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At least 361 records · Page 20Linked to original sources
PubMed1995

The acutely burned hand: management and outcome based on a ten-year experience with 1047 acute hand burns.

Optimal hand function has a very positive impact on the quality of survival after burn injury. Over a 10-year period, 659 patients with 1047 acutely burned hands were managed at the Sumner Redstone Burn Center of the Massachusetts General Hospital. Our approach to acutely burned hands emphasizes ranging and splinting throughout hospitalization, prompt sheet autograft wound closure as soon as practical, and the selective use of axial pin fixation and flaps. This approach is associated with normal function in 97% of those with superficial injuries and 81% of those with deep dermal and full-thickness injuries requiring surgery. Although only 9% of those with injuries involving the extensor mechanism, joint capsule, or bone had normal functional outcomes, 90% were able to independently perform activities of daily living.

Acute Disease↗
PubMed2004

Anatomical variations of the extensor tendons to the fingers over the dorsum of the hand: a study of 50 hands and a review of the literature.

The extensor tendons to the fingers were studied in dissections of 50 fresh cadaveric hands, and the divisions of the tendons, as well as the communications (juncturae), were analyzed. The pattern of distribution most frequently observed was as follows. The extensor digitorum communis provided one tendon to the index finger, one to the middle finger, two to the ring finger, and none to the little finger. The extensor indicis exhibited one tendon, whereas the extensor digiti minimi exhibited two tendons. The extensor indicis tendon was always observed to lack a junctura tendinum. The extensor indicis was absent in both hands of one cadaver. A tendon slip from the extensor digiti minimi to the ring finger was observed in one hand. All surgeons must bear in mind the existence of these variations when performing common tendon transfers.

Aged↗
PubMed2005

The hand eczema severity index (HECSI): a scoring system for clinical assessment of hand eczema. A study of inter- and intraobserver reliability.

BACKGROUND: There is a need for a standardized clinical grading system for a more objective and accurate assessment of the severity of hand eczema (HE). OBJECTIVES: To develop and validate a scoring system called the hand eczema severity index (HECSI) designed for clinical assessment of HE. METHODS: Twelve dermatologists (observers) assessed 15 HE patients twice, with an interval of 30 min. The study was performed blinded for the observers, and only the hands and wrists of the patients were visible to the observers. Agreement between the observers was determined by using the intraclass correlation coefficient (ICC), which is the correlation between (single) ratings of the same patient. RESULTS: ICC for total HECSI score was 0.79 at the first assessment and 0.84 at the second assessment. ICC for intraobserver agreement was 0.90. CONCLUSIONS: Overall excellent agreement existed for both inter- and intraobserver reliability and the scoring system is suggested for use in future clinical studies on HE. Because HECSI is an entirely objective assessment of clinical signs, in addition, inclusion of patient-rated symptoms should be considered.

Adolescent↗
PubMed2003

Reproducibility of dorsal hand vein responses to phenylephrine and prostaglandin F2 alpha using the dorsal hand vein compliance method.

Assessment of drug-induced venodilation by the dorsal hand vein compliance method requires stable constriction of the vein. This study was designed to investigate intra- and intersubject reproducibility of the venous preconstriction technique in response to phenylephrine and prostaglandin F2 alpha and to determine the influence of basal vein size. Twelve healthy male nonsmokers participated in a prospective cross-over study. Inter- and intrasubject variability was tested in response to phenylephrine and PGF2 alpha on different study days in the same hand vein. The dose of the respective constrictor causing approximately 80% constriction of the vein (ED80) was determined and infused for another 100 minutes. Actual vein size was measured every 5 minutes. Coefficient of variation and regression analyses were performed to analyze influence of vessel size on ED80 of the respective constrictor. Adjusted constriction levels were stable and well reproducible in all subjects. The intersubject coefficient of variation of ED80 ranged from 0.9% to 6.7% for phenylephrine and from 0.9% to 6.9% for PGF2 alpha. Whereas responses to phenylephrine were independent of basal vein diameter, there was a positive correlation between ED80 of PGF2 alpha and basal vein size. Thus, the hand vein compliance method is a suitable method to study dilatory responses in phenylephrine- or PGF2 alpha-constricted veins with considerable interindividual but small intraindividual variability. However, in such studies, phenylephrine appears to be a more reliable tool than PGF2 alpha.

