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PubMedDate not supplied

[The distribution of destructive polyarthritic changes in the hand skeleton].

The distribution of common and erosive changes in advanced polyarthrosis is radiologically demonstrated in the hands of 32 patients. 23 of them showed erosive destructions in at least one joint. In general the alterations were symmetrical. Most of the destructions were seen in the distal and proximal interphalangeal joints, especially in DIP II, III, V and PIP III. Usually the thumb was spared. Most emphasis has been put on the differential diagnosis to rheumatoid arthritis and arthritis in psoriasis and gout. A recent concept concerning mechanical factors in the pathogenesis of so called primary osteoarthritis in the small finger joints is discussed.

Aged↗
PubMed1983

[Oligoarthritic joint symptoms of the hands in metastasizing bronchial carcinoma].

Bronchial carcinomata very frequently metastasize to bony tissue. The most common sites are generally known, but metastases can also occur in atypical locations where they then simulate other clinical syndromes. The present paper describes the clinical picture of a patient with small-cell bronchial carcinoma metastasizing to the finger joints. The frequency of this manifestation is investigated on the basis of the literature.

Aged↗
PubMed1988

Three-dimensional geometric analysis of the metacarpophalangeal joint.

No prosthesis yet designed for replacement of the metacarpophalangeal (MCP) joint incorporates all considerations of anatomy and geometry of the natural joint to restore the normal kinematics. Loss of stability, recurrent deformity, and early loosening are persistent problems. In this study, a detailed three-dimensional geometric analysis of the MCP joint was performed. The sagittal contours of both metacarpal heads and base of the proximal phalanx under loaded and unloaded conditions were analyzed. The geometric parameters of the MCP joint articulating surfaces were analyzed, including the center and radius of curvature and the location and size of the contact area. The pressures on articulating surfaces during various hand functions were also established. These findings provided important information for better understanding the kinematics of finger joint articulation, as well as the cause of joint degeneration.

Adult↗
PubMed1989

[The motion stable intraosseous wire suture--a prospective study].

In a prospective study the results of 86 cases of transverse metacarpal and phalangeal fractures, corrective osteotomies and bone grafts treated by intraosseous wiring were reviewed six months postoperatively. The follow-up rate was 98%. Data included the time off work, the functional results in terms of total active range of motion of finger joints, intraoperative and postoperative complications, and additional stabilizing procedures.

Adolescent↗
PubMed1992

Anatomy of the joints of the fingers.

The anatomy and function of the three joints within each finger are mutually complementary; none functions independently of the other two. A complex, yet precise, intrinsic and extrinsic soft-tissue support links these three joints and provides a precisely articulated balance for the mobility of the finger. This complex interrelationship requires both strength and stability, which are inherent in the design of the bony architecture and their surrounding soft tissues. Understanding this interrelationship is essential for the accurate diagnosis and treatment of the numerous problems with which these joints are sometimes afflicted.

Biomechanical Phenomena↗
PubMed1999

[Technique of finger arthrodesis by dorsal thread tension band fixation. Comparing biomechanical investigations].

Dorsal tension band fixation is a wide-spread technique of finger arthrodesis. When using a resorbable PDS-suture as tension band fixation a costly implant removal is not needed. Aim of this study is the investigation of the primary stability of this technique in combination with the cup-in-cone-procedure. Freeze-preserved fingers with thread tension band fixation using the PDS-material (series 1), the same fixating method on formaldehyde preserved fingers (series 3), freeze-preserved fingers with a standard tension band fixating (wire loop, series 2) are load in a four-point-bending in the direction of palmarflexion. From 6 degrees onwards the wire-tension-system requires a higher torque for bending, but in case of higher torque frequently leads to fracture. The examination shows that the thread-tension-band method by PDS-loop for the stabilisation of finger joint arthrodesis has a sufficient initial stability against bending forces.

Adult↗
PubMed1982

Skeletal tuberculosis of the wrist and hand: a study of 27 cases.

The 27 cases of skeletal tuberculosis in the hand and wrist reported represented 6.9% of the skeletal tuberculosis seen at our hospital and 32% of the skeletal tuberculosis found in the upper extremity. In a majority of these patients a single bone or joint was involved and 18.5% of the patients had bone and/or joint involvement outside the hand. Pulmonary tuberculosis was present in 10.7% of these cases. The clinical picture of tuberculosis is similar to that of other infections and tumorous conditions, but a history of absent bacille Calmette Guérin protection and positive tine test should arouse one's suspicion to the condition. Eight-six percent of our patients had x-ray findings that included bone atrophy, bone or joint destruction with discrete periostitis, or the presence of the typical spina ventosa. We found no case of resistance to various combinations of the usual drugs in any patients. Supportive orthopaedic splints were used over short periods (3 months) and surgery was used for diagnostic purposes (biopsies) and in treatment by fusion of two wrists in this patient series. Finger joint involvement responded satisfactorily to drug and conservative orthopaedic treatment and in no case were these joints fused or replaced by a prosthesis.

