Introduction Isolated single-digit clubbing is an uncommon clinical finding that has been reported mainly in isolated case reports describing benign tumors of the distal phalanx, with limited characterization in the hand surgery literature. Methods A retrospective chart review was performed of patients presenting with single-digit clubbing to a tertiary referral center between 2006 and 2023. Patients with diffuse or bilateral clubbing, prior local trauma or infection, or systemic disease associated with clubbing were excluded. Medical records were reviewed for demographic information, clinical presentation, physical examination findings, imaging studies, histopathologic diagnosis, and postoperative outcomes. Results Six patients (4 women, 2 men; median age, 32 years) presented with progressive isolated clubbing and nail deformity involving a single digit, most commonly the middle finger (n = 4) and less commonly the index finger (n = 2). The median time from symptom onset to referral was 2 years (range, 1-10 years; mean, 3.2 years). All patients underwent clinical and radiographic evaluation and subsequently surgical excision, with histopathology demonstrating osteoid osteoma in five patients and enchondroma in one. Following operative treatment, all osteoid osteoma patients showed complete resolution of clubbing, whereas the enchondroma patient showed significant but incomplete improvement, with persistent residual clubbing. No complications, revision procedures, or recurrences were documented during a median postoperative follow-up of 7 years (range, 3-17 years). Conclusion Isolated single-digit clubbing is an uncommon but recognizable clinical finding that may be associated with benign distal phalanx tumors. In patients presenting with chronic pain and nail deformity in the absence of systemic illness or trauma, this physical sign should prompt evaluation for localized distal phalanx pathology. Level of Evidence Therapeutic Level V.

BACKGROUND:Scaphoid non-union with humpback deformity is commonly managed with volar structural bone grafting. This meta-analysis compares outcomes of distal radius bone graft (DRBG) versus iliac crest bone graft (ICBG). METHODS:Following PRISMA guidelines (PROSPERO CRD420251106177), MEDLINE, Embase, ClinicalTrials, and SPORTDiscus were searched to March 1, 2026. Comparative adult studies of scaphoid non-union with humpback deformity treated via volar DRBG or ICBG with headless compression screw fixation were included. Primary analysis pooled vascularized and non-vascularized grafts; subgroup analysis compared non-vascularized grafts. RESULTS:Three studies (166 patients; 73 DRBG, 93 ICBG) were included. No statistically significant difference was detected between the union rates reported across the included studies (DRBG: 87-100%; ICBG: 79-96%) (P = 0.33). Time to union favored DRBG by a mean of 1.02 weeks (P = 0.006), although the magnitude of this difference is unlikely to be clinically meaningful. Grip strength, pinch strength, and range of motion showed no significant differences (P ≥ 0.42). In the non-vascularized subgroup (2 studies, 126 patients), union remained similar (P = 0.64) while Mayo Wrist Score favored DRBG (MD = 3.45; P = 0.03). ICBG had higher donor-site morbidity, specifically persistent pain and hematomas (20% vs. 0%). Certainty of evidence was very low. CONCLUSION:DRBG and ICBG showed no detectable differences in union or most functional outcomes. DRBG may be associated with lower donor-site morbidity; however, this observation was based on two studies and could not be quantitatively pooled. Although time to union and subgroup functional outcomes favored DRBG, findings are based on very low certainty evidence and limited data, may lack clinical significance, and warrant caution.

The 4-corner and 3-corner fusions are established treatments for scapholunate and scaphoid nonunion advanced collapse arthritis, effectively alleviating pain while maintaining partial mobility. Traditionally performed via open techniques, advancements in arthroscopy now allow for minimally invasive approaches that may prove to reduce complications and accelerate recovery. Various fixation methods, including compression screws, dorsal plates, staples, and Kirschner wires influence stability and outcomes. Although arthroscopic approaches show promise in preserving motion and grip strength, long-term comparative data remain limited. The choice of technique should be tailored to patient needs, surgeon expertise, and anatomic considerations, balancing pain relief with functional restoration.

