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PubMedDate not supplied

The impact of compliance on the rehabilitation of patients with mallet finger injuries.

While patient compliance with hand therapy intuitively seems important to the outcome of treatment, no formal study has validated this assumption. The records of 44 patients who sustained mallet finger injuries were examined retrospectively. Compliance ratings were based on self-reports of performance with home programs and attendance at therapy appointments. Results of therapy were divided into excellent, good, or poor groups depending on the patient's final range of motion and final active extension lag at the distal interphalangeal joint. Statistical analysis reveals that compliant patients have excellent outcomes more often than do noncompliant patients (61.5% and 9.1%, respectively) in the treatment for mallet finger injuries. While increased age may negatively affect the final result of mallet finger injuries, an older individual can favorably influence his or her result by choosing to be compliant with treatment. Even patients who delay initiation of treatment can achieve favorable results.

Adult↗
PubMed1990

Finger injury resulting from pulse oximeter probe during orthognathic surgery.

Pulse oximetry is a useful technique for perioperative monitoring of the surgical patient. The use of the finger clamp design of oximeter probes may cause finger injury in lengthy surgical procedures. A case is presented and discussed with respect to an ischemic finger injury created by an oximeter probe during a hypotensive anesthetic technique. Avoidance of this type of problem includes proper placement of the probe on the finger and changing the probe to a different finger every 3 to 4 hours.

Adolescent↗
PubMed2004

The indications for toe transfer after "minor" finger injuries.

Toe-to-hand transfer is widely considered to be unjustified for "minor" finger injuries. In this invited personal view article the indications for toe-to-hand transfer for finger amputation and neurocutaneous and major pulp defects are discussed, and a classification of multidigital injury that has both prognostic and decision-making value is presented. In the author's opinion a toe transfer should always be considered as an option when reconstructing "minor" finger injuries, as it can reproduce significant long-term benefit to the hand and the patient's sense of well being. The procedure should be carried out in the acute period, not only because it is technically easier and better for hand function, but above all because the surgeon can save structures that will be lost if the transfer is delayed.

Amputation, Traumatic↗
PubMed2005

[High frequency sonography in the detection of finger injuries in sport climbing].

Sport climbing shows an increasing popularity, including even school sport activity on high climbing levels. Climbing related injuries are predominantly located in fingers/ hands ("climber's finger"), and can present as annular pulley rupture or more common as overuse injury. Beside clinical examination imaging modalities such as MRI and high frequency sonography have shown to allow for detection of climbing related injuries. High frequency sonography enables for exact differential diagnosis of climbing related finger/hand injuries and therefore plays a central role in adequate therapeutic management.

Athletic Injuries↗
PubMed2006

[Classification of finger flaps and its use in emergency treatment for finger injuries].

OBJECTIVE: To choose the homo-digital and the hetero-digital flaps in the reconstruction of the distal finger injuries and to summarize the treatment results obtained in the clinical practice. METHODS: From August 2001 to June 2005, 112 injured fingers in 108 patients (68 males, 40 females; aged 16-63 years) were surgically treated. The injuries were due to emotion, crushing or avulsion, and they underwent operations 2 hours after the injuries. Nine kinds of flaps were taken from the dorsal or volar aspect of the injured fingers to cover the defects of the distal fingers. The flaps were divided into two kinds: 1) The flaps were nourished by the main digital arterial branches, including the V-Y island flap based on the digital neurovascular bundles, the reversed digital artery flap, the modified Moberg flap, and the twins flaps based on the digital general neurovascular bundles (flaps ranging in area from 1.5 cm X 2.00cm); and r The flaps were nourished by the collateral digital arterial branches, including the dorsoulnar arterial retrograde flap of the thumb(flaps ranging in area from 1. cm X 1.. cm to 3.. cm Xx2. 5 cm) and the reverse flap based on the dorsal branches of the digital artery (flaps ranging in area from 1. 7 cmX x1. 0 cm to 4. 5 cmX x . 0 cm), the volar flap based on the transverse palmar branch of the digital artery (flaps ranging in area from 2.0 cm Xx1.0 cm to 2. 5 cm Xx2. 0 cm). and the island flap from the dorsum of the index finger and the digital local flaps. RESULTS: The follow-up for 2 weeks to 8 months revealed that all the flaps survived with an exception of flap necrosis in 3 patients and superficial necrosis in 3 patients. The sensation reached almost normal levels in the flaps based on collateral digital arteries and the two-point discrimination was between 5 mm and 10 mm in the flaps based on the arterial branches. The finger motion ability was good and the finger appearance was satisfactory. CONCLUSION: The choice of the above-mentioned skin flaps can repair the soft tissue defects of the distal parts of the fingers, which can have a satisfactory restoration contour.

Adolescent↗
PubMed2006

Acute finger injuries: part II. Fractures, dislocations, and thumb injuries.

Family physicians can treat most finger fractures and dislocations, but when necessary, prompt referral to an orthopedic or hand surgeon is important to maximize future function. Examination includes radiography (oblique, anteroposterior, and true lateral views) and physical examination to detect fractures. Dislocation reduction is accomplished with careful traction. If successful, further treatment focuses on the concomitant soft tissue injury. Referral is needed for irreducible dislocations. Distal phalanx fractures are treated conservatively, and middle phalanx fractures can be treated if reduction is stable. Physicians usually can reduce metacarpal bone fractures, even if there is a large degree of angulation. An orthopedic or hand surgeon should treat finger injuries that are unstable or that have rotation. Collateral ligament injuries of the thumb should be examine with radiography before physical examination. Stable joint injuries can be treated with splinting or casting, although an orthopedic or hand surgeon should treat unstable joints.

Clinical Trials as Topic↗
PubMed1994

Comparison of digital versus metacarpal blocks for repair of finger injuries.

STUDY OBJECTIVE: This study compared efficacy, degree of discomfort, and time to anesthesia of digital blocks and metacarpal blocks for digital anesthesia. DESIGN: Randomized, prospective, nonblinded, clinical study conducted from April 1992 to January 1993. Patients served as their own controls. SETTING: Inner-city and community hospital emergency departments. TYPE OF PARTICIPANTS: Convenience sample of 30 adult patients, with third or fourth finger injuries including and distal to the proximal interphalangeal joint that required digital anesthesia. INTERVENTIONS: Digital blocks and a metacarpal blocks were performed (one per side) on all 30 patients (total of 60 blocks). The order of the blocks was randomized. MEASUREMENTS: A digital block and a metacarpal block were performed on each patient. Patients immediately rated the pain associated with each technique on a nonsegmented visual analog scale. Efficacy was assessed by requirement for additional anesthesia and anesthesia to pinprick. Time to anesthesia was assessed after each block in 23 patients. RESULTS: Mean visual analog scale pain scores were 2.53 for digital block and 3.38 for metacarpal block (P = .1751, Student's t-test). Metacarpal block failed anesthesia to pinprick in 23% of patients compared to 3% for digital block (P = .0227, chi 2). Time to anesthesia was significantly shorter for digital block compared to metacarpal block, with a mean of 2.82 minutes versus 6.35 minutes (P < .0001, Student's t-test). CONCLUSION: Digital block and metacarpal block, as described in this study, are equally painful procedures. Digital block, however, is more efficacious and requires significantly less time to anesthesia for the injured finger.

Adult↗