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PubMed1995

[Closed extensor tendon injuries of the finger].

The extensor apparatus of the fingers is a complex structure. The diagram of the extensor apparatus as seen in figure 1 is in reality not so clearly structured. Closed lesions are the mallet finger, where either an avulsion of the bony insertion of the tendon occurs or where a fracture of the base of the distal phalanx with dislocation of a bone-fragment together with the tendon insertion has happened. Other closed lesions are the closed Boutonnière deformity and the avulsion of a lumbrical muscle. The mallet finger is mostly treated conservatively with a prefabricated splint holding the DIP-joint in extension or with a temporary arthrodesis with a Kirschner-wire blocking the DIP-joint in extended position. If bigger pieces of bone are extruded from the base of the terminal phalanx this fragment must be fixed operatively. Today, very fine screws are often used. Also in these cases, a temporary arthrodesis may be helpful. This treatment lasts for 7 weeks. Afterwards for another two weeks the DIP-joint should be immobilised with a Stack-splint during the night. In the Boutonnière deformity the PIP-joint is in flexion and the DIP-joint in hyperextension. The reason is a lesion of the central extensor tendon over the PIP-joint with anterior dislocation of the lateral bands of the interosseus tendon. In early cases by stretching the finger passively the lateral band will be repositioned. In these cases, a conservative treatment with a splint holding the PIP-joint in extension may be successful. This can be combined with revision and suturing of the ruptured part.(ABSTRACT TRUNCATED AT 250 WORDS)

Finger Injuries↗
PubMed1989

Flexor tendon sheath haematoma: a case report.

An open finger injury reported here was diagnosed as a division of the flexor tendons of the little finger. However, surgical exploration revealed intact tendons encased in a tense flexor tendon sheath haematoma. Decompression of the haematoma led to a satisfactory recovery of finger function.

Finger Injuries↗
PubMed2003

Don't save the ball!

OBJECTIVES: To identify, over a period of 12 months, all attendances at an accident and emergency department by children over the age of 5 years with an injury to a wrist, hand, or finger, and to examine those sustained as a result of a blow from a ball. METHODS: The case notes of all children aged 6-13 years attending the Accident and Emergency Department of the Royal Aberdeen Children's Hospital in the year 2001 as a result of a wrist, hand, or finger injury sustained from a blow by a ball were reviewed, and the cause, type, and severity of the injury noted. RESULTS: A total of 187 children were identified; 69% were boys and football was the main sport involved. Most (93%) were radiographed, and 40% were positive; most fractures were sustained outwith school. Hand dominance was not significant. CONCLUSIONS: These injuries are common and may be preventable with modification of rules, equipment, and coaching. A register of youth sporting injuries may show if there are any detrimental long term effects.

Adolescent↗
PubMed1999

Contribution of lumbrical muscle activity to the paradoxical extension phenomenon induced by injuries to the finger flexor tendons.

The "Extensor habitus" phenomenon occurs in finger flexor tendon injuries and consists of a paradoxical extension of the interphalangeal joints after an attempt to flex the finger. The mechanism of extension is considered to be a contraction of the flexor digitorum profundus that is then transmitted via the lumbrical muscle structure to the extensor expansion. Using electromyography, we recorded the lumbrical muscle activity during the paradoxical extension phenomenon to determine whether the lumbrical muscle contributed to this event. Two patterns of electromyographical activity of the lumbrical muscle were observed. Group I (6 fingers) displayed electrical activities in the lumbrical muscle during flexion tasks, while group II (12 fingers) did not. In group I, the lesions were mainly located in zone V, and the response to range of motion exercises was satisfactory. In group II, nearly all of the lesion were located in zone II, and half of the cases required additional surgical interventions. Group II appeared to exhibit the "Extensor habitus" phenomenon, while group I exhibited an "Extensor habitus-like phenomenon." To distinguish between these two phenomena, an electromyographical examination of the lumbrical muscle must be performed.

Adolescent↗
PubMed2005

[Prevention of school sport injuries--an analysis of ballsports with 2234 injuries].

PURPOSE: Ball sport school injuries account for a significant morbidity among children and adolescents. MATERIALS AND METHODS: During a school year 2234 school sport injuries have been reported to the Gemeinde Unfall Versicherung (GUV) Niedersachsen, Germany. RESULTS: Regarding the non-gender-specific distribution of the ball sport disciplines, basketball leads with 32 % (n = 431), followed by soccer (24 %, n = 316), volleyball (17 %, n = 232), handball (8.3 %, n = 110) and hockey (4.9 %, n = 65). Sprains (27 %) dominate in basketball, followed by ligament distorsions and ruptures (23 %) and fractures (21 %), with frequent finger injuries (61 %) without contact of an opponent, and injuries of the lower extremity (28 %). Soccer leads to contusions (29 %), in 52 % of the lower extremity frequently after collision with an opponent (22 %) or the ball (20 %). In volleyball upper extremity injuries (71 %) dominate with 53 % finger sprains in individual volleyball play. CONCLUSION: Ball school sport injuries account for a significant morbidity with frequent finger injuries. Proprioceptive deficits may play a role in those finger injuries in basketball, volleyball and handball. During hockey, severe dental and facial injuries were apparent. A prospective proprioceptive training program aiming on fingers and the ankle region may therefore be a preventive measure such as helmets with facial protection in hockey school sport.

