Background: Dupuytren's disease (DD) is a fibroproliferative disorder of the palmar fascia that results in progressive digital flexion contractures. Various treatment strategies have been developed to restore extension, ranging from minimally invasive collagenase clostridium histolyticum (CCH) injection to more invasive surgical procedures such as open selective aponeurectomy. While CCH has gained widespread adoption due to its limited invasiveness and rapid recovery, questions remain about its long-term durability compared with open surgery (OS). This study aims to compare long-term outcomes of CCH injection and OS in patients with stage 2 or higher single-digit DD, focusing on recurrence, patient satisfaction, complications, and return to work at least 10 years after treatment. Methods: A retrospective cohort study was conducted on patients treated in 2012 with either CCH injection or OS. All patients had at least stage 2 DD and at least 10 years of follow-up. The primary outcome was to compare recurrence rates between the two patient cohorts. Secondary outcomes included visual analogue scale (VAS) satisfaction, Michigan Hand Questionnaire (MHQ) scores, complications, and time to return to work. Results: A total of 97 patients completed 10-year follow-up (60 OS, 37 CCH). Recurrence at 7 years was relatively similar between groups. However, a pronounced divergence emerged between 7 and 10 years. At 10 years, recurrence occurred in 10 patients in the OS group versus 15 in the CCH group, with statistically significant differences overall (p = 0.0175) and particularly in the PIP subgroup (p = 0.0041). VAS satisfaction at 10 years was higher after OS (7.9 +/- 1.5) than after CCH (6.4 +/- 1.6), and return to work was significantly faster after CCH. MHQ scores were comparable. Conclusion: Both treatments provided acceptable patient satisfaction at 10 years; however, OS yielded better long-term recurrence rates and fewer complications. Although CCH offers rapid recovery, its durability beyond 7 years appears markedly inferior. These findings reinforce the need for careful patient selection and long-term counseling when considering minimally invasive treatment.

Background: Thumb carpometacarpal (CMC) arthritis affects up to 25% of women and 8% of men over 70 years of age, significantly compromising their activities of daily living. With the rapid growth of the elderly population globally and their specific clinical needs, understanding optimal surgical treatment for this age group is crucial. This systematic review compares trapeziectomy with ligament reconstruction and tendon interposition (LRTI) versus dual-mobility prosthesis for treating thumb CMC arthritis in elderly patients over 70 years old. Methods: A systematic search was conducted across PubMed, Scopus, Web of Science, and the Cochrane Library for studies published up to August 2025. Studies that directly compared both techniques were included, with subgroup analyses performed for elderly patients over 70 years of age when data were available. Primary outcomes included pain relief, functional improvement, grip and pinch strength, complications, and patient satisfaction. Results: Five studies met the inclusion criteria for direct comparison of both techniques, encompassing 313 patients (324 thumbs). While none exclusively focused on patients over 70, elderly patients represented 25-41% of study populations. Due to the absence of age-stratified data in the original studies, our analysis encompasses all age groups with specific considerations for elderly patients where identifiable. Dual-mobility prostheses demonstrated faster pain relief and earlier functional improvement, particularly within the first 3-6 months postoperatively. Prostheses consistently provided superior grip and pinch strength outcomes throughout follow-up periods. Both procedures effectively preserved thumb function, but prostheses better maintained thumb length and metacarpophalangeal stability. While complication rates were comparable, LRTI complications were typically minor and self-limiting, whereas prosthesis complications, though rare, could potentially require revision surgery. Longer-term follow-up data (>3 years) remain limited, particularly regarding implant degradation and adverse local tissue reactions. Conclusions: Both procedures effectively treat thumb CMC arthritis in elderly patients, with distinct advantages. Dual-mobility prostheses offer faster recovery, enhanced strength, and better thumb length preservation, making them potentially advantageous for elderly patients prioritizing rapid functional recovery. Trapeziectomy with LRTI provides reliable long-term pain relief with fewer serious complications, making it suitable for patients with poor bone quality or significant comorbidities. Treatment selection should be individualized based on patient characteristics, functional demands, and surgeon expertise. Future research specifically focusing on elderly populations with longer follow-up periods (>5 years) is critically needed to provide stronger evidence for this growing demographic and to better understand long-term implant performance.

