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High-definition Transcranial Direct Current Stimulation over Right Dorsolateral Prefrontal Cortex to Enhance Metacognitive Sensitivity
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The balance between artificial and human intelligence in clinical practice.

Domenico Marrella1, Turkka Anttila2, Jorma Ryhänen2

  • 1Department of Hand Surgery, Strasbourg University Hospitals, FMTS, France.

The Journal of Hand Surgery, European Volume
|January 16, 2026
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Summary

Artificial intelligence (AI) enhances hand surgery across diagnosis, treatment, and recovery. Careful implementation is crucial to mitigate risks like bias and ensure AI augments, not replaces, clinical judgment for better patient outcomes.

Keywords:
Artificial intelligenceclinical decision supportdata governance machine learningdiagnostic imagingethicshand surgerysurgical robotics

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Area of Science:

  • Orthopedic Surgery
  • Medical Artificial Intelligence
  • Digital Health

Background:

  • Artificial intelligence (AI) is increasingly integrated into clinical hand surgery.
  • AI applications span diagnosis, surgical planning, intraoperative assistance, and postoperative care.

Purpose of the Study:

  • To review the current applications of AI in hand surgery.
  • To identify the risks and challenges associated with AI adoption in this field.
  • To propose strategies for the balanced and ethical integration of AI in hand surgery.

Main Methods:

  • Literature review of AI applications in hand surgery.
  • Analysis of AI's role in diagnostic imaging, prognostication, pre- and intraoperative procedures, and postoperative care.
  • Examination of risks including data privacy, algorithmic bias, and ethical considerations.

Main Results:

  • AI improves fracture detection, osteoporosis estimation, and soft tissue injury identification in diagnostic imaging.
  • AI aids in carpal tunnel syndrome diagnosis and prognostic modeling, with variable performance.
  • AI supports surgical planning, navigation, robotic assistance, and postoperative monitoring through telemonitoring and mobility tracking.

Conclusions:

  • AI offers significant potential to enhance hand surgery outcomes.
  • Addressing risks like data privacy, bias, and skill erosion is critical for safe AI integration.
  • Ethical considerations, transparency, and continuous monitoring are essential for AI to augment clinical judgment and ensure patient-centered care.