Adolescent↗
PubMed1985

Radiographic evaluation of patients with Bechterew's syndrome (ankylosing spondylitis). Findings in peripheral joints, tendon insertions and the pubic symphysis and relations to non-radiographic findings.

One hundred and twenty-two consecutive hospitalized patients aged 35 years or more, and with definite radiographic bilateral sacro-iliitis were re-examined. All but 3 met established criteria for definite ankylosing spondylitis (AS). All peripheral joints from 114 of these patients were radiographed, and definite arthritis in one or several joints was demonstrated in 47 (41%) of them. The distribution pattern of arthritis was generally symmetric or slightly asymmetric. Articular new bone formation was a common finding in arthritic joints. The frequency of patients with hip arthritis was low (24% including patients with hip joint replacements); possible explanations include the selection of patients examined and difficulties in distinguishing between a primary osteoarthritis and osteoarthritis secondary to arthritis in a single radiographic examination in such patients. Although the hip joints were often severely affected, with extensive new bone formation, the erosions were generally small and protrusion of the acetabulum was not seen. Arthritis of the shoulder or of the hip was associated with an early onset of AS. Arthritis in the finger joints was associated with clinical psoriasis but was also a frequent finding in HLA B27-positive patients free from this condition (23%). Arthritic changes of small joints with extensive new bone formation ('egg in shell', 'pencil in cup' or 'gull wing' appearance) were seen in patients without clinical psoriasis. New bone formation of the ischium was frequent in HLA B27-positive patients (36%), but was not seen in HLA B27-negative patients. No differences concerning the frequency or severity of different radiographic pathologic changes recorded were observed between the sexes.

Adult↗
PubMed2005

Lack of a difference in increased capillary blood cell velocity in the skin over proximal interphalangeal joints between rheumatoid arthritis and osteoarthritis.

Early detection of synovitis in rheumatoid arthritis (RA) and distinction from osteoarthritis (OA) are important to establish the most appropriate treatment. Increased perfusion over affected joints observed by laser Doppler perfusion imaging was supposed to arise from the underlying joint, because it was detected only by a near-infrared laser and not by a less penetrating red laser source. Using laser Doppler anemometry, this study addressed two questions: (1) whether capillary blood cell velocity (CBV) is increased in the skin over finger joints affected by RA or OA; (2) whether there is a difference between RA and OA in CBV above affected proximal interphalangeal (PIP) joints. Levels of soluble adhesion molecules were measured, because they indicate rheumatoid vasculitis raising flow resistance. Thirty-one patients with RA and 20 with OA were investigated. Compared to 18 controls, CBV (mean+/-SEM) was elevated above PIP joints clinically affected by RA (0.35+/-0.06 mm/s vs. 0.21+/-0.02 mm/s; P<0.05) and over PIP (0.27+/-0.02 mm/s vs. 0.21+/-0.02 mm/s; P<0.05) and distal interphalangeal joints (0.27+/-0.02 mm/s vs. 0.17+/-0.01 mm/s; P<0.001) affected by OA. Levels of soluble adhesion molecules were not correlated with CBV over PIP joints in RA. These observations demonstrated that elevated blood cell velocity is detectable by laser Doppler anemometry in skin capillaries over interphalangeal joints affected by RA or OA and contradict the previous assumption that there is hyperemia only in the affected joint. The lack of a significant difference in CBV over PIP joints between RA and OA patients might be due to some inflammation also occurring in OA rather than to vasculitic processes in RA associated with elevated levels of soluble adhesion molecules.

Adult↗
PubMed1980

[Cementing of small osteochondral fragments in hand surgery using a fibrin glue--clinical experiences].

A short historical review of the development of a new fibrinogen adhesive system, consisting of highly concentrated fibrinogen, thrombin, and factor XIII, is given. Small osteochondral fragments are well fixed with this system. This was demonstrated in five cases with good success, the fragments being early revascularized. Some of these patients have had severe damage to the finger joint surface. The problems of a prematured fibrinolysis were discussed.

Amputation, Traumatic↗
PubMed1986

Tuberculosis of the upper limb joints.

