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At least 973 records · Page 54Linked to original sources
PubMed1988

Symphalangism in Hawaii: a study of three distinct ethnic pedigrees.

Symphalangism was introduced into Hawaii by a Cherokee Indian in the late 1800s. The resultant pedigree, along with two other racially distinct pedigrees, confirms that the condition is an autosomal dominant genetic trait. Associated conditions include carpal and tarsal coalitions, cervical fusions, brachydactylism, symphalangism of the toes, and hearing loss. Surgical intervention in the hands is seldom, if ever, indicated but correction of the associated hearing loss is rewarding.

Adolescent↗
PubMed1998

Flexor digitorum profundus tendon-to-bone repair: an ex vivo biomechanical analysis of 3 pullout suture techniques.

Avulsions or distal transsections of the flexor digitorum profundus tendon are typically repaired by direct suture of tendon to the distal phalanx. The tensile properties of tendon-tobone repairs performed in cadaver fingers using 3 common suture patterns, the Bunnell, the Kessler, and the Kleinert techniques, were compared; 3-0 Prolene (monofilament) suture was used. Repairs done using the Kessler pattern had an average yield force of 30 N, compared to 39 N for the Bunnell and Kleinert patterns. Although these average yield forces were greater than that required for active digital flexion, considerable elongation (average, 8 mm) was measured at a force of 20 N. Data indicated that the safety factor achieved with these repair methods is lower than that achieved with modern tendon-to-tendon repair methods. The authors conclude that the common tendon-to-bone repair techniques are insufficient to withstand the higher forces associated with controlled passive and active motion rehabilitation methods that are currently advocated.

Aged↗
PubMed2002

Injured metamere and functional surgery of the tetraplegic upper limb.

The size of injured metamere (IM) in tetraplegia exhibits a high variability that explains the different clinical presentations in patients who have the same neurologic level. Even when functional electrical stimulation is not planned, the lower motor neuron (LMN) integrity of paralyzed muscles must be evaluated, especially in patients with high-level tetraplegia. During the acute phase, detecting the size of the IM is important to prevent supination contracture and stiffness of the thumb and finger joints. When planning functional surgery, the LMN integrity of intrinsic muscles helps the surgeon adapt his surgical procedures. Assessing IM size must be integrated systematically into the evaluation of tetraplegic patients.

Hand↗
PubMed1994

[Reconstruction of the long fingers using toe transfers].

The authors review 29 toes transfers on 24 patients with injury of long fingers between 1985 and 1990. The series contains 16 complete toes and 13 partial toes transfers. The results, inconvenience and indications are discussed.

Adolescent↗
PubMed1993

[Lipoma of the fingers].

Benign tumours of the hand are a common disease, usually corresponding to nodes. Other etiologies are less common. Lipomas of the hand are a rare feature, especially in the fingers. We present four cases of digital lipomas and a review of surgery of lipomas over the past ten years, and of the literature.

Adult↗
PubMed2000

Protease inhibitor therapy and bleeding.

Shortly after the introduction of protease inhibitor drugs (PIs) for the treatment of human immunodeficiency virus infection an association between these drugs and an increased bleeding tendency in patients with hereditary bleeding disorders was observed. Not only do patients experience an increased bleed frequency in usual sites, but bleeds can also occur in unusual places such as the finger joints. Mucus membrane bleeding and haematuria are also common. Ritonavir appears to be associated with the highest risk of bleeding followed by indinavir. As yet there has not been enough experience with the newer PIs to assess fully their potential to induce increased bleeding, although nelfinavir seems to pose less of a risk than the original PIs. PI-associated bleeds tend to be more resistant to factor concentrate treatment and periods of prophylaxis may be required in individuals with frequent persistent bleeds. Patients continuing on PI therapy tend to develop a tolerance to this adverse effect with time. The mechanism of the bleeding tendency has not been elucidated. There is no consistent evidence of a disturbance of coagulation, fibrinolysis or platelet function which raises the possibility that PIs may exert a direct local effect on blood vessels. It is very important that this class-specific side-effect is recognized and understood by both treaters and patients.