Background: Carpal tunnel syndrome (CTS) is the most prevalent peripheral nerve entrapment neuropathy, with rising incidence in aging populations. Uncertainty persists regarding the efficacy and safety of carpal tunnel release (CTR) in patients aged ≥ 70 years. Objectives: To systematically evaluate the indications, clinical outcomes, and utility of CTR in elderly patients (≥70 years), with comparison to younger cohorts. Methods: Following PRISMA 2020 guidelines, PubMed/MEDLINE, Scopus, CENTRAL, Embase, Web of Science, and grey literature sources were searched from inception through September 2025. Two independent reviewers extracted data; inter-rater agreement was strong (κ = 0.81–0.86). The primary outcome was the Boston Carpal Tunnel Questionnaire (BCTQ). Weighted mean differences (WMDs) with 95% confidence intervals (CIs) were calculated using DerSimonian–Laird random-effects models. Certainty of evidence was assessed using the GRADE framework. Results: A total of 20 studies encompassing 3841 operated hands, including 1139 hands in elderly patients and 2702 hands in younger comparators across comparative studies, were analyzed. Mean SS-BCTQ improvement was 1.8 points (95%CI: 1.6–2.0; exceeding the established MCID of 1.04–1.05 points). FS-BCTQ improvement was 1.1 points (95%CI: 0.9–1.3; marginally below the pooled MCID of 1.13 points). Elderly patients demonstrated SS-BCTQ improvement of 1.7 points and satisfaction rates of 72–94%, comparable to younger cohorts (75–95%; p = 0.38). Grip strength improved 15–25% in younger patients but remained unchanged in elderly patients (p < 0.001). Sensory recovery reached 42% in elderly versus 58% in younger patients (p < 0.01). Complication rates were low and age-independent (3.1%; RR 1.08; 95%CI: 0.86–1.35; p = 0.52). GRADE certainty was as follows: low for symptom and functional improvement; very low for surgery versus conservative management. Conclusions: CTR is associated with significant symptomatic benefit in elderly patients when conservative treatment fails, with complication rates comparable to younger populations. Age alone should not constitute a surgical contraindication. Preoperative counseling must establish realistic expectations regarding grip strength and functional recovery. High-quality randomized trials in elderly populations remain an urgent research priority.

BACKGROUND:Soccer kicking biomechanics has traditionally focused on lower limbs, overlooking whole-body integration. Three-dimensional motion analyses have demonstrated that upper limbs contribute substantially through tension arc formation, counterbalancing, and kinetic chain coordination. The hand-wrist complex may influence performance through proprioceptive pathways, yet this remains untested. METHODS:Following PRISMA-ScR guidelines, we searched PubMed/MEDLINE, Web of Science, and SPORTDiscus (inception-February 2026). Peer-reviewed studies examining kicking mechanics, kinetic chains, and joint proprioception were included. Two reviewers independently screened records and extracted data. Narrative synthesis was used to organize findings across four thematic categories: upper limb biomechanics, kinetic chain principles, wrist-hand stability, and proprioceptive enhancement. RESULTS:From 3847 records, 51 studies (1988-2025) were included. Upper limbs are essential for kicking through tension arc formation, energy transfer, and balance maintenance. Kinetic chains operate bidirectionally; available evidence suggests that proximal segment deficits are associated with substantially increased compensatory demands at distal segments. External joint support has been shown to enhance proprioception and force perception. CONCLUSIONS:This scoping review identifies a theoretical rationale and a critical research gap: no direct empirical evidence exists that hand-wrist bandaging affects kicking performance. Evidence from adjacent domains (upper limb kicking biomechanics, kinetic chain theory and proprioceptive enhancement with external supports) provides indirect, translational support for the plausibility of a hypothesis that remains entirely untested. Future research should employ within-subject crossover designs in elite soccer players to determine whether this intervention produces any measurable effect. Practical recommendations to athletes or practitioners are premature and are not supported by the current evidence base.

