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At least 181 records · Page 10Linked to original sources
PubMed1991

[Compound vascularized island joint transfer in hand surgery. Apropos of a series of 16 cases].

Sixteen compound island joint transfers performed in 14 patients were reviewed with a mean follow up of 37.6 months. 15 were harvested from a non conservable "finger bank" and one as an homodigital islanded DIP to PIP transfer. The "donor" joint was an MP joint (7 cases), a PIP joint (5 cases) and DIP joint (4 cases). The reconstructed joint was the MP joint (10 cases) or the PIP joint (6 cases). If we exclude one failure (arthrodesis), the average range of flexion was 45 degrees for MPJ and 42 degrees for PIPJ. In selected cases with good patient motivation, available "donor" finger and intact flexor tendon in recipient digit, this technique provided a one stage composite reconstruction, a good lateral stability in pinch with possibility of growth in children and long term preservation of the articular cartilage.

Adult↗
PubMed1995

Responsiveness of Keitel functional index compared with laboratory measures of disease activity in rheumatoid arthritis.

This study compares functional changes to change in measures of disease activity following the introduction of slow-acting anti-rheumatic drugs (SAARD) in patients with active rheumatoid arthritis (RA). Clinical and laboratory variables were simultaneously monitored at 6-monthly intervals, over approximately 18 months. Function was measured by a performance testing, the Keitel function index (KFI), which was divided into sections representing small and large joints [hand (HFI); wrist (WFI) and limb function index (LFI)]. One-hundred-and-fifteen patients were studied, of whom 21 were male. The mean age of the subjects was 49 yr (S.D. +/- 12) and mean duration of disease 7 yr (S.D. +/- 7). The mean KFI at entry was 38 (S.D. +/- 18) while at the end of the study it was 31 (S.D. +/- 17) (P < 0.0001). The change in KFI following therapy correlated with the change in Ritchie articular index (RAI) (r = 0.4; P < 0.0001), early morning stiffness (EMS) (r = 0.3; P = 0.004), swollen joint count (JC) (r = 0.4; P = 0.0005), C-reactive protein (CRP) (r = 0.2; P < 0.05) and Lansbury systemic index (LSI) (r = 0.35; P = 0.002), but not with change in Westergren erythrocyte sedimentation rate (ESR) or change in time to onset of fatigue. Multiple regression analysis showed that 32% of the variation in KFI at the end of the study could be predicted by a combination of ESR, sulphasalazine therapy, RAI, disease duration and chloroquine treatment at onset (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Inflammatory Agents↗
PubMed1977

Correlation between pseudospondylolisthesis and arthrosis of the hands.

Two groups of 25 patients, one with pseudospondylolisthesis (PSL) and the other without, have been compared in order to verify the impression that arthrosis of the hands occurs more frequently in those with PSL. The observed differences were significant, being especially marked in women in whom five or more hand joints were involved and increasing in frequency with age. No relation was found between PSL and either discarthrosis or being overweight. The presence of PSL can probably be included in the pattern of generalized osteoarthrosis described by Kellgren and Lawrence (1958).

Adult↗
PubMed1987

[Arthroses of the radial ray of the wrist joint with special reference to the correlation between trauma and arthrosis].

Incidence of arthrosis in the region of the hand-joint and carpal bones has proved to be substantially higher than generally assumed. This was established by X-ray analysis in more than 80 per cent of all cases investigated. The changes thus recorded were found to be related to sex and age. Studies were conducted into the relationship between arthrosis and previous trauma.

Adult↗
PubMed1993

A randomized controlled trial of home exercise on the rheumatoid hand.

OBJECTIVE: To study differing home hand exercise interventions to determine effects on grip strength, and secondarily any immediate or short term effects on range of motion, pain, deformities, hand disease activity, and dexterity. METHODS: Randomized controlled trial of 12 weeks of home hand exercise performed for 10-20 min twice daily. Study exercise interventions were range of motion exercises, balanced resistive exercises, and range of motion plus balanced resistive exercises. RESULTS: Aside from transient, mild to moderate discomfort, exercises were well tolerated. Range of motion exercises were associated with improved right hand joint count. Range of motion plus balanced resistive exercises were associated with increased left hand dexterity. Home hand exercise (exercise groups combined) significantly increased left grip strength. CONCLUSIONS: Temporary use of home hand exercise has acceptable side effects and is an effective means of increasing grip strength.

