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The influence of age and exercise on the mobility of hand joints: 1: Metacarpophalangeal joints of the three-phalangeal fingers.

Mobility of metacarpophalangeal joints (MP) of the three-phalangeal fingers was measured in university students (52 males and 49 females), senior citizens (30 males and 30 females), and pianists (21 males and 31 females). We consider the student data file to be a control group with hand mobility unchanged by external influence. Extension, flexion, and total abduction in this group are greater in the left than the right hand. Only extensions were greater in females compared to males. In seniors, all types of studied movements are, with the exception of total abduction in females, lesser that in the control group. The difference is more apparent in males than in females. Intersexual difference showing better MP joint mobility in females than males is thus greater in seniors than in students; however, greater mobility of MP joints in left compared to right hand is less noticeable. Compared to students, pianists show greater finger abduction, and--less markedly--also passive and active extensions, while we did not notice difference in finger flexion. Intersexual difference in MP joint mobility in pianists were not recorded, and better mobility on the left hand compared to the right hand was evident only in dorso-palmar movements in males (the exception was total finger abduction, which is greater for the left hand in males as well as in females). In the three studied series we did not register differences in interfinger abduction between the left and right hand or between sexes. Active dorso-palmar MP joint range of motion is greatest in the little finger and smallest in the index finger, smallest in seniors and greatest in pianists. In all three groups, the range is greater in the left than the right hand and in females compared to males.

Adolescent↗

The influence of age and exercise on the mobility of hand joints: 3. thumb joints.

Following our previous study about mobility of the three-phalangeal fingers we have measured flexion in the interphalangeal (IPP) and metacarpophalangeal (MPP) thumb joints as well as thumb opposition (hyperadduction) in university students (52 males and 49 females), seniors (30 males and 30 females) and pianists (21 males and 31 females). In the student control group we did not find difference between males and females or right and left hand, unlike in the previous study of three-phalangeal fingers. The MPP has greater flexion variability than the IPP joint. We have recorded greater limitation in all measured movements in seniors, in the thumb opposition significantly greater in males than in females. Pianists, on the other hand, always show greater thumb opposition, while greater flexion was significant only in the MPP joint in males. We did not record a difference between right and left hand in seniors or pianists.

Adolescent↗

[Therapy of hand joint fractures using the external fixator. Experiences - results].

In the treatment of multi-fragment fractures of the base of the radius plate osteosynthesis using the small-fragment instrument set is preferred to conservative treatment due to the superior results achieved. However, one still cannot dispense with an additional immobilization of the fracture in a plaster cast. The extension of intra-articular comminuted fractures of the base of the radius is a technically relatively simple procedure and does not require a supporting plaster cast. In this paper we report the results of the treatment of twenty-seven wrist-fracture patients who were treated by external fixator. We also describe the indications and operative techniques. The results are reported by functional and radiological findings. For a great number of cases the results were quite good. We can highly recommend this procedure in the treatment of wrist injuries due to the simplicity of the operative technique employed and minimal follow-up treatment needed in conjunction with the good results achieved.

Adult↗

Articular, B-cell, non-Hodgkin's lymphoma mimicking rheumatoid arthritis: synovial involvement in a small hand joint.

Polyarticular joint manifestations as the predominant symptom of non-Hodgkin's lymphoma (NHL) are quite rare. In the absence of peripheral lymph node and visceral involvement, lymphomas presenting as polyarthritis create a problem for the patients as another rheumatic disease. We present a case that had been diagnosed with rheumatoid arthritis because of symmetrical articular symptoms. The patient later developed severe pain and marked swelling in her right fourth finger, and a diagnosis of septic arthritis and osteomyelitis complicating rheumatoid arthritis was assumed. The final diagnosis of NHL with synovial involvement could be made only after histopathologic examination of a biopsy specimen obtained from the amputated finger. This is the first case report demonstrating direct synovial involvement of a small joint in a patient with NHL presenting with polyarthritis. Articular and periarticular involvement of multiple joints shown by MRI in this patient suggests that direct synovial involvement may be responsible for the polyarticular symptoms in such patients.

Aged↗

[A method for early diagnosis of reduced mobility of hand joints in diabetes mellitus type I].

The study aimed at elaborating the technique of an early diagnosis of cheiroarthropathy. The study involved 170 patients with diabetes mellitus type I aged between 16 and 45 years and disease duration ranging from 1 year to 33 years. Advanced cheiroarthropathy with shining waxy skin was diagnosed in 41 patients (group I). No lesions characteristic for cheiroarthropathy was diagnosed in 122 patients (group II) while in 7 patients (group III) only skin lesions without contractures were noted. Proliferative retinopathy was significantly more frequent (p less than 0.001) in the group with cheiroarthropathy--39% to 8%. Mean age of patients of group I is 31.5 +/- 5.9 years, in group II--31.0 +/- 6.6 years. Duration of diabetes mellitus is 17.8 +/- 6.2 and 9.6 +/- 7.2 years respectively (p less than 0.05). An angle of metacarpophalangeal joint of the V finger extension was measured in all patients with goniometer. A significant difference was noted in both groups: 34.4 +/- 8.08 degrees and 56.5 +/- 7.1 degrees, respectively (p less than 0.01). Mathematic models were designed basing on the value of measured angle and duration of the disease. These models facilitate possible risk of cheiroarthropathy. Systematic measurements of metacarpophalangeal joint extension seems valuable means of early diagnosis of diabetic cheiroarthropathy and follow-up of such patients.

Adolescent↗