PURPOSE:To systematically review the clinical presentation, imaging findings, arthroscopic characteristics, and treatment outcomes of dorsal wrist capsular impingement, a distinct cause of chronic dorsal wrist pain. METHODS:A review was performed in accordance with PRISMA guidelines. MEDLINE, EMBASE, CENTRAL, and CINAHL were searched from inception to January 11, 2026. Eligible studies included patients diagnosed with dorsal wrist capsular impingement. Data were synthesized narratively. RESULTS:Six studies comprising 231 patients (233 wrists) met inclusion criteria. Age ranged from 27 to 42 years, and 53% of patients were male (122/231). Follow-up ranged from 6 to 42 months. All patients presented with dorsal-central wrist pain (231/231, 100%). Extension-provoked pain was reported in 177 wrists (77%) and in all patients in the five studies describing this symptom. MRI findings were inconsistently reported and demonstrated limited correlation with intraoperative pathology. Across four studies, hypertrophied or redundant dorsal capsular tissue interposed within the radiocarpal joint was identified in all evaluated wrists (66/66, 100%). Following arthroscopic debridement, most treated wrists demonstrated postoperative pain reduction. QuickDASH scores improved across studies, decreasing from approximately 33-49 preoperatively to 4.8-17 at 3-12 months postoperatively. Recurrence was uncommon (2 wrists, 1%), and complications were rare. CONCLUSION:Dorsal wrist capsular impingement presents with chronic, extension-provoked dorsal-central wrist pain, often despite nondiagnostic imaging. Arthroscopy may aid diagnosis and management, with reported intraoperative findings and symptomatic improvement in selected patients. Current evidence is limited to small retrospective studies, and prospective research is needed to better define diagnostic criteria and outcomes.

CASE:Diaphyseal nonunions after bone tumor resection present a significant reconstructive challenge. We report a 39-year-old woman who developed a diaphyseal humeral nonunion after giant cell tumor resection and reconstruction with vascularized fibula graft. She presented with symptomatic segmental bone loss and hardware failure. Two-stage Masquelet-induced membrane procedure was performed, resulting in complete union and excellent functional recovery at 12 months postoperatively. CONCLUSION:This case highlights the potential of the Masquelet technique in reconstruction of refractory nonunions despite previous failed reconstructive attempts.

PURPOSE:To evaluate the short-term safety and clinical effectiveness of arthroscopic-assisted reduction with percutaneous proximal-row stabilization performed without intrinsic ligament repair for acute perilunate injuries. METHODS:Patients with acute, isolated perilunate injuries treated by a single surgeon between 2021 and 2025 were prospectively enrolled. All underwent arthroscopic-assisted reduction and percutaneous proximal-row stabilization without intrinsic ligament repair. Clinical evaluation included objective functional assessment and patient-reported outcome measures. Radiographic analysis included measurement of the scapholunate interval, scapholunate, radiolunate and radioscaphoid angles, dorsal scaphoid translation, fracture union, and presence of degenerative changes. RESULTS:Ten male patients (36 ± 14 years) were treated at a mean of 5 ± 3 days post-injury; 40% presented with median neuropathy. Eight injuries were Mayfield stage III and two stage IV, with five fracture-dislocation patterns. At a mean 14-month follow-up, patients demonstrated favorable early outcomes (Disabilities of the Arm, Shoulder and Hand score 7 ± 10, Modified Mayo Wrist Score 89 ± 7, Patient-Rated Wrist Evaluation 14.6 ± 15.1, and Visual Analog Scale pain score 0.4 ± 1), near-symmetric motion and grip strength, and maintained radiographic alignment (mean scapholunate gap 2.3 ± 0.8 mm). All fractures united, there were no post-operative complications, and all manual laborers returned to unrestricted work at 28 ± 16 weeks. CONCLUSION:Arthroscopic-assisted reduction and percutaneous proximal-row fixation without ligament repair appears feasible and safe, yielding excellent short-term functional and radiographic outcomes with minimal morbidity. Larger studies with longer follow-up are needed to determine long-term durability. PROSPECTIVE CASE SERIES:Level IV.

Scapholunate (SL) ligament injuries are a common cause of wrist pain and instability but can be diagnostically challenging. Standard radiographs, ultrasound, computed tomography, and magnetic resonance imaging have been used for many years to assist in the diagnosis of these injuries, and all of them have benefits and limitations. Advanced dynamic modalities, such as real-time magnetic resonance imaging and four-dimensional computed tomography, can distinguish functional from static injuries but are not widely available. The emergence of artificial intelligence applications is promising to improve diagnostic accuracy in automated SL gap detection and kinematic analysis. As each imaging modality presents strengths and trade-offs in terms of invasiveness, resolution, and dynamic assessment, combining imaging with thorough clinical examination remains essential. This current concepts review summarizes modern imaging techniques for SL ligament injuries and highlights emerging innovations.

