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PubMed1998

Radiographic assessment of equine interphalangeal joints asymmetry: articular impact of asymmetric bearings (Part II).

This study is part of a work to develop a radiographic method that defines objectively the individual conformation of an equine digit and its appropriate trimming. The authors used isolated distal limbs fastened on a rotation support with variable inclinations to study the influence of induced asymmetric bearings on various angles measured from specific radiographs. The digit responded to asymmetric bearings by 1. deformation of the hoof; 2. rotation of the phalanges; and 3. joint asymmetry or local articular space narrowing. The two last situations occurred mainly in the distal interphalangeal joint. Some of the angles mentioned above allow quantification of interphalangeal articular asymmetry, angular deformity and rotational deviation of a distal limb.

Animals↗
PubMed1991

Paraterminal ligaments of the distal phalanx.

The paraterminal ligaments of the distal phalanges have been studied by dissection. They are a normal feature of all distal phalanges in both the hand and foot, and connect the paraterminal spines and paraterminal tubercles of the distal phalanx on both sides. Branches of the proper palmar digital artery and nerve pass under the ligament to reach the matrix of the nail, which they supply.

Arteries↗
PubMedDate not supplied

Total joint replacement in digits of the foot.

Digital deformities present one of the most common entities seen by the podiatric physician today. Surgical correction of these deformities has historically centered upon the "arthroplasty" or phalangeal head resection, but the advent of Silastic implants that replace the interphalangeal joints of the lesser digits may improve the results of revision arthroplasties or severely arthritic joints. This paper will present two types of lesser digital implants that have successfully been used when the proper indications are met.

Humans↗
PubMedDate not supplied

Second metatarsophalangeal joint fusion: a new technique for crossover hammertoe deformity. A preliminary report.

The author reports on second metatarsophalangeal joint arthrodesis for the severe crossover hammertoe deformity. Eleven patients underwent an arthrodesis of the second metatarsophalangeal joint with a.062 Kirschner wire intramedullary fixation and a dorsal small bone staple and resection of the proximal phalangeal head of the second digit. Outcomes were retrospectively reviewed at average follow-up time of 19 months. A subjective patient satisfaction survey along with a clinical and radiographic evaluation was undertaken in the postoperative period. Ten of 11 patients scored good to excellent results based on the patient subjective survey at final follow-up. Ten of 11 patients obtained primary arthrodesis. One patient experienced an asymptomatic nonunion. This new technique appears to be reliable for the maintenance of long-term correction of a crossover second toe with arthrodesis of the second metatarsophalangeal joint.

Adolescent↗
PubMed1984

Abnormal distal phalanges and nails, deafness, mental retardation, and seizure disorder: a new familial syndrome.

A 10-year-old boy and his 9-year-old sister, with abnormalities of distal phalanges of hands and feet, onychodystrophy, deafness, mental retardation, seizure disorder, and abnormal dermatoglyphics, are described. Six similarly affected patients have been reported. These eight patients represent a new syndrome, which is inherited as an autosomal recessive trait.

Abnormalities, Multiple↗
PubMedDate not supplied

The Zimmermann-Laband syndrome.

We report on two patients who exhibit the typical features of the rare Zimmermann-Laband syndrome such as gingival fibromatosis, swelling of perioral tissues, nail hypo/aplasia, and abnormalities of terminal phalanges. The older patient suffers from epileptic seizures and shows osseous mandibular hypertrophy, two maxillary mesiodentes and lumbar spondylodysplasia. In the 2nd patient, a 3 year old male, the characteristic morphological features are already present.

Abnormalities, Multiple↗
PubMed1984

The acro-osteolysis (Hadju-Cheney) syndrome. Review of the literature and report of a case.

Acro-osteolysis ( Hadju - Cheney ) Syndrome is a rare disorder of bone metabolism characterized by progressive destruction of the distal phalangeal bone, curvature of the spine, aplasia of the facial sinuses, and persistence of the cranial sutures. The purpose of this manuscript is to focus on the description of the oro-facial and dental manifestations of the disorder.

Adult↗
PubMed1992

Three sibs with phalangeal anomalies, microcephaly, severe mental retardation, and neurological abnormalities.

This paper describes three children of a Pakistani first cousin marriage with a distinctive, non-progressive disorder characterised by variable phalangeal anomalies, microcephaly, pre- and postnatal growth retardation, poor vision, dystonic movements, a characteristic face, and severe mental retardation. This combination of features seems to be distinct and to represent a new autosomal recessive syndrome.

