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At least 793 records · Page 44Linked to original sources
PubMed1989

[The value of the free external brachial flap in surgery of the hand].

The lateral brachial flap is a septo-cutaneous flap raised from the lateral surface of the arm. It is a thin and reliable flap with a neurovascular pedicle and its donor site can be self-closing in the case of small flaps. The authors report six cases of closure of hand defects by means of this flap, including one case of emergency repair. Due to its simplicity, the lateral brachial flap now constitutes one of the alternatives for cover of hand defects and its pedicled version may be useful cover of the elbow region.

Adult↗
PubMedDate not supplied

Goniometry of the proximal and distal interphalangeal joints, Part II: placement prefereces, interrater reliability, and concurrent validity.

The purposes of this repeated-measures single-case-design study were to describe goniometric placement preferences and their effect on the measurement of the proximal and distal interphalangeal joints, to determine interrater reliability, and to determine concurrent validity. Thirty-nine therapists measured one patient dorsally and laterally with the DeVore and the 6" clear goniometers. No significant differences were found between the two goniometers used in the study. Comparison of the means of lateral and dorsal measurements revealed that the only joint associated with a significant difference was the contracted index proximal interphalangeal joint (p=0.0347). Preferences did affect the standard deviations and ranges but not the means of the measurements. Interrater reliability was high (ICC 2,1: 0.99 and 0.86). Clinical and radiographic measurements were markedly different from each other (paired-difference t-tests), leading to inconclusive concurrent validity.

Data Collection↗
PubMedDate not supplied

Intrarater reliability of a new method and instrumentation for measuring passive supination and pronation: a preliminary study.

Because of the clinical impression that traditional forearm goniometry has several potential sources of error and is therefore inherently unreliable, a new method using a newly designed goniometer was compared with traditional forearm passive range-of-motion goniometry. The new method utilized an offset face with a plumbline design and a patient-held tubular handle. Thirty orthopedic patients (31 wrists) were measured by three experienced hand therapists in a test-retest protocol to determine the reliability of both the traditional and new methods. Both the intraclass correlation coefficients and standard error of the measure showed improved scores with the new goniometric technique, compared with the traditional one. The differences between methods may not be clinically significant.

Adult↗
PubMedDate not supplied

Melorheostosis: unusual presentation in a girl.

Melorheostosis is a rare bone disease of unknown etiology. It is characterized by tense and erythematous skin, contractures and shortening of the affected limbs. Radiographs reveal hyperostosis in long bones resembling melting wax, and spotty or patchy endostic deposits in short bones. An 11-year-old girl showed, since birth, contractural deformities in the right hand without bone abnormalities. At the age of 12 months, she complained of soft tissue tightness in the right buttock. At 3 years, limitation of flexion and extension of the right knee was evident. Radiographs revealed findings typical of melorheostosis.

Bone and Bones↗
PubMed2000

[Extension osteotomy of the long metacarpal bones. A therapeutic solution to repairing flexion defects. Apropos of 14 cases].

Fourteen extension osteotomies were performed in 13 patients with angular metacarpal malunion. Surgery was indicated by the limitation of mobility, the reduction in gripping capacity, and pain following digitopalmar grasping movements. After surgery, the patients regained good articular mobility. However, in 60% of cases a teno-arthrolysis was required upon removal of consolidation hardware to restore digital function. The operation allowed pain relief in two-thirds of the patient population; in the remaining subjects, pain was experienced when making grasping movements. At the final examination, in the majority of cases gripping strength was similar to that of the contralateral hand. In conclusion, correction of angular malunion by extension osteotomy is a demanding procedure, and whenever possible should be avoided by a precise reduction of the metacarpal fracture during initial surgery. A fractured metacarpal with a palmar angulation of over 15 degrees should systematically be reduced and fixed if unstable.

Adolescent↗
PubMed1977

Urinary mucopolysaccharides in acheiropodia.

Urinary mucopolysaccharides from three patients with acheiropodia were qualitatively and quantitatively analysed by agar gel electrophoresis coupled with enzymatic degradation. Although no abnormal pattern was characterized, eventual metabolic dysfunction detected only in bone/cartilage tissues could not be ruled out.

Abnormalities, Multiple↗
PubMed2002

Improvements in activities of daily living following functional hand surgery for treatment of lesions to the cervical spinal cord: self-assessment by patients.