Background:The 2022 American Academy of Orthopaedic Surgeons/American Society for Surgery of the Hand (AAOS/ASSH) guideline discourages routine operative fixation of distal radius fractures (DRF) in patients aged 65 years or older. This study examined the impact of this recommendation on operative management patterns in this population. Methods:A retrospective, quasi-experimental before-after study was conducted, including all DRF diagnoses among patients aged 65 years or older at a tertiary medical center during 2012 to 2024. Annual age-standardized and sex-standardized DRF incidence and surgery rates were estimated. Multivariable logistic regression evaluated postguideline versus preguideline odds of surgery and model-based projection compared expected with observed postguideline surgery rates. Results:During the study period, 3,137 DRF cases were diagnosed with stable incidence. Surgery rates significantly increased among patients aged 65 to 69 years from 9% to 16% after guideline publication, whereas rates were unchanged in patients aged 70 years or older. Patients aged 65 to 69 years were nearly twice as likely to undergo operative management in the postguideline versus preguideline period. Model-based projection among patients aged 65 to 69 years predicted a postguideline surgery rate of 11%, whereas the observed rate of 16% represented a 44% relative increase. Conclusions:Despite a guideline discouraging operative management of DRF at ages ≥65 years, surgery rates did not decline, and increased in those aged 65 to 69 years, highlighting the limitations of an age-only treatment threshold. Level of Evidence:Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Purpose To evaluate and compare the responses of ChatGPT and Google Gemini to common patient questions about scaphoid fracture and scaphoid nonunion, and to compare responses between hand fellowship-trained orthopedic and plastic surgeons. Methods A list of 30 common patient questions about scaphoid fracture and nonunion was developed and classified using Norman Webb’s Depth of Knowledge levels 1–4. Each question was input into ChatGPT-4o and Google Gemini 2.0 Flash. An evaluation guide was created with four domains for each response, each rated on a Likert scale from 1–5: accuracy, clarity, Artificial Intelligence Response Metric, and comparison to an in-person clinician interaction. Responses were evaluated by three orthopedic and three plastic hand surgeons. Statistical comparisons were performed using nonparametric tests to assess differences between AI platforms, domains, question complexity, and surgical specialty. Results There were no considerable differences between mean Likert scale scores for ChatGPT and Google Gemini. Plastic surgeons rated responses higher than orthopedic surgeons overall and for ChatGPT. Google Gemini performed better for DOK level 2 and level 3 questions. ChatGPT’s responses had greater clarity. For both platforms, ratings for clinician comparability across all DOK levels were considerably lower than scores for all other metrics. Conclusions Our findings suggest that ChatGPT and Google Gemini offer clinical use for patient care regarding scaphoid fracture and nonunion. However, clinician comparability was not a key strength for either platform, highlighting a key area for improvement for AI-based large language models in clinical application. Type of Study/level of evidence Diagnostic V.

Abstract Generative artificial intelligence (AI) models are designed to process a wide variety of inputs and produce responses that closely resemble natural human communication. There is a growing body of research evaluating the ability of these systems to answer common patient medical questions. The current evidence on AI in patient education for hand and wrist conditions is limited. This narrative review evaluates the literature on generative AI models for patient education in hand and wrist surgery. By characterizing the current evidence, the paper summarizes the utility of these systems for patient education and highlights gaps that can guide future research, helping optimize the use of generative AI in patient care. Studies evaluating generative AI models for patient education in hand and wrist surgery were identified through targeted literature review and reference screening. Relevant original studies were reviewed and synthesized narratively. Eight studies were included, all of which evaluated ChatGPT (Chat Generative Pre-trained Transformer). There was variability in question prompts and the method of evaluation of AI models. The studies suggested that ChatGPT performed well, and the conversational nature of the platform was identified as a strength. Limitations included a lack of comprehensive responses and concerns regarding readability. Clinical recommendations advised the use of ChatGPT as an adjunct, but not as a replacement for clinical counseling. Collectively, the studies suggest ChatGPT may serve as a supplementary tool for patient education in hand and wrist surgery, while highlighting the need for cautious integration and clinician oversight.

