Hand Surgery Research

Hand Surgery is defined as the management of afflictions of the hand and wrist, management of upper limb conditions that affect hand function and microsurgical reconstruction of the hand and upper limb. Hand surgery deals with the skin and its contents, all of which are based on the skeleton of the hand and upper limb; the joints which allow positioning and function of the hand; the tendons and their muscles which control joint motion; the nerves which provide the messages for muscle control and activity, supply sensation to the skin and instruct the position and integrity of joint behaviour; and the vessels which provide life for all tissues, bone and soft tissue.

The Department of Hand Surgery and Peripheral Nerve Surgery is involved in numerous research projects within Royal North Shore Hospital and North Shore Private Hospital. Research projects are run in collaboration with:

  • The Children's Hospital at Westmead;
  • Royal North Shore Hospital's Department of Orthopaedics, Tetraplegia unit, multi-disciplinary Spasticity Clinic, and the Department of Physiotherapy;
  • The Kolling Institute's Maxwell Murray Biomechanics Research Laboratory and Sutton Laboratories;
  • The University of Sydney;
  • International hospitals and universities (e.g. ERASMUS Medical Centre in Rotterdam, Netherlands; Loma Linda University, California, USA)
  • Pharmaceutical companies and external groups with a hand surgery interest.

Research conducted within the department includes surgical outcome reviews, surgical technique developments (animal models), multi-centre international trials and publishing of case reports. The department receives 6-8 Australian and international fellows each year and each actively pursues a research project during their term. Hand surgery registrars from the Australian Orthopaedic and Plastic Surgery training schemes are required to undertake research and medical students are encouraged to assist. Master of Surgery and Master of Philosophy students may also undertake projects in the field of hand surgery. Research findings are published in Hand Surgery journals and presented at national and international meetings.

The number of worthwhile studies that can be conducted is limited only by imagination and by resources and facilities. From these studies comes better understanding and better methods of management, leading to better outcomes of care.

Current AND RECENTLY COMPLETED PROJECTS

Clinical Studies

  • Efficacy of XIAFLEX® (collagenase clostridium histolyticum) injection for Dupuytren’s contracture
  • Cost comparison of treatment of Dupuytren’s Disease: Collagenase injection vs fasciectomy
  • Congenital thumb hypoplasia:  A retrospective review of results of surgical reconstruction of Grade 2 thumbs
  • Radiological assessment of the reconstructed thumb CMC joint following pollicisation
  • Outcomes of the Medial Femoral Condyle (MFC) Free Bone Flap Procedure
  • Donor site morbidity following the Medial Femoral Condyle (MFC) Free Bone Flap Procedure – Patient reported outcomes
  • Review of CMCJ arthroplasty: case series
  • Web position measurement: pre- and post-syndactyly release

Anatomical / Biomechanical studies

  • Intramuscular anatomy and innervation of the muscular components of the axillary nerve: Cadaveric study
  • Effect of the saggital bands on metacarpophalangeal joint extension
  • Effect of extensor tendon adhesions on amplitude of finger joint movements: cadaveric study
  • Axonal count of the intercostal nerves
  • Biomechanical variation in headless compression screw fixation
  • Ligament of Struthers: Cadaveric study of comparative anatomy

Case studies/series

  • Neutrophilic dermatosis of the hand - a case series
  • Free medial femoral condyle flap for treatment of scaphoid nonunion with avascular necrosis in skeletally immature patients
  • One bone forearm procedure with medial femoral condyle osseous free flap
  • Recurrent cubital tunnel syndrome with ulnar nerve subluxation
  • The Austrian Flag: Severe carpal tunnel syndrome
  • Congenital hallucal hypoplasia equivalent to a grade 3 hypoplastic thumb in a patient with VACTERL association

Literature reviews

  • Treatment outcomes in congenital syndactyly release: a systematic review
  • Treatment outcomes of surgical reconstruction of congenital thumb hypoplasia, excluding pollicisation: a systematic review
  • Treatment outcomes of pollicisation for thumb hypoplasia: a systematic review