Adult↗
PubMedDate not supplied

Responsiveness of the disability of the arm, shoulder, and hand (DASH) and patient-rated wrist/hand evaluation (PRWHE) in evaluating change after hand therapy.

A hand therapy clinic used a systematic process to select an outcome tool for routine use. After a literature review of available instruments, the choice had been narrowed to two instruments: the Disability of the Arm, Shoulder, and Hand (DASH) and the Patient-Rated Wrist Evaluation (PWRE). The PRWE was modified to attribute to the hand/wrist. A cohort of 60 patients (36 hand problems, 24 wrist problems) completed a DASH and PRWHE at their initial clinic visit and three months later. Standardized response means (SRMs) and effect sizes indicated a large treatment effect. The PRWHE had slightly higher responsiveness than the DASH (SRM=1.51 vs. 1.37). Because this level of responsiveness was obtained with fewer items, it was considered more efficient. A supplementary esthetics question was less responsive than either scale, but was thought to be an important option for selected patients. On completion of the trial period, the therapists unanimously selected the PRWHE with a supplemental esthetics question to be routinely used in measurement of outcomes.

Disability Evaluation↗
PubMed2001

Involuntary hand levitation associated with parietal damage: another alien hand syndrome.

The alien hand syndrome (AHS) usually consists of an autonomous motor activity perceived as an involuntary and purposeful movement, with a feeling of foreignness of the involved limb, commonly associated with a failure to recognise ownership of the limb in the absence of visual clues. It has been described in association to lesions of the frontal lobes and corpus callosum. However, parietal damage can promote an involuntary, but purposeless, hand levitation, which, sometimes, resembles AHS. In the present study, four patients (cortico-basal ganglionic degeneration - n=2; Alzheimer's disease - n=1 and parietal stroke - n=1) who developed alien hand motor behaviour and whose CT, MRI and/or SPECT have disclosed a major contralateral parietal damage or dysfunction are described. These results reinforce the idea that parietal lobe lesions may also play a role in some patients with purposeless involuntary limb levitation, which is different from the classic forms of AHS.

Aged↗
PubMed1990

Relation of hand skill to spatial reasoning in male and female left-handers with left- and right-hand writing.

The relation of mental ability for spatial reasoning (Cattell's Culture Fair Intelligence Test) to hand skill assessed by peg-moving task was studied in normal left-handers. Nonlinear, quadratic relationships were established between these two parameters exhibiting different characteristics according to sex and writing hand. It was concluded that the contributions of the right and left cerebral hemispheres to the cognitive-motor output of the brain depend on sex and writing hand as well as the degree of left-handedness in left-handers.

Adolescent↗
PubMed1976

Flexor tendon synovectomy of the hand in rheumatoid arthritis. A follow-up study of 201 operated hands.

A follow-up study of 201 flexor tendon synovectomies of the hand in patients with rheumatoid arthritis is presented. The operations were performed from 1/2-49 years after onset of the disease, and the patients were between 16 and 76 years of age. The follow-up study is based on questionnaires and, in addition, 78% of the patients also had a physical re-examination. The follow-up time spanned 12-78 months. Nearly 70% of the operated hands were subjectively improved; the others were unchanged or worse. The poor results were often caused by progression of arthritis in finger joints. Recurrence of the tenosynovitis was observed in about 37% of the hands, but in very few to such an extent that reoperation has been necessary.

Arthritis, Rheumatoid↗
PubMedDate not supplied

Grip strength of the human hand--measurements on normal subjects with a new hand strength analysis system (Hastras).

