This review explores the historical and current significance of gestures as a universal form of communication with a focus on hand gestures in virtual reality applications. It highlights the evolution of gesture detection systems from the 1990s, which used computer algorithms to find patterns in static images, to the present day where advances in sensor technology, artificial intelligence, and computing power have enabled real-time gesture recognition. The paper emphasizes the role of hand gestures in virtual reality (VR), a field that creates immersive digital experiences through the Ma blending of 3D modeling, sound effects, and sensing technology. This review presents state-of-the-art hardware and software techniques used in hand gesture detection, primarily for VR applications. It discusses the challenges in hand gesture detection, classifies gestures as static and dynamic, and grades their detection difficulty. This paper also reviews the haptic devices used in VR and their advantages and challenges. It provides an overview of the process used in hand gesture acquisition, from inputs and pre-processing to pose detection, for both static and dynamic gestures.

BACKGROUND: Handgrip strength (HGS) is an indicator of muscular strength, used in the diagnosis of sarcopenia, undernutrition, and physical frailty as well as recovery. Typically, the maximum HGS value is used; however, recent evidence suggests the exploration of new indicators provided based on the force-time curve to achieve a more comprehensive assessment of muscle function. Therefore, the objective was to identify indicators of the HGS profile beyond maximum HGS, based on force-time curves, and to systematize knowledge about their applications to various types of samples, health issues, and physical performance.
METHODS: A systematic review was performed including studies whose participants\' HGS was assessed with a digital or adapted dynamometer. The outcome measures were HGS profile indicators calculated from the force-time curve.
RESULTS: a total of 15 studies were included, and the following indicators were identified: grip fatigue, fatigability index, fatigue rate, fatigue resistance, time to 80% maximal voluntary contraction, plateau coefficient of variability, time to maximum value, T-90%, release rate, power factor, grip work, average integrated area, endurance, cycle duration, time between cycles, maximum and minimum force-velocity, rate of grip force, final force, inflection point, integrated area, submaximal control, and response time.
CONCLUSIONS: Various indicators based on the force-time curve can be assessed through digital or adapted dynamometers. Future research should analyze these indicators to understand their implications for muscle function assessment, to standardize evaluation procedures, to identify clinically relevant measures, and to clarify their implications in clinical practice.

The purpose of this systematic review is to describe the pathoanatomy, presentation, diagnostic workup, treatment modalities, and outcomes of posterior interosseous nerve (PIN) palsy in patients with rheumatoid arthritis (RA). All reported cases of PIN palsy in patients with RA were reviewed to yield 72 cases of PIN palsy in 70 patients. The male-to-female ratio was 1:2.7. Pain involving the elbow was very common (20/33 cases reporting this information), and paralysis or weakness of digit extension was noted in 27/33 cases and 6/33 cases, respectively. Only 1 of the 54 cases undergoing surgical intervention reported persistent weakness, and this 1 patient had undergone a 3-month trial of conservative management. In conclusion, Appropriate pharmacologic management in conjunction with magnetic resonance imaging (MRI) and ultrasound monitoring may be used for conservative management, but surgical decompression should still be utilized for patients with a compressive disease pathology who fail to improve with 6 weeks of conservative treatment, or for those with advanced disease on initial presentation.

UNASSIGNED: Pillar pain is a recognized postoperative complication of carpal tunnel release (CTR). Minimally invasive and alternative surgical techniques can theoretically prevent pillar pain, and the aim of this review was to compare the incidence of pillar pain after standard open CTR and alternative surgical techniques.
UNASSIGNED: MEDLINE, Embase, and Scopus databases were thoroughly searched. Randomized controlled trials comparing minimally invasive surgical techniques to standard open CTR were identified. Data, including surgical technique, number of hands, incidence of pillar pain, and follow-up intervals, were extracted. Odds ratios (OR) were expressed as pillar pain incidence in the intervention group relative to standard open CTR.
UNASSIGNED: There were 12 studies included. No statistically significant differences were noted among endoscopic (OR = 0.53, P = .20), flexor retinaculum lengthening (OR = 1.00, P = 1.00), short incision (OR = 0.41, P = .07) or illuminated knife techniques (OR = 0.18, P = .16). There was a statistically significant decrease in pillar pain after minimally invasive CTR (OR = 0.41, 95% confidence interval 0.20-0.86, I2 = 0%, P = .02) between 3- and 6-months follow-up; however, analyses at all other follow-up periods failed to reach statistical significance.
UNASSIGNED: Although our findings suggest that standard open CTR may be associated with an increased duration of pillar pain between 3 and 6 months postoperatively, our results suggest that minimally invasive CTR techniques do not affect either the initial development or persistence of pillar pain.
UNASSIGNED: Our results illustrate the natural history of pillar pain with the majority of cases resolving after 6 months, highlighting the utility of symptomatic and conservative treatments and patient education in the management of pillar pain.

