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At least 991 records · Page 55Linked to original sources
PubMed1989

The use of dolorimetry in the assessment of post-traumatic algodystrophy of the hand.

We have investigated the use of dolorimetry in the assessment of algodystrophy of the hand. Findings in 12 affected patients following Colles' fracture were compared with age- and sex-matched normal controls. Algodystrophy was associated with a significant increase in tenderness of both the finger joints and bones. Tenderness of the whole hand was quantified by summing the dolorimetry readings at each site within the hand and the ratio of the summed readings for the two hands was defined as the dolorimetry ratio. This ratio was highly reproducible and independent of external variables. It was significantly lower in patients with algodystrophy than in controls and may provide a method for the diagnosis and serial assessment of the disorder.

Adult↗
PubMed1991

Total palmar resurfacing with scapular free flap in a 26-year contracted hand.

The scapular free flap offers a large-sized and well-vascularized coverage for variable defects. It is not regarded, however, as a favorite tool for palmar resurfacing because of its bulky and rigid nature. A 28-year-old man had sustained a contact dermal injury at the age of 2 years that resulted in a severely deformed hand. The total palmar defect was resurfaced by surgical intervention with a scapular free flap. After secondary procedures, the final result was promising. The present report focuses on the secondary procedures, which make a more functional and aesthetically pleasing hand after coverage with the scapular flap. Also, our result suggests that even finger joints contracted for 26 years can recover motion if they have not been directly damaged.

Adult↗
PubMed2000

Complete congenital bony syngnathia in a case of oromandibular limb hypogenesis syndrome.

Congenital fusion of the maxilla and mandible (syngnathia) is rare and can present in a wide range of severity from single mucosal bands (synechiae) to complete bony fusion (synostosis). Congenital synostosis of the mandible and maxilla is even less common than synechiae, with only 19 cases reported in the literature. Most of them have presented as an incomplete, unilateral fusion. Only three of the reported cases showed more extensive but still incomplete, intermaxillary bony fusion. We present a case of complete bony fusion of the maxilla and mandible associated with a cleft palate, hypoglossia, micrognathia, unilateral choanal atresia, and limb abnormalities as a feature of oromandibular limb hypogenesis syndrome. Details of operative management are presented.

Choanal Atresia↗
PubMed1994

A technique for simultaneous replantation of multiple amputated digits at Tamai's Zone V.

A technique for simultaneously replanting multiple digits amputated at Tamai's Zone V is described. Since these multiple amputated digits are connected together, they should be replanted as a single unit. The technique includes applying the pneumatic tourniquet first, debridement, bone shortening, and fixation of all the amputated digits, including tendon repairs, application of vascular clamps before releasing the tourniquet, followed by vascular anastomosis in one-by-one fashion for each digit. The disadvantage of this technique is the difficulty in keeping the digit cool. The advantages are it is a less time-consuming operation, there is reduced blood loss and contamination, and there is a better axial arrangement of the bony framework.

Adolescent↗
PubMed1987

A combined regimen of controlled motion following flexor tendon repair in "no man's land".

A program of controlled motion following repair of flexor tendons in the hand is presented. This regimen incorporates the features of active extension against rubber band passive flexion, as well as those of controlled passive extension and passive flexion. In this prospective study, 44 digits with complete lacerations of the flexor digitorum profundus and flexor digitorum superficialis in zone 2 were treated. Using the Strickland formula of total active motion of the interphalangeal joints, 36 fingers (82 percent) were rated "excellent"; 7 fingers (16 percent) were rated "good"; 1 finger (2 percent) was rated "fair"; none was rated "poor". There was no statistical difference between the results of delayed primary repair and immediate primary repair.

Adolescent↗
PubMed1998

Tissue preservation in hand injury: the first step to toe-to-hand transplantation.

The recommendations outlined in this editorial for the initial management of nonreplantable amputation injuries emphasize tissue preservation. This facilitates future toe-to-hand transplantation in terms of reconstructive options, functional and aesthetic outcomes in the hand, and donor-site morbidity in the foot. It is hoped that surgeons involved in the emergency surgical care of such cases will find these guidelines useful. Although tissue conservation is the main goal at this stage of treatment, this should not be at the expense of tissue viability. If in doubt about management issues, advice should be sought from the reconstructive microsurgery unit.