Background/Objectives: Trapeziometacarpal osteoarthritis (TMC OA) is a common disabling condition. This study compared clinical and radiographic outcomes of trapeziectomy with suspension arthroplasty and dual mobility TMC joint replacement in a prospective comparative cohort study design. Methods: A prospective comparative study was conducted on 122 patients contributing 129 hands with Eaton–Littler stage II–III TMC osteoarthritis. Patients were treated with trapeziectomy with suspension arthroplasty (58 patients, 60 hands) or TMC joint replacement with a dual mobility prosthesis (64 patients, 69 hands), based on surgical indication and shared decision-making. Clinical and radiographic evaluations were performed up to 24 months postoperatively. Results: Both techniques significantly improved pain, function, range of motion, and strength (p < 0.05). Joint replacement provided faster pain relief and functional recovery, with superior strength at all follow-up points. At 12 months, pain and functional outcomes were comparable between groups. No implant loosening or failures were observed. Conclusions: Both surgical techniques are effective for TMC osteoarthritis. Dual mobility TMC joint replacement allows faster recovery and greater strength, while achieving comparable mid-term clinical outcomes to suspension arthroplasty.

Thumb carpometacarpal (CMC) osteoarthritis in advanced stages is frequently associated with metacarpophalangeal (MCP) hyperextension, resulting in the characteristic Z-deformity and reduced pinch stability. Standard basal joint reconstruction may fail to correct MCP hyperextension, contributing to persistent functional impairment. Prosthetic trapeziometacarpal arthroplasty may partially correct Z-deformity but becomes unreliable when MCP hyperextension exceeds 30 degrees. This article describes a reproducible surgical technique combining trapeziectomy, APL suspension arthroplasty, and EPB reinsertion onto the dorsal aspect of the first metacarpal head to restore sagittal balance of the MCP joint. In this configuration, the EPB is intentionally converted from an active extensor into a passive dorsal stabilizer, providing a tenodesis-like restraint against hyperextension while preserving flexion arc. In 10 consecutive patients with Eaton-Littler stage III-IV disease and MCP hyperextension ≥30 degrees, mean hyperextension improved from 38.6 degrees preoperatively to 5.4 degrees at 12-month follow-up, with preservation of MCP flexion and improvement of key pinch strength and QuickDASH scores. This approach provides stable correction of MCP hyperextension while maintaining MCP motion, offering a motion-preserving alternative to capsulodesis or arthrodesis.

Background/Objectives: Percutaneous cryoneurolysis (CNL) has emerged as a minimally invasive neuromodulatory technique for focal spasticity management, with growing international clinical adoption since 2018. Its application to upper limb motor nerve targets-including branches of the musculocutaneous, radial, median, ulnar, pectoral, and thoracodorsal nerves-is of direct relevance to clinicians involved in the surgical and non-surgical management of hand and upper extremity spasticity. The existing literature lacks a comprehensive systematic appraisal of its evidence base. This systematic scoping review aimed to map all published evidence on CNL for spasticity across all aetiological groups and anatomical regions, with particular attention to upper limb and hand-relevant targets; appraise methodological quality using design-appropriate tools; characterise the safety profile; apply the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework to key outcome domains; and identify critical evidence gaps. Methods: A systematic scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines (search through February 2026). PubMed/MEDLINE, Embase (via Ovid), Scopus, and the Cochrane Library were searched. Methodological quality was assessed using JBI Critical Appraisal Checklists, Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I), and A MeaSurement Tool to Assess systematic Reviews-2 (AMSTAR-2). Certainty of evidence was evaluated using GRADE. Results: Twenty-five studies met inclusion criteria; no randomised controlled trials (RCTs) were identified. In the largest prospective observational cohort (n = 59, 12-month follow-up), CNL produced statistically significant improvements in passive range of motion (ROM), Modified Ashworth Scale (MAS) scores, and pain in patients with upper limb spasticity refractory to botulinum toxin type A (BoNT-A). A prospective safety study (n = 113 patients; 277 nerves) documented that 96.75% of nerve treatments produced no post-procedural sensory disturbance; the risk was approximately 10-fold higher for mixed sensorimotor than purely motor nerve targets (7.1% vs. 1.1%). Certainty of evidence was Very Low (&oplus;◯◯◯) for all efficacy outcomes and Low (&oplus;&oplus;◯◯) for safety. Conclusions: CNL represents a mechanistically sound second-line or complementary intervention for refractory focal spasticity. In the upper extremity context, it may additionally serve as a reversible functional evaluation tool before irreversible surgical decisions-including selective neurotomy-are made. The evidence base is critically constrained by the absence of RCTs, confirmed cohort overlap between the two largest primary studies, financial conflicts of interest with the primary device manufacturer identified in ≥48% of included studies (≥12/25), and single-institution concentration of primary evidence (≥69% of primary clinical studies from one research group). Multiple ongoing controlled trials are expected to provide higher-quality evidence to inform guideline development.

