Conflicts of interest (COI) are pervasive in hand surgery, where clinical practice, research, and education intersect with industry. Beyond financial ties, COIs can be research-related, personal, social media-associated and royalty-based, influencing implant choice, study outcomes and educational content. Evidence shows that inaccurate disclosures remain common, with up to 81% of authors failing to report COIs correctly, while social media and mentorship reveal hidden biases. These conflicts risk undermining scientific integrity and patient trust. Mitigation requires a multi-level approach: full transparency in disclosures, adherence to social media guidelines, distancing from decision-making roles when conflicts exist, institutional COI registries, standardized journal policies and unbiased selection for conferences and leadership positions. Fostering a culture of integrity ensures collaboration with the industry and helps to advance innovation without compromising ethics or patient care.
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