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At least 253 records · Page 14Linked to original sources
PubMed1992

Rheumatoid arthritis-like deformities in an early 16th-century painting of the Flemish-Dutch school.

Hand deformities resembling those of rheumatoid arthritis have been depicted in a painting by an anonymous artist of the Flemish-Dutch School, mid-15th to early 16th century. The painting is presently in the Escorial Museum near Madrid, Spain. This observation, like other earlier observations of rheumatoid deformities in paintings of the Middle Ages, suggests that rheumatoid arthritis is not a modern disease; it had, indeed, appeared several centuries before Landré-Beauvais' description in 1800.

Arthritis, Rheumatoid↗
PubMed2006

[Reparation and reconstruction of the postburn deformity and functional disability].

OBJECTIVE: To investigate the development made in the reparation and reconstruction of the postburn deformity and functional disability in the advanced-stage patients. METHODS: Based on the reviewed literature at home and abroad and combined with our clinical experience, the new reparative and reconstructive techniques for the patients with advanced-stage deformity and functional disability were evaluated. RESULTS: The reparative and reconstructive microsurgical techniques achieved a significant development in treating the following pathologic changes after burn: deformity due to proliferation and contracture of the scars, severe hand deformity, defects occurring in the muscle tendons and nerves due to electricity burn, and defects occurring in the long tubular bones of the extremities. CONCLUSION: Although there has been a great achievement in this field, there is still a hard task of finding out newer therapeutic approaches and achieving more effective results in the future.

Burns↗
PubMed1998

Pollicisation of the index finger. A 27-year follow-up study.

We have reviewed 11 patients with congenital absence of the thumb, treated by pollicisation of the index finger, after follow-up for 20 to 38 years. Seven of the hands also had an associated radial club-hand deformity. Function as assessed by the Percival score was excellent in six, good in three, fair in two and poor in four; three of the poor results were in patients with radial club hand. Ten of the 15 transfers were used as normal thumbs, but in five hands function required trick movements. Of the seven unilateral cases, two transplants were used as the dominant hand, and in another two thumb strength was more than 50% of that on the opposite side. For patients with isolated congenital absence of the thumb, pollicisation of the index finger gives good functional and cosmetic results which are maintained. The results are less reliable for those with radial club hand.

Activities of Daily Living↗
PubMed1996

A clinical study on severe hydroa vacciniforme.

OBJECTIVE: To describe a severe type of hydroa vacciniforme (HV) in order to provide basis for treatment and prevention of this disease. METHODS: Nine cases of HV were collected in our outpatient department, and clinical and laboratory examinations were performed. RESULTS: All the cases had erythemas, papules, bullae, erosions or ulcers on exposed sites, with recurrences, gradually resulting in deformation. Five patients suffered from hand deformation manifesting rigidity, flexor tetanus, or malposition of the first, second and third interphalangeal joints of hands. Two of the above mentioned patients manifested partial bone absorption of fingers. Five patients showed partial defect of auricle. Two patients showed saddle nose, and partial absorption of nasal cartilage. One patient displayed cicatricial contracture of lower lip, with incisor extrusion. Four patients showed opacity of cornea. Through laboratory examinations, porphyrinopathies were excluded. Phototests showed increased sensitivity to ultraviolet-A radiation (UVA). CONCLUSIONS: Based on the clinical features and laboratory examinations, these patients were diagnosed as having severe HV. It is believed that this condition belongs to a disease spectrum induced by ultraviolet light. Our analysis suggests that for children with severe type of HV, preventive measures and therapeutic agents should be taken as soon as possible in order to avoid deterioration of the disease and malformations.

Adolescent↗
PubMed1994

Relationship between weakness and muscle wasting in rheumatoid arthritis.