Aim To confirm the effectiveness of the ActiPatch device in treating and preventing pillar pain following open carpal tunnel release surgery.Methods Ten elderly patients with pillar pain after carpal tunnel release surgery were treated with ActiPatch for seven days. When these patients underwent surgery on the opposite hand, they were pre-emptively treated with ActiPatch to prevent pillar pain. Pain was measured using the Visual Analog Scale (VAS), functionality was assessed using the Quick Disability of the Arm, Shoulder and Hand (QuickDASH) and Michigan Hand Questionnaire (MHQ) scoring systems, and patient satisfaction was evaluated. Results All patients showed an improvement in pain level and functional capacity after using ActiPatch for pillar pain management. Additionally, none of the patients experienced pillar pain during the subsequent preventive phase. Conclusion The use of ActiPatch proves to be a viable and effective approach for managing and preventing pillar pain in elderly patients with weight-bearing hands who have undergone carpal tunnel release surgery.

Background: Thumb carpo-metacarpal arthritis, a form of arthritis at the base of the thumb, causes pain, swelling, and limited mobility, significantly affecting patients' quality of life. This study aimed to evaluate the efficacy of an exercise protocol, comparing standard treatment with an app-assisted approach. Methods: Two groups of 10 patients each were randomly assigned standard treatment or standard treatment plus a Hand Rehab App. Both groups received physiotherapy sessions over three phases spanning three months. Results: Both groups showed improvement, with Group 0 showing more significant improvements in several variables. However, the clinical significance of these improvements differed between groups. Discussion: Group 0 had significant improvements in FLEX IF, FLEX MF TT, and VAS AT NIGHT, while Group 1 had significant improvements in FLEX MF and TT. Group 1 showed greater improvement in JAMAR and TT, while both groups showed similar improvements in other variables. Overall, Group 1 showed more improvement in key measurements. Conclusion: This study suggests that adding a specific app to exercise therapy may enhance outcomes for trapeziometacarpal osteoarthritis patients, particularly in terms of pain relief and functionality.

Introduction: The scapholunate interosseus ligament (SLIL) is critical for wrist stability, with injuries causing carpal instability and potential scapholunate advanced collapse (SLAC). This technical note presents a novel ligament-sparing surgical technique for treating SLIL tears ranging from grade 2 to 4 of the Garcia-Elias classification. Materials and Methods: A retrospective study was performed on ten patients treated with this novel technique. The technique involves a dorsal approach to the wrist through a 5–7 cm incision ulnar to Lister’s tubercle. After exposing the scapholunate joint, reduction is performed using Kirschner wires (K-wires) as joysticks, followed by stabilisation with three K-wires through the scapholunate, scapho-capitate, and radio-lunate joints. Two 2.3 mm suture anchors with double sutures are placed where the reduction K-wires were removed. One pair of sutures connects the anchors and any remaining SLIL tissue, while the second pair create a shoelace-like capsulodesis. Post-operative care includes staged K-wire removal at one and two months, with progressive rehabilitation before returning to weight-bearing activities at six months. Results: All patients improved in pain and function. The technique addresses SLIL injuries by restoring both coronal alignment through ligament repair and sagittal alignment via dorsal capsulodesis. The use of suture anchors and direct repair preserves the native tissue while reinforcing the dorsal capsule–scapholunate septum complex, avoiding the need for tendon grafts or extensive bone tunnelling. Conclusions: This ligament-sparing technique offers several advantages, including absence of donor site morbidity, minimal damage to carpal cartilage and vascularity, and preservation of surgical options should revision be necessary. The procedure effectively addresses both components of scapholunate instability while maintaining a relatively straightforward surgical approach.