Introduction Postoperative pain management is a major concern for patients undergoing distal radius open reduction internal fixation (ORIF). Inadequate pain control negatively impacts patient’s satisfaction and may increase opioid use. Topical tranexamic acid (TXA) has been demonstrated as an effective intervention that reduced acute postoperative pain in total knee arthroplasty. There is no study evaluating the effects of TXA on acute postoperative pain for distal radius ORIF. This study aims to evaluate the effect of topical TXA administration during isolated distal radius ORIF on early postoperative pain.Methods and analysis The effect of topical TRanexamic Acid versus placebo on acute postoperative pain following Distal Radius fracture fixation (TRADR) study is a randomised controlled double-blinded trial that will enrol 90 patients, 18 years of age or older, undergoing volar open reduction internal fixation. Patients will be randomly assigned to topical TXA versus topical saline (placebo) in a 1:1 ratio. The surgeon at the time of surgical closure after standard distal radius fixation will apply either 1 g of topical TXA (100 mg/mL; treatment group) or 10 mL of saline (control group) to the wound and let it sit for 5 min. Surgeons, patients, and outcome assessors will be blinded to the treatment group. The primary outcome is acute postsurgical pain as measured by the visual analogue scale (VAS). Pain outcomes will be between postoperative days 0 to 7, and at 2 and 6 weeks postsurgery. The secondary outcomes include opioid usage, unscheduled emergency visits, wrist swelling and adverse events.Ethics and dissemination This study was approved by the University Health Network Research Ethics Board (REB 23–5708). The results of this trial will be disseminated through peer-reviewed journals and presented at related conferences. The principal investigator will communicate the results with patients who have indicated an interest in knowing the results.Trial registration number Clinicaltrials.gov NCT06384456, April 26, 2024; Pre-enrolment.Protocol version Version 2.0: August 26, 2024.

Malunion is a common complication of non-operative management of distal radius fractures and can lead to poor functional outcomes. Corrective osteotomy is an option to improve patient satisfaction. The Lift-Off Screw (LOS) technique described by Roebke et al. uses the equation Ls = [tan(Tc) * Lp + C] / [cos(⍬s)] to plan the sagittal plane deformity correction based on a calculated LOS length. We aim to clinically validate this technique for volar tilt correction (VTC) in patients undergoing corrective osteotomy for dorsally angulated distal radius fracture malunions. We hypothesized that the clinical VTC would be within 5 degrees of the calculated VTC, with a strong correlation between LOS length and clinical correction achieved (r > 0.7). We conducted a retrospective review of 23 consecutive patients with dorsally angulated distal radius fracture malunions treated with corrective osteotomy using the LOS technique. We compared the calculated VTC to the clinical VTC achieved, using paired t-test and Pearson correlation coefficient. Pre-operative volar tilt ranged from -6° to -50° (mean = -22.9° ± 10.6°), with an average desired correction of 32.5° ± 9.6°. The clinical VTC was 25.8° ± 9.3°. The difference between the clinical and calculated correction was -6.9°, with an average post-operative clinical volar tilt of 2.8° ± 5.7°, compared to a calculated volar tilt of 9.7° ± 4.4° (p The LOS technique is an easy and reproducible method to plan the amount of sagittal plane correction during corrective osteotomy surgery for dorsally angulated DRF malunions. We demonstrate that this technique under-estimates the clinical correction achieved by around 7°, which may be attributable to the effect of soft tissues and bone quality in a clinical setting. Under-correction of VTC during corrective osteotomy should be anticipated by surgeons, and considered in future implant and cutting guide designs.

Purpose: The extended flexor carpi radialis (EFCR) approach for distal radius fractures and malunions was first described in 2001 by Orbay et al. This approach ensures optimal radial and dorsal exposure by releasing the radial septum and simplifies reduction by releasing deforming forces while providing access to the critical volar ulnar corner. We hypothesize the EFCR approach is safe and effective for routine use in the management of acute/subacute distal radius fractures without increased complication rates. Methods: In total, 100 patients who underwent open reduction and internal fixation using an EFCR approach and a volar locking plate between 2018 and 2023 were included. A retrospective review of prospectively collected data was conducted including wrist range of motion, grip strength, Disabilities of Arm, Shoulder, and Hand scores, and complications. Volar tilt, radial inclination, ulnar variance and articular stepoff were measured after surgery. Descriptive statistics were used for analysis. Results: The average follow-up period was 14 months with a mean Disabilities of Arm, Shoulder, and Hand score of 6.8 at the final visit. The mean wrist range of motion was 72° (±11) flexion, 60° (±11) extension, 78° (±8) supination, 77° (±6) pronation. The mean grip strength was 28 kg (±10). After surgery, the mean volar tilt was 7o (±6), radial inclination 24o (±4), and ulnar variance 0 mm (±1.6). Overall, the complication rate was 9%. There was one revision fixation for a periprosthetic fracture. Hardware removal was performed for plate-tendon irritation in 3% and patient preference in 2%. All other complications (3%) were minor and treated nonsurgically. Conclusions: Our study supports the safety and effectiveness of the routine use of EFCR approach for acute/subacute operative distal radius fractures. It demonstrates excellent clinical, radiographic, and patient-reported outcomes. This series further supports its value in providing advantageous exposure and more efficient fracture reduction without increasing morbidity rates. Type of study/level of evidence: Therapeutic IV.