Abnormalities, Multiple↗
PubMed1996

Idiopathic multicentric osteolysis principally affecting the phalanges of the hands and feet.

The case of a 64-year-old man with idiopathic symmetrical osteolysis affecting both hands and feet is presented. The phalanges were principally affected, with relative sparing of the carpus and tarsus. The relevant literature has been reviewed and this reveals that the distribution of osteolysis in this case is unique. We suggest that this case represents a different disease entity, which has not been described previously.

Fingers↗
PubMed2006

Clinical phenotype associated with homozygosity for a HOXD13 7-residue polyalanine tract expansion.

Synpolydactyly (SPD) is an autosomal dominant malformation of the distal limbs caused by mutations in the homeobox gene HOXD13 located on chromosome 2q31. We detail the clinical findings in a consanguineous Pakistani family segregating a HOXD13 7-residue polyalanine tract expansion. Three members of this pedigree were heterozygotes with features typical of SPD. Two further members demonstrate a more severe phenotype consistent with homozygosity for the familial mutation. We also report a child from a consanguineous Somali family homozygous for the same molecular lesion. Characteristic changes include a complex central polydactyly in the hands, abnormal modelling of the metacarpals and metatarsals, an increased number of carpal bones with abnormal shapes, hypoplasia or absence of the fifth digital rays in the feet, hypoplasia of the middle phalanges and abnormally long proximal phalanges in hands and feet. These cases illustrate the distinct phenotype associated with homozygosity for a HOXD13 mutation and also highlight the importance of considering homozygosity for a dominant mutation in consanguineous pedigrees.

Consanguinity↗
PubMed1995

Bone regrowth in young mice stimulated by nail organ.

Recent studies of postamputational repair following digit-tip amputation revealed an unexpected correlation between nail regrowth and bone regrowth in mice. To examine putative effects of nail on bone regrowth, phalangeal tips were amputated such that nail was artificially removed from distal levels or retained following proximal level amputations. In the absence of nail, bone did not regrow at distal levels. Conversely, when nail was surgically retained bone regrew from proximal levels. The nail organ profoundly influences bone regrowth.

Amputation, Surgical↗
PubMed1977

[A new complex polymalformative syndrome (author's transl)].

The authors discuss the nosological position and the aetiology of a complex of malformations affecting a boy, born at the end of a 40-week pregnancy with a weight of 1420 g and height of 42.5 cm, who died at the age of 3 1/2 months. The case presented an association of an acrocephalosyndactyly, phalangeal hypoplasias with anonychia, aplasia of the abdominal muscles, a genital hypoplasia with cryptorchidism and hypospadias, patches of lipodystrophy localised on the outside of the arms, at the folds of the elbow and the popliteal fossae. The autopsy revealed a large interventricular communication, absence of common mesentery and especially important cerebral anomalies (smooth brain, absence of interhemispherical suture, disorganization of the basal ganglia). The genetic study suggested a spontaneous abortion 2 1/2 months before the birth of the patient and revealed, in the mother, the presence of bilateral clinodactylies of the fingers and a unilateral syndactyly of the big toes.

Abdominal Muscles↗
PubMed2005

Arthrodesis or total replacement arthroplasty for hallux rigidus: a randomized controlled trial.

BACKGROUND: Arthrodesis is the current treatment for end-stage hallux rigidus, although there are many reports advocating total joint replacement arthroplasty. The aim of this randomized controlled trial was to evaluate clinical outcomes after first metatarsophalangeal joint (MTPJ) arthrodesis and replacement arthroplasty. METHODS: Between November, 1998, and January 2001, 63 patients between the ages of 34 and 77 years, with unilateral or bilateral MTPJ arthritis were recruited and randomly selected to have either MTPJ arthrodesis or arthroplasty. Twenty-two patients (38 toes) had arthrodesis and 27 patients (39 toes) had arthroplasty. A single surgeon performed all surgery. The primary outcome measure determining successful surgery was a decrease in pain as measured on a Visual Analogue Scale (VAS). Functional outcome was assessed at 6 months and 1 and 2 years. Cost data were simultaneously collected. RESULTS: At 24 months, pain improved in both groups (p < 0.001), but there were significantly greater improvements after arthrodesis (p = 0.01). All 38 arthrodeses united at a mean dorsiflexion angle of 26 degrees, with few complications. In contrast, in the arthroplasty group, six of the 39 inserted implants had to be removed because of phalangeal component loosening. In the remainder the range of motion gained was poor, and the patients tended to bear weight on the outer border of their foot. The cost ratio was 2:1 in favor of arthrodesis. CONCLUSIONS: Outcomes after arthrodesis were better than those after arthroplasty. The results were partially attributable to an unacceptably high incidence of loosening of the phalangeal components, which resulted in removal of the implants. However, even when data from the failures were excluded, arthrodesis was clearly preferred by most patients.

