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At least 847 records · Page 47Linked to original sources
PubMed1987

A new treatment of painful amputation neuroma: a preliminary report.

Two cases of painful amputation neuroma treated by a new method are described. A vascularized island transfer from a less important finger was used, but the accompanying nerve was divided and its distal end sutured to the proximal end of the nerve in the recipient finger, after excision of the neuroma. Four years and two years later, no clinical evidence of neuroma was present at either amputation stump or donor site.

Amputation Stumps↗
PubMed1988

Traumatic aneurysms of two proper digital arteries in the same patient: a case report.

Aneurysms in the hand are infrequent and aneurysms of the proper digital arteries are particularly rare, only 11 cases having been reported in the literature. The authors describe the case of a patient operated on for two traumatic false aneurysms of the ulnar digital arteries of the middle and ring fingers. Arterial aneurysms should be carefully evaluated to exclude other lesions such as cysts, abscesses, neuromas. The choice between ligation and resection or reconstruction of the vessel should be based on pre-operative and intra-operative evaluation of circulation.

Adult↗
PubMed1989

Dorsal dislocation of the D.I.P. joint with fracture of the volar base of the distal phalanx.

Between 1978 and 1985, we treated 12 cases of dorsally displaced fracture-dislocation of the I.P. joint of the thumb or of the D.I.P. joint of the finger, with a volar bony fragment. All were treated surgically, active exercise being started three to five weeks later. At the last follow-up, averaging 6.4 years (range 4.3-10 years) after operation, none of the joints was painful but the range of motion was somewhat limited.

Adolescent↗
PubMed1989

Restoration of sensibility in fingers repaired with free sensory flaps from the toe.

The sensibility of 25 fingers reconstructed with three different types of free sensory flaps from the toe was evaluated. The relationships between sensory restoration and the patient's age, type of sensory flap, selection of sutured nerves, and circulatory complications in the flap were analyzed. Wrap-around flaps were used in 5 fingers, hemipulp flaps in 11, and toe-to-finger transfers in 9. The follow-up period ranged from 16 to 79 months. Restoration of sensibility in the flap was closely related to the patient's age and vascular insufficiency of the flap. Therefore, establishing and maintaining and adequate circulation in the flap at operation is essential for good sensory restoration.

Adolescent↗
PubMed1989

Repair of the proximal interphalangeal joint with a homograft.

We describe the delayed reconstruction of a destroyed proximal interphalangeal joint by implantation of a partial articular homograft in a 17-year-old boy. One year after the operation the joint is painless and has a normal range of motion.

Adolescent↗
PubMed1992

Acute open reduction and rigid internal fixation of proximal interphalangeal joint fracture dislocation.

We report the application and results of a technique of open reduction and rigid internal fixation of dorsal fracture/dislocation of the proximal interphalangeal joint with an interfragmentary screw in two cases. Articular congruity was restored, and the proximal interphalangeal joint was stabilized. This technique permitted immediate range-of-motion exercises. Excellent results were obtained in both cases. Previous descriptions have not detailed the indications, the surgical approach, or the results of this technique.

Adolescent↗
PubMed1992

Evaluation of digital prostheses.

Fifty-one digital prostheses were made for 33 patients between 1986 and 1988. A questionnaire was developed to assess the patients' satisfaction with these prostheses and was administered 6 months and 3 years after the prostheses were made. The majority of patients requested prostheses for esthetic reasons. While they reported satisfaction with the appearance of the prostheses, at 3 years 36% of the patients no longer continue to use the prostheses.

Adult↗
PubMed1992

Vascular anatomy of the finger dorsum and a new idea for coverage of the finger pulp defect that restores sensation.

The cutaneous vascular anatomy of the finger dorsum was studied by dissection under loupe magnification of 71 fingers from 19 preserved cadaver hands. All specimens were injected with red latex or epoxy resin through a cannula in the brachial artery to identify the small vessels. The finger dorsum was supplied by the terminal branches from the dorsal metacarpal artery around the metacarpophalangeal joint. Other areas were nourished by the dorsal cutaneous branch from the proper palmar digital artery. There were two or three dorsal branches in the proximal phalangeal region and two in the middle phalangeal region. On the basis of these findings, we have developed a new method for one-stage reconstruction of finger pulp defect that restores sensation. Our innervated reverse vascular pedicle digital island flap includes the dorsal digital nerve and the proper palmar digital artery as a retrograde vascular pedicle. We have used the technique in three patients, with excellent results. The advantage of this procedure is that it provides a one-stage reconstruction of the pulp defect and restores sensation. The disadvantage is that the procedure requires neurorrhaphy.

Adult↗
PubMed1993

Measurement of range of motion of the finger after flexor tendon repair in zone II of the hand.

The purpose of this study was to compare classification systems of active range of motion of the finger after flexor tendon surgery in zone II of the hand. Active range of motion of 20 fingers (16 subjects) was classified according to five systems. Agreement between the systems was only fair. Strickland's original system and the Louisville system rated the results most strictly, followed by Strickland's adjusted system. Buck-Gramcko's systems (in centimeters and degrees) rated the results least strictly. Strickland's systems conformed most closely to measurement principles. This article concludes that at this time Strickland's original classification system is preferable for scientific and clinical purposes. However, additional research is needed to evaluate reliability of the measurement, the variability of the scaling factor of 175 degrees, the sensitivity of the measurement, and the validity of the measurement with regard to functional use of the finger and gliding of the repaired tendon.

Adult↗
PubMed1993

Tension band arthrodesis of small joints in the hand.

Two-hundred three patients underwent 290 tension band arthrodeses of the metacarpophalangeal and proximal interphalangeal joints of the hand. Nine patients (3%) failed to achieve bony union, four had painless pseudarthroses, and one patient had a small finger amputation. Twenty-five fusions (9%) required hardware removal. There were 10 superficial infections (all responded to oral antibiotic therapy), and three fusions were malrotated. Tension band arthrodesis is our choice for fusion of the metacarpophalangeal and proximal interphalangeal joints. It is reliable and provides stable fixation, pins do not protrude, and external splinting is unnecessary in the cooperative patient.

Adolescent↗