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Results for “Finger Injuries”

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At least 1,009 records · Page 56Linked to original sources
PubMed1986

Results of central ray resection without bony transposition.

Central ray resection, without bony transposition, was performed in 13 patients. Closure of the defect created by the ray resection was accomplished by the approximation of the adjacent metacarpals, with reconstruction of the deep transverse metacarpal ligament and dorsal dermadesis. Esthetic and functional results were satisfactory in all but one patient. The average length of follow-up was 43 months. No late scissoring or malrotation occurred in this series.

Adult↗
PubMed1986

Dynamic traction and early passive movement for fractures of the proximal interphalangeal joint.

Unstable intra-articular fractures that involve the proximal and middle phalanges often lead to joint stiffness and loss of function. Ten patients with comminuted intra-articular fractures of the proximal interphalangeal (PIP) joint were treated by dynamic traction splinting and early mobilizations. Distal traction, with a force of 300 g, was provided by a rubber band connecting a transosseous wire to a movable component on an arcuate splint made of thermoplastic material. Intermittent passive movement was carried out on a timed schedule. Follow-up at 16 months (5 months to 51/2 years) showed a pain-free final range of motion (ROM) of 87 degrees (5 degrees to 92 degrees), with preservation of articular symmetry and space. this is the first report of treatment of intraarticular fractures in the hand by a combination of dynamic traction and passive movement.

Adolescent↗
PubMed1987

An unusual variety of skier's thumb.

An unusual thumb injury with an avulsion of the ulnar collateral ligament of the metacarpophalangeal joint and simultaneous dislocation of the carpometacarpal joint is presented. Immediate repair of the ruptured structures at both joints produced a satisfactory result.

Adult↗
PubMed1987

Independent index extension after extensor indicis proprius transfer.

The extensor indicis proprius was used to restore mobility to a variety of hand movements in 27 patients. Retained independent index finger extension was obtained in a majority of patients postoperatively. Potential postoperative complications of index extension lag and deviation may be avoided if the extensor indicis proprius is sectioned immediately proximal to the dorsal hood. A corresponding laboratory study was undertaken to better define the anatomic constraints limiting independent finger extension. Distinct differences between juncturae tendinum and extensor compartment musculature help explain why the index finger may function as a relatively independent unit.

Arthritis, Rheumatoid↗
PubMed1988

Complications and prognosis of treatment of mallet finger.

This study reviews complications of treatment in 123 mallet fingers treated operatively and nonoperatively. In the 84 digits splinted there was a 45% rate of complications, mostly skin related; however, these complications were almost always transient. For the 45 surgically treated digits the complication rate was 53%, with 76% of these complications still present at a mean follow-up of 38 months. Six digits treated initially with splinting (minimum of 6 weeks) and later with surgery were included in both groups. Major complications in the patients undergoing surgery included deep infection (4%), joint incongruity (18%), and nail deformity (18%). In addition, seven patients (16%) required reoperation, and all of these had an unsatisfactory result except that in one finger the outcome was unknown.

Adolescent↗
PubMed1989

The "cap" technique: nonmicrosurgical reattachment of fingertip amputations.

With the exception of children, amputations at the level of the lunula survive poorly by direct reattachment. Microsurgical replantation is costly and often fails because of poor venous drainage. In a series of seven adult patients the severed tip was filleted and replaced as a "cap" over the skeletonized distal phalanx of the stump. A 2 mm remnant of germinal matrix was preserved for nail regrowth. The reconstructed digits, although shortened by an average of 6 mm, give the "illusion" of a normal finger. All were successful with small areas of tip necrosis in two, healing by secondary reepithelialization. Mean static two-point discrimination was 6.5 mm (range, 3 to 10 mm) and pulp pinch was 67% of normal. The "cap" technique of nonmicrosurgical reattachment is a simple, reliable method of functional preservation of pulp tissue, as well as normal esthetic appearance of the nail complex.

Adolescent↗
PubMed1989

Extensor tenotomy: a technique for correction of posttraumatic distal interphalangeal joint hyperextension deformity.

Tenotomy of the dorsal apparatus over the middle phalanx was done in 13 digits for treatment of posttraumatic hyperextension of the distal interphalangeal joint associated with a boutonniere deformity. All but one patient was improved with distal interphalangeal joint flexion averaging 45 degrees at follow-up. Four digits had a 5 degree to 10 degree extensor lag. This procedure is simple and reliable and should be considered when increased distal interphalangeal joint flexion is desired.

Adolescent↗
PubMed1998

A biomechanical assessment of ligaments preventing dorsoradial subluxation of the trapeziometacarpal joint.