Adolescent↗
PubMed1991

Simultaneous reconstruction in severe degloving injuries of the fingers.

The reconstruction of degloved fingers often requires tissue coverage from a distant donor site, transferred to the defect by means of pedicle flaps. The authors propose three main donor areas, depending on the reparative needs of the hand: the contralateral upper limb, the abdomen, and the retroauricular-mastoid region. The reconstruction techniques described in this paper guarantee satisfactory morphological and functional results and are therefore preferred in immediate reconstruction of the fingers following degloving injuries.

Adult↗
PubMed1994

Reverse dorsometacarpal flap in digits and web-space reconstruction.

Skin defects in some areas of the digits are difficult to reconstruct, such as the ulnar aspect of the little or ring finger, radial aspect of the index, dorsal or volar aspect of fingers with proximal interphalangeal or metacarpophalangeal joint involvement, and proximal phalanx of the thumb. Moderate or severe contracture of the web space and multiple finger injuries without an available cross-finger flap are also a challenge to reconstructive surgeons. The reverse dorsometacarpal flap presents an option for reconstruction because of these difficulties. It is reliable and versatile in design. The donor site can be closed primarily provided the flap is less than 2 cm wide.

Adult↗
PubMed1994

The rupture rate of acute flexor tendon repairs mobilized by the controlled active motion regimen.

A series of 233 patients with complete divisions of flexor tendons in zones 1 and 2 underwent operation following emergency admission over a period of 3.5 years. These included 203 patients with 317 divided tendons in 224 fingers injuries in zones 1 and 2 and 30 patients with 30 complete divisions of the flexor pollicis longus tendon in zones 1 and 2. All of these patients were mobilized post-operatively in a controlled active motion regimen. 13 (5.8%) fingers and five (16.6%) thumbs suffered tendon rupture during the post-operative period. Patients treated during the last year of the study were followed prospectively for a minimum period of 3 months; ten of the 16 (62.5%) fingers with zone 1 repairs, 50 of the 63 (79.4%) fingers with zone 2 repairs, all three (100%) FPL divisions in zone 1 and three of four (75%) FPL divisions in zone 2 had good and excellent results on assessment by the original Strickland criteria (Strickland and Glogovac, 1980). These results confirm the safety of this regimen as an alternative to other regimens of post-operative flexor tendon repair mobilization in zone 1 and 2 finger injuries. However, in the unmodified form used in this series, this regimen has too high a rupture rate for FPL mobilization.

Acute Disease↗
PubMed2006

Injuries of the fingers and thumb in the athlete.

Injuries of the fingers and thumb in the athlete are common. Mallet finger, jersey finger, boutonniere deformity, Bennett and Rolando fractures, and gamekeeper's thumb are just a few of the injuries that can occur in athletes. A thorough understanding of the mechanism of injury, osseous and soft tissue abnormalities, imaging features, and treatment is important in the care of athletes. Prompt and accurate diagnosis is important and may help minimize outcomes of malunion, posttraumatic arthritis, and debility.

Athletic Injuries↗
PubMed1998

Epinephrine in digital blocks: revisited.

Digital block anesthesia with epinephrine, ring technique, and digital tourniquet have been implicated in causing finger gangrene. An extensive review of the literature provided no case of finger gangrene attributed solely to the adjunctive use of epinephrine with lidocaine for digital block. By causing vasoconstriction, epinephrine complements the local analgesic by prolonging the duration of action and providing a temporary hemostatic effect. Epinephrine augmentation of digital block anesthesia was used in the treatment of 23 finger injuries without a complication.

Adolescent↗
PubMed1988

The versatile axial pattern digital transposition flap.

The anatomic and clinical basis for a reliable and versatile axial pattern transposition flap for reconstruction of complex distal finger injuries is presented. This is a one-step procedure utilizing the nondominant side digital skin with possible preservation of the nerve to the fingertip. This flap obviates the necessity for a distant donor site and provides nonbulky good quality tissue. In eight patients requiring nine flaps, it has proved valuable in the salvage of severely injured digits. These injuries probably would have required distant flap reconstruction or flaps that might have jeopardized adjacent digits.

Adolescent↗
PubMed1987

Foreign body granuloma and synovitis of the finger: a hazard of ring removal by the sawing technique.

A case of chronic digital synovitis and foreign body reaction secondary to metallic filings is reported. The patient had a digital mass and a previous history of a ring finger injury. A saw action ring remover was implicated as a source of foreign bodies produced by ring removal over the open wound. Care should be taken to avoid implantation of metal filings with this technique, and an alternate method of removing rings from injured fingers should be considered.

Adult↗