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At least 829 records · Page 46Linked to original sources
PubMed1998

Free tendon interposition grafting for the repair of ruptured extensor tendons in the rheumatoid hand. A clinical and biomechanical assessment.

Sixteen ruptured extensor tendons were repaired in seven rheumatoid hands using autogenous palmaris longus tendon as a free interposition graft. The patients were reviewed at an average of 17 months (range, 5-45) after repair. Subjectively all patients were satisfied with the clinical results, and achieved a return to their level of ability before tendon rupture. A biomechanical model suggests that tendon repair using an interposition graft, rather than a traditional end-to-side tendon transfer retains the anatomical axis of tendon function, and achieves greater forces during active finger extension.

Adult↗
PubMed1983

Restoration of thumb-index pinch by a double tendon transfer following ulnar nerve paralysis.

Repair of ulnar nerve lesions by suture or grafts often gives good results, but in some cases there persists a long-term isolated paralysis of the muscles of the first web space. There is certain to be a resulting loss of function from loss of the thumb-index pinch which can be corrected by tendon transfers. In 11 cases the authors have used two tendon transfers: the short extensor of the thumb to re-establish the function of the first dorsal interosseous muscle, and the extensor indicis proprius to improve adduction. In every case there was notable improvement in the function of the hand.

Adolescent↗
PubMed1995

[Clinical aspects of arthrosis].

Symptoms, physical, laboratory, and x-ray findings in osteoarthrosis are reviewed, special emphasis is drawn to the different clinical forms as compensated, activated, decompensated osteoarthrosis. A sample of 2,494 patients with degenerative joint disease or functional disorders as e.g. myalgia were studied with respect to symptoms and physical findings. As previously described in other studies it turned out, that osteoarthrosis of the knee specially in women is correlated with high body weight; furthermore it could be shown that foot deformities--hallux valgus and pes planus in gonarthrosis, hallux valgus and hammer-toe in polyarthrosis of the finger joints--are significantly more frequent in some degenerative joint diseases.

Adolescent↗
PubMed2006

A tribute to our teacher, Dr. Judith Hall: a child with the trait of the Earl of Shrewsbury.

"Organized human endeavor can be lifted an order of magnitude through teaching if it is inspiring" (Editor, Am J Dis Child, 1972). The benevolent influence of Dr. Judy Hall's inspiring clinical teaching in the field of genetic syndromes and birth defects is illustrated through the eventual surgical remediation of conductive hearing loss for a 4-year-old girl with unusual knuckles. The fascinating history of this child's syndrome has been further explored in the descendents of the first Earl of Shrewsbury. The legends of his story and his role in the Hundred Years War were immortalized by William Shakespeare in his play Henry VI Part I, but neither Shakespeare nor historians documented that the Earl actually had abnormal finger joints. Heterozygous mutations in the human noggin gene (NOG) cause a spectrum of joint fusions, including this child's traits. On behalf of practitioners of medicine, pediatrics, clinical genetics, and dysmorphology, as well as research scientists in the many domains of genetics, thank you, Judy, for your inspiration, enthusiasm, and teaching.

Abnormalities, Multiple↗
PubMed1994

[Deformities of the fingers secondary to fingersucking].

After prolonged finger-sucking in early infancy, skeletal digital deformities, especially of the index finger, may occur. Thumb-sucking causes primarily dental disturbances whereas prolonged index--sucking may deform this finger, with functional as well as aesthetic consequences on the grip. Acquired rotation of the index finger is the most frequent deformity and does not always resolve spontaneously so that a rotation osteotomy had to be performed in 3 cases.

Finger Joint↗
PubMed2001

MRI of the arthritic small joints: comparison of extremity MRI (0.2 T) vs high-field MRI (1.5 T).

The aim of this study was to compare the diagnostic capabilities of extremity MRI (E-MRI) with high-field MRI in arthritic small joints, and to evaluate the patients' acceptance and perceptions of the two MR systems. One hundred three patients (group 1 = 28 patients with RA < 3 years, group 2 = 25 patients with reactive and psoriatic arthritis and mixed connective tissue disease, group 3 = 25 patients with rheumatoid arthritis (RA) more than 3 years and group 4 = 25 patients with arthralgia) underwent dedicated E-MRI and high-field MRI of the wrist and finger joints. Coronal short tau inversion recovery and transversal 3D T1-weighted images before and after gadodiamide (Gd) were performed in both cases to outline the volume of the synovial membrane (Vsm) and to evaluate joints with enhancement, effusion, bone edema, and erosions. Investigators blinded to the clinical findings evaluated the images. Patients' compliance and acceptance of E-MRI and high-field MRI were evaluated. The median Vsm obtained on E-MRI did not differ significantly from that obtained on high-field MRI. Vsm = 1 ml (E-MRI) and 1.1 ml (high-field MRI) before Gd and Vsm = 0.1 ml (E-MRI) and 0 ml (high-field MRI) after Gd (Wilcoxon test, p > 0.05). The difference in agreement was 8% for joint enhancement, 2% for joint effusion, 3% for bone edema, and 4% for bone erosions. Of the patients, 64% preferred E-MRI due to more comfortable positioning and less claustrophobia and noise. Extremity MRI of the small arthritic joints is comparable to high-field MRI and more readily accepted than high-field MRI by this patient group.