Background: Wrist arthritis significantly impacts the quality of life in elderly populations. While total wrist arthroplasty and wrist arthrodesis are established treatments, partial resurfacing procedures are emerging as a solution offering advantages for patients over 70 years of age. Objective: To systematically evaluate the efficacy, safety, and functional outcomes of radial versus carpal resurfacing procedures for the management of wrist arthritis in patients over 70 years of age. Methods: A comprehensive search of PubMed, Scopus, and Web of Science was conducted for studies published from these databases’ inception to May 2025. Studies reporting the outcomes of either radial or carpal resurfacing in patients ≥70 years of age with wrist arthritis were included. Primary outcomes were pain reduction, functional improvement, and complication rates. Results: Twenty studies met the inclusion criteria. Both carpal and radial resurfacing provided pain relief, with mean VAS scores ranging from 0 to 3.8 across studies and DASH scores ranging from 13 to 59 points, while carpal resurfacing showed better preservation of range of motion, with flexion/extension arcs of 27–65° compared to 22–46° for radial implants. Complication rates were comparable, though implant loosening was uncommon with both radial and carpal resurfacing. Both procedures demonstrated satisfactory patient-reported outcomes at midterm follow-up (median: 32 months; range: 6–84 months). Conclusion: In patients over 70 years of age with wrist arthritis, both radial and carpal resurfacing appear to be viable options with distinct advantages. Radial resurfacing may be preferred for patients with previous distal radius fractures, while carpal resurfacing offers better motion preservation and is indicated in SLAC and SNAC wrists. Patient selection should consider specific arthritis patterns, activity requirements, and comorbidities. Long-term studies are needed to evaluate durability beyond 5–10 years in this population.

Aim Trapeziometacarpal (TMC) joint osteoarthritis is a common source of wrist pain, predominantly affecting women aged 45 to 70 years. While traditional surgical options like trapeziectomy with abductor pollicis longus (APL) arthroplasty are effective, their limitations in advanced disease stages have led to the exploration of alternative techniques. This study compares the clinical outcomes of conventional trapeziectomy with APL arthroplasty to a novel personalized suspensory arthroplasty technique. Methods A retrospective analysis was conducted on 150 patients with Stage III-IV TMC osteoarthritis who underwent either the conventional APL arthroplasty (n=65) or the novel suspensory arthroplasty (n=85) in the period between 2015 and 2018. Outcomes were assessed using the Numeric Pain Rating Scale (NPRS), Disabilities of the Arm, Shoulder, and Hand (DASH) scores, thumb range of motion, grip strength, and patient satisfaction. Statistical analyses included t-test, χ2 test, and repeated measures ANOVA. Results Both surgical groups demonstrated significant pain reduction and functional improvement postoperatively. The novel technique resulted in lower NPRS and DASH scores, greater thumb metacarpophalangeal joint flexion-extension, and higher patient satisfaction compared to the traditional method. The prevalence of complications, particularly flexor carpi radialis (FCR) tendinitis, was also lower with the novel technique. Radiographic assessments indicated stable joint positions postoperatively in both groups. Conclusion The novel personalized suspensory arthroplasty technique offers superior clinical outcomes compared to traditional APL arthroplasty, with enhanced pain management, improved function, and reduced complications. This approach represents a cost-effective and minimally invasive alternative for advanced TMC osteoarthritis, leading to better patient satisfaction and faster recovery.

