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At least 811 records · Page 45Linked to original sources
PubMed1998

Trichorhinophalangeal syndrome type I.

A 32-year-old short statured woman with alopecia, typical facies, shortened angulated fingers and toes with Trichorhinophalangeal syndrome type I (TRPS I) is reported. The absence of exostosis and mental retardation rule out TRPS II. The absence of generalized shortness of all phalanges, metacarpals and metatarsals distinguish it from TRPS III. Possibly the various types of Trichorhinophalangeal syndrome are genetically identical but have a varied clinical spectrum.

Adult↗
PubMed2001

[Tension force in dynamic splints made of neoprene].

Dynamic splints are the most difficult ortheses to make. Unrestricted finger joint mobility is usually prevented by the size of their components. Ortheses made out of neoprene material have the advantage of being pliable and at the same time can be constructed as dynamic splints. Neoprene material elasticity allows conforming it into a tube that can be fitted over a finger, spreading uniform pressure. A traction slip can be cemented to the neoprene finger tube. With neoprene splints, lever arms are more efficient. Their tubular design applies and spreads traction and countertraction forces in all directions. Neoprene material's elasticity contributes in reducing edema formation as well as distributes forces applied to the finger over a large area. The risk of excessive pressure is the only drawback of an elastic tubular design, it may cause pain and tissue ischemia. A meticulous tailoring prevents this potential risk.

Biomechanical Phenomena↗
PubMed1997

Hand function following Silastic arthroplasty of the metacarpophalangeal joints in the rheumatoid hand.

Twenty-one consecutive rheumatoid patients (23 hands, 92 joints) who underwent Silastic metacarpophalangeal joint arthroplasty between 1989 and 1993 had the 33-task Baltimore quantitative upper extremity function test prior to surgery and then repeated at intervals from 6 weeks to 1 year for all 23 hands and 3 to 4 years for 14 of the hands. In addition all hands had goniometer measurement of active range of finger joint motion and ulnar drift at each assessment. The average preoperative score was 71 improving rapidly to 89 at 6 weeks, to 91 at 1 year and 92 at 3 to 4 years. Most improvement occurred in functions requiring pinch span or hook grip and could be attributed largely to correction of ulnar drift and the change of metacarpophalangeal arc of motion. These results confirm that the Silastic metacarpophalangeal joint arthroplasty significantly improves hand function and that the improvement is maintained over a 3- to 4-year period.

Adult↗
PubMed2005

Simultaneous double second toe transfer for reconstruction of adjacent fingers.

BACKGROUND: The authors reviewed their results with simultaneous double second toe transfer for reconstruction of adjacent fingers. METHODS: From January of 1984 to January of 2003, simultaneous double second toe transfer was performed for reconstruction of adjacent fingers in 140 patients (48 before wound closure, 92 after). Functional thumbs were present in all of them. There were 104 male and 36 female patients, with an average age of 29.1 years (range, 2 to 57 years). Index and middle fingers were reconstructed in 90 patients, middle and ring fingers in 49 patients, and ring and little fingers in one patient. The average operation time was 11 hours 25 minutes, which was much shorter than double the average time of a single second toe transfer (8 hours 31 minutes; double time, 17 hours 2 minutes). Twenty-six toes were reexplored for vascular insufficiency and three of them were lost. Secondary surgery was performed in 98 patients to improve function and cosmesis. RESULTS: Patients were followed up at an average period of 47.5 months (range, 2 to 210 months). Forty-two patients had complete functional evaluation at a minimum 2-year follow-up. The mean active range of motion of the reconstructed finger joints in these patients was 69.4 degrees for metacarpophalangeal joints, 31.1 degrees for proximal interphalangeal joints, and 8.2 degrees for distal interphalangeal joints. Two-point discrimination was between 3 and 13 mm (average, 7.5 mm). All donor sites were closed primarily and no obvious donor-site morbidity was noted, except for one hallux valgus deformity that was corrected by surgery. CONCLUSIONS: The functional and aesthetic results of double second toe transfers for adjacent two-finger reconstruction are superior to those of a single second toe-to-single finger reconstruction in multiple-finger amputations. Double second toe transfer performed simultaneously reduces the cost and total time of the operation, enables faster rehabilitation, and hastens patient adaptation.

Adolescent↗
PubMed1998

Macrodactyly.

