J Hand Microsurg
· 2026 Mar · PMID 41623414
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BACKGROUND: Digital nerve injuries can result in significant sensory impairment, and reconstruction of segmental defects remains challenging when tension-free primary repair is not feasible. Processed nerve allograft (PN...BACKGROUND: Digital nerve injuries can result in significant sensory impairment, and reconstruction of segmental defects remains challenging when tension-free primary repair is not feasible. Processed nerve allograft (PNA) provides a biological scaffold without donor-site morbidity; however, reported outcomes vary, and there is limited focused evidence for digital nerve reconstruction. This systematic review and pooled analysis evaluated sensory and functional outcomes following digital nerve reconstruction using PNA. METHODS: PubMed, Embase, and Scopus were searched for studies reporting clinical outcomes of digital nerve reconstruction using PNA. Eligible studies included human digital nerve reconstructions with quantitative sensory outcomes such as static two-point discrimination (s2PD), moving two-point discrimination (m2PD), or meaningful sensory recovery. Data regarding demographics, defect characteristics, outcomes, and complications were extracted. Pooled analyses for continuous and proportional outcomes were performed using random-effects models. RESULTS: Sixteen studies, with 664 patients and 886 allografts, demonstrated consistent sensory improvement after PNA reconstruction. Pooled s2PD averaged approximately 7-8 mm, while m2PD averaged 5-6 mm. Meaningful sensory recovery was achieved in over 80 % of reconstructions. Complication and infection rates were low, with no significant graft-related adverse events reported. Although clinical outcomes were favourable, notable heterogeneity was observed in study design, outcome measures, and follow-up duration. CONCLUSION: A processed nerve allograft provides generally favourable sensory recovery in most reported series, in digital nerve gap reconstruction, with low complication rates, and offers an effective alternative to autograft when primary repair is not possible. Standardised outcome measures and prospective comparative studies are needed to refine patient selection and define predictors of optimal recovery.
J Hand Microsurg
· 2026 Mar · PMID 41623413
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Osteomyelitis and tumors of the wrist present a unique reconstructive challenge, as proper debridement or resection often leaves large, complex defects that can involve the articular surfaces of the distal radius and car...Osteomyelitis and tumors of the wrist present a unique reconstructive challenge, as proper debridement or resection often leaves large, complex defects that can involve the articular surfaces of the distal radius and carpus. Non-vascularized bone grafts are often ineffective in this setting, resulting in resorption or high nonunion rates. Vascularized bone flaps (VBF) represent an ideal reconstructive option for wrist reconstruction and arthrodesis in challenging recipient sites due to their rich, inherent blood supply, superior structural strength and regenerative properties allowing them to heal via primary union and undergo adaptive hypertrophy. VBF arthrodesis for tumor reconstruction demonstrates superior functional outcomes, improved tumor control, and more durable constructs especially in irradiated beds. Similarly, VBF arthrodesis for osteomyelitis creates an infection-resistant construct that can effectively support the mechanical demands of the wrist and optimize long-term patient reported outcomes for quality-of-life optimization. This review will cover common presentations for osteomyelitis and tumors of the wrist with case examples, principles of wrist arthrodesis, and donor site options.
J Hand Microsurg
· 2026 Mar · PMID 41550119
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PURPOSE: The thumb carpometacarpal (CMC) joint is one of the most common sites for osteoarthritis. It is often treated with basal joint arthroplasty (BJA), a procedure known for high patient satisfaction. Despite this, e...PURPOSE: The thumb carpometacarpal (CMC) joint is one of the most common sites for osteoarthritis. It is often treated with basal joint arthroplasty (BJA), a procedure known for high patient satisfaction. Despite this, early reoperations following BJA still occur and remain poorly understood. To address this gap, the TriNetX database was used to gain better insights into the frequency and underlying circumstances around early reoperations to better inform patients and surgeons. The study hypothesis was that the rate of reoperation following BJA surgery is low. METHODS: This is a retrospective cohort study analyzing patient data from 2017 to 2023 on TriNetX Research Network. Query initially included patients with unilateral thumb CMC arthritis who underwent index thumb BJA and further refined to include early reoperation. This was defined as any patient who had at least one relevant reoperation within 2 years of the index surgery. Demographics and clinical characteristics were compared; statistical analysis with Z-Test was performed to assess significant differences over the study period. RESULTS: A query for patients with an index thumb BJA surgery performed during the study period returned 9853 patients. There was a total of 757 patients having at least one documented additional surgery within 2 years of the index BJA, yielding a reoperation rate of 8 %. Among these reoperations, 63 % were deemed to involve a revision or reconstructive procedure indicating failure of the index BJA, while the remaining 37 % represented accessory surgeries such as cyst excision and tenosynovectomies which may not directly be related to the index BJA. The reoperation group was older and had a higher rate of obesity (P < 0.05). SUMMARY POINTS: Early reoperation rates following thumb BJA is approximately 8 % at 2 years postoperatively, with approximately 5 % representing potentially a failure requiring revision of the index surgery. Increasing age and obesity were risk factors for reoperation. Technique-specific reoperation cannot be determined by this study.