Adult↗
PubMed1979

Ocular findings in thoracic-pelvic-phalangeal dystrophy.

Two unrelated patients with thoracic-pelvic-phalangeal dystrophy syndrome had retinal degeneration. A pathologic study of both eyes from one of the patients showed severe degeneration of the peripheral retina, with predominantly cone-type cells remaining.

Abnormalities, Multiple↗
PubMed1976

Angiography of equine metacarpus and phalanges: alterations with medial palmar artery and medial palmar digital artery ligation.

Vascular supply of the equine forelimb was partially disrupted by ligation of the medial palmar and medial palmar digital arteries. Vascular architecture was evaluated before and after ligation by angiography. It was apparent from the present study that existing collaterals or newly formed collaterals, or both, were sufficient to maintain limb viability.

Angiography↗
PubMed2001

Painless electrodiagnostic current perception threshold and pain tolerance threshold values in CRPS subjects and healthy controls: a multicenter study.

The purpose of this study is to evaluate both painless and painful sensory transmission in patients with Complex Regional Pain Syndrome (CRPS) using the automated electrodiagnostic sensory Nerve Conduction Threshold (sNCT) test. This test generates reliable, painless Current Perception Threshold (CPT) and atraumatic Pain Tolerance Threshold (PTT) measures. Standardized CPT and PTT measures using constant alternating current sinusoid waveform stimulus at 3 different frequencies 5 Hz, 250 Hz, and 2 kHz (Neurometer CPT/C Neurotron, Inc. Baltimore, MD) were obtained from CRPS subjects at a distal phalange of the affected extremity and at an ipsilateral asymptomatic control site. Matched sites were tested on healthy subjects. Detection sensitivities for an abnormal PTT and CPT test were calculated based on specificity of 90% as determined from data obtained from healthy controls. A Spearman rank correlation was used to test for a significant association between presence of allodynia and an abnormal PTT or CPT at any frequency tested. Thirty-six CRPS subjects and 57 healthy controls were tested. The highest detection sensitivity of the PTT test from symptomatic test sites was 63% for the finger and 71% for the toe. PTT abnormalities were also detected, to a lesser degree, at the asymptomatic control site (41% finger control site, 16% toe control site). The highest CPT detection sensitivity at the symptomatic site was 37% for the finger site and 53% for the toe site. CPT abnormalities were also detected at the asymptomatic control site (29% finger control site, 37% toe control site). Eighty-six percent of the CRPS subjects had either a PTT or CPT abnormality at any frequency at the symptomatic site. There was a significant correlation between presence of allodynia and presence of an abnormal CPT and PTT, respectively (P < .01). The correlation coefficient was lower for CPT than for PTT, ie, 0.34 versus 0.6 for the finger and 0.48 versus 0.67 for the toe, respectively. In studied CRPS patients an abnormal PTT was detected with higher sensitivity than an abnormal CPT. Assessing PTT may become a useful electrodiagnostic quantitative sensory test for diagnosing and following the course of neuropathic pain conditions.

Journal Article↗
PubMed1982

Anatomico-radiological study of intraosseous epidermoid cysts.

Anatomico-radiological study of 8 cases of intraosseous epidermoid cysts (1 in the skull, 6 in distal phalanges of the hand, 1 in distal phalanx of the foot with invasion of the adjacent joint). The epithelium was malpighian with hyperkeratosis (therefore the scales filled the cavity), sometimes with parakeratosis and even dyskeratosis but without signs of malignancy. The adjacent connective tissue and bone reactions were more active in the phalanx than in the skull and this could explain the frequent pain in the phalanges. The bone remodelling explains the radiological pictures and sustains the differential diagnosis. In 5 out of the 8 cases (particularly in the skull) a history of previous local trauma was present. However, the etiological importance of trauma should be discussed with respect to that of dysembryoplasia.

Adult↗