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At least 919 records · Page 51Linked to original sources
PubMed1986

Operative correction of posttraumatic and congenital swanneck deformity--a new technique.

Volar plate reconstruction by using a part of the slip of the superficialis tendon is a new technique in the treatment of posttraumatic and congenital swanneck deformity. This small series represents two patients with a posttraumatic swanneck deformity due to volar plate rupture and one patient with a congenital swanneck deformity in six fingers. The results of the operation with a two years follow-up show seven fingers with a normal flexion-extension range without hyperextension. Only one finger has an extension lag of five degrees. All fingers have a normal grip strength and normal fine movements without pain. There were no complications.

Adolescent↗
PubMed1991

Epidemiological and structural findings supporting the fibromatous origin of dorsal knuckle pads.

Epidemiological, optical and electron microscopical findings suggest that dorsal knuckle pads and Dupuytren's disease are fibrosing disorders with common features. In all cases examined, knuckle pads were always associated with Dupuytren's contracture and, in a significant number of cases, with bilateral Dupuytren's contracture. In a statistically significant number of patients with knuckle pads, Ledderhose's and Peyronie's diseases were also present (P less than 0.001). Optical and electron microscopical studies showed that cell types and extracellular matrix were identical in knuckle pads and Dupuytren's nodules in different patients.

Adult↗
PubMed1992

Partial flexor tendon injuries: to repair or not.

The correct management of partially divided flexor tendon injuries is still in dispute. This study compares the results of repair with non-repair in zone 2 injuries. We conclude that tendons divided by 60% or less in cross-sectional area should not be repaired.

Adolescent↗
PubMed1994

A comparative study of the heterodigital neurovascular island flap in thumb reconstruction, with and without nerve reconnection.

41 heterodigital neurovascular island flaps were used to cover defects of the tactile pad of the thumb in 17 years. With an average follow-up of 75.5 months, 30 patients were reviewed. 17 were treated by the original Littler technique and 13 were treated with the same flap reconstruction but with division of the digital nerve innervating the flap and re-anastomosis of this nerve to the proximal nerve end of the ulnar digital nerve of the thumb. Good aesthetic and functional results were achieved in both groups. Sensory acuity did not appear to decrease with time. The nerve reconnection technique solves the "double sensibility" phenomenon (present in 41.1% of our cases treated by the original technique), but two-point discrimination is less than that achieved by the Littler technique. Most complaints were related to the donor site such as hypertrophic scarring or scar contracture and cold intolerance, but these did not cause any real functional impairment.

Adolescent↗
PubMed1988

A simple inexpensive post-operative management regime following surgery for Dupuytren's contracture.

A simple regime has been devised for the post-operative management of patients following surgery for Dupuytren's contracture; this includes splintage of the hand for two weeks and active and passive mobilisation by the patient according to precise instructions. Selective help was provided by minimal occupational therapy in 5 of 50 patients. The results of the method were assessed prospectively by subjective criteria and objective assessment by measuring the deformity of the finger joints, lateral and tip pinch and grasp and shear forces.

Dupuytren Contracture↗
PubMed1988

The microvascular anatomy of the distal digital extensor tendon.

The circulation of six hands from four human cadavers was washed out, the hand then being injected with contrast material to provide 24 fingers for analysis under the dissecting and light microscopes. The microvascular anatomy of the distal part of the extensor tendon was outlined and is described, with particular emphasis on the fine vessels within the tendon and on the tendon surface. An area of deficient blood supply was shown within the tendon which may have implications in the aetiology and treatment of mallet finger.

Cadaver↗
PubMed1988

A cryptic cause of monarthritis in the hand: the juxta-articular osteoid osteoma.

Three patients with an isolated arthritis in the hand are described. All three had long-term complaints and had undergone surgery before presenting in our clinic. The cause of arthritis, in all three patients, was a juxta-articular osteoid osteoma. In one patient the diagnosis was established by a plain X-ray. Additional radiological studies were necessary to arrive at the diagnosis in another patient, while in the third no preoperative diagnosis could be made, despite extensive investigations. Treatment consisted of curetting the nidus.