The primary objective of this meta-analysis is to systematically evaluate and compare complication, reoperation, and hardware removal rates between volar and dorsal plating in the context of corrective osteotomy for dorsally-angulated distal radius malunions. An extensive search across the MEDLINE, Embase, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases was conducted to identify studies reporting outcomes following corrective osteotomy for dorsally-angulated distal radius malunions. Coprimary outcomes included: the occurrence of major complications, minor complications, reoperation, and hardware removal rates. Meta-analysis comparing each outcome with further meta-regression model based on surgical approach to compare the odds for each outcome was built. A total of 403 patients were included; 253 patients underwent volar corrective osteotomy and 150 underwent dorsal corrective osteotomy. Mean follow-up was 30 months. Volar plating was associated with fewer reoperations (9% vs. 28%), less hardware removal (3% vs. 18%) and comparable major complications (5% vs. 6%) compared to dorsal plating. The adjusted model showed a significant reduction (approximately 85%) in the odds of reoperation and hardware removal in the volar group. There was no difference in major or minor complications between the groups. This study shows that volar plating for dorsally angulated distal radial osteotomy significantly reduces the odds of reoperation and hardware removal compared to dorsal plating, even after careful adjustment for potential confounders.

Introduction: Avascular necrosis (AVN) of the hamate is an exceptionally rare condition, with limited cases reported in the literature. This case highlights the successful management of idiopathic hamate AVN using core decompression and a vascularized pedicle bone flap from the distal radius based on the 4–5 extensor compartmental artery (ECA). Case Report: A 45-year-old construction worker presented with chronic left wrist pain of 2 years’ duration following minor trauma. Despite conservative treatment with cast immobilization, the symptoms persisted. Magnetic resonance imaging revealed AVN of the hamate, prompting surgical intervention involving core decompression and a 4–5 ECA vascularized bone flap supplemented with cancellous autograft. Post-operative follow-up demonstrated significant functional improvement, grip strength restoration, and successful revascularization confirmed by imaging. Conclusion: This report demonstrates the successful use of the 4–5 ECA-based vascularized bone flap technique in managing hamate AVN, as well as a literature review of 13 previously described cases. Keywords: Avascular necrosis, hamate, vascularized bone flap.

PURPOSE:Distal radius fractures (DRFs) represent up to 20% of the fractures in the emergency department. Delays to surgery of more than 14 days are associated with poorer functional outcomes and increased health care utilization/costs. At our institution, the average time to surgery is more than 19 days because of the separation of surgical and nonsurgical care pathways and a lengthy referral process. To address this challenge, we aimed to create a convolutional neural network (CNN) capable of automating DRF x-ray analysis and triaging. We hypothesize that this model will accurately predict whether an acute isolated DRF fracture in a patient under the age of 60 years will be treated surgically or nonsurgically at our institution based on the radiographic input. METHODS:We included 163 patients under the age of 60 years who presented to the emergency department between 2018 and 2023 with an acute isolated DRF and who were referred for clinical follow-up. Radiographs taken within 4 weeks of injury were collected in posterior-anterior and lateral views and then preprocessed for model training. The surgeons' decision to treat surgically or nonsurgically at our institution was the reference standard for assessing the model prediction accuracy. RESULTS:We included 723 radiographic posterior-anterior and lateral pairs (385 surgical and 338 nonsurgical) for model training. The best-performing model (seven CNN layers, one fully connected layer, an image input size of 256 × 256 pixels, and a 1.5× weighting for volarly displaced fractures) achieved 88% accuracy and 100% sensitivity. Values for true positive (100%), true negative (72.7%), false positive (27.3%), and false negative (0%) were calculated. CONCLUSIONS:After training based on institution-specific indications, a CNN-based algorithm can predict with 88% accuracy whether treatment of an acute isolated DRF in a patient under the age of 60 years will be treated surgically or nonsurgically. CLINICAL RELEVANCE:By promptly identifying patients who would benefit from expedited surgical treatment pathways, this model can reduce times for referral.