Degenerative arthritis of the trapeziometacarpal joint is commonly associated with ligament laxity and joint subluxation. Specifically, key pinch in an affected joint often results in dorsoradial joint subluxation. This study examined the role the 4 ligaments of the trapeziometacarpal joint play in preventing dorsoradial subluxation. Six fresh-frozen cadaver hands were dissected of all soft tissue to expose the joint capsule and ligaments of the trapeziometacarpal joint. Serial random sectioning of the intermetacarpal ligament, anterior oblique ligament, palmar oblique ligament, and dorsoradial collateral ligament (RCL) was performed. Dorsoradial displacement of the metacarpal shaft in relation to the trapezium was measured using a linear variable dimension transformer. In all 6 specimens, sectioning of the RCL resulted in the greatest dorsoradial subluxation of the metacarpal. The mean displacement due to sectioning of the RCL was 1.4 mm, compared with 0.08 mm for the intermetacarpal ligament, 0.06 mm for the anterior oblique ligament, and 0.2 mm for the palmar oblique ligament. The importance of the RCL in preventing dorsoradial subluxation may have clinical significance. This study suggests that repairing or reconstructing the RCL during ligament reconstruction of the trapeziometacarpal joint should be considered.

Biomechanical Phenomena↗
PubMed1998

Self-tapping versus standard tapped titanium screw fixation in the upper extremity.

Most screws used in fracture fixation necessitate a separate step for tapping of the screw hole. Titanium screw systems have been developed in which the screws can be inserted directly after a drill hole is made. These self-tapping screws thereby eliminate an operative step. A retrospective study was conducted that evaluated all wrist and hand procedures performed between January 1992 and December 1994 by 1 surgeon using screw fixation. The results of 39 cases treated with standard tapped titanium screws were compared with 28 cases treated with self-tapping titanium screws. Nearly identical union and complication rates were obtained in each group. Comparable results can be obtained with self-tapping screw fixation, which limits the number of instruments needed, eliminates an operative step, and thereby may diminish operative risk and shorten operative time.

Adolescent↗
PubMed1998

Evaluation of "neocollateral" ligament formation by magnetic resonance imaging after total excision of the proximal interphalangeal collateral ligaments.

The presence of palpable thickening and maintenance of stability within weeks of total excision of the proximal interphalangeal (PIP) joint collateral ligaments is an established, although somewhat mysterious, phenomenon. To further investigate this postoperative thickening, magnetic resonance imaging (MRI) scans were obtained on 10 joints in 9 patients who had undergone total ligament excision for posttraumatic stiff PIP joints 3 months to 14 years earlier. Although the ultrastructure of these newly formed structures is yet unknown, their palpable consistency, MRI contour, distribution, and signal intensity suggest the formation of a new soft tissue structure, albeit scar, which has all the attributes of a collateral ligament. This MRI of a "neocollateral ligament" would help explain the consistent observation of complete joint stability within weeks following total excision of both PIP joint collateral ligaments. All patients from the 14-year span sampled were found to have a similar, consistent, linear low signal density structure crossing the joint margins and essentially identical to that of a normal collateral ligament.

Adult↗
PubMed1994

[The strategy of the finger bank].

The authors present 40 cases of multidigital amputations with a "bank-finger" reconstruction. They use of flaps, tendons, nerves grafts .... from the injured finger. Moreover, they propose a guide in the use of heterotopic implantations, in emergency and in secondary. The indications of the digital translocation is discussed about the priority finger and the localisation of the others fingers to be reimplanted. They make mention of the rare possibility of temporary ectopic implantation.

Adolescent↗
PubMed1995

[A reverse vascular autograft finger island flap. A review of 15 cases and of the literature].

The authors discuss the indications for homodigital island flap with a reverse vascular pedicle. This flap is based on the anastomoses between the radial and ulnar digital arteries. These anastomotic branches lie between the posterior wall of the tendon sheath and the periosteum to form an arch and are named the "digitopalmar arches". The vascularization of the reverse homodigital island flap is derived by using the middle transverse palmar arch. This flap was performed successfully in 14 patients involving 15 fingers to resurface amputation of the distal phalanx. In 6 cases the flap was used as an "artery" flap, and in 9 cases as a "sensitive" homodigital island flap. The pedicle in these cases was neurovascular also containing the digital nerve. The sensitivity of the flap was obtained by neurorraphy between the transposed digital nerve of the flap and the receiving digital nerve of the recipient finger. This technique achieves cover of the tactile pad in one operative stage and provides well vascularized skin allowing early mobilization. Sensation of the flap can be restored rapidly when neurorraphy of the transposed digital nerve is performed.

Adolescent↗
PubMed1990

Transfer of a composite island homodigital distal interphalangeal joint to replace the proximal interphalangeal joint. Technique and case report.

The authors present an original technique of PIP joint reconstruction by an homo-digital island compound DIP joint transfer. The transfer consists of joint, capsule, volar plate, and ligaments. The distal joint is fused and the islanded joint interposed at the PIP level. In our clinical case, a flexion of 80 degrees was obtained with an extension lack of 15 degrees. This salvage procedure can be useful in selected well motivated patients. It provides rapid bone healing, good lateral stability, potential for growth in children, long term preservation of cartilage and acceptable range of motion.

Adult↗