J Hand Microsurg
· 2026 Mar · PMID 41550117
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BACKGROUND: Carpal tunnel release (CTR) is a common surgery with a well-described complication profile, but it is unclear whether patients' self-reported risk acceptance is higher than, equal to, or lower than actual sur...BACKGROUND: Carpal tunnel release (CTR) is a common surgery with a well-described complication profile, but it is unclear whether patients' self-reported risk acceptance is higher than, equal to, or lower than actual surgical risks. We aimed to investigate patients' self-reported levels of risk acceptance for complications of CTR, factors associated with higher risk acceptance, and whether PROMIS Upper Extremity, PROMIS Pain Interference, and PROMIS Pain Intensity scores correlate with risk acceptance. METHODS: A prospective, cross-sectional study was conducted of 47 adult patients with idiopathic carpal tunnel syndrome (CTS) who were indicated for mini-open CTR using a standard published technique with a well-described complication profile. A standardized questionnaire was used to survey patients about the highest acceptable risk of infection, persistent or recurrent symptoms, and nerve or vessel injury as a percentage from 0 % to 100 %. Our explanatory variables included PROMIS Upper Extremity, PROMIS Pain Interference, PROMIS Pain Intensity, and other patient-related factors. RESULTS: The median patient-reported risk acceptance for infection after CTR surgery was 30 % (interquartile range 10 %-50 %), for persistent or recurrent symptoms was 40 % (interquartile range 20 %-50 %), and for nerve or vessel injury was 20 % (interquartile range 10 %-50 %). Diabetes mellitus was associated with higher risk acceptance for nerve or vessel injury during CTR. Lower PROMIS Upper Extremity scores were weakly correlated with higher risk acceptance for nerve or vessel injury during CTR. Higher PROMIS Pain Interference scores were weakly correlated with higher risk acceptance for persistent or recurrent symptoms after CTR. CONCLUSIONS: The actual risks of common complications after CTR are much lower than most patients' self-reported risk acceptance. The severity of preoperative CTS symptoms affects patients' acceptance of the risk of surgical complications and symptom persistence after CTR.
J Hand Microsurg
· 2026 Mar · PMID 41550116
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INTRODUCTION: The use of intramedullary screw fixation for proximal phalanx fractures has gained popularity recently due to its ability to provide rigid fracture fixation whilst allowing early mobilization and rehabilita...INTRODUCTION: The use of intramedullary screw fixation for proximal phalanx fractures has gained popularity recently due to its ability to provide rigid fracture fixation whilst allowing early mobilization and rehabilitation. However, few reviews explored the complications of this surgical method on proximal phalanx fractures despite an increasing number of clinical series. This review aims at providing an updated analysis on the complications of intramedullary screw fixation on proximal phalanx fractures. METHODS: A systematic literature search was performed using PubMed, Ovid MEDLINE, Embase, and Cochrane Controlled Register of Trials. All primary research studies were identified and screened in accordance with the PRISMA guidelines. Complications were reported qualitatively and were analyzed using descriptive statistics and an exploratory meta-analysis of proportions. RESULTS: 12 studies were included in the systematic review among 657 studies identified from database search. A total of 301 proximal phalanx fractures were included, with an overall mean follow-up period of 90.1 weeks. The overall complication rate of 10.0 % (30/301; 95 % CI: 6.6 %-13.4 %). The most common complication was delayed union (n = 8), followed by loss of reduction (n = 6), and screw impingement, discomfort or pain (n = 6). 18 patients received revision surgery, yielding a revision surgery rate of 6.0 % (18/301; 95 % CI: 3.3 %-8.7 %). Most revision surgeries (15 out of 18) involved screw removal. 2 cases underwent revision fixation and 3 cases received splintage for extension lag. CONCLUSION: While intramedullary screw fixation offers stable fixation for early mobilization of proximal phalangeal fractures, surgeons need to be aware of the common complications associated with the procedure.