HIV Protease Inhibitors↗
PubMed2002

A long-term study of ring finger transfer in the reconstruction of transmetacarpal amputations.

Restoration of adequate function in patients with metacarpal hands is a major challenge. In 1984, we presented a technique in which the contralateral uninjured ring finger was transferred by microvascular techniques to restore the dual hand functions of pinch and palmar grips. This was performed in combination with thumb reconstruction when necessary. The original 5 patients described in 1984, as well as 2 later cases, were reviewed for a long-term follow-up study (average, 19 y; range, 8-25 y). The average age of the patients at follow-up evaluation was 44 years (range, 13-73 y). Range of motion, grip span, sensibility, and grip strengths were measured. The Disabilities of the Arm, Shoulder, and Hand outcome measure was used to evaluate disability. The data show persistent good function with improving sensibility over the years. The ring finger transfer in reconstruction of transmetacarpal amputation has proven to be a good technique with an overall satisfactory outcome, especially in its ability to restore some capacity for palmar grip, a function that has hitherto been unattainable by other means.

Adolescent↗
PubMed2005

[Epidermolysis bullosa dystrophica (Hallopeau-Siemens syndrome) of the hand -- surgical strategy and results].

Dystrophic epidermolysis bullosa is an inherited, blister-forming skin disease. The Hallopeau-Siemens syndrome type is one of the most severe forms. Even minimal trauma to the skin leads to excessive blister formation that always heals with scars because the defect is located in the dermis at the dermoepidermal junction. A genetic defect of collagen VII leads to insufficient or missing anchoring fibrils. The patients suffer from protein loss, anaemia, secondary infections, oesophageal strictures, malignant transformation and hand deformities. These present as pseudosyndactyly, flexion contractures and, in advanced stages, as a mitten-like deformity. This results in the complete loss of function of the hands and consequently to severe psychosocial problems for the young patients. There is no cure for this disease at present, so surgical treatment of the hand deformities is the only option. From 1998 to 2002 seven hands in four patients were operated on in our clinic. Operations included pseudosyndactyly separation, arthrolysis with Kirschner-wire fixation of finger joints, as well as "metacarpolysis" of the thumb. Redressing splints/dressings were applied. Spontaneous epithelialisation was awaited and was complete within four weeks without problems. Afterwards customised silicon splints and cotton gloves are complimented by intensive physiotherapy. There were no serious complications. Recurrence is unavoidable, but we could restore basic hand functions for at least 2.5 years. Postoperative care is important to postpone reoperations. We prefer the most simple operative procedure as described without skin grafts, flaps or keratinocyte transplants, because a comparable outcome is achieved with less trauma and stress for the patients.

Child↗
PubMed1993

[Ultrasound in inflammatory rheumatic joint diseases].

Inflammatory changes of the shoulder joint could be detected at a very early stage, when the clinical and radiological examinations were unremarkable. In 50% of the cases a rupture of the rotator cuff could be demonstrated. Only 10% of the shoulder joints had normal sonographic findings, whereas 50% were normal on clinical or radiological examination. Synovitis and effusion of the hand can be diagnosed very well by clinical examination, and can be documented in ultrasound. The sonographic diagnostic accuracy in tendon ruptures of the hand is lower than accuracy of the clinical examination. New technical developments may yield better results. Inflammatory changes of the hip joint are very difficult to diagnose by clinical examination. Synovitis, effusion and changes of the capsule can be better detected by ultrasound. Sonography of the hip joint has become part of our routine diagnostic programme, especially because early changes of the joint do not present clear symptoms.

Arthritis, Rheumatoid↗
PubMed1996

Ring avulsion injuries: microsurgical management.

