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PubMedDate not supplied

[Ultrasound patterns of rheumatoid and psoriatic arthritis in finger joints].

PURPOSE: Rheumatoid and psoriasic arthritis involve proximal joints symmetrically and distal joints asymmetrically, respectively, the differential diagnosis between these two types of arthritis is not easy. Therefore we investigated which US signs could help the diagnosis and/or treatment of these conditions and compared them with radiographic patterns and articular and physical symptoms. MATERIAL AND METHODS: Fifty-one patients, 30 women and 21 men aged 19-42 years were enrolled in this study. Thirty patients had rheumatoid and 21 psoriasic arthritis. US of the skin and joints of the fingers was performed with a GE Sonora Logic 500 MD unit with 7.5 and 10 MHz scanheads. We studied the shape of articular bone heads, the intra-articular space distance and the thickness of extensor tendon and of the dermis and hypodermis covering it. These findings show the extent of damage in articular bone heads and intra-articular space and they indicate cutaneous and articular inflammation. US patterns were also compared with radiographic findings in all patients. RESULTS: US showed bone and joint and/or inflammatory damage in both types of arthritis. Articular bone heads had a bodkin-like appearance in proximal phalanges in rheumatoid arthritis, versus a hook-like appearance in distal phalanges in psoriasic arthritis. Inflammatory damage was indicated by intra-articular space thinning and by tendon, dermis and hypodermis thickening. These signs, confirmed radiographically, account for finger deformation and functional impairment, swelling and pain. CONCLUSION: US signs can help the diagnosis of rheumatoid and psoriasic arthritis. US can show inflammatory damage and the disease evolution.

Adult↗
PubMed1975

Implants designed for finger joints. A roentgenorgraphic study and a study of implant wear and tear.

Two types of flexible finger implants (one intramedullary movable, the Silastic Finger Joint Implant, Swanson design, and the other presumable intramedullary fixed, the Niebauer T-M Cutter Metacarpophalangeal Joint Prosthesis) were subjected to animal trials. Forty-four Swanson implants and 33 Niebauer implants were implanted in the knee joint of rabbits. Roentgenographic examinations were carried out immediately after surgery and then at monthly intervals. The joint was examined in the lateral projection in a flexed and in an extended position to obtain better information about the behaviour of the implant. The Swanson implant was assessed as being intramedullary movable. The Niebauer implant was found to bend within other parts than just the thin central part of the midsection as it is supposed to do. Intramedullary bone formation was seen along the distal stem of the Swanson implant. It developed in a very typical manner considered to be related to the motion of the stem. A similar phenomenon was seen along the distal stem of some of the Niebauer implants and was considered a sign of insufficient fixation of the stem. Cortical erosion and periosteal callus formation were found in the femur at the site at which the proximal stem of the Swanson implant was in direct contact with the bone. The implants were examined at autopsy both in situ and after removal. The Swanson implants showed consistently a wearing of the surface and a permanent deformation. Isolated cracks were seen in 8/44 implants, while fractures, either isolated or in combination with cracks and/or fragmentation, were seen in 22/44 implants. It was not possible to evaluate deformation of the Niebauer implants. Slight wearing was seen in 4/32 implants. Cracks, fragmentations and fractures were seen either isolated (except for the fragmentations) or in different combinations with no specific pattern in 25/32 implants. The combination of inelastic dacron fibres and elastic silicone rubber in one functional unit as in the Niebauer implant was considered the main cause of the damage.

Animals↗
PubMed2004

Three-dimensional rotations of human three-joint fingers: an optoelectronic measurement. Preliminary results.

Longitudinal axial rotations of phalanges during flexion motions of digits have scarcely been analyzed with current anatomical or radiological methods. Recent optoelectronic systems were developed for three-dimensional (3D) kinematic analysis of human motion. These systems have the advantages of being non-invasive and non-irradiating. The current study was based on the VICON optoelectronic system. A validation of the protocol was made among a sample of volunteers for further direct clinical applications. An experimental protocol was set up with adaptations to the requirements of finger analyses (multiple infrared markers inside small-sized capture volumes). The set-up and the protocol details are described. Kinematic studies consisted in recording the movements of the right hand of six volunteers (free from any visible pathology). Results were displayed for the joints of each three-joint finger with calculation of 3D rotations. Metacarpophalangeal (MCP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) flexion angles ranged from 78 degrees to 118 degrees, 72 degrees to 119 degrees and 9 degrees to 66 degrees respectively. Lateral angles ranged from 5 degrees to 39 degrees (MCP), 4 degrees to 39 degrees (PIP) and 4 degrees to 30 degrees (DIP). Mean longitudinal axial rotations of MCP, PIP and DIP joints ranged from 11 degