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At least 559 records · Page 31Linked to original sources
PubMed1990

Maximum finger force prediction using a planar simulation of the middle finger.

Maximum isometric finger-grip forces were predicted using a biomechanical model for plane motion of the middle finger. In the course of this study, mathematical representations of tendon displacement, the moment arm of tendon at the finger joints and muscle force-length relationship were investigated. The information gathered was applied to the model to estimate the maximum grip force of the middle finger gripping cylinders of different sizes. Muscle force per unit physiological cross-section area of 30 N/cm2 resulted in good agreement with measured force. However, for finger postures having an acute proximal interphalangeal joint angle, the estimated force was greater than that measured. Various joint angles were applied to the model to simulate the wrist and finger postures not limited to the cylinder grip. In general the finger force was greatest with the wrist in its extended position and at acute flexion of the proximal interphalangeal joint. The maximum finger force occurred at reduced metacarpophalangeal joint angles as the wrist joint changed from an extended position to a flexed one. It is also postulated that muscle force-length relationship is an important factor in muscle force predictions. The data obtained by this research are useful for the design of handles and the current model is applicable to the analysis of hand postures for workers using hand tools.

Biomechanical Phenomena↗
PubMed1990

Simultaneous dorsal dislocation of interphalangeal joints in a finger.

Simultaneous proximal and distal interphalangeal joint dislocations in a single finger are rare. Even though the joints above and below are routinely evaluated, one of the joint dislocations can be missed. When phalangeal dislocations are suspected, special attention should be given to obtaining sufficient roentgenographic views both before and after reduction. The joints should be thoroughly examined in an attempt to distinguish capsular contraction from soft-tissue interposition. Failure to recognize initial simultaneous dislocations may result in capsular contraction and require surgical intervention.

Adult↗
PubMed1987

Simultaneous dislocation of the interphalangeal joint of the thumb and the carpal lunate.

A dislocation of the interphalangeal joint of a thumb was treated without problems. The simultaneous dislocation of the lunate was not diagnosed or treated until the plaster cast was removed. Even in cases with an obvious lesion like a finger joint dislocation it is necessary to investigate all other fingers and the wrist to exclude other lesions and to avoid delay in treatment.

Adult↗
PubMed1986

Locking of the metacarpophalangeal joint.

Intrinsic finger metacarpophalangeal (MP) joint locking is infrequent, although not rare. Our experience and the recent literature suggest that metacarpophalangeal locking is being recognized with increasing frequency. The various mechanisms responsible for intrinsic finger MP locking, as well as the diagnosis and treatment of this condition, are reviewed. Four additional cases of the condition are presented.

Adult↗
PubMed2001

Biomechanical properties of the crimp grip position in rock climbers.

Rock climbers are often using the unique crimp grip position to hold small ledges. Thereby the proximal interphalangeal (PIP) joints are flexed about 90 degrees and the distal interphalangeal joints are hyperextended maximally. During this position of the finger joints bowstringing of the flexor tendon is applying very high load to the flexor tendon pulleys and can cause injuries and overuse syndromes. The objective of this study was to investigate bowstringing and forces during crimp grip position. Two devices were built to measure the force and the distance of bowstringing and one device to measure forces at the fingertip. All measurements of 16 fingers of four subjects were made in vivo. The largest amount of bowstringing was caused by the flexor digitorum profundus tendon in the crimp grip position being less using slope grip position (PIP joint extended). During a warm-up, the distance of bowstringing over the distal edge of the A2 pulley increased by 0.6mm (30%) and was loaded about 3 times the force applied at the fingertip during crimp grip position. Load up to 116N was measured over the A2 pulley. Increase of force in one finger holds by the quadriga effect was shown using crimp and slope grip position.

Adult↗
PubMed1999

[New methods of joint replacement in the hand yield better function and pain relief].

Arthroplasty of the hand has hitherto been performed with rather simple methods such as the interposition of soft tissue or silicone implants. Surface replacement techniques, both cemented and cementless, currently routine methods in orthopaedic surgery, are becoming more and more commonly used in hand surgery. The article consists in a review of old and new methods for the replacement of wrist and finger joints, and a report of the results of osseo-integrated titanium implants in metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints, and of short-term outcome of non-constrained implants in wrist and PIP joints.

Arthroplasty, Replacement↗
PubMed1989

[Treatment of fresh subcutaneous flexor tendon rupture of the distal joint of long fingers with temporary bone wire arthrodesis].

Drop-finger at the distal joint or mallet-finger from injury occurs because of the extensor apparatus is so much weaker than the flexor tendon that it breaks under strain. We report on 100 cases treated by internal splinting with longitudinal applied Kirschner wire in the distal and middle phalanx of the finger. It affords an absolute immobilisation of the distal interphalangeal joint in slight hyperextension with relaxation of the extensor apparatus. The wire was removed after six weeks. The results evaluated in 76 patients by follow-up four to 84 months were classified as excellent in 86.8% (full range of motion), good in 11.9% (loss of motion 5 to 15 degrees), and poor in 1.3% (loss of motion more than 15 degrees). The excellent and good results emphasize that internal splinting in ruptures of the extensor apparatus near the distal interphalangeal joint.

Adolescent↗
PubMed2000

Intrinsic and extrinsic contributions to the passive moment at the metacarpophalangeal joint.

The purpose of this investigation was to determine whether the passive range of motion at the finger joints is restricted more by intrinsic tissues (cross a single joint) or by extrinsic tissues (cross multiple joints). The passive moment at the metacarpophalangeal (MP) joint of the index finger was modeled as the sum of intrinsic and extrinsic components. The intrinsic component was modeled only as a function of MP joint angle. The extrinsic component was modeled as a function of MP joint angle and wrist angle. With the wrist fixed in seven different positions the passive moment at the MP joint of eight subjects was recorded as the finger was rotated through its range at a constant rate. The moment-angle data were fit by the model and the extrinsic and intrinsic components were calculated for a range of MP joint angles and wrist positions. With the MP joint near its extension limit, the median percent extrinsic contribution was 94% with the wrist extended 60 degrees and 14% with the wrist flexed 60 degrees. These percentages were 40 and 88%, respectively, with the MP joint near its flexion limit. Our findings indicate that at most wrist angles the extrinsic tissues offer greater restraint at the limits of MP joint extension and flexion than the intrinsic tissues. The intrinsic tissues predominate when the wrist is flexed or extended enough to slacken the extrinsic tissues. Additional characteristics of intrinsic and extrinsic tissues can be deduced by examining the parameter values calculated by the model.

Adult↗
PubMed1987

[Simultaneous luxation of proximal and distal interphalangeal joints of the fingers].

We report five cases of simultaneous dislocation of both interphalangeal joints of the finger. We observed that the mechanism, diagnosis and treatment of our cases were similar to the published reports of the world literature. In conclusion, we remark that this injury, of rare occurrence, should be treated with conservative treatment by manipulation, and if a good functional result is desired, adequate physiotherapy treatment is required.

Finger Injuries↗
PubMed1975

Metacarpophalangeal joint implants. III. Roentgenographic study of the in vivo function.

With tomographic examination of the metacarpophalangeal joint in the straight lateral projection with maximum active extension and flexion, performed after the implantation of 42 Swanson and 41 Niebauer finger joint implants, it was possible to study the in vivo function of these implants. A method was devised to determine the position of the proximal phalanx in relation to the metacarpal bone in the plane of flexion. This was correlated to the ideal position of the proximal phalanx as determined for each of the implants in experimental studies and defined only by the implant axis of rotation. A displacement of the phalanx in the proximal and volar direction was found. Usually, this was more pronounced with fracture of the implant, and could be about 7-8 mm in each direction. The hinge of the Niebauer implant was found to bend significantly less than expected, indicating movements taking place in other parts of the implant. The two blocks of the midsection were found to move in relation to the adjacent bones. Indicating an insufficient intramedullary fixation of the stems, these findings explained why cortical erosions appeared at the sites where the stems were in close contact with the bone: dorsally in the metacarpal bone and volarly in the proximal phalanx.

Arthritis, Rheumatoid↗
PubMed1987

Complex dislocation of the metacarpophalangeal joint of the little finger.

Complex dislocation of the little finger metacarpophalangeal joint is very rare. In the English literature, we have found only ten published cases. The condition usually requires open reduction, and most authors advocate a dorsal incision. We report two additional cases, treated by the volar approach, which makes a direct access to the incarcerated structures possible.

Adult↗
PubMed2006

Congenital contractural arachnodactyly (Beals syndrome).

