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State of the Art in Hand Surgery
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State of the Art in Hand Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Plastic, Reconstructive and Aesthetic Surgery/Aesthetic Medicine".

Deadline for manuscript submissions: 25 June 2025 | Viewed by 584

Special Issue Editors

Prof. Dr. Leszek Romanowski

E-Mail Website
Guest Editor
Department of Traumatology, Orthopaedics and Hand Surgery, Poznań University of Medical Sciences, 61-545 Poznań, Poland
Interests: nerve surgery; congenital hand; hand surgery
Dr. Piotr Czarnecki

E-Mail Website
Guest Editor Assistant
Department of Traumatology, Orthopaedics and Hand Surgery, Poznań University of Medical Sciences, 28 Czerwca 1956 r. Street, No. 135/147, 61-545 Poznań, Poland
Interests: nerve; congenital abnormalities; hand surgery, shoulder, wrist; traumatology; nerve reconstruction

Special Issue Information

Dear Colleagues,

Hand surgery is fast-developing specialty connecting surgeons of different specialties and hand therpists. From the very beginning, there was a high demand for the scientific justification of the solutions and procedures used to treat our patients. On the other hand, through the determination of the pioneers and their followers, we can offer predictable treatment for most hand conditions despite the lack of hard evidence.

THe state of the art can be interpreted in different ways. I am happy to open and lead this Special Issue and to include both review papers summarizing actual knowledge and practice but also research manuscripts that investigate our present work or new ideas. It is a perfect combination of what we already know and do and also what we could do in a better way, including criticism, which is so important to further development.

We invite you to contribute, as we all need good science in the background of our daily practice.

Prof. Dr. Leszek Romanowski
Guest Editor

Dr. Piotr Czarnecki
Guest Editor Assistant

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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

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

Keywords

  • hand surgery
  • nerve surgery
  • state-of-the-art
  • hand therapy
  • tendons
  • thumb arthritis
  • hand fractures

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Further information on MDPI's Special Issue polices can be found here.

Published Papers (1 paper)

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Research

12 pages, 5235 KiB  
Article
Results of the Nerve Transfers and Secondary Procedures to Restore Shoulder and Elbow Function in Traumatic Upper Brachial Plexus Palsy
by Piotr Czarnecki, Michał Górecki and Leszek Romanowski
J. Clin. Med. 2024, 13(23), 7396; https://doi.org/10.3390/jcm13237396 - 4 Dec 2024
Viewed by 356
Abstract
Background: Damage to the upper trunk of the brachial plexus, often caused by high-energy trauma, leads to significant functional impairment of the upper limb. This injury primarily affects the C5 and C6 roots, resulting in paralysis of muscles critical for shoulder and elbow [...] Read more.
Background: Damage to the upper trunk of the brachial plexus, often caused by high-energy trauma, leads to significant functional impairment of the upper limb. This injury primarily affects the C5 and C6 roots, resulting in paralysis of muscles critical for shoulder and elbow function. If spontaneous nerve regeneration does not occur within 3–6 months post-injury, surgical intervention, including nerve transfers, is recommended to restore function. Methods: This study evaluates long-term outcomes of nerve transfer surgeries performed between 2013 and 2023 on 16 adult patients with post-traumatic brachial plexus injuries. The most common cause of injury was motorcycle accidents. Nerve transfers targeted shoulder and elbow function restoration, including transfer of the accessory nerve to the suprascapular nerve, the radial nerve branch to the long or medial head of the triceps brachii to the axillary nerve, or the transfer of motor fascicles of the ulnar and median nerves (double Oberlin) to the brachialis and biceps brachii motor nerves. Results: Postoperative results showed varying degrees of functional recovery. In the shoulder, most patients achieved stabilization and partial restoration of active movement, with average flexion up to 92° and abduction up to 78°. In the elbow, full flexion with M4 strength was achieved in 64% of patients. In both the shoulder and the elbow, double nerve transfers yield better long-term outcomes than single transfers. Secondary procedures, such as tendon transfers, were required in some cases to improve limb strength. Conclusions: The study concludes that nerve transfers offer reliable outcomes in restoring upper limb function, although additional surgeries may be necessary in certain cases. Full article
(This article belongs to the Special Issue State of the Art in Hand Surgery)
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Figure 1

Figure 1
<p>A prone position of the patient with marked anatomical landmarks for transferring the accessory nerve to the suprascapular nerve (black arrow) and the branch of the radial nerve for the triceps brachii to the axillary nerve (white arrow).</p> Full article ">Figure 2
<p>Intraoperative photo on the left side showing the prepared and protected accessory nerve (black asterisk) and the suprascapular nerve (white asterisk) and on the right side after the end-to-end transfer.</p> Full article ">Figure 3
<p>Intraoperative photo on the left side showing the prepared and protected axillary nerve (white asterisk) and the branch of the radial nerve of the triceps brachii (black asterisk) and on the right side after the end-to-end transfer.</p> Full article ">Figure 4
<p>Intraoperative photo on the left side showing the dissected and isolated fascicle from the middle of the median nerve (white asterisk), in the middle photo after the Oberlin end-to-end transfer to the motor branch of the biceps brachii muscle (black asterisk), and on the right side after the double Oberlin transfer with the added transfer of the fascicle from the ulnar nerve (white arrow) to the motor branch of the brachialis muscle (black arrow).</p> Full article ">
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