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At least 955 records · Page 53Linked to original sources
PubMed1996

Recurring digital fibroma of childhood.

A case of recurring digital fibroma of childhood is presented. The natural history of this condition over several years is documented. The literature is reviewed, with particular reference to the management of the condition. Surgeons should be aware of the clinical features and the principles of management of this condition, as patients may be referred because of associated finger or toe deformities.

Disease Progression↗
PubMed1996

Melorheostosis of the hand.

We report a case of melorheostosis of the hand which showed a sclerotomal pattern of involvement, with swelling and pain. Surgical debulking resulted in correction of the deformity and relief of pain.

Adult↗
PubMed1998

Distal digital replantations and revascularizations. 237 digits in 192 patients.

Since January 1990, 237 replantations or revascularizations have been attempted in 192 patients with distal traumatic amputations of the digits. The amputations were complete in 182 digits and incomplete in 55 digits. Sixty-three amputations were in zone I and 174 in zone II (Tamai's classification). The overall success rate was 91%. Twelve digits failed in zone I and ten in zone II. We conclude that zone I and zone II replantation or revascularization is quick and worthwhile, providing acceptable sensation, appearance and near-normal function.

Adolescent↗
PubMed1998

A study of the dimensions and taper angles of the medullary canals of the proximal and middle phalanges.

The morphology and dimensions of the medullary canals of the proximal and middle phalanges have been studied with particular interest shown to the angle of taper of these canals. Measurements of 50 cadaveric fingers were taken from computer aided tomographic images using AutoCAD software. Tangents were fitted to the inner cortices in two orthogonal planes and the angles between them were measured. The angles of canal taper in the proximal phalanx were remarkably similar for each digit. This was also true for the middle phalanx of the index, middle and ring fingers but the taper of the middle phalanx of the little finger was found to be different.

Aged↗
PubMed1998

Flexor tendon repair using a stainless steel internal anchor. Biomechanical study on human cadaver tendons.

We have developed a stainless steel internal tendon anchor that is used to strengthen a tendon repair. This study tested its use in vitro to produce a repair that can withstand the tensile strength demands of early active flexion. Fresh human cadaver flexor digitorum profundus tendons were harvested, divided, and then repaired using four different techniques: Kessler, Becker or Savage stitches, or the internal tendon anchor. The internal splint repairs demonstrated a 99-270% increase in mean maximal linear tensile strength and a 49-240% increase in mean ultimate tensile strength over the other repairs. It is hoped that this newly developed internal anchor will provide a repair that will be strong enough to allow immediate active range of motion.

Cadaver↗
PubMed1998

The effect of the extent of A1 pulley release on the force required to flex the digits. A cadaver study on the thumb, middle and ring fingers.

The A1 pulley was released distally in consecutive stages by 25%, 50%, 75% and 100% of its length. The force required to fully flex the digit at each stage was recorded. The force decreased with more extensive A1 pulley release and this became significant when more than 50% of the pulley was released. These changes were probably due to loss of friction force rather than bowstringing of the tendon.

Biomechanical Phenomena↗
PubMed1998

The effect of partial excision of the A2 and A4 pulleys on the biomechanics of finger flexion.

The purpose of this study was to investigate the effect of partial excision of the A2 and A4 pulleys on digital angular rotation and the energy required to flex the finger. Partial excision of A2 resulted in a statistically significant decrease in angular rotation of 3 and 5% after 50 and 75% excision, respectively. Partial excision of A4 failed to produce any significant differences in angular rotation. Combined partial excision of A2 and A4 resulted in a significant decrease of 5 and 8% after 50 and 75% excision, respectively. Significant differences in work of flexion occurred only after excision of 75% of the A2 pulley. Although optimal finger function relies on the integrity of the A2 and A4 pulleys which maintain the efficiency of the digital flexor system, these data suggest that 25% of the A2 pulley, up to 75% of the A4 and 25% of the A2 and A4 together can be excised without significant effects on angular rotation.

Biomechanical Phenomena↗
PubMed1998

A method for developing biomechanical profiles of hand-intensive tasks.