Adult↗
PubMed1978

Unstable fracture dislocations of the proximal interphalangeal joint of the fingers: a preliminary report of a new treatment technique.

A linkage of Kirschner wires activated by a single rubber band creates a force couple across a fracture-dislocated proximal interphalangeal joint. The method dynamically achieves concentric joint reduction, which is maintained through a full active range-of-joint flexion and extension. Two case reports accompany a description of the technique.

Adolescent↗
PubMed1984

The control of hand movements in a case of hemianaesthesia following a parietal lesion.

A 46-year-old patient with a lesion limited to the left retrorolandic area without involvement of the prerolandic motor strip was examined. Anaesthesia to tactile, warm, cold, and painful stimuli was complete for the right hand and wrist. Position sense was abolished for the right wrist and finger joints. Performance of the right hand in motor tasks was severely impaired. Simple visual and auditory reaction times were lengthened. Sustaining a constant level of force was impossible. In the absence of visual feedback, only simple, monoarticular movements could be correctly executed; more complex movements requiring coordination between several joints, such as prehension, were poorly, or not, performed. The role of somatosensory cortex in conveying kinaesthetic input to the motor areas and the importance of vision in substituting for kinaesthetic loss, are discussed.

Brain Neoplasms↗
PubMed2000

No influence of osteoarthritis of the hand on phalangeal osteography in elderly women.

We investigate the influence of hand osteoarthritis on skeletal quantitative ultrasound (QUS) measurement through the proximal phalanges in female geriatric inpatients. In a cross-sectional study, bone status was assessed with QUS at the distal metaphysis of the first phalanges of fingers II-V. Thirty-three of 101 female geriatric inpatients met the clinical criteria of the American College of Rheumatology for osteoarthritis of the hands (median age: 85 years) and were compared to 68 female inpatients without swellings of the small finger joints (median age: 88 years). Amplitude-dependent speed of sound at the distal metaphysis, the electronic signal of the ultrasonic wave after crossing the phalanx (graphic trace), and the thickness of the each phalanx were measured and compared between the two groups by a phalangeal QUS device (DBM-Sonic 1200). There were no significant differences between the phalangeal QUS readings of both groups. The only statistically significant difference was observed in the comparison of the small finger thickness with a lower value in the osteoarthritis group (p = 0.02). These findings suggest that at the metaphyseal level of phalanges, the degenerative process of osteoarthritis doesn't influence the QUS assessment. This could be explained by the finger thickness at metaphyseal level, which was not increased in patients with osteoarthritis compared with control subjects, at least as detected by the applied finger ultrasound method.

Aged↗
PubMed1985

Osteocutaneous flaps for thumb and digit reconstruction. In unique situations.

Osteocutaneous flaps from the foot are being utilized more for thumb and digit reconstruction. We have presented a few unique situations in which these flaps are beneficial. Not all patients with deformities similar to those described in this presentation should have these reconstructive procedures. The patient must understand the risks of donor site morbidity and possible complications. However, the advantages of this technique are that only one surgical procedure is necessary, the hospitalization is short, the cosmetic result is good, and the functional restoration is satisfactory.

Adolescent↗
PubMed1999

[Efficacy of radiation synovectomy in degenerative inflammatory and chronic inflammatory joint diseases].

AIM: Effect of radiosynovectomy (RS) should be evaluated both by subjective and objective parameters in patients with osteoarthritis and in patients with inflammatory joint disorders not caused by rheumatoid arthritis. METHODS: A total of 98 joints in 61 patients were investigated. Patients were divided into two groups. The first group included 35 patients with therapy-resistant effusions caused by severe osteoarthritis (46 joints). The second group consisted of 26 patients (52 joints) with ankylosing spondylitis, reactive arthritis, undifferentiated spondylarthropathy, psoriatic arthritis, pigmented villo-nodular synovitis, and recurrent synovitis following surgery. Effect of RS was evaluated by a standardized questionnaire and quantified by T/B-ratios derived from blood pool images prior to and after RS. RESULTS: Within the first patient group suffering from osteoarthritis, 40% showed a good or excellent improvement of clinical symptoms, 51% were unchanged, and in 9% symptoms worsened. Similar results were found in the second patient group. The majority of unchanged results were small finger joints. In contrast, wrist and knee joints showed a better improvement. Good correlation between results of bone scan and patients subjective impression was found in 38% and 67% in the first and the second patient group, respectively. CONCLUSION: Radiosynovectomy might be an effective treatment in osteoarthritis and inflammatory joint disorders not caused by rheumatoid arthritis.

Adult↗
PubMed2003

Biomechanics and hand trauma: what you need.

Mutilating hand trauma presents the surgeon with many reconstructive challenges. This article establishes some biomechanical guidelines to help the surgeon evaluate the hand trauma patient. Through a basic understanding of hand biomechanics, the surgeon may access more accurately what motion and function can best be salvaged. By understanding how amputation, fusion, and tendon loss impact on postoperative hand motion, the surgeon can better focus his or her reconstructive efforts to achieve the highest functional outcome for the patient.

Amputation, Traumatic↗