Ambulatory Care↗
PubMed2006

Computational model of a primate arm: from hand position to joint angles, joint torques and muscle forces.

Three-dimensional reaching by non-human primates is an important behavioral paradigm for investigating representations existing in motor control areas of the brain. Most studies to date have correlated neural activity to a few of the many arm motion parameters including: global hand position or velocity, joint angles, joint angular velocities, joint torques or muscle activations. So far, no single study has been able to incorporate all these parameters in a meaningful way that would allow separation of these often highly correlated variables. This paper introduces a three-dimensional, seven degree-of-freedom computational musculoskeletal model of the macaque arm that translates the coordinates of eight tracking markers placed on the arm into joint angles, joint torques, musculotendon lengths and finally into an optimized prediction of muscle forces. This paper uses this model to illustrate how the classic center-out reaching task used by many researchers over the last 20 years is not optimal in separating out intrinsic, extrinsic, kinematic and kinetic variables. However, by using the musculoskeletal model to design and test novel behavioral movement tasks, a priori, it is possible to disassociate the myriad of movement parameters in motor neurophysiological reaching studies.

Algorithms↗
PubMed2005

A device for assessment of hand and wrist coronal plane strength.

Diagnostic and rehabilitative assessments of hand function commonly omit measurement of twisting strength even though many activities of daily living require turning handles, lids, and objects of many sizes. A simple device to quantify twisting strength was designed and constructed to establish normative data and test hypotheses about hand function. The instrument is easy to use and includes an electronic torsional load cell and disks of several sizes. Tests were conducted on the dominant and nondominant hands of 64 normal subjects and 13 arthritic patients with arthritis of the thumb carpometacarpal joint. Hands were tested with disks ranging in diameter from 2.5 to 12.5 cm. A three-way repeated measures analysis showed that gender (p < 0.001), handedness (p < 0.001), and disk size (p < 0.001) had significant effects. There was no difference between radial and ulnar deviation strengths (p = 0.365). The arthritic group had significantly reduced strength (p < 0.02). Nine subjects were tested twice, with 1 day between tests: no differences occurred between the first and second testing (p = 0.930). The ability to distinguish the test groups with reproducible results proves that the device fulfills all basic requirements; continued testing and development are warranted.

Adult↗
PubMed2005

[Joint denervations in hand surgery: a plea].

Since the original description of wrist denervation, the principle of joint denervation in hand surgery has been extended to other joints like the first carpometacarpal, interphalangeal and metacarpophalangeal joints. At the wrist level as at the digital level, the results are comparable to those obtained with other surgical alternatives. In case of unsatisfactory results, a more traditional intervention remains always possible.

Denervation↗
PubMed1999

[The quantitative assessment of functional disorders of the hand and upper limb].

Methods have been developed for calculation of quantitative indicators of the hand and upper limb function, which rely on measurement of sensitivity of fingers, the pick-objects-up test (a modified Moberg test), measurement of active and passive movements of joints, hand grips. The following quantitative indicators are computable from formulae: sensitivity, motor function of joints, grips/grasps, coordination of movements. Based on the above four indicators is computation of the integral function of the hand and upper extremity. Computation procedure for quantitative determinants of the upper limb function has been approved of in 156 patients with sequelae of injuries. For a comparative analysis an assessment was performed in these patients of the nerve function by the scoring scale M0-M5, S0-S5, and of the tendon function by the methodology of the American Association of surgeons of the hand and as recommended by Strickland J. W. (1989). The proposed methodology significantly reflects the principal determinants of the function, secures quantitative data on different aspects and integral determinants of the function of the hand and upper extremity.

Amputation, Traumatic↗
PubMed1985

Movements at the carpometacarpal and metacarpophalangeal joints of the hand and their effect on the dimensions of the articular ends of the metacarpal bones.