Adult↗
PubMed1994

Intraneural topography of the ulnar nerve in the cubital tunnel facilitates anterior transposition.

The surgical management of cubital tunnel syndrome includes anterior transposition of the ulnar nerve. The success of all transposition procedures is dependent on placement of the nerve anterior to the medial epicondyle without tension. Fifteen cadaveric upper extremities underwent anterior transposition followed by anterior transposition with separation of the most proximal motor branches from the main ulnar nerve for a distance of 1, 2, and 3 cm. Proximal dissection of these motor branches achieved an average gain in distance from the epicondyle of 71%, with an average distance from the epicondyle of 3.6 cm. The intraneural topography of the ulnar nerve was studied in five additional cases. Cross-section analysis of the fascicular anatomy at 333 microns intervals along the length of the nerve with longitudinal reconstructions confirmed a safe dissection plane without interfascicular plexus formation. The most proximal motor branch in the forearm could be traced proximally an average of 6.7. cm within the nerve before interfascicular mingling occurred (range 6.0 to 7.5 cm). Thus, 6.0 cm represented the upper limit of safe proximal dissection in these nerves. Proximal separation may be performed without disruption of interfascicular plexus connections and will facilitate anterior transposition.

Cadaver↗
PubMed2004

Inter- and intralimb transfer of a bimanual task: generalisability of limb dissociation.

The present study examined whether the ability to dissociate bimanual limb movements following learning of a new coordination task (i.e. star-line drawing paradigm) can be generalised to different effector systems, as expressed by inter- and intralimb transfer. In Experiment 1, subjects practised the 'Line-Star' task (i.e. left arm traced the line/right arm traced the star) and then transferred this pattern to its symmetry partner: the 'Star-Line' task (left arm star/right arm line). In Experiment 2, intralimb transfer from the shoulder-elbow (proximal) to the wrist-finger joints (distal), and vice versa, was investigated. Results revealed positive interlimb transfer among symmetry partners of the star-line movement. Moreover, learning the star-line task spontaneously transferred from the trained to the untrained effector system whereby proximal to distal transfer was larger than vice versa. It is concluded that learning to spatially dissociate the movements of both limbs is generalisable to different motor conditions even though transfer to some conditions is suboptimal. It is hypothesised that the nature of the representation of the spatial interference task is largely effector independent.

Adult↗
PubMed2005

Percutaneous trigger finger release: the 'lift-cut' technique.

One hundred and eighty patients with 240 trigger digits were treated by percutaneous release using a 'lift-cut' technique. All patients were reviewed at 3 months following release. Overall, 94% achieved an excellent or good result. Ten patients experienced recurrent symptoms and required a subsequent open release. There was no clinical evidence of digital nerve or flexor tendon injury. We recommend this technique as a safe and effective outpatient procedure.

Ambulatory Surgical Procedures↗
PubMed2006

The Acticoat glove-an effective dressing for the completely burnt hand: how we do it.

The choice of the silver impregnated Acticoat dressing (Smith & Nephew, UK) for burns is well documented due to its recognised sustained bactericidal activity, reduction of inflammation and ability to promote healing. Its use in the burnt hand, however, is a compromise between adequate dressing cover of this injury and the ability to splint and perform hand therapy on the injured limb. Trying to wrap individual fingers, maintaining web spaces and keep a relatively light dressing for the hand therapists is often difficult and time consuming. We introduce a simple, effective method of creating a custom made Acticoat glove which provides a thin, light dressing covering the hands allowing full mobilisation of the wrist and finger joints.

Bandages↗
PubMed2006

Evaluation of passive and active rehabilitation and of tendon repair for partial tendon lacerations after three weeks of healing in canines.

