[Problems relative to congenital abnormalities of the hands].
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OBJECTIVE: To investigate the effectiveness of Swanson silastic metacarpophalangeal joint arthroplasty (SMPA) in improving hand function for patients with rheumatoid arthritis. METHODS: A systematic overview of all published series in the literature on SMPA from 1966 to 1999. RESULTS: Research design deficiencies were quite prevalent in the literature on SMPA. However, SMPA was effective in correcting ulnar drift and in improving the arc of motion of the fingers. Health related quality of life was improved in the domains of hand function, pain, activities of daily living, aesthetics, and satisfaction. CONCLUSION: SMPA appeared to be an effective procedure in correcting rheumatoid hand deformities. Future research must establish objective, quantifiable measures of hand function improvement by using standardized hand function tests and validated hand outcome questionnaires.
In a newborn girl diastasis of the distal tibiofibula joint was associated with cleft hand deformity, and cardiac anomalies. While at least 3 cases of congenital distal tibiofibular diastasis have been reported previously, this patient seems to be the first to have had hand and cardiac defects. The diastasis is believed to be secondary to tibial hypoplasia. The initial presentation was that of an apparent clubfoot deformity and emphasizes the point that roentgenograms of all equinovarus deformities in the newborn should be mandatory.