STUDY DESIGN: Tetraplegic patients were tested for hand strength before and after hand surgery. They also answered questions about how they rated the results of surgery. OBJECTIVES: Presentation of the efficacy of reconstruction of hand raising, lateral grip, and cylindrical grip in the tetraplegic hand. SETTING: The study was conducted in the Werner Wicker Clinic, Bad Wildungen, Germany, from 1991 to 1998. METHODS: The results of reconstruction surgery performed on 23 tetraplegic hands, as reflected in lifting the hand (n=3), lateral grip (n=21), and cylindrical grip (n=14), are presented. In a follow-up study in 22 patients, their management of activities of daily living 34.1 months (9-51 months) after the surgery is compared with the preoperative situation. Subjective satisfaction levels were elicited for each of the 22 patients by means of a questionnaire. RESULTS: The gain in force corresponded to 893 g (150-1500 g) for cyclindrical grip and 488 g (100-1200 g) for lateral grip, while they were able to develop grade 4 force for lifting the hand. After the operation 28 aids/appliances that patients had formerly used regularly were no longer necessary. There were 75 separate activities listed in the questionnaire, and on average the 22 patients were able to perform 8.7 (0-20) more of these. Most patients (19) said they would advise others to have the operation and 18, that they would have the operation again. There were 12 complications in nine patients. CONCLUSION: Reconstructive surgery on the hands of tetraplegic patients leads to gains in both cylindrical grip and lateral grip force and to increased manual dexterity. Patient satisfaction with the procedure is high.

Activities of Daily Living↗
PubMed2003

Pachydermodactyly: a forme fruste of knuckle pads?

A 16-year-old boy presented with painless swellings localized to the radial and ulnar aspects of his second through to the fifth fingers on the left hand, with more subtle changes affecting two fingers on the opposite hand. This had developed in the absence of mechanical trauma. Investigations for an arthropathy were negative, while a biopsy showed marked epidermal hyperplasia and an expanded dermis. These features are typical of pachydermodactyly, a benign dermatosis of uncertain aetiology. The interesting feature of this case is the presence of knuckle pads in the father of the patient, which raises the possibility that these two similar entities are related.

Adipose Tissue↗
PubMed1997

Cystic hygroma as an early first-trimester ultrasound marker for recurrent Fryns' syndrome.

We present a case of a fetus who at a 12-week ultrasound examination was shown to have a large cystic hygroma. Fryns' syndrome was suspected because the mother's previous pregnancy had been affected by the condition. Pathological examination confirmed the diagnosis at this early stage of gestation. In families with increased risk for Fryns' syndrome, first-trimester ultrasound screening should be offered to exclude cystic hygroma as an ultrasound marker for this most often lethal malformation.

Abnormalities, Multiple↗
PubMedDate not supplied

Adams-Oliver syndrome with unusual central nervous system alterations.

The association of aplasia cutis congenita of the scalp with distal malformations of the limbs is known as Adams-Oliver syndrome. Other reported associations include palatine or auricular malformations, cardiovascular alterations, and spina bifida. Multiple hereditary patterns have been described for this condition, and sporadic cases have also been reported. We report an infant with Adams-Oliver syndrome associated with intracranial calcifications in whom no evidence of intrauterine infection could be demonstrated.

Abnormalities, Multiple↗
PubMedDate not supplied

Ectrodactyly-ectodermal dysplasia-clefting syndrome (EEC): report of a case with perioral papillomatosis.

We report a 13-year-old boy with ectodermal dysplasia, ectrodactyly, and syndactyly, hypospadias, photophobia, conductive hearing loss, and perioral papillomatosis. His father had ectrodactyly and hypotrichosis. The clinical picture suggested ectrodactyly-ectodermal dysplasia-clefting (EEC) syndrome. The presence of perioral papillomatosis, classically seen in Goltz syndrome, has been reported only once before in EEC syndrome.

Abnormalities, Multiple↗
PubMed2002

Ulnar-sided cleft hand.

Three cases of ulnar-sided cleft hand are presented in which clefting was accompanied by ring finger absence in 2 and by small finger abduction, supination, shortening, and camptodactyly in all 3. An approach to surgical reconstruction is described with marked improvement in appearance.

Child, Preschool↗
PubMed2000

Higher grip strength increases the risk of incident radiographic osteoarthritis in proximal hand joints.

Quadriceps strength may protect against knee osteoarthritis (OA), but muscle activity is a major determinant of forces at the hand joints. Gripping objects is a common task during which high muscular forces are sustained, particularly at the proximal hand joints (metacarpophalangeal (MCP) joints and thumb base). The association between maximal grip strength and incident OA at different hand joints was examined in a longitudinal study of radiographic hand OA. Subjects with higher maximal grip strength were at increased risk for development of OA in the proximal interphalangeal (PIP) joints, MCP and thumb base joints in men; and in the MCP in women. No association was found between maximal grip strength and incident distal interphalangeal (DIP) joints OA in men or women. The conclusion is that increased grip strength, which is the major force of loading across proximal hand joints, increases the risk of OA in those joints.

Female↗
PubMed2002

Free phalangeal transfer: donor-site outcome.

The role of non-vascularised free proximal phalangeal transfer in digital reconstruction in children remains controversial. Significant cosmetic and functional deficits can result in the donor foot. We compare the donor-site outcome following a new technique of reconstruction using a cylindrical iliac-crest bone graft (n = 11) with the outcome following the technique previously described by Buck-Gramcko (n = 18). We have found better preservation of toe stability and length following the bone-graft technique.

Bone Transplantation↗