BACKGROUND: Both passive and active rehabilitation have been shown to be superior to immobilization following partial tendon laceration, but few studies have directly compared these two rehabilitation protocols. In addition, controversy still remains over whether a partial tendon laceration should be repaired. METHODS: We evaluated gap formation, adhesions, gliding function and structural properties of repaired and unrepaired tendons following 3 weeks of unrestricted active rehabilitation versus passive mobilization for partial laceration of canine flexor digitorum profundus tendons. An ex vivo radiographic method was used to measure tendon excursion and rotation at each finger joint. The tendon was examined for adhesions, and gapping was measured with calipers. The tendons were tensile tested to failure. FINDINGS: We found no significant differences in tendon excursion, total joint rotation, or adhesions between any groups. Gap size was higher with active mobilization. We found no effect of rehabilitation protocol on the strength or stiffness of healing tendons at 3 weeks. Tendon repair did not affect tendon strength, but did produce higher stiffness in healing tendons at 3 weeks. INTERPRETATION: The results indicate that active rehabilitation appears safe for partial lacerations less than 60 percent. Though repair appears to weaken the tendon in the early stages of healing, it may provide some biomechanical benefit by the middle stages of healing.

Animals↗
PubMed2005

Influence of breech presentation on the development of fetal arm posture.

BACKGROUND: In previous research, an age-related developmental trend towards increasing arm flexion has been found for cephalic fetuses. AIM: To determine if the development of arm posture in breech fetuses is comparable to that of cephalic ones. SUBJECTS AND METHODS: Fetal arm posture was studied longitudinally by means of real-time ultrasound in 13 healthy breech and 10 healthy cephalic fetuses. Observations started from 33 weeks gestational age until birth and were performed weekly in the breech group and every 2 weeks in the cephalic group. RESULTS: No difference could be found in arm posture between the left and the right arm in either group. Both breech and cephalic fetuses showed a clear preference for flexion in elbow and finger joints at all studied ages. After 36 weeks gestational age, the breech group showed significantly less wrist flexion when compared to the cephalic group (p = 0.037). A clear preference for location of the fetal hands near the fetal head could be observed for both groups. CONCLUSIONS: As there is no evidence for an abnormal neuromotor development in healthy breech fetuses, the observed difference in wrist flexion is probably due to differences in intrauterine environment. Because of the preference for location of the hands in the vicinity of the fetal head, breech fetuses probably experience a less restricted environment (in the upper part of the uterus) than cephalic fetuses (in the lower part of the uterus).

Arm↗
PubMed2005

Experimental protocol for the kinematic analysis of the hand: definition and repeatability.

A quantitative and objective method based on the optoelectronic kinematic analysis of hand segments and on the calculation of global and partial parameters, which provide measures of the degree of long finger and thumb extension is proposed for the evaluation of the hand's voluntary range of motion and maximal opening of the fingers and thumb. To test the precision and repeatability of the method, the protocol was applied on 14 healthy subjects (28 hands). The proposed parameters are repeatable and show a precision between 5.5 degrees and 10.4 degrees (mean value: 7.3 degrees), comparable to values obtained with other methods. Advantages of the present approach include simultaneous analysis of all fingers, absence of cumbersome connecting cables and no need for individually customized devices. The method, also applied to the paretic hands of two hemiplegic stroke patients before and after electrical stimulation of the wrist and finger extensor muscles, has shown encouraging results for its clinical feasibility and utility in addition to functional tests.

Adult↗
PubMed2005

Development and evaluation of an optimization-based model for power-grip posture prediction.

An optimization-based model for power-grip posture prediction was proposed. The model was based on the premise that the hand prehensile configuration in a power grip best conforms to the object shape. This premise was embodied by an optimization procedure that minimized the sum of distances from the finger joints to the object surface. The model was evaluated against data from an experiment that measured the grasp postures of 28 subjects having diverse anthropometry. The intra- and inter-person variabilities in grip postures were empirically assessed and used as benchmark values for model evaluation. The evaluation showed that the root-mean-square (RMS) values of angle differences between the predicted and measured postures had a 13.7 degrees grand mean (across all joints, subjects, and two cylindrical handles grasped), whereas the RMS values of the inter- and intra-person variabilities in measured postures had grand means of 13.0 degrees and 4.4 degrees , respectively. The model can be readily generalized to the prediction of postures in power-grasping objects of different shapes, and adapted for testing alternative prehensile strategies or performance criteria.

Adult↗