Background: Cubital tunnel syndrome is the second most common compressive neuropathy of the upper limb, and it is characterized by ulnar nerve compression at the elbow. Traditional surgical options, including simple decompression and anterior transposition, have limitations in addressing ulnar nerve instability. This study introduces and evaluates the short-term outcomes of a novel surgical technique, the fascio-aponeurotic epicondylar flap (FAEF), for stabilizing the ulnar nerve and managing its instability. Materials and methods: A retrospective study was conducted on ten patients with longstanding cubital tunnel syndrome and confirmed ulnar nerve dislocation or instability. All patients underwent surgical intervention using the FAEF technique, which involves creating a quadrangular fascial flap from the epicondylar fascia to stabilize the ulnar nerve within the retrocondylar groove. Outcomes were assessed using clinical follow-ups, the Michigan Hand Outcomes Questionnaire (MHQ), VAS, and qDASH scores over a 90-day postoperative period. Results: All ten patients experienced complete resolution of neurological symptoms, including paresthesia, pain, and nerve clicking, by the final follow-up. Postoperative recovery was uneventful, with no complications such as infections or hematomas. Grip strength and hand functionality were fully restored, with significant improvements in MHQ scores (mean: 94). Dynamic elbow mobilization initiated on the first postoperative day resulted in full recovery of elbow range of motion. No recurrence of ulnar nerve dislocation was observed. Discussion: The FAEF technique effectively stabilizes the ulnar nerve, alleviates symptoms, and restores function while minimizing risks associated with traditional procedures, such as nerve trauma and elbow instability. By preserving the anatomical integrity of the medial epicondyle and enhancing nerve mobility, this approach represents a less invasive alternative to anterior transposition and medial epicondylectomy. Conclusions: The FAEF technique is a viable and effective surgical option for managing ulnar nerve instability in cubital tunnel syndrome. It offers a less invasive solution with excellent short-term outcomes, making it a promising addition to the surgical armamentarium for this condition. Further studies are warranted to evaluate long-term efficacy and broader applicability.

Background: Primary lymphoma of peripheral nerves (PLPN) is a rare extranodal non-Hodgkin lymphoma that mimics benign nerve conditions, leading to diagnostic delays. This systematic review evaluates the clinical, radiological, and pathological features of PLPN, alongside diagnostic and therapeutic strategies. Materials and Methods: A systematic search was conducted across PubMed, Scopus, and Web of Science, and identified 23 studies reporting 27 cases of PLPN. Data on demographics, clinical presentation, diagnostics, treatment, and outcomes were extracted and synthesized qualitatively due to study heterogeneity. Results: The sciatic nerve was most involved (48.15%), followed by the ulnar (18.5%) and radial nerves (18.5%). The median age at diagnosis was 58 years, with symptoms including motor deficits (88.9%), sensory disturbances (74.1%), and pain (70.4%). B-cell lymphomas accounted for 81.5% of cases, predominantly diffuse large B-cell lymphoma. MRI findings were non-specific; however, diffusion-weighted imaging (DWI) showed diagnostic potential. Treatments included combination therapies (51.9%), chemotherapy (25.9%), and surgery. Complete remission was achieved in 70.8%, with a 2-year survival rate of 83.3%. Conclusions: PLPN is rare but likely underdiagnosed. Early recognition requires multidisciplinary collaboration, advanced imaging, and standardized protocols. Future research should focus on molecular characterization, diagnostic criteria, and treatment optimization to improve outcomes for this challenging condition.