This study describes a method of acquiring data from healthy and non-injured men that can be used as reference data when measuring the grip strength of the human hand using newly developed, PC-based hand strength analysis equipment--'Hastras'. Hastras can be used for continuous measurement and recording of force when the subject grips a sensor with maximum power. Computerized analysis of the force signal gives information about maximum force, fatigue, area and rise (force/s). The statistical analysis of the measurements on 81 subjects are consistent with earlier published data from other hand strength equipment. It is concluded that Hastras gives easy processing and storage of data, and also a detailed analysis of grip function.

Adult↗
PubMed1996

Hand grip increases shoulder muscle activity, An EMG analysis with static hand contractions in 9 subjects.

We examined 4 shoulder muscles--the supraspinatus, infraspinatus, the middle portion of the deltoid and the descending part of the trapezius--with electromyography (EMG) in adducted and flexed arm positions, in 9 healthy subjects. The subjects were asked to produce a static handgrip force of 30% and 50% of maximal voluntary contraction (MVC) in 8 different arm positions. In all positions, the subjects held a dynamometer in the hand. The myoelectric activity in the shoulder muscles with only the dynamometer in the hand was compared to the EMG activity when static contractions were added. There was an association between static handgrip and shoulder muscle activity, as revealed by E < G. The EMG activity increased in the supraspinatus muscle in humeral flexion from and above 60 degree in 120 degree abduction. In the infraspinatus muscle, the changes were less; a significant increase, however, was noticed in flexion. In the deltoid muscle there was a tendency towards increased activity in positions lower than 90 degree, in the higher arm positions, the activity decreased. There was no significant alteration regarding the EMG activity of the trapezius. Our findings imply that high static handgrip force, particularly in elevated arm positions, increases the load on some shoulder muscles. The stabilizing muscles (the rotator cuff) were more influenced than the motor muscles by hand activity. Handgrip activity is important to evaluate while assessing shoulder load in manual work an in clinical evaluations of patients with shoulder pain.

Adult↗
PubMed1992

[Pathology of the joints of the hand and periarticular tissues in exposure to local vibration and functional overload of the hands].

The hand joint is a multi-joint formation, including the wrist, carpal, intercarpal, carpometacarpal, intermetacarpal, distal radioulnar joints. Features of hand joint and periarticular tissue disease were studied in 536 workers exposed to local vibration and functional overstrain. The most prevalent diseases are arthroses with deformation of the wrist, radiocarpal, carpometacarpal joints, often with involvement of the triangular fibrous disk and carpals, periarthroses of the hand joint with compression neuropathy of the median and ulnar nerves.

Adult↗
PubMed2005

The effectiveness of using two different types of anti-vibration gloves compared to bare hand condition at dampening the frequencies associated with hand-arm vibration syndrome.

The ability of a foam-padded and air-bladder glove to significantly attenuate hand-arm vibration compared to an individual's bare hands (after the effect of adipose content of the distal upper extremity had been removed) was studied. Subjects consisted of 3 male and 8 female university students' aged 20 to 22 years. After the effect of adipose content of the distal upper extremity was removed, the effect of the gloves on transmissibility was significant with F2,959 = 5.27, p<0.000. The effect of the frequencies was significant with F31,959 = 8.80, p<0.000. There was no significant interaction between the gloves and frequencies on transmissibility with F62,959 = 0.22, p = 1.000. Post-hoc analysis revealed that there was a significant difference was between bare hand and foam-padded glove conditions, F1,1052 = 8.13, p = 0.004, where foam-padded gloves had significantly greater transmissibility. Post-hoc analysis of the frequencies indicated that there were significant differences between frequencies at with the highest transmissibility occurring at 100 Hz.

Adult↗
PubMed1977

Grip function of the healthy hand in a standardized hand function test. A study of the Rancho Los Amigos test.