OBJECTIVE: To develop a methodology for generic, comprehensive biomechanical profiling of hand-intensive tasks. DESIGN: Based on a multifactorial model of work-related musculoskeletal disorder development, a method was developed for continuous, simultaneous measurement of relevant variables (wrist and finger joint position, force, muscle activity, and carpal tunnel pressure). Joint dynamics and tendon travel were derived. BACKGROUND: Few generic dose-response relationships have been identified for work-related musculoskeletal disorders. This may improve if methodologies are developed that quantify multiple factors along several dimensions (means, cumulative exposure, etc.). This requires continuous, simultaneous measurements, and facilitates examination of interactions. METHODS: Five touch-typists were instrumented to quantify their biomechanical profiles using the methodology, and to evaluate the sensitivity of the method to various work organization/design conditions. RESULTS: The method captured individual and group responses to design conditions and revealed interactions and trade-offs between response variables. Carpal tunnel pressure was found to be sensitive to radial-ulnar wrist posture. CONCLUSIONS: Multi-variable biomechanical profiling can provide insight into effects of work design on workers; however, to achieve statistical significance large numbers of subjects are needed.

Journal Article↗
PubMed1997

Injection versus surgery in the treatment of trigger finger.

One hundred nine trigger fingers in 102 patients were reviewed with respect to management plan and response to treatment. Thirty-four digits eventually underwent surgical release of the A1 pulley, while the other 75 digits were treated with local steroid injection only. All patients were evaluated with respect to clinical resolution of symptoms, dollar cost of treatment, and general satisfaction as measured with a post-treatment questionnaire. These data suggest that surgical management may be the next best option in patients with trigger finger who continue to be symptomatic after a single injection. Although surgical release of the A1 pulley cost our Medicare patients $250.00 more than a second injection, this additional cost may be offset by the benefit conferred through permanency of relief. Subjective data from the patient questionnaire responses also support surgery as a reasonable choice after one injection failure. The information from this study better delineates differences between injection and surgery as treatment choices and may aid the patient and physician in choosing an individually optimal care plan.

Adult↗
PubMed1991

Solitary osseous sarcoidosis in a finger.

Sarcoidosis confined to a single bone in a patient with chronic systemic sarcoidosis and seen as a soft tissue mass is exceedingly rare. The combination of lytic and sclerotic changes within one bone has not been previously reported.

Adult↗
PubMed1979

Vascular anatomy of flexor tendons. I. Vincular system and blood supply of the profundus tendon in the digital sheath.

The detailed blood supply of the flexor tendons in the digital canal was studied in 35 fresh human hands by means of an India ink-latex vascular injection technique. The specimens were examined by first exposing the pulley system, followed by examination of the intact tendon which had been rendered transparent by immersion in a solution of tributyl and tricresyl phosphate. Five annular and three cruciform pulleys were shown. There were five types of long vincula to the profundus (VLP) and three types of long vincula to the superficialis (VLS). The vincular systems of index and little fingers were symmetrical. Occasionally, neither the VLP nor the VLS was found in either the long or the ring fingers. The vincula received blood supply from four transverse branches of the digital arteries. A volar avascular area of the profundus tendon was seen in the cleared cross-sections, and the cross-over zone of its intrinsic vessels was found to be at the midproximal phalanx.

Adolescent↗
PubMed1981

The effect of succinylcholine on denervated skeletal muscle.

Succinylcholine, commonly used in anesthesia, paralyzes normal skeletal muscles by blocking transmission at the myoneural junction, but in denervated muscle, it produces sustained muscle contractions lasting several minutes. This denervation hypersensitivity, believed to be due to the progressive enlargement of the receptor area, begins within 2 to 3 weeks and may last for months. Three patients with denervation hypersensitivity were studied: one with isolated denervation of the flexor pollicis longus and two with combined median and ulnar nerve palsy. Within 1 to 2 minutes after administration of succinylcholine, sustained contraction of the denervated muscles occurred and lasted 4 to 5 minutes. Succinylcholine, due to its ability to produce sustained muscle contraction in denervated muscles, may be a useful diagnostic aid in distinguishing loss of function due to nerve injury from tendon disruption.

Adult↗