Wang GY, Hu JN, Zhai RK
… +3 more, Mai Tu di MMTY, Tian X, Dong JM
J Hand Microsurg
· 2026 Mar · PMID 41550114
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BACKGROUND: Varus-posteromedial rotatory instability (VPMRI) of the elbow is a relatively uncommon yet significant injury that can often present with subtle clinical symptoms, such as mild joint misalignment. These initi...BACKGROUND: Varus-posteromedial rotatory instability (VPMRI) of the elbow is a relatively uncommon yet significant injury that can often present with subtle clinical symptoms, such as mild joint misalignment. These initial symptoms may be easily overlooked or misdiagnosed, especially in the absence of overt signs of instability. As a result, the injury is frequently missed in early stages, leading to improper or delayed treatment. If left untreated, VPMRI can result in severe long-term complications, including rapid joint degeneration, traumatic arthritis, heterotopic ossification, elbow stiffness, and ulnar nerve entrapment. The progressive nature of these issues can lead to permanent functional impairment and reduced quality of life. METHODS: A comprehensive literature review was performed to investigate the study objective. RESULTS: By examining both conservative and surgical interventions, the review provides a comprehensive understanding of this injury, emphasizing the importance of early diagnosis and appropriate management. Understanding the specific forces involved, such as axial loading, varus stress, and forearm pronation, is crucial for developing effective treatment strategies. CONCLUSION: Early intervention can prevent long-term complications and improve functional outcomes, making timely and accurate diagnosis essential for optimal care.
Gotani H, Miyashima Y, Charoenpol T
… +7 more, Sasaki K, Yagi H, Siripoonyothai S, Tsujimoto J, Kimura H, Murakami Y, Tsuchiya T
J Hand Microsurg
· 2026 Jan · PMID 41536813
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PURPOSE: The purpose of this study was to introduce the thumb reconstruction technique both by microsurgical reconstruction using a great toe transfer and dual bone lengthening technique with an Ilizarov mini-fixator for...PURPOSE: The purpose of this study was to introduce the thumb reconstruction technique both by microsurgical reconstruction using a great toe transfer and dual bone lengthening technique with an Ilizarov mini-fixator for the fingers. METHODS: The great toe was transferred to the amputated thumb, followed by a bone lengthening procedure for the residual metacarpal bone to enable easy pinching. During the metacarpal bone lengthening, osteotomy was performed at two sites to shorten the period of bone fusion. RESULTS: The great toe transfer was performed successfully and metacarpal bone fusion was achieved earlier than usual by dual osteotomy technique, allowing the patients to eventually resume their previous jobs. CONCLUSION: Our procedure reported herein, i.e., great toe transfer by microsurgery + dual osteotomy distraction lengthening, seems to serve as a useful procedure for thumb reconstruction from both cosmetic and functional improvement.
Tos P, Ciclamini D, Crosio A
… +2 more, Cecconato V, Battiston B
J Hand Microsurg
· 2026 Jan · PMID 41502985
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BACKGROUND: Large post-traumatic defects of the lateral malleolus are uncommon but present major reconstructive challenges, particularly in the presence of segmental bone loss, infection, or soft-tissue compromise. The l...BACKGROUND: Large post-traumatic defects of the lateral malleolus are uncommon but present major reconstructive challenges, particularly in the presence of segmental bone loss, infection, or soft-tissue compromise. The lateral malleolus is essential for ankle stability, and its absence leads to mechanical imbalance and early degenerative changes. Traditional solutions-including non-vascularized grafts, allografts, arthrodesis, or fibular transfers-may be inadequate when biological conditions are poor or when three-dimensional reconstruction is required. Vascularized bone flaps offer improved union rates and enhanced resistance to infection. The vascularized iliac crest flap, although well-established in limb reconstruction, remains infrequently reported for distal fibula restoration. METHODS: Three patients with severe post-traumatic lateral malleolar defects were treated between 2002 and 2015 at two microsurgical centers. Reconstruction was performed using free vascularized iliac crest flaps based on the deep circumflex iliac artery. Flap configuration (osteo-muscular or osteo-cutaneous) was adapted to defect size and soft-tissue requirements. Technical details-including flap harvest, shaping of the iliac crest segment, fixation, and vascular anastomoses-are described. Clinical and radiographic outcomes were evaluated over 8-14 years. RESULTS: All flaps survived without major postoperative complications. Radiographs demonstrated consistent osseous union between the iliac crest graft and tibia. All patients achieved full weight-bearing and stable ankle function. Mild-to-moderate radiographic osteoarthritis occurred at long-term follow-up but remained asymptomatic. Soft-tissue coverage was reliable, and no secondary flap procedures were required. CONCLUSIONS: The free vascularized iliac crest flap is a dependable and versatile reconstructive option for extensive lateral malleolar defects. It provides stable ankle restoration, predictable union, and durable function, and should be considered when conventional grafting or fibular transfers are unsuitable, particularly in complex post-traumatic or infected environments.