In an experimental study 30 healthy subjects performed the tests of prehensile function in the Rancho Los Amigos test. The subjects were allowed a free choice of grip instead of those prescribed when the test is used for clinical purposes. The hand-grips were filmed and registered by means of a descriptive code system and the results were subjected to automatic data processing. The results showed that healthy subjects performing the RLA test used a stereo-typed grip pattern as a consequence of the uniform purpose of the hand-grips. Comparison with the results from a standardized meal study in the same subjects showed that functional assessment of a patient with a test of this type is not directly applicable to integrated daily activities, as several of the hand-grips most frequent in daily activities were rarely used. Comparison with types of grip prescribed for clinical use of the test showed that normal subjects often did not spontaneously handle the objects in the manner intended by the test.

Activities of Daily Living↗
PubMed1984

[Hand burns in children. Retrospective study of 137 cases from 1973-1982 representing 177 hands].

One hundred and seventy seven burnt hands observed in children during the last ten years were reviewed at our hospital. One third were severely injured with burns deeper than 2nd degree. The infrequent greasy occlusive dressing was performed under general anesthesia in 87% of the burnt hands as the primary treatment. Out of 19 cases, five necessitated a secondary procedure one year or more later. Excision followed by full thickness skin grafts or flaps was used initially in 11%. Besides the common sequelae of burnt hands, we found some proper to children: clinodactyly, inhibition of longitudinal growth following epiphyseal plate destruction. The annual increase in the observed number of cases which doubled in ten years, shows the importance of prevention.

Adolescent↗
PubMed1995

Hand transmitted vibrations caused by orbital hand sanding machines.

The paper reports and analyses results of vibration measurement carried out on orbital hand sanding machines. Vibrations were measured on the front and rear handles of the FESTO LRB-W1 and LRB-T1 orbital hand sanding machines and at two points on the holding handle of the FESTO RTL-F1 hand sanding machine. The measured levels of the weighted vibration accelerations were compared to the daily exposure limits according to ISO 5349, ISO/TC 108/SC4/14 and NF E90-402. Daily exposures for each type of sanding machine were determined according to the same standards.

Hand↗
PubMed1998

[Callus distraction for lengthening of mid-hand and finger stumps in congenital hand abnormalities--personal results and review of the literature].

Distraction-lengthening technique is quite useful in a variety of congenital hand deformities with hypoplastic, or primary normal but secondary shortened (constriction ring syndrome) finger rays. It appears that around the age of two years is the earliest practical time to start distraction; certainly distraction and secondary surgical procedures to improve function should be completed before school entry age whenever possible. Between June 1990 and March 1993, nine distraction lengthening procedures (5 thumbs, 1 index, 3 little fingers) in five patients presenting with congenital hand deformities, were carried out. Although restoring length to the finger, lengthening does not provide normal circumference or, of course, interphalangeal joint motion. Amelioration in function seems to be more important than the esthetic gain. Distraction lengthening tolerates only few errors of indication, operative technique, and/or postoperative management. A high compliance of the patient and her/his parents as well as a close follow-up by an experienced surgeon, are mandatory for a good result. A variety of possible complications have been described. Generally, complication risk increases in cases of simultaneous and multiple level lengthening. Provided adequate operative technique and postoperative care, superficial pin infection and fracture in the region of distraction are the major complications. Contrary to adults, sufficient bone formation by distraction is the rule in children. Therefore, the distraction-lengthening technique is preferred to the distraction-interposition technique in the treatment of congenital hand deformities. The latter should only be used as a salvage procedure in the rare cases of insufficient callus formation. Because of the missing growth potential and reduced joint mobility, distraction lengthening is the therapy of second choice when compared to microvascular second toe transplantation.

Acrocephalosyndactylia↗
PubMed1995

Outcomes of hand surgery. British Society for Surgery of the Hand.

The findings are presented of a conference on Outcomes of Hand Surgery organized by the audit committee of British Society for Surgery of the Hand in 1993. Measures of outcome in terms of movement, power, sensibility, pain, activities of daily living, complications and patient satisfaction are considered, and an example of a patient evaluation measure given as an appendix.

Adult↗