OBJECTIVE: To relate weakness of grip to loss of forearm muscle bulk, hand joint deformity, and hand joint tenderness in patients with rheumatoid arthritis (RA). METHODS: Using anthropometric data we have estimated the anatomical cross-sectional area (CSA) of forearm muscles in 100 subjects with RA compared with 100 aged and sex-matched normal subjects. We also recorded hand joint tenderness using a modification of the Ritchie articular index, and a simple index of hand joint deformity. RESULTS: We found a significant reduction in anatomical CSA in RA (forearm CSA in normal subjects 29.7 cm2 and in RA 25.9 cm2; p = 0.002). In simple linear regression we found that 46.3% of the variation in grip strength in normal subjects was explained by variation in muscle CSA; in RA this figure decreased to 33.4%. Adding terms for joint deformity and pain in a multiple regression model improved the amount of variation explained to 37.9%. CONCLUSIONS: Although there is significant muscle wasting in RA, it is likely that reduction in strength is also attributable to joint deformity and pain leading to inhibition of grip directly and, indirectly, by arthrogenous muscle inhibition. Doubts remain about the quality of muscle in RA.

Adult↗
PubMed1980

Salvage procedures for mutilated burnt hands.

In a severely burnt hand one of the most difficult problems in reconstructive surgery is the prevention of contractures. Early skin grafting, and the reduction of oedema and joint stiffness by early mobilization, will minimize contraction, but will not altogether prevent it. When the dominant hand has also suffered damage, the need for a reconstructive procedure is absolutely essential, and by far the best functional and cosmetic results are achieved with the use of local tissue from the damaged digits. This paper describes various reconstructive salvage procedures for severely deformed hands.

Adult↗
PubMed1977

Split hand and food deformity and the syndrome of ectrodactyly, ectodermal dysplasia, and clefting (EEC). A report of five patients.

Five new casses of ectrodactyly are described. Two patients have the syndrome of ectrodactyly, extodermal dysplasia, and clefting (EEC). In one patient with the EEC syndrome, the disorder seems to represent a new mutation. One woman with isolated ectrodactyly has a daughter with the EEC syndrome. The variation in the clinical expression of this disorder among affected members of the same family makes it difficult to determine whether there may be several mutant alleles responsible for ectrodactyly and its related manifestations.

Abnormalities, Multiple↗
PubMedDate not supplied

Palmaris longus--a muscle with multiple uses in leprosy-affected hands.

The present paper reviews the anatomy of palmaris longus muscle and also the situations where palmaris longus muscle has been used as an independent motor or as a donor of tendon graft material. Its relevance in leprosy-affected hands is also discussed because the muscle is usually spared in hand palsies consequent to leprotic neural damage. The advantages and disadvantages of its use in different operative procedures have been analyzed. The author's experience with this muscle in the correction of hand deformities in leprosy is described.

Hand Deformities↗
PubMedDate not supplied

Development rate of mutilans fingers in patients with rheumatic disease.

OBJECTIVE: To describe arthritis mutilans (AM) deformity during the progression of rheumatic disease. METHODS: The development of mutilans-like hand deformities in 2 patients with juvenile chronic arthritis (JCA) and in 2 patients with adult onset rheumatoid arthritis (RA) are presented. The hands of these patients were evaluated at least at two time points during the course of disease using two different scoring methods based on differently summed Larsen grades of the hand joints. RESULTS: Two patients (one with JCA and one with RA) showed AM changes after a disease period of less than 10 years and 2 not until after 30 years. The patients with adult onset disease were young at the onset of joint disease. Early wrist fusions were performed on both patients showing a slow development rate. CONCLUSIONS: The development rate of AM is very variable, even in patients with the same diagnoses. Wrist fusion prevents shortening of the carpus and may decrease the development rate of AM.

Adult↗
PubMed1979

[Arterial patterns in congenital deformities of the hand (author's transl)].

Etiology of congenital deformities of the hand is still unknown in most cases. But anomalous development of arteries has been suspected to play a role in faulty development of the hands. Senior (1926) and Singer (1933) have reported arterial anomalies in the developmental stage of these vessels. Between 1968 and 1978, 367 patients with 453 congenital deformities of the hand visited the hand service of Kyoto University Hospital. These hand anomalies were classified according to Swanson's classification. Angiography was performed on 74 hands of 70 patients in this series, and attempts were made to correlate these with the types of the deformities. From the standpoint of embryological development of arteries, it is concluded that failure of formation of parts (arrest of development), failure of differentiation (separation) of parts and duplication are generated in the same stage from 48 days postovulatory (18 mm embryo), overgrowth (gigantism) of the hand and congenital constriction band syndrome are generated after 52 days postovulatory (23 mm embryo). Generalized skeletal anomalies are considered to be generated in the various developmental stages depending on the each malformed hands. Developmental stage of malformed hands with generalized skeletal abnormalities is discussed with special reference to the embryological development of other anomalies.