BACKGROUND: Amateur and professional participation in sport and physical activity worldwide is increasing in popularity, which in turn is increasing the volume and types of injuries sustained by athletes. Ensuring these injuries are treated appropriately and efficiently is paramount for athletes\' recovery and return to sport in a timely and safe manner.
METHODS: A scoping review to map the evidence regarding the treatment, outcomes and management of hand, wrist, finger, and thumb injuries in the professional/amateur athlete from contact sports. A search of seven electronic databases; SPORTdiscus, CINAHL, Medline, Scopus, Web of Science, Embase and Cochrane Library and grey literature was conducted in January 2024. The reporting of the review is in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist. Inductive content analysis was used to examine the data and the Critical Appraisal Skills Programme was used to appraise the quality of the included studies.
RESULTS: Eight papers met the inclusion criteria and three themes emerged addressing the return to play/sport, surgical and conservative treatment and the most common/reoccurring injuries sustained from contact sports.
CONCLUSIONS: Managing hand, wrist, finger, and thumb injuries in athletes requires a varied approach depending on the type of injury, treatment options, and external pressures. While conservative treatment is common and effective, surgical intervention may be necessary in certain cases to improve recovery and facilitate a faster return to sport. Preventive measures in high-risk sports settings could help reduce the incidence of these injuries.

Diabetes mellitus may for the first time present with its classical features or with long term complications which may or may not be recognised. Knowledge of diabetes mellitus and its complications, sociocultural beliefs and perception, patronage of traditional healers may influence time of presentation and hence, outcomes. We report the case of a female Nigerian food vendor, who was admitted in coma and managed for septic left-hand ulcer and incidental diabetes mellitus. She had painless peripheral neuropathy, which gave her the \'\'ability\'\' to handle hot objects. This was misconstrued as some special gift derived from a benevolent spirit, until she sustained thermal injury and a non-healing wound on her left hand. She presented to a traditional healer which delayed hospital presentation. She was eventually brought to hospital in coma and related diabetes mellitus was found. She was appropriately managed for hyperglycaemic coma and sepsis as well as wound care and was discharged to the out patients\' services on appropriate drugs and life style measures.

BACKGROUND: The use of prophylactic antibiotics in surgery is contentious. With the rise in antimicrobial resistance, evidence-based antibiotic use should be followed. This systematic review and network meta-analysis will assess the effectiveness of different antibiotics on the prevention of surgical site infection (SSI) following hand trauma surgery.
METHODS: The databases Embase, MEDLINE, CINAHL and CENTRAL, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform will be searched. Abstracts will be screened by two persons independently to identify eligible studies. This systematic review will include both randomised and non-randomised prospective comparative studies in participants with hand and/or wrist injuries requiring surgery; bite injuries will be excluded. The network meta-analysis will compare the use of different prophylactic antibiotics against each other, placebo and/or no antibiotics on the development of SSI within 30 days of surgery (or 90 days if there is an implanted device). The Cochrane risk-of-bias tool 2 will be used to assess the risk of methodological bias in randomised controlled trials, and the Newcastle-Ottowa scale (NOS) will be used to assess the risk of bias in non-randomised studies. A random-effects network meta-analysis will be conducted along with subgroup analyses looking at antibiotic timing, injury type, and operation location. Sensitivity analyses including only low risk-of-bias studies will be conducted, and the confidence in the results will be assessed using Confidence in Network Meta-Analysis (CINEMA).
CONCLUSIONS: This systematic review and network meta-analysis aims to provide an up-to-date synthesis of the studies assessing the use of antibiotics following hand and wrist trauma to enable evidence-based peri-operative prescribing.
BACKGROUND: PROSPERO CRD42023429618.