Background: Trapeziometacarpal osteoarthritis (TMC OA) is a prevalent degenerative disorder that causes considerable pain and functional limitations, especially in older individuals, whose ideal treatment is still debated in the literature. Various treatments are described to restore a good functional outcome of the thumb; over the past 50 years, biological arthroplasties have been considered the gold standard for treating advanced stages of TMC OA. However, in the last decade, the use of dual mobility cup prostheses has significantly increased, with numerous studies reporting excellent clinical outcomes. In this case report, we show the results of a patient treated on the left hand with suspension arthroplasty and on his right hand with dual mobility arthroplasty in one-stage surgery. The aim of this case report is to directly compare outcomes between trapeziometacarpal prosthesis and suspension arthroplasty performed simultaneously in the same patient. Case Presentation: The present case reports a 71-year-old male patient with bilateral TMC osteoarthritis, referred to our clinic in May 2024. His medical history included hypertension, hypertriglyceridemia, paroxysmal atrial fibrillation, and benign prostatic hyperplasia. On examination, the right hand showed grade 3 osteoarthritis according to the Eaton–Littler classification, with the trapezium maintaining adequate bone stock, making the patient eligible for trapeziometacarpal prosthesis implantation. Conversely, the left hand demonstrated scaphotrapezoid arthritis with a slight reduction in trapezial bone stock, indicating the need for trapeziectomy followed by suspension arthroplasty. Both procedures were performed during the same surgical session by the same experienced hand surgeon using a lateral approach. On the right side, the trapeziometacarpal joint surfaces were resected and replaced with a dual mobility prosthesis, while on the left side, the trapezium was excised, and suspension arthroplasty was performed using a slip of the flexor carpi radialis (FCR) tendon. Methods: The patient underwent simultaneous treatment with a dual mobility trapeziometacarpal prosthesis on the right hand and trapeziectomy with suspension arthroplasty on the left hand. Clinical outcomes (grip and pinch strength, pain, QuickDASH, satisfaction, and range of motion) were evaluated at 1, 3, 6, and 12 months. Paired comparative statistics were applied with significance set at p < 0.05. Results: At all follow-up intervals (1, 3, 6, and 12 months), the hand treated with a trapeziometacarpal prosthesis demonstrated superior grip and pinch strength compared to the hand treated with trapeziectomy and suspension arthroplasty, with the greatest difference observed at 3 months. At 12 months, grip strength increased from 28 kg to 40 kg in the prosthesis-treated hand and from 25 kg to 33 kg in the suspension arthroplasty hand. Paired comparisons were performed at each follow-up interval up to 12 months, confirming a significant difference for grip strength. Pain levels (VAS, Visual Analogue Scale) decreased progressively in both hands, with a more rapid reduction in the hand treated with a trapeziometacarpal prosthesis, reaching statistical significance. QuickDASH scores indicated an earlier return to daily activities in the hand treated with the prosthesis, although this difference was not statistically significant. Patient satisfaction was consistently higher for the hand treated with a trapeziometacarpal prosthesis, with the patient reporting a ‘very satisfied’ rating at all timepoints. Range of motion recovery, assessed through the Kapandji score and measurements of thumb abduction and extension, also favored the hand treated with the prosthesis, with statistically significant differences for abduction and extension, whereas the hand treated with trapeziectomy and suspension arthroplasty demonstrated more gradual improvement over time. Conclusions: This case highlights the functional efficacy of both surgical approaches—biological arthroplasty and trapeziometacarpal prosthesis—in the treatment of TMC osteoarthritis. Both procedures resulted in a good clinical outcome and high patient satisfaction. However, recovery was noticeably faster in the hand treated with a trapeziometacarpal prosthesis, which is consistent with findings previously reported in the literature. These observations suggest that, while both techniques are valid and effective, trapeziometacarpal prosthetic replacement may offer a quicker return to function in appropriately selected patients.

Scaphoid non-union is a challenging orthopaedic condition, frequently resulting from missed or untreated fractures of the scaphoid bone. Delayed diagnosis or inadequate treatment can lead to long-term complications, such as osteoarthritis and carpal collapse. Various surgical techniques are employed to address scaphoid non-union, each with differing success rates and indications. This review aims to evaluate the most effective surgical interventions for scaphoid non-union and provide an overview of treatment outcomes and advances in the field. A comprehensive literature search was performed using databases including PubMed and MEDLINE to identify studies published from 2014 to 2024. Articles that focused on surgical techniques for scaphoid non-union, including vascularized bone grafting, non-vascularized bone grafting, and fixation methods, were included. The primary outcomes assessed were union rates, functional outcomes, and complication rates across different techniques. Surgical options for scaphoid non-union are varied and include non-vascularized bone grafting, vascularized bone grafting, PRP and fixation with K-wire, screws, staples or plates. Non-vascularized bone grafting is most effective in early-stage non-union with minimal bone resorption, while vascularized grafts show superior outcomes in avascular necrosis or cases with poor blood supply. Percutaneous screw fixation offers a minimally invasive option with high union rates, though complex cases often require open surgery. Also bone graft without any fixation is effective. Overall, the union rates ranged from 70 to 95