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PubMedDate not supplied

[Experience with 46 cases of digital replantation and revascularization].

Forty-six cases of digital replantation and revascularization are reviewed. There were eight failures, seven of them in the group of 20 replantations. Solitary low level replantations (PI, PIP) have a disappointing functional result. The better indications are: distal amputations (P2, P3), multidigital lesions and of course the thumb at every level.

Amputation, Traumatic↗
PubMed1982

Reliability and validity of American Medical Association's guide to ratings of permanent impairment.

We examined the American Medical Association's Guides to the Evaluation of Permanent Impairment rating schedule to determine whether this guide provided a reliable and valid assessment of hand impairment. A sample of 118 patients with permanent hand impairment was assessed using the guide. In addition, each patient underwent tests of finger dexterity, hand strength, hand-eye coordination, and the rate of manipulation. The reliability, based on the correlation between the two raters, was 0.75. For the injured hand, psychomotor test scores were highly correlated with the rating of permanent impairment in all cases. These differences were statistically significant for approximately two thirds of the cases. The guide's ratings showed both substantial reliability and accuracy with the various tests of hand function.

Adolescent↗
PubMed1981

[Evaluation of functional results after replantations and revascularizations in the area of the upper extremity].

Several established methods of functional assessment are presented and compared, in order to standardize the end result following replantation. It appears that none of the available evaluation systems permits comprehensive analysis of underlying functional problems of replantation surgery. However, this becomes possible when different methods of functional assessment are simultaneously applied.

Finger Injuries↗
PubMed1995

[Traumatic aneurysms of the hand. Description of 5 cases].

We report about three cases of true aneurysm in the finger artery and one in the superficial palmar arch. Three of these developed after blunt trauma. Vascular reconstruction was performed either by direct suture or using a venous graft. Another case of a false aneurysm after finger replantation is reported.

Aneurysm, False↗
PubMed1999

Clinical significance of an extensor tendon anomaly to the little finger--a new finding.

A new anatomical variation of extensor digiti minimi (EDM) was discovered during our anatomical studies. The EDM usually gives one tendon to the little finger to extend the metacarpophalangeal joint (MPJ) independently from the other fingers. The EDM in our cadaver had three tendon slips. It supplied the MPJ of the little finger with two tendon slips. Along with the extensor digitorum communis (EDC), the EDM also had an additional slip to the ring finger MPJ extensor hood apparatus. The little finger also received a separate tendon from EDC.

Finger Injuries↗
PubMed2006

Injuries to the finger flexor pulley system in rock climbers: current concepts.

Closed traumatic ruptures of finger flexor tendon pulleys began to be recognized specifically over the past several decades. This injury, although rare in the general population, is seen more commonly in rock climbers. This article analyzes this type of injury and the current diagnostic and therapeutic criteria. Ultrasound and magnetic resonance imaging are used to differentiate between a pulley strain, partial rupture, complete rupture, or multiple ruptures. Grade I to III injuries (strains, partial rupture, single ruptures) are treated conservatively with initial immobilization and early functional therapy under pulley protection. Grade IV injuries (multiple ruptures) require surgical repair.

Algorithms↗
PubMed2006

Childhood soccer injuries treated in U.S. emergency departments.

OBJECTIVES: Soccer, an increasingly popular sport among children in the United States, is a common precipitant to injury-related emergency department (ED) visits. The authors estimated the number of children treated in EDs for soccer-related injuries and described the nature of these injuries. METHODS: Data from the 2000 National Electronic Injury Surveillance System All Injury Program were used to estimate the overall number and rate of soccer injuries in children, calculate injury rates per 1,000 children, and describe the body regions affected and types of injuries. Results were stratified by five-year age groups (5-9 years, 10-14 years, and 15-19 years). RESULTS: Approximately 144,600 children sustained soccer-related injuries in 2000 for a rate of 2.36 injuries per 1,000 children. Injury rates increased with age (0.8, 5-9 year olds; 3.1, 10-14 year olds; 3.2, 15-19 year olds). Common types of injuries were strains/sprains (36.7%), fractures (23.0%), and contusions (20.9%). Fractures decreased with age; sprains/strains increased with age. Commonly injured body regions varied by age. Wrist and finger injuries were most common (12.7% and 12.4%, respectively) in the youngest group; in the 10-14-year-old group, ankle and wrist injuries were most common (15.7% and 13.6%, respectively). In the oldest age group, ankle injuries were most common (21.9%), followed by knee injuries (17.6%). CONCLUSIONS: Substantial numbers of children were treated in EDs for soccer-related injuries. Injury types and affected body regions varied by age. Injury prevention efforts to reduce soccer-related injuries may need to be age specific.