A detailed study was undertaken to quantify the range of various movements at the carpometacarpal and metacarpophalangeal joints of the hand in cadavers and compare the values so obtained with those in the living, measured with the help of skiagrams. Longitudinal sections of hand were also prepared to bring out the nature of articulations at the carpometacarpal joints. Based on the data available, metacarpal mobility formulae of 1 greater than 5 greater than 4 greater than 2 greater than 3 for the carpometacarpal, and 5 greater than 4 greater than 3 greater than 2 greater than 1 and 5 greater than 2 greater than 4 greater than 3 greater than 1 for metacarpophalangeal joints are being proposed with the hope that these formulae will find their application in the clinical practice to assess the extent of functional damage to these joints as well as to evaluate the rate of progress or deterioration, in course of time. As an extension of our earlier study (Batmanabane, 1982), osteometric analysis of the metacarpus was also carried out and it is confirmed that it is the mobility which determines the osteometric features of the articular ends of these miniature long bones.

Adult↗
PubMed2006

Crossed hands and the SNARC effect: a failure to replicate Dehaene, Bossini and Giraux (1993).

Dehaene et al. (1993, Experiment 6) presented evidence that the mental number line is left-to-right oriented with respect to representational associations and not with respect to left and right hands. Here we tried to replicate the study of Dehaene et al. (1993) in a larger sample (n = 32) using four different stimulus notations (Arabic numbers, number words, auditory number words, and dice patterns). As in the study by Dehaene et al. (1993), the spatial numerical association of response codes (SNARC) effect was examined with an incongruent hand assignment to left/right response keys (crossed hands). In contrast to Dehaene et al. (1993), we did not observe a SNARC effect in any condition. Power analyses revealed that n = 32 should have been large enough to detect SNARC effects of usual size. Furthermore, time-course analyses revealed no SNARC slope in faster and slower responses, so that the null effect could not be due to relatively slow responses with crossed hands. Joint analyses with previous data (Nuerk et al., 2005b) revealed significantly steeper SNARC slopes with congruent hand assignment, and no interaction between hand assignment and notation. Altogether, these findings suggest that the results of Dehaene et al. (1993) only hold under specific conditions. Differences between studies are discussed. We suggest that spatial context has an influence on the SNARC effect and that hand-based associations (and not only representational associations) are relevant for the SNARC effect.

Adolescent↗
PubMed1986

Small-joint arthrodesis in the hand.

Arthrodesis of selected small joints of the hand is often indicated; however, in previously reported series nonunion is not uncommon. There were 171 consecutive arthrodeses of small joints performed on 134 patients. The operative method employed was essentially the method described by Littler. Emphasis was placed on the accurate coaptation of bone surfaces, the use of cancellous bone graft when needed, maintenance of the coaptation with Kirschner wires, and the need for postoperative immobilization. This technique resulted in union of 170 out of 171 arthrodeses (a nonunion rate of 0.6%). There were no infections. There were four delayed unions.

Arthritis, Rheumatoid↗
PubMed1995

Reliability of the articular examination in children with juvenile rheumatoid arthritis: interobserver agreement and sources of disagreement.

OBJECTIVE: To assess the interobserver agreement of articular examination in children with juvenile rheumatoid arthritis (JRA) and identify sources of disagreement. METHODS: Four rheumatologists graded tenderness/pain on motion, swelling, and limitation of motion in the joints of 10 children with JRA, as recommended by the Pediatric Rheumatology Collaborative Study Group, and 17 different joint indices were computed. Agreement was measured by kappa (kappa) and intraclass correlation coefficients (Ri). RESULTS: All 4 observers detected tenderness in 15.7% of the joints, but they disagreed (2 vs 2) on 4.2% (kappa = 0.71). They detected swelling in 5.2% but disagreed on 6.2% (kappa = 0.47). They found limitation in 4.9%, but disagreed on 8.1% (kappa = 0.54). The tender joint count, and the American Rheumatism Association cooperating clinics and Hart modified Ritchie indices were the most reliable (Ri > 0.93); the swelling severity index fared the worst (Ri = 0.40). There were differences in examination maneuvers and judgment among examiners. Discrepancies were larger in metacarpophalangeal joints and in patients with many involved joints. CONCLUSION: There was low agreement in the assessment of joint swelling and limitation of motion. Differences in examiners' techniques, patients with severe disease, and the small hand joints were important sources of disagreement.

Adolescent↗
PubMed1992

Joint impairment and hand function in the elderly.