Adolescent↗
PubMed1986

Upper limb amputations and prostheses.

The management of amputations is an important area of surgery of the hand and demands the same measured judgment, global perspective, and technical skill of any other reconstructive procedure. The needs of each patient are different, even when physical losses are similar. In terms of physical impairment, the bilateral hand amputee is a totally different problem than the unilateral. Logical choice requires knowledge of and consideration of all the alternatives, including prosthetic fitting potentials. As surgical procedures often are irreversible, it is important that the best master plan be devised as early as possible. Major reconstructions for the partially amputated hand and prosthetic fitting usually have a remarkably common physical goal--restoration of a simple vise mechanism. Today, this goal must include restoration of a socially acceptable presentation of the constantly exposed hands. To many patients in our mobile and competitive society, the latter will be their greater need. Both active and passive prosthetic devices are functional; they simply meet different needs and each has advantages and disadvantages. The usefulness of motorized units for unilateral amputees remains severely limited as all such devices are "second-thought" mechanisms having no sensory feedback, an indispensable requirement for automatic control. Hand prostheses are playing an increasingly important role in the treatment of amputees. The surgeon charged with primary responsibility of care must be knowledgeable about them. With the rapid changes in our work force and the ever-increasing mobility of our society, it is unrealistic to ignore or deny that a grotesque or badly deformed hand is a serious socioeconomic liability. The needs of each patient are different, but the prosthetic needs of most patients in the future will include mechanically simple devices of socially acceptable appearance.

Amputation, Traumatic↗
PubMed1962

Mirror hand.

Explore the source record for details and available documents.

Hand Deformities↗
PubMed2006

Precision grip function after free toe transfer in children with hypoplastic digits.

Although toe-to-hand transfer has a defined role in the management of congenital hand deformities, it remains unclear how well children integrate the transferred digits into physiological grasping. We analysed fingertip forces in the precision grip of 13 patients when lifting a test object more than three years after free toe transfer for absent or hypoplastic digits. Clinically, most patients showed normal sensibility of transferred digits, but active motion and pinch strength were limited as compared to the normal hand. For the control of fingertip forces, two key features of the normal two-digit opposition grip were seen in all operated hands: adaptation of grip force to object weight and parallel coordination of lift and grip forces. These physiological grasping strategies developed independently of the patients' age at the time of operation, which ranged from one to 13 years. In four patients, we observed increased tangential load forces with the operated hand due to misalignments in the application of fingertips on the grasp surfaces. Such forces lead to increased grip force requirements on both fingers that may overload transferred digits with limited motor function. The need for optimal alignment of the grip axis during toe-transfer surgery is emphasised.

Adaptation, Physiological↗
PubMed2001

Brachydactyly type C.

Brachydactyly type C is an autosomal dominant disorder with markedly variable penetrance. A patient with limited gene expression has shortening limited to the middle phalanges and the first metacarpal and an elongation of the radial side of the base of the second proximal phalanx. When completely expressed the characteristic radiographic findings are shortening of all the metacarpals, greatest in the thumb, followed by the little, ring, middle, and index fingers; brachymesophalangy (shortening of the middle phalanges); shortening of the proximal phalanges of the index and middle fingers, with the proximal phalanges of the ring and small fingers of normal length; elongation of the radial side of the base of the second proximal phalanx resulting in a trapezoidal shaped epiphysis; ulnar deviation at the second and third metacarpophalangeal joints; and hypersegmentation (extra phalanx) of the index and middle fingers. The ulnar deviation of the index and middle fingers may result in scissoring and require surgical correction. The hand deformities of 10 patients with brachydactyly type C are presented to characterize the hand abnormalities in the syndrome and its variable presentation.

Adult↗