Nguyen JD, Chen AJ, Khong J
… +5 more, Snee IA, Quach M, Elhelali A, Tuffaha SH, Dellon AL
J Hand Microsurg
· 2026 Jan · PMID 41487286
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BACKGROUND: Breast surgery carries the risk of intercostal nerve injuries, with symptoms ranging from sensory disturbances to chronic pain. This study characterizes post-operative intercostal nerve injuries following bre...BACKGROUND: Breast surgery carries the risk of intercostal nerve injuries, with symptoms ranging from sensory disturbances to chronic pain. This study characterizes post-operative intercostal nerve injuries following breast surgery and available microsurgical management options. METHODS: A systematic review was conducted using PubMed, Embase, Web of Science, and Scopus for the years 2003-2024. The primary inclusion criteria was a patient experiencing any neuropathic symptoms (defined as pain or sensory changes) following mastectomy, breast reconstruction, or aesthetic breast surgery. RESULTS: Of 514 unique studies, 39 (n = 9083 patients) were included. The procedures included breast augmentation (n = 6291, 69.3 %), mastectomy without reconstruction (n = 1701, 18.7 %), mastectomy with reconstruction (n = 654, 7.2 %), and breast reduction (n = 434, 4.9 %). After these procedures, 1144 (12.6 %) patients experienced chronic pain and 135 (1.8 %) had nerve injuries, consisting of intercostal nerves (n = 133, 98.5 %) or brachial plexus nerves (n = 2, 1.5 %). Of patients with nerve injuries, 23 (9.2 %) underwent surgical interventions, which included neurectomy (n = 11, 47.8 %), neuroma excision (n = 10, 43.5 %), implant removal (n = 8, 34.8 %), and dorsal rhizotomy (n = 1, 4.3 %). CONCLUSION: This study demonstrates a substantial risk of chronic pain and peripheral nerve injuries following breast surgery. The low utilization of surgical options (4.6 %) may indicate limited patient unawareness of the pain relief which microsurgical intervention offers when conservative approaches fail in reduction or resolution of symptoms.
Reinoso T, Rowe E, Kirby D
… +2 more, Ramtin S, Ilyas AM
J Hand Microsurg
· 2026 Jan · PMID 41480576
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BACKGROUND: Various modalities exist for repairing transected nerves not amenable to primary repair; including, autograft, vein graft, conduit, and allograft. The study was hypothesis was that there is increasing utiliza...BACKGROUND: Various modalities exist for repairing transected nerves not amenable to primary repair; including, autograft, vein graft, conduit, and allograft. The study was hypothesis was that there is increasing utilization of allografts for peripheral nerve repairs. MATERIALS & METHODS: The TriNetX Research Network was queried from 2002 to 2022 for all patients undergoing peripheral nerve repair. Demographic information, usage patterns, and comorbidities associated with different grafting methods by CPT were extracted and analyzed. RESULTS: Out of 33,262 patients undergoing peripheral nerve repair, 31,756 with available demographic data were identified and included. Primary repair cases totaled 17,159, followed by conduit (n = 9282), allograft (n = 3582), autograft (n = 2886), and vein autograft (n = 353). Noting that a cpt for an allograft was introduced in 2017, a logistical regression analysis was performed to further sub-analyze allograft usage. The utilization of allografts significantly increased in 2021-2022 compared to 2019-2020, with an odds ratio (OR) of 1.4 (95 % confidence interval [CI]: 1.1-1.7; P = 0.001), indicating a greater increase compared to autograft utilization during the same interval. The mean per-year rate of change (range) between 2017 and 2022 for nerve allograft, conduit, autograft and vein autograft was +93.4 (+16.5 to +176.5), +6.3 (-37 to +45), -1.4 (-7.5 to +7.5), and +2 (-2.5 to +6.5), respectively. CONCLUSION: This study presents a twenty-year analysis of the changing trends in nerve repair and grafting techniques employed by nerve surgeons. Conduit repair has remained a major grafting technique used among surgeons. However, since its introduction, nerve allograft repair demonstrates a consistent positive upward trend in usage within the last 6 years, In contrast, autograft usage has decreased while vein graft usage is least common with a less relevant change in usage. These trends suggest an increasing preference for allograft, potentially displacing other nerve grafting methods, including autografting.