OBJECTIVE: To test the contribution of joint impairment to observed hand function (grip strength and Williams Test) in the elderly, using a multivariate model. DESIGN: Cross-sectional observational data (baseline data from an ongoing longitudinal study). SUBJECTS: Five hundred forty-one persons over age 60, including continuing care retirement community (n = 222), homebound (n = 72), and ambulatory (n = 247) respondents. Mean age at assessment 76.7, (SD = 9.0). MEASUREMENT: Independent variables included sociodemographics, physician measures of upper joint impairment, an index of comorbidities derived from physical examination or chart abstract, self-assessed arthritis pain, depression, and anxiety. The dependent variables included grip strength and a modified Williams Test [Williams Test (M)]. MAIN RESULTS: The multiple regression explained 59% (Adjusted R2 = .59) of the variance in grip strength, with joint impairment accounting for a change in R2 of .07. Upper joint impairment and grip strength accounted for 3% and 5%, respectively, of the variance in the Williams Test (M) (total amount of explained variance = 45%). CONCLUSIONS: Demographics explain most of the variance in grip strength and performance on the Williams Test (M). Controlling for demographics, musculoskeletal disease represented by joint impairment is associated with diminished grip strength. Reduced grip strength is associated with poorer performance on the Williams Test (M).

Activities of Daily Living↗
PubMed1998

Atypical Takayasu arteritis: late onset and arthritic manifestations: report of two cases.

We recently experienced two cases of Takayasu arteritis rendered atypical by late onset (over 60 years of age) of disease, involvement of distal branch arteries, and association with rheumatoid arthritis. In both cases, roentgenologic examination revealed typical appearance of the abdominal aorta and stenosis of the subclavian artery entirely compatible with Takayasu arteritis. In addition, Case 1 had occlusive lesions of the superficial femoral arteries and Case 2 manifested occlusion of the axillary artery. Laboratory findings showed increased ESR and CRP but negative HLA B52 locus. Both cases showed arthritis symptoms with swelling, pain, and tenderness in joints. Case 1 did not manifest erosive lesions and positive RA test; Case 2 showed roentgenologic erosive lesions in hand joints with positive RA test. A surgical specimen from the femoral artery of Case 1 showed lesions suggesting Takayasu arteritis. Based upon these findings, we diagnosed the two patients as having atypical Takayasu arteritis with late middle age onset and arthritic manifestations.

Anastomosis, Surgical↗
PubMed1995

Quantification of the volume of articular cartilage in the metacarpophalangeal joints of the hand: accuracy and precision of three-dimensional MR imaging.

OBJECTIVE: Cartilage loss is central to the development of joint failure in arthritis. However, radiographic assessment of cartilage loss is highly unreliable. This study examined the accuracy and reproducibility of a noninvasive technique for quantifying the volume of articular cartilage in the metacarpophalangeal joints of the hand by use of three-dimensional (3D) MR imaging. SUBJECTS AND METHODS: Eight metacarpophalangeal joints (four normal, one rheumatoid arthritic, and three normal cadaveric) each were imaged three times with a 1.5-T clinical MR imaging scanner with a small partial volume coil and a fat-saturated 3D spoiled gradient-echo sequence optimized for delineating articular cartilage. The volumes of cartilage over the metacarpal and phalangeal surfaces were quantified by summing the voxels within segmented 3D reconstructions of the images. Cartilage volumes in the three cadaver joints also were estimated by scraping cartilage off the articular surfaces and measuring water displacement in graduated cylinders. These values were used as the gold standard for assessing the accuracy of cartilage volume quantification by MR imaging. RESULTS: The fat-saturated sequence discriminated the articular cartilage from adjacent joint structures with high contrast and high spatial resolution. Cartilage volumes determined by MR imaging for the different subjects ranged from 115 microliters to 222 microliters for metacarpal cartilage and from 34 microliters to 86 microliters for proximal phalangeal cartilage. Accuracy errors for quantifying cartilage volume by MR imaging were -1.8% (95% confidence interval, -3.5% to -0.7%) for metacarpal cartilage and 9.1% (4.3% to 14.7%) for proximal phalangeal cartilage. Reproducibility errors were 5.2% (95% confidence interval, 2.9% to 7.6%) and 9.9% (5.4% to 15.1%), respectively. CONCLUSION: Fat-suppressed T1-weighted 3D MR imaging provides sufficient contrast and spatial resolution to allow accurate and reproducible quantification of articular cartilage volume in the metacarpophalangeal joints of the hand. This technique may be useful for monitoring cartilage loss in patients with arthritis.

Adult↗