Finger Injuries↗
PubMed2003

Dupuytren's disease in a child: a case report.

Dupuytren's disease commonly affects men over the age of 40 years. It is very rare to find it in the paediatric age group. We describe a case of histologically proven Dupuytren's disease in a 10-year-old boy who presented with a nodule in his palm. Dupuytren's disease should be considered in the differential diagnosis of a nodule in hand or contracture of a finger joint in the paediatric age group.

Child↗
PubMed2005

Adult hand injuries on artificial ski slopes.

Artificial ski slope skiing is a popular sport in Great Britain with significant risk of injury. We reviewed 36 patients who had been treated for hand injuries excluding the wrist in our plastic surgery department over a 14-month period after skiing on an artificial ski slope. Specifically, they were 15 fractures of the digits, 3 dislocations of the finger joints, 7 ulnar collateral ligament injuries of the metacarpophalangeal joint of the thumb, and 11 bruises and abrasions. The mean age of the patients was 28 years, and there were 20 men and 16 women. It is concluded that the hardness of the surface of the artificial ski slopes could be responsible for the types of injuries.

Adolescent↗
PubMed1981

Circadian variations in the signs and symptoms of rheumatoid arthritis and in the therapeutic effectiveness of flurbiprofen at different times of day.

1 Seventeen patients with rheumatoid arthritis were studied in a double-blind crossover trial contrasting three different times of administration of twice-daily flurbiprofen. 2 Twelve of these patients were also studied when taking the same dose of flurbiprofen as a split dose four times a day. 3 Symptoms and signs of the disease were self-assessed throughout the day for several days on each regimen and the information was analysed for rhythmicity. 4 Twice a day flurbiprofen may be more effective than four times daily flurbiprofen, and the regimen without an evening dose was the least effective of three twice-daily treatments tested. 5 Circadian rhythms of grip strength and finger joint size were demonstrated, and were similar on all treatment regimens. 6 These rhythms have a similar pattern to those detected during studies of immune responses, and it is suggested that morning stiffness in rheumatoid arthritis is not only the result of nocturnal inactivity, and may respond to appropriately timed medication given to decrease inflammation or to suppress other aspects of the immune response.

Arthritis, Rheumatoid↗
PubMed1993

Multiple cutaneous granular cell tumors with systemic defects: a distinct entity?

BACKGROUND: The association between cutaneous granular cell tumors and systemic defects is extremely rare, this being the tenth case reported in the literature. The reported defects in the literature include lentiginosis, face and skull alterations, heart defects, muscular and neural pathologies, among other sporadic defects in other organs. The patients do not present visceral granular cell tumors. CASE REPORT: An 11-year-old girl had 124 skin granular cell tumors associated with face and skull defects, pulmonary stenosis, EEG and other neurologic alterations, diffuse muscle hypotonia, and an excess of finger joint mobility. CONCLUSIONS: The combination of multiple cutaneous granular cell tumors with repeated alterations in other organs seems to be more than simply coincidental, thus suggesting a syndromic separate entity.

Cell Nucleus↗
PubMedDate not supplied

Hand abnormalities are associated with the complications of diabetes in type 2 diabetes.

Limited finger joint mobility, Dupuytren's contracture, and the complications of diabetes were assessed in 233 Type 2 diabetic patients. Limited joint mobility was present in 34% and Dupytren's contracture in 26%. The prevalence of limited joint mobility and Dupuytren's contracture increased with duration of diabetes and with age. Logistic regression analysis showed that, after allowing for age and duration of diabetes, limited joint mobility was independently associated with Dupuytren's contracture (odds ratio 5.7, 95% CI 2.0-16.4) and retinopathy (odds ratio 3.1, CI 1.5-6.4). Dupuytren's contracture was independently associated with vision-threatening retinopathy (odds ratio 2.6, CI 1.1-6.4), limited joint mobility (odds ratio 2.5, CI 1.3-4.8), and foot ulceration (odds ratio 4.9, CI 1.4-16.4). Both Dupuytren's contracture and limited joint mobility were associated with peripheral neuropathy but neither hand abnormality was associated with neuropathy independently of other complications of diabetes. The association of connective tissue abnormalities in the hand with the complications of diabetes suggests that similar factors may be contributing to their pathogenesis.