Seventy-four cases of tuberculosis of the upper limb joints (sterno-clavicular 1; shoulder 12; elbow 42; wrist 10 and fingers 9), treated by two of the authors, were reviewed. Eighty-seven percent presented at an advanced stage of destruction. The diagnosis was proved in 71 our of 74 cases. In most, the treatment was 6-12 months of chemotherapy, plaster immobilization (in order to prevent or correct deformity) and functional rehabilitation whenever possible. The sterno-clavicular and finger joints were not immobilized. Response to chemotherapy was favourable in 66 of the patients followed up. One relapse occurred at the 18th month. The affected shoulder joints healed with loss of movement, but were not painful. At the elbow, ten patients developed spontaneous bony fusion in the right-angle position, 27 had a useful range of motion and 19 had more than 70 degrees of flexion-extension movement. One patient had an arthrodesis. At the wrist, two patients healed with painful stiffness and an arthrodesis was performed. All the finger lesions healed with painless stiffness which did not interfere much with function because rehabilitation had been started early. The authors believe that conservative management usually gives better results than arthrodesis or excision of the joint.

Adult↗
PubMed1979

[Graphic demonstration of finger mobility in the grasping region].

To test the functional capacity of a finger, the documentation of its range of motion is of great importance. The capacity to grasp is determined by the flexion and extension ability of the finger joints. Dexterity is based on the mobility field of the finger end, within the grasping area. Both can be shown graphically. A table is described with which the mobility within the grasping area of each finger can be tested and documented without joint measuring. The advantage of this method is the easy handling and the graphic demonstration, allowing a very precise judgment of the functional capacity of a finger. The graphic demonstration is especially qualified for testing disabled fingers as well as showing progress during physiotherapy.

Anthropometry↗
PubMed2005

Randomized controlled trial on low level laser therapy (LLLT) in the treatment of osteoarthritis (OA) of the hand.

BACKGROUND AND OBJECTIVES: Low level laser therapy (LLLT) offers promising symptomatic relief of osteoarthritic (OA) pain. We examined efficacy of active LLLT versus sham LLLT on finger joints and three superficial nerves. STUDY DESIGN/MATERIALS AND METHODS: OA-patients randomly assigned, received three treatments per week for 6 weeks of LLLT (n = 42) or sham LLLT (n = 46). RESULTS: Pain relief, morning stiffness, and functional status did not significantly improve for LLLT versus placebo. No significant differences were found in finger range of motion, except carpometacarpal opposition (P = 0.011), grip strength, and patient global assessment which improved for active LLLT participants (P = 0.041). CONCLUSIONS: LLLT is no better than placebo at reducing pain, morning stiffness, or improving functional status for OA-hand patients.

Aged↗
PubMed2006

Successful treatment with rasburicase of a tophaceous gout in a patient allergic to allopurinol.

BACKGROUND: A 56-year-old white woman was referred to our institution with a 16-month history of severe, gouty, recurrent, acute polyarthritis involving the finger joints. She also had numerous small subcutaneous tophi in her hands. The patient was intolerant to allopurinol and had mild renal insufficiency attributed to uric-acid nephrolithiasis and interstitial nephropathy. INVESTIGATIONS: Physical examination, laboratory testing, X-rays of the hands, feet and pelvis, CT of the pelvis, microscopic analysis of an aspirate from a finger tophus. DIAGNOSIS: Tophaceous gout associated with urate nephropathy in a patient intolerant to allopurinol. MANAGEMENT: Acute polyarthritis was successfully managed by intravenous bolus methylprednisolone combined with codeine, diclofenac and low-dose colchicine. Rasburicase infusions combined with fenofibrate and sodium bicarbonate achieved to maintain serum acid uric below 360 micromol/l.

Allopurinol↗
PubMed2003

Differential impairment of individuated finger movements in humans after damage to the motor cortex or the corticospinal tract.

The purpose of this study was to quantify the long-term loss of independent finger movements in humans with lesions relatively restricted to motor cortex or corticospinal tract. We questioned whether damage to the motor cortex or corticospinal tract would permanently affect the ability to move each finger to the same degree or would affect some fingers more than others. People with pure motor hemiparesis due to ischemic cerebrovascular accident were used as our experimental sample. Pure motor hemiparetic and control subjects were tested for their ability to make cyclic flexion/extension movements of each finger independently. We recorded their finger joint motion using an instrumented glove. The fingers of control subjects and of the unaffected hands (ipsilateral to the lesion) of hemiparetic subjects moved relatively independently. The fingers of the affected hands (contralateral to the lesion) of hemiparetic subjects were differentially impaired in their ability to make independent finger movements. The independence of the thumb was normal; the independence of the index finger was slightly impaired, while the independence of the middle, ring, and little fingers was substantially impaired. The differential long-term effects of motor cortical or corticospinal damage on finger independence may result from rehabilitative training emphasizing tasks requiring independent thumb and index movements, and from a greater ability of the spared components of the neuromuscular system to control the thumb independently compared with the other four fingers.

Adult↗