Microsurgical treatment of ring avulsion injuries is often difficult, due to widespread intimal damage of the digital vascular bundles. Thirty-one patients with such injuries in varying degrees were treated during the period 1986 to 1992: of these, 15 underwent microsurgical revascularization. In addition to the traditional procedures applied in seven patients (arteriolysis, direct vessel suture, vein grafts), a technique consisting of vessel transfer from the middle finger was also employed. In five patients, the ulnar digital artery of the middle finger was transferred to the ring finger. In four patients, at least one vein was transferred from the dorsal aspect of the middle finger. Twelve of 15 microreconstructions were successful: with an average follow-up of 48.3 months, these patients showed very good functional (mean total active range of motion: 234 degrees and mean s2PD: 9.8mm) and cosmetic recovery. These results lead to the conclusion that, except for cases characterized by proximal amputation at the flexor superficialis tendon insertion, microsurgical treatment should always be carried out.

Adult↗
PubMed1997

[Wheelchair basketball from the orthopedic viewpoint].

155 (aged 16 to 52 years) wheelchair basketball players were surveyed to determine athletic injuries and overload-syndromes. During their active participation in wheelchair basketball 60.6% of the players have suffered 272 injuries and overload-syndromes. Those were mainly localised at the upper extremity (74.6%). Acute injuries predominate with 57.7%. Strains of the finger joint and skin injuries were found to be the most common injuries. Myogelosis and tendinosis were the most common reported overload-syndromes. A significantly higher number of complaints were associated with wheelchair basketball participation at league-level and depending on the player's position. At the end of the article the means of possible additional disability and consequences to specify therapy and prevention for disabled will be discussed.

Adolescent↗
PubMedDate not supplied

[Effect of constitutional ligament laxity and physical stress on development of patellar tip syndrome].

Studies were performed in order to obtain information on the pathogenesis of patellar tip syndrome (PTS). Using a finger hyperextensiometer, ligamental laxity tests were performed on athletes, non-athletes and controls. Ninety-eight PTS patients who did not indulge regularly in sports, 39 patients from the German federal volleyball league, and 400 healthy controls were examined. No difference in the extensibility of ligaments was found between the patients from the group of competitive athletes and the controls. However, a significantly increased extensibility of the finger joints was found in all age and sex groups with "spontaneous" PTS. The authors conclude that 1) constitutional laxity of the ligaments is a key predisposing factor for PTS, and 2) PTS is triggered by physical stress. Susceptibility to microtrauma at the insertion of the patellar ligament is a function of the constitutional strength of the ligaments.

Adult↗
PubMedDate not supplied

[Etiopathology of camptodactyly (case report and literature review)].

First, a review on the literature about camptodactyly and its pathogenesis is given. A case report is presented on a 13-year-old girl with a camptodactyly of both little fingers. Intraoperatively it was observed that the superficial flexor tendon of the right little finger ended in the palmar aponeurosis and was then found to be without function. It is our understanding that this type of anomaly of the superficial flexor tendon of the little finger as an aetiology of camptodactyly has not been reported yet in the previous literature.

Adolescent↗
PubMed1970

Purkinje cells in the cerebellum: their responses to postural stimuli in cats.

The responses of Purkinje cells in the cerebellum produced by various positions of the limbs were studied in decerebrated unanesthetized cats. The majority of units located in the intermediate zone of the anterior lobe selectively reacted to definite postures of the limbs: some of them were active when a given limb was in an extended position and were silent when it was in flexion; the other ones, on the contrary, were active when the limb was flexed and silent when it was extended. The rate of discharges was in both cases the same and amounted to 40 to 80 per second. It did not change with the lapse of time, and remained the same when flaxedil was administered. These results, in connection with some other data, seem to explain the problem of how the cerebellum transforms the information about the tensions of tendons and muscles, delivered by the tendon organs and muscle spindles, respectively, into the information about movements.

Animals↗
PubMed1987

Finger flexion function in rheumatoid arthritis: the reliability of eight simple tests.

The inter- and intra-observer errors of eight tests of finger flexion function were estimated from the results obtained by three observers assessing 10 patients with rheumatoid hand involvement. Measurements of finger flexion and muscle power involved both conventional and novel techniques using simple and easily constructed apparatus. For each test, measurements were in agreement between observers and were reproducible on three occasions. These tests may now be used with confidence by other investigators.

Aged↗