Contracture↗
PubMed1979

The responses of afferent fibres from the glabrous skin of the hand during voluntary finger movements in man.

1. Afferent activity of 111 single units from the glabrous skin area was recorded percutaneously in the median nerve of human subjects, using tungsten electrodes. 2. The majority of the units (103) were classified as low-threshold mechano-sensitive units belonging to one of the four categories previously described: rapidly adapting with small receptive fields (RA), rapidly adapting with large receptive fields (PC, presumed Pacinian corpuscle units), slowly adapting with small fields (SA I), and slowly adapting with large fields (SA II). The size of the responses (in number of impulses) to indentation and stretching of the skin was compared with that of the responses elicited during voluntary isotonic finger movements, which avoided trivial excitation of the units by direct touch. 3. All four types of units, and 77% of the single units, were activated by isotonic movements. The decreasing order of responsiveness was PC, SA II, SA I, RA. 4. Almost all responsive units were excited during the dynamic phase of ramp and smooth oscillatory movements. Static responses, on the other hand, occurred only with 50% of the slowly adapting units, corresponding to a third of the total sample (SA II, 81%; SA I, 17%. 5. For all four types of units the dynamic responses to movements were of similar size as the responses to localized skin indentation with a von Frey hair at five times threshold. 6. The results are discussed with regard to the possible implications for kinaesthesia and motor control.

Adult↗
PubMed1983

The function of the antagonist muscle during fast limb movements in man.

We have examined fast flexion movements of the human thumb and fast extension movements of the elbow over three different distances at a variety of speeds in order to elucidate the function of the antagonist muscle in these circumstances. All movements were of such a velocity that they showed the typical bi- or triphasic pattern of muscle activation in agonist and antagonist. Slower movements, with continuous agonist activity, were not analysed. For movements made through the same angle at different velocities, there was a linear relationship between the amount of antagonist activity needed to halt the movement and the peak velocity. However, the slope of this relationship was a function of the distance moved. Movements made through large angles showed less antagonist activity than those made through small angles at the same speed. The timing of the antagonist activity also changed as a function of both distance and speed. Fast, small movements showed earlier onset of antagonist activity than slow, large ones. Movements which were halted mechanically with the subject's prior knowledge had little or no antagonist activity, since it was no longer necessary in these conditions. The complexity of these relations indicates that the triphasic pattern of muscle activity underlying these movements can no longer be regarded as a simple immutable 'programme'. The size and timing of the bursts of muscle activity are subtly adjusted to the precise nature of the task.

Action Potentials↗
PubMed2004

Manipulabilities of the index finger and thumb in three tip-pinch postures.

Tip-pinch, in which the tips of the index finger and thumb pick up and hold a very fine object, plays an important role in the function of the hand. The objective of this study was to investigate how human subjects affect manipulabilities of the tips of the index finger and thumb within the flexion/extension plane of the finger in three different tip-pinch postures. The index finger and thumb of twenty male subjects, were modeled as linkages, based on measurement results obtained using two three-dimensional position measurement devices. The manipulabilities of the index finger and thumb were investigated in three tip-pinch postures, using three criteria indicating the form and posture of the manipulability ellipse of the linkage model. There were no significant differences (p > 0.05, ANOVA) in each criterion of each digit across the subjects, except for two criteria of the thumb. The manipulabilities of the index finger and thumb were separately similar across all subjects in tip-pinch postures. It was found that the manipulability for the cooperation of the index finger and thumb of all the subjects in tip-pinch depended on the posture of the index finger, but not on the posture of the thumb. In two-dimensional tip-pinch, it was possible that the index finger worked actively while the thumb worked passively to support the manipulation of the index finger.

Adult↗