BACKGROUND: Loss of hand function causes severe limitations in activity in daily living. The hand-soft robot is one of the methods that has recently been growing to increase the patient\'s independence. The purpose of the present systematic review was to provide a classification, a comparison, and a design overview of mechanisms and the efficacy of the soft hand robots to help researchers approach this field.
METHODS: The literature research regarding such tools was conducted in PubMed, Google Scholar, Science Direct, and Cochrane Central Register for Controlled Trials. We included peer-reviewed studies that considered a soft robot glove as an assistive device to provide function. The two investigators screened the titles and abstracts, then independently reviewed the full-text articles. Disagreements about inclusion were resolved by consensus or a third reviewer.
RESULTS: A total of 15 articles were identified, describing 210 participants (23 healthy subjects). The tools were in three categories according to their actuation type (pneumatic system, cable-driven, another design). The most critical outcomes in studies included functional tasks (fourteen studies), grip strength (four studies), range of motion (ROM) (five studies), and user satisfaction (five studies).
CONCLUSIONS: Function and grip parameters are the most common critical parameters for tests of hand robots. Cable-driven transmission and soft pneumatic actuators are the most common choices for the actuation unit. Radder et al. study had the highest grade from other studies. That was the only RCT among studies.
CONCLUSIONS: Although few soft robotic gloves can be considered ready to reach the market, it seems these tools have the potential to be practical for people with a disability. But, we lack consistent evidence of comparing two or more soft robot gloves on the hand functions. Future research needs to assess the effect of soft robotic gloves on people with hand disorders with more populations.

UNASSIGNED: Systematic review.
UNASSIGNED: Proximal phalangeal fractures of the hand are challenging to treat, and significantly impact hand function and quality of life if poorly managed.
UNASSIGNED: A systematic review to determine the efficacy of conservatively managed extra-articular proximal phalanx fractures to optimise recovery and prevent the need for surgical intervention and its associated risks.
UNASSIGNED: A literature search that included variations of the phrases \'proximal phalanx\', \'fracture\' and \'conservative management\' was performed on 17 December 2023 using seven electronic databases and trial registries. Article screening, data extraction and critical appraisal using the Structured Effectiveness Quality Evaluation scale was performed independently.
UNASSIGNED: Seven studies that captured 389 fractures from 356 unique patients were included. Studies were of level II to IV evidence and included one comparative cohort study and six prospective case series. Interventions involved timely rehabilitation, a plaster or orthotic device, controlled metacarpophalangeal joint flexion and free mobilisation of the interphalangeal joints. A weighted mean total active motion score of 249° was achieved, with 99.5% (387/389) of fractures achieving union.
UNASSIGNED: This systematic review cautions against definitive recommendations on conservative techniques for managing proximal phalanx fractures due to limitations of the available literature. However, our findings tentatively supports non-operative approaches as an alternative to surgery.

OBJECTIVE: Using a set of process-of-care quality measures for electrodiagnostic testing in suspected carpal tunnel syndrome (CTS), the research team previously documented large variations in electrodiagnostic testing practices and adherence to quality measures. This study sought to enhance the applicability and validity of the quality measures by integrating acceptable variations in testing practices.
METHODS: We recruited 13 expert electrodiagnostic medicine specialists from five specialty societies. The experts iteratively refined five quality measures, and then rated the validity of the refined quality measures (1-9 scale). During this process, the experts reviewed data on adherence to existing quality measures and variations in electrodiagnostic testing practices, and considered recently published quality measures from the American Association of Neuromuscular and Electrodiagnostic Medicine.
RESULTS: Three quality measures (electrodiagnostic testing before surgery for CTS, temperature assessment during electrodiagnostic testing, and electrodiagnostic criteria for severe median neuropathy) underwent few refinements and were rated valid (medians 8-9). Two measures (essential components of electrodiagnosis, criteria for interpreting electrodiagnostic tests as median neuropathy) were judged valid (medians 8) after revisions. For these measures, experts\' ratings on the recommended components of sensory or mixed nerve conduction studies varied: agreement among the experts about the use of sensory peak latency was greater than for onset latency or sensory velocity.
CONCLUSIONS: This study produced quality measures that provide minimum standards for electrodiagnostic testing for suspected CTS that are more comprehensive and nuanced than prior versions. Future work can assess the feasibility, reliability, and validity of these refined measures in diverse physician practices.