Biomedical subjects
Publications and source records attributed to G M Rayan.
A case is reported in which a radial deviation deformity of the middle fingers at the proximal interphalangeal joints developed in a young athlete who sustained repeated trauma to the finger tips by a basketball. There were no other factors that suggest a different etiology for this deformity.
Traumatic recurrent dislocation of the extensor carpi ulnaris tendon may occur in athletes. Two such cases are discussed; the first is a bareback bronco rider and the second is a tennis player. It is suggested that acute wrist trauma followed by chronic repetitive forearm rotation, wrist palmar flexion, and ulnar deviation are common factors in producing this entity. Immobilization of the wrist and forearm following acute wrist trauma in a suspected case may prevent this condition.
Compression by a cervical rib may result in neurologic and/or vascular symptoms. Two patients are reported with thoracic outlet syndrome (TOS) secondary to cervical rib. Both patients had vague shoulder pain as well as neurologic manifestations due to compression neuropathy of the lower trunk of the brachial plexus. One patient was suspected initially to have carpal tunnel syndrome.
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We evaluated twenty-eight patients (30 thumbs) after ligament reconstruction arthroplasty for trapeziometacarpal arthrosis. The mean age was 60 years, 86% were women, and the average follow up was 38 months. Subjective results showed excellent (40%) or good (57%) pain relief in 97% of patients. Return to previous work or activity level was achieved in 98%. Overall satisfaction was observed in 86% of patients, mostly because of pain relief. Functional improvement was reported for many activities except for jar opening, which continued postoperatively to be the most difficult task to perform. Thumb mobility improved postoperatively. Key pinch strength showed an overall decrease of 27%. Proximal migration of the thumb metacarpal measured 27% and radial subluxation measured 1%. Thumb metacarpophalangeal joint hyperextension was present in > 50% preoperatively and in 7 of 30 thumbs postoperatively. Hyperextension was prevalent among women on hormone replacement therapy including three patients who had recurrence of these deformities in spite of attempts to stabilize this joint during surgery.