Adolescent↗
PubMed1999

Occupational injuries reported to insurance companies in Norway from 1991 to 1996.

Occupational injuries represent a relatively high proportion of the total number of injuries in Norway and thereby deserve more attention than they are currently receiving. Occupational injury claims made to insurance companies in Norway from 1991 to 1996 were analyzed for determination of their patterns. The types of injury with the highest incidence rates among men were fractures; among women, the highest rates were for those for sprains. The injury rates were more than twice as high in young men as in young women; this difference declined with increasing age. Young men had an increased risk of finger injuries, compared with older age groups. The injury rates increased with increasing age, especially for fractures and contusions. A somewhat higher number of injuries per working day occurred in January and February than in the other months. Action should be taken to prevent fractures and contusions among older workers.

Adolescent↗
PubMed2005

Estimation of finger muscle tendon tensions and pulley forces during specific sport-climbing grip techniques.

The present work displayed the first quantitative data of forces acting on tendons and pulleys during specific sport-climbing grip techniques. A three-dimensional static biomechanical model was used to estimate finger muscle tendon and pulley forces during the "slope" and the "crimp" grip. In the slope grip the finger joints are flexed, and in the crimp grip the distal interphalangeal (DIP) joint is hyperextended while the other joints are flexed. The tendons of the flexor digitorum profundus and superficialis (FDP and FDS), the extensor digitorum communis (EDC), the ulnar and radial interosseus (UI and RI), the lumbrical muscle (LU) and two annular pulleys (A2 and A4) were considered in the model. For the crimp grip in equilibrium conditions, a passive moment for the DIP joint was taken into account in the biomechanical model. This moment was quantified by relating the FDP intramuscular electromyogram (EMG) to the DIP joint external moment. Its intensity was estimated at a quarter of the external moment. The involvement of this parameter in the moment equilibrium equation for the DIP joint is thus essential. The FDP-to-FDS tendon-force ratio was 1.75:1 in the crimp grip and 0.88:1 in the slope grip. This result showed that the FDP was the prime finger flexor in the crimp grip, whereas the tendon tensions were equally distributed between the FDP and FDS tendons in the slope grip. The forces acting on the pulleys were 36 times lower for A2 in the slope grip than in the crimp grip, while the forces acting on A4 were 4 times lower. This current work provides both an experimental procedure and a biomechanical model that allows estimation of tendon tensions and pulley forces crucial for the knowledge about finger injuries in sport climbing.

Adult↗
PubMed1998

[The flow cytometric analysis of activated platelets of severed finger by severe injury before and after replantation].

To investigate the significance of activated platelet levels before and after surgical operation in patients with severed finger by severe injury, the P-selectin (CD62p) positive platelet percent in peripheral blood was studied in 32 patients before and after operation by flow cytometric immunology. At the second and third day after operation, seventeen patients, which in a high positive platelet percent, were measured again after anticoagulation treatment with a large dose of urokinase etc. The results were that the levels of CD62p positive platelet in peripheral blood before and after operation were significantly higher than that of the normal group (P < 0.01). The CD62p positive platelet percent was increased not much more in the anti-coagulation patients than in the normal ones (P > 0.05). There were a few vascular crisis observed. This study suggested that severed fingers by a crushing or wringing injury enhance the platelet activity and resulted in hypercoagulation, thus anti-coagulation measures should be taken to avoid possible thrombosis and improve the survival rate of replantation. CD62p was one of the sensitive indices of activated platelet, which could be used in calculating hypercoagulation accurately.

Adolescent↗
PubMedDate not supplied

Primary flexor tendon repair: surgical techniques based on the anatomy and biology of the flexor tendon system.

The anatomy, biology and bio-mechanics of the flexor tendon system demand a precise approach to flexor tendon repair. Within the fibroosseous canal, the synovial fluid and a complex intratendinous vascular network provide nutrition for intrinsic flexor tendon healing. Retention of the synovial sheath theoretically maintains an enclosed tendon/tendon sheat environment in which the tendon repair is bathed in synovial fluid, and may glide within a smooth tunnel. The preservation of the intricate double tendon inter-relationship and the annular pulley system is vital to the efficiency of finger flexion. This review details surgical and postoperative techniques aimed at restoring the normal anatomy and providing optimal conditions for the return of flexor tendon function.

Finger Injuries↗