We report the results of the treatment of 23 patients with macrodactyly. Eighteen had a two-stage bulk-reducing (defatting) procedure; phalangectomy was used to shorten the digits. At a mean follow-up of nine years (2 to 12), two patients had been lost to follow-up, and three await a second-stage procedure. Good cosmetic correction was achieved in 12 patients, with satisfactory results in seven; two patients had poor results and required amputation.

Adipose Tissue↗
PubMed1981

Royal College Lecture, prevention of arthritis through preservation of cartilage.

In the face of current enthusiasm for total replacement of joints, we must not forget that much degenerative arthritis is preventable. Three causes of iatrogenic damage to articular cartilage are pressure necrosis, obliterative degeneration and drug-induced degeneration. Our experiments with continuous passive motion have shown striking beneficial effects on the healing and regeneration of cartilage. We are beginning to test this clinically at knee, elbow and finger joints with encouraging results.

Animals↗
PubMed2006

Transpositional adipofascial flaps for complicated acute finger injries.

Seven patients who presented with complicated acute finger injuries were treated successfully with local transpositional adipofascial flaps. This is a one-stage procedure with advantages of simplicity and rapidity. This flap is thin with good pliability and provides a very versatile and reliable covering for soft-tissue defects of the fingers. Full-thickness skin grafts were applied to the raw surface of the adipofascial flaps in all patients. All cases had excellent wound healing and restored full range of motion. This procedure facilitates early wound healing and early range of motion for finger joints; it also reduces wound pain, minimizes scar formation, and eliminates the need for second-stage surgery.

Acute Disease↗
PubMedDate not supplied

Bilateral organization of physiological tremor in the upper limb.

The bilateral patterns of physiological tremor in the upper limb of adults were examined under conditions where eight combinations of the elbow, wrist and index-finger joints of the right arm were braced using individually molded splints. The hypotheses tested were that: (a) coordination of upper-limb tremor involves (compensatory) coupling of intra- but not inter-limb segments, (b) splinting the respective joints of the right arm changes the organization of this synergy in both limbs, and (c) reducing the involvement of joint-space degrees of freedom through restricting their motion (by splinting) results in increased tremor in the distal segments. Under no-splinting conditions, significant relationships were only observed between adjacent (intra-limb) effector units, with the strength of the correlation increasing from proximal to distal. Splinting the right limb resulted in an increase in the strength and number of significant intra-limb relationships in both limbs. No inter-limb tremor relationships were found between any segment during this task, irrespective of the splinting condition. The frequency profile for the tremor in each limb segment showed two prominent frequency peaks (at 2-4 Hz and 8-12 Hz). A third, higher frequency peak (18-22 Hz) was observed in the index fingers only. Splinting the right limb produced a general increase in the amplitude and variability of tremor in the fingertip of both arms. This effect was particularly strong under conditions where the more proximal joints were splinted. The lack of any between-limb relationships, coupled with the fact that splinting one limb influenced both limbs, suggests that some form of linkage does exist between the limbs. It is unlikely that mechanical linkages can explain fully these relationships. It is proposed that the tremor observed in either limb represents the output of a central oscillatory mechanism(s), but that this output is subsequently independently filtered in a parallel fashion on its way to each respective limb. A common bilateral (compensatory) strategy is employed to minimize the tremor in either limb during this multiple-degrees-of-freedom task.

Adult↗
PubMed1991

Locked metacarpophalangeal joint of the finger.

Twenty-one patients who had received treatment for a locked metacarpophalangeal joint of an index finger were reviewed. Five cases were successfully treated with manipulation after an intra-articular injection of a local anesthetic, while the remaining 16 required open reduction. In the vast majority (15 of the 16 operated patients), the locking was attributed to catching of the radial accessory collateral ligament on a bony prominence of the metacarpal head of the finger. All patients who underwent manipulation, and 14 of the 16 patients who were operated on, regained full range of motion of the metacarpophalangeal joint with no pain. Our experience suggests that manipulation is the treatment of choice. However, if it is unsuccessful, it should be followed by surgical exploration to avoid further damage to the joint.

Adult↗
PubMed1994

A comparison of post-operative mobilization of flexor tendon repairs with "passive flexion-active extension" and "controlled active motion" techniques.

We report a comparative study of the outcome of flexor tendon repairs mobilized by either a "passive flexion-active extension" or a "controlled active motion" regimen. We show that the controlled active motion regimen conferred significant benefits on the final range of motion and extensor lag. The rupture rate was raised with "controlled active motion" but this was not greater than levels reported by other authors using "passive flexion-active extension" regimens.

Finger Injuries↗