Congenital contractural arachnodactyly (Beals syndrome) is an autosomal dominantly inherited connective tissue disorder characterized by multiple flexion contractures, arachnodactyly, severe kyphoscoliosis, abnormal pinnae and muscular hypoplasia. It is caused by a mutation in FBN2 gene on chromosome 5q23. Although the clinical features can be similar to Marfan syndrome (MFS), multiple joint contractures (especially elbow, knee and finger joints), and crumpled ears in the absence of significant aortic root dilatation are characteristic of Beals syndrome and rarely found in Marfan syndrome. The incidence of CCA is unknown and its prevalence is difficult to estimate considering the overlap in phenotype with MFS; the number of patients reported has increased following the identification of FBN2 mutation. Molecular prenatal diagnosis is possible. Ultrasound imaging may be used to demonstrate joint contractures and hypokinesia in suspected cases. Management of children with CCA is symptomatic. Spontaneous improvement in camptodactyly and contractures is observed but residual camptodactyly always remains. Early intervention for scoliosis can prevent morbidity later in life. Cardiac evaluation and ophthalmologic evaluations are recommended.

Abnormalities, Multiple↗
PubMedDate not supplied

[Findings on the saddle and multangulum-naviculare joints in erosive polyarthritis].

The x-rays of 110 patients with erosive Heberden-Bouchard arthrosis and the x-rays of 104 patients with non-erosive Heberden-Bouchard arthrosis were compared in order to determine the frequency and the severity of arthrotic changes in the thumb-saddle and the multangulum-navicular joints. In erosive Heberden-Bouchard arthrosis we found more characteristic arthrotic changes than in the non-erosive form. The more characteristic the erosive changes of the finger joints, the more extended the changes were in the thumb-saddle and the multangulum-navicular joints. Erosions of the carpal joints do occur during an erosive Heberdandan-Bouchard arthrosis, but seem to be very rare.

Age Factors↗
PubMedDate not supplied

An evaluation device for quantifying joint stiffness in the burned hand.

An electronic device capable of measuring finger joint stiffness has been developed and used to evaluate the effects of dynamic flexion splinting on the recovery of joint motion in patients with burned hands. The device locates an angle of primary (greatest) resistance and the reactive torque at that angle for a selected joint. Using the device, four subjects with stiff hands were measured before and after dynamic splinting treatments. During the 3-day treatment period, there were statistically significant differences in the angle of primary resistance (p less than 0.0001) and reactive torque (p less than 0.001). This initial trial suggests that: (1) finger stiffness can be quantified in terms of reactive torque as well as joint excursion, (2) dynamic rubber-band flexion splinting does alter joint condition and allow increased motion, (3) the amount of initial joint stiffness may be an indicator of treatment outcome, and (4) increasing treatment time may not enhance outcome.

Burns↗
PubMed1978

The surgical management of stiff joints in the hand.

Significant and lasting improvement in stiff MP and PIP joints can be achieved by operative management. Operative intervention should be considered only after persistence of stiffness after a vigorous program of nonoperative therapy. In our series of 135 such stiff finger joints, capsulotomy increased the range of motion in MP joints by more than 30 degrees in 68 percent of the patients, more than 50 degrees in 57 percent, and more than 70 degrees in 32 percent. The increased range of motion for the PIP joints was more than 30 degrees in 63 percent of the patients, more than 50 degrees in 41 percent, and more than 70 degrees in 25 percent.

Exercise Therapy↗
PubMed1988

[Reconstruction of metacarpophalangeal and interphalangeal joints with endoprostheses following injuries].

Implants have been used since 1969 by the authors for the replacement of damaged finger joints following trauma. In several cases reconstruction of other damaged tissues in the same finger was also performed. A method is described for replacement of the central slip of the extensor tendon over the PIP joint. Analysis of twenty-one MP and sixty-eight PIP endoprostheses placed in eighty-three patients until 1979 is given. Significant improvement in the range of movement is seen. Preoperative pain was relieved in all cases. There was a need to change occupation in ten percent of patients. Careful analysis of early and late complications calls attention to the proper selection of patients for surgery.

Adolescent↗
PubMed1976

Joint contracture--common manifestation of childhood diabetes mellitus.

Sixty-five of 229 seven to eighteen-year-old campers with diabetes were found to have contractures of finger joints; in two thirds of affected children only the fifth finger was involved. Stiff resistance to passive finger manipulation and thickened adherent skin over the dorsa of the hands were additional features. Short stature was associated with involvement of more than one finger; the shortest youngsters also had contractures of large joints. Joint changes were independent of age, sex, age of onset of diabetes, and control of diabetes, but correlated with duration of the diabetes.

Adolescent↗