Case: An 11-year-old boy with osteogenesis imperfecta (OI) type 1 presented with a chronic scaphoid waist nonunion accompanied by cyst formation and dorsal intercalated segment instability. He had a history of treatment with bisphosphonate therapy and discontinued zoledronate 3 months before surgery. He underwent scaphoid reconstruction using nonvascularized, corticocancellous bone graft from the iliac crest and a buried headless compression screw. Within 12 weeks, imaging demonstrated union with bony remodeling and he resumed zoledronate. Conclusion: Temporary discontinuation of bisphosphonate therapy may normalize bone healing and reduce the risk of bisphosphonate-related delayed union in scaphoid reconstruction for children with OI.

BACKGROUND:Proximal phalanx fractures are common hand injuries with multiple fixation options. This meta-analysis compared outcomes of closed extra-articular fractures treated with intramedullary screws (IMS), percutaneous pinning (PCP), plating, or lag screws. METHODS:A systematic review of MEDLINE, Embase, CINAHL, and Cochrane databases (January 2010-May 2025) was conducted according to PRISMA guidelines. Primary outcomes were complication and revision rates; secondary outcomes included immobilization duration, total active motion [TAM] and grip strength. Data were pooled using random- or fixed-effects models based on heterogeneity. Risk of bias and certainty of evidence were assessed using validated tools. RESULTS:Eleven studies (19 treatment arms; 403 patients; 528 fractures) were included: IMS (n = 104), PCP (n = 285), plating (n = 100), and lag screws (n = 39). Mean age was 39 years; mean follow-up, 16.4 months. IMS had the lowest pooled complication rates (major: 0.96%; minor: 2.1%). Compared with IMS, plating had higher odds of major complications (OR 12.63, 95% CI 1.39-114.7; p = 0.02), while minor complications were more frequent with lag screws (OR 78.3, 95% CI 4.2-1465.1; p = 0.005) and PCP (OR 18.6, 95% CI 1.7-199.6; p = 0.02). Revision rates ranged from 5.8% (IMS) to 10.3% (lag screws), without statistical significance. Immobilization was shortest with IMS (mean difference vs. PCP -3.3 weeks; p = 0.01). TAM was highest with IMS (231°) but not statistically significant (p = 0.6). CONCLUSIONS:Intra medullary screw fixation was associated with lower complication risk and shorter immobilization compared with other fixation methods, likely reflecting the advantages of a minimally invasive, stable construct. As current evidence is limited to short-term outcomes and heterogeneous study designs, further high-quality prospective trials with longer follow-up are needed to validate these findings and to clarify the long-term outcomes of intramedullary screw fixation, including the potential implications of cartilage damage. LEVEL OF EVIDENCE:III.

PURPOSE:The purpose of this prospective study was to evaluate the influence of perioperative glycemic control, as detected by glycosylated hemoglobin (HbA1c) levels, on clinical outcomes after open carpal tunnel release (CTR) surgery. METHODS:The demographic and clinical data of the study participants were prospectively collected prior to surgery and at one year postoperatively. Objective evaluations included grip and pinch strength, along with sensation testing over the index finger using Semmes-Weinstein monofilaments (SWMF). Subjective assessments, including pain intensity (measured by the visual analog scale (VAS)), the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and the Mayo Wrist Score, were also recorded. RESULTS:The study included 50 patients, comprising 27 with type 2 diabetes mellitus (mean HbA1c: 7.49 ± 1.42) and 23 without diabetes. HbA1c levels were measured up to one month prior to surgery. No statistically significant differences were found in grip strength, pinch strength, or Semmes-Weinstein monofilament (SWMF) values pre- and postoperatively in both diabetic and non-diabetic groups. Pain intensity decreased in both groups at 12 months postoperatively, but the degree of pain improvement was not statistically different between groups. Both groups showed postoperative improvement in DASH and Mayo Wrist Scores, with no significant difference in the level of improvement between the groups. Pearson analysis showed no correlation between objective and subjective measures pre- and postoperatively and HbA1c levels. CONCLUSIONS:Elevation of perioperative HbA1c levels in diabetic patients did not negatively affect surgical outcomes compared to non-diabetic patients. Both groups demonstrated significant functional improvements, with no notable differences in recovery or postoperative hand function.