group without antibiotic treatment. The prophylaxis group (P) underwent surgery in the main operating theater under intravenous anesthesia, whereas the non-prophylaxis group (NP) was treated under WALANT (Wide Awake Local Anesthetic No Tourniquet) in an outpatient operating theater without receiving preoperative antibiotics. Theater construction and installation were otherwise similar, and both were classified as grade 1 theaters. We applied propensity modeling and inverse probability of treatment weighting (IPTW) to achieve balanced treatment groups with respect to risk factors for infection, and we calculated the odds ratio of prophylaxis and infection. Inclusion factors for risk of infection were age, female sex, smoking, diabetes, metabolic disease, inflammatory disease, substance abuse, cardiovascular disease, hepatopathy, renal disease, polytrauma, open fracture, being a manual worker, and occupational accidents. To assess the severity of the cases, we considered whether the fractures were intraarticular, multi-fragmentary, or open, and we collected data on the types of surgical implants that were used. Results: No significant association was found between antibiotic prophylaxis and postoperative infection rate (infection rate P: 3.86%; NP: 3.27%; unadjusted OR: 1.19; adjusted OR after IPTW: 1.09). In terms of risk factors, there was an insignificant trend of higher infection rates in the subgroups smoking, cardiovascular disease, open fracture, occupational accident, and open fixations. Conclusions: In this cohort, routine use of preoperative antibiotics in hand osteosynthesis did not reduce infection rates. The effectiveness of the widespread standardized application of prophylactic antibiotics to reduce the risk of postoperative infections in osteosynthesis of the hand and wrist remains debatable. Our findings set the basis for further prospective studies aiming at clearer guidelines for evidence-based perioperative patient care. Full article
(This article belongs to the Special Issue Current Trends in Hand Surgery)
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14 pages, 6490 KB  
Article
Dorsal Cortical Alignment Predicts Functional Outcomes in Proximal Phalangeal Fractures Treated with Intramedullary Headless Compression Screws but Not in Metacarpal Fractures
by Bert Vanmierlo, Hans Lowyck, Charles Matthys, Tim Vanmierlo, Joris Duerinckx and Bert O. Eijnde
J. Clin. Med. 2025, 14(13), 4691; https://doi.org/10.3390/jcm14134691 - 2 Jul 2025
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Abstract
Background/Objectives: Intramedullary headless compression screw (IMHCS) fixation has emerged as a minimally invasive and biomechanically robust method for treating metacarpal and proximal phalangeal fractures. While the clinical outcomes are generally favorable, the impact of anatomical fracture reduction on postoperative function has not [...] Read more.
Background/Objectives: Intramedullary headless compression screw (IMHCS) fixation has emerged as a minimally invasive and biomechanically robust method for treating metacarpal and proximal phalangeal fractures. While the clinical outcomes are generally favorable, the impact of anatomical fracture reduction on postoperative function has not been systematically examined. Methods: We retrospectively analyzed 69 patients (41 metacarpal, 28 proximal phalanx) treated with IMHCSs between June 2020 and March 2025. Fractures were classified radiographically as reduced or non-reduced. Functional outcomes were assessed using the Total Active Motion (TAM) scoring system. The association between the reduction quality and TAM outcome was analyzed separately for metacarpal and proximal phalangeal fractures using the Fisher–Freeman–Halton exact test. Results: All fractures achieved radiographic union. In the metacarpal fractures, 90% of the patients attained good-to-excellent TAM scores, with no statistically significant association between the reduction quality and functional outcome (p = 0.1303). In contrast, for the proximal phalangeal fractures, anatomical reduction was significantly associated with superior TAM outcomes (p = 0.0014; Cohen’s w = 0.802). The postoperative radiographs in this group revealed smooth dorsal cortical alignment in the patients with good outcomes, suggesting preserved tendon gliding surfaces. Conclusions: Anatomical fracture reduction significantly predicts postoperative function in proximal phalangeal fractures treated with IMHCSs. In contrast, metacarpal fractures appear more tolerant of minor malalignment. These findings underscore the importance of achieving cortical continuity in phalangeal fractures to optimize digital biomechanics. A minimal open approach should be considered to ensure proper alignment during IMHCS fixation. Full article
(This article belongs to the Special Issue Current Trends in Hand Surgery)
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Other

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10 pages, 4796 KB  
Case Report
3D-Planned, Patient-Specific Distal Radius Reconstruction with a Vascularized Double-Barrel Free Fibular Graft After Secondary Aneurysmal Bone Cyst
by Bita Kallenbach, Philipp Honigmann, Martin Haug and Marco Keller
J. Clin. Med. 2026, 15(5), 1857; https://doi.org/10.3390/jcm15051857 - 28 Feb 2026
Viewed by 312
Abstract
Background/Objectives: An Aneurysmal Bone Cyst (ABC) is a rare benign osteolytic bone lesion with locally destroying growth. It occurs mostly in the first two decades of life, rarely in older patients, and commonly affects the metaphysis. Clinical presentation includes pain and pathologic [...] Read more.
Background/Objectives: An Aneurysmal Bone Cyst (ABC) is a rare benign osteolytic bone lesion with locally destroying growth. It occurs mostly in the first two decades of life, rarely in older patients, and commonly affects the metaphysis. Clinical presentation includes pain and pathologic fractures. While most ABCs occur as primary lesions, there is an entity of secondary (reactive) ABC following osseous lesions such as fractures. We report a rare case of a secondary aneurysmal bone cyst of the distal radius following a distal radius fracture 4 years prior, with subsequent treatment and reconstruction. Methods: A 67-year-old female patient presented with a pathologic distal forearm fracture with radiologically expansive lytic bone lesion of the metaphysis of the distal radius, suspicious of an ABC. A biopsy and primary fracture management with an external fixator were performed due to the unclear dignity of the lesion. The diagnosis of an ABC was confirmed in the biopsy. The tumor resection and reconstruction were performed with a vascularized free fibula graft (ipsilateral, double barrel), using patient-specific 3D-printed osteotomy templates. Results: Follow-up radiographs showed excellent bone union with progressive remodeling. The functional outcome was very good with almost the same range of motion and grip strength as the contralateral side. No limitation in everyday life and no donor site morbidity was reported. Conclusions: ABC is a rare benign bone tumor the treatment of which consists of complete resection and reconstruction. Reconstruction of the distal radius can be achieved with a fibula graft. In our case, an excellent result was achieved with patient-specific osteotomy templates. Only a few cases of ABC in the distal radius and at this age have been reported; nevertheless, it should be considered as a differential diagnosis for osteolytic bone lesions Full article
(This article belongs to the Special Issue Current Trends in Hand Surgery)
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