Boutros M, Awad G, Saad JP
… +3 more, Hamdan KB, Hamdan MB, Elhassan B
J Hand Microsurg
· 2026 Jan · PMID 41480575
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BACKGROUND: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper extremity. In addition to traditional open carpal tunnel release (OCTR), endoscopic (ECTR) and mini-open (MOCTR) approaches h...BACKGROUND: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper extremity. In addition to traditional open carpal tunnel release (OCTR), endoscopic (ECTR) and mini-open (MOCTR) approaches have been developed as minimally invasive alternatives. However, comparative evidence regarding their clinical efficacy and safety remains inconsistent. METHODS: A systematic review and meta-analysis were performed according to PRISMA guidelines, including 44 comparative studies (38 comparing ECTR vs OCTR and 6 comparing ECTR vs MOCTR) involving adult patients with idiopathic CTS. Outcomes extracted included pain (VAS), functional scores (BCTQ-SSS, BCTQ-FSS, DASH), grip and pinch strength, sensory symptoms, and complications such as pillar pain, nerve injury, opioid use, and revision CTR. RESULTS: Across all functional measures (DASH, BCTQ-FSS, BCTQ-SSS), pain, and sensory outcomes, pooled analyses demonstrated no statistically significant differences between ECTR, OCTR, and MOCTR. Grip and pinch strength were also comparable, indicating equivalent long-term motor recovery. Postoperative VAS pain scores did not differ significantly between ECTR and OCTR (p = 0.10). Nerve injury also showed no significant difference between techniques in the random-effects model (p = 0.56). Opioid prescription rates were similar across groups. Notably, ECTR demonstrated a significantly lower revision CTR rate compared with OCTR (risk ratio = 0.46, 95 % CI 0.29-0.73; p = 0.0009). CONCLUSION: Open, mini-open, and endoscopic carpal tunnel release techniques provide comparable outcomes in pain relief, functional recovery, strength, sensory symptoms, and overall safety for idiopathic CTS. Although revision CTR occurred less frequently after ECTR in the pooled analysis, the clinical significance of this difference remains uncertain. Technique selection should therefore be individualized based on surgeon expertise, patient priorities, and resource availability.
Crosio A, Mijno E, Monticelli L
… +6 more, Fissore F, Giacalone F, Bertolini M, Ciclamini D, Titolo P, Battiston B
J Hand Microsurg
· 2026 Jan · PMID 41437978
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INTRODUCTION: Traumatic lower-limb amputations and severe leg injuries may necessitate below-knee amputation when replantation or reconstruction is not feasible. In these situations, tibial bone and soft tissue may be in...INTRODUCTION: Traumatic lower-limb amputations and severe leg injuries may necessitate below-knee amputation when replantation or reconstruction is not feasible. In these situations, tibial bone and soft tissue may be insufficient to preserve the knee. The use of tissue from the amputated part, particularly the foot fillet flap, can allow knee salvage with significant functional benefit. The foot fillet flap is a composite flap that can be designed as pedicled or free, depending on injury characteristics. However, venous insufficiency remains a potential complication. This study investigated the venous drainage of the flap using cadaveric specimens. MATERIALS AND METHODS: Five fresh-frozen lower limbs were prepared and injected with colored latex into both the superficial and deep venous systems. Flaps were then dissected to analyze venous drainage pathways. RESULTS: Injection of the superficial system demonstrated that medial and lateral dorsal skin territories were not interconnected. Both territories showed perforating connections with the anterior tibial veins. Additional connections were identified between the deep system and the peroneal veins. These findings indicate that in large foot fillet flaps, approximately 230 cm in size, reliable venous drainage requires inclusion of both the medial system (great saphenous vein or tibial veins) and the small saphenous vein. Alternatively, the anterior tibial veins may provide sufficient outflow, as they appear capable of collecting venous blood from both systems. CONCLUSIONS: For extensive foot fillet flaps, optimal venous drainage can be achieved either by combining medial and lateral systems or by utilizing the anterior tibial veins. From a practical perspective, extending the plantar and medial ankle skin-territories drained by the posterior tibial and great saphenous veins-may allow reliance on a single venous system, thereby reducing the risk of venous congestion.
J Hand Microsurg
· 2026 Jan · PMID 41437977
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INTRODUCTION: The "Eve" procedure is a vascularized composite flap consisting of rib, cartilage, serratus anterior muscle, and fascia. We aimed to re-assess its role in metacarpal reconstruction by means of a literature...INTRODUCTION: The "Eve" procedure is a vascularized composite flap consisting of rib, cartilage, serratus anterior muscle, and fascia. We aimed to re-assess its role in metacarpal reconstruction by means of a literature review and by evaluating the long term outcomes in two cases after a follow-up of more than 30 years. The long term structural stability of the bone and the functional value of the neo-joint were the focus of assessment. METHODS: A literature review was conducted using PubMed with key terms related to the Eve procedure and metacarpal reconstruction. The two cases published in 1996 were followed more than 30 years later with a clinical and radiological examination. RESULTS: Since its introduction, the Eve procedure has been reported in 14 patients across various case series. The robust vascularization, muscle coverage for debrided areas, anatomical suitability for metacarpal dimensions, and low rate of donor site complications are amongst its benefits. No other bone flap can offer the same advantages with a safe donor site complications profile. Different joint and metacarpal reconstruction techniques have been elaborated. The clinical scenario usually dictates the possible options for joint reconstruction. In the two original cases, long term follow-up confirmed durable bone integration and preservation of joint space. Imaging showed intact cartilage acting as a joint spacer rather than enabling motion. Functional thumb opposition allowing power grip was achieved through dynamic first webspace reconstruction using the serratus muscle slip. Patient satisfaction with the reconstructed functional hand was high in both cases. CONCLUSION: The serratus anterior-rib composite flap remains a valuable one-stage reconstructive option in young patients with complex metacarpal defects involving bone and soft tissue loss. Although the vascularized cartilage does not reliably restore joint motion, it contributes to long term structural joint space preservation. Given the low donor site morbidity and positive anatomical, functional, economical and aesthetic outcomes, the Eve procedure still holds clinical value in carefully selected trauma cases.
J Hand Microsurg
· 2026 Jan · PMID 41437976
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Football continues to be one of the most popular sports in the United States. It is associated with a high rate of injuries, particularly to the upper extremity. Outside data on professional play, there is limited data o...Football continues to be one of the most popular sports in the United States. It is associated with a high rate of injuries, particularly to the upper extremity. Outside data on professional play, there is limited data on the epidemiologic trends of these injuries in other participant groups. The purpose of this study was to analyze the incidence and demographic trends of football related hand and finger injuries presenting the U.S. emergency departments from 2013 to 2022. The National Electronic Injury Surveillance System (NEISS) database was queried for football related injuries to the hand and fingers over the 10-year study period. Demographics, injury characteristics, and injury location were analyzed. An Estimated 257,052 football related hand and finger injuries were reported. Finger injuries were more common than hand injuries. Most injuries were fractures. Males accounted for 89 % of cases with the 10-19 age group compromising 75.6 % of injuries. The most common injury settings were recreational sports venues (46.6%) and schools (19.6%). Injury incidence peaked in September and most commonly occurred on Mondays. These findings can inform clinician and coaches to guide injury prevention and return to play programs.
Esmati H, de Jong T, Jochem KY
… +3 more, Stirler VMA, van Doremalen RFM, Rakhorst HA
J Hand Microsurg
· 2026 Jan · PMID 41404637
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Three-dimensional (3D) technology has rapidly evolved from an innovative concept into an essential surgical tool. The increasing availability of high-resolution imaging, affordable 3D printers and user-friendly software...Three-dimensional (3D) technology has rapidly evolved from an innovative concept into an essential surgical tool. The increasing availability of high-resolution imaging, affordable 3D printers and user-friendly software has accelerated the integration of 3D technology into clinical practice, including upper extremity surgery. Despite the growing interest, many surgeons remain uncertain about how to practically implement this technique in clinical workflows. This review illustrates the clinical use of 3D technology in upper extremity bone defect reconstruction. We highlight both the preoperative and intraoperative applications of 3D technology, illustrated by detailed case examples. We also provide a practical guideline to support clinicians in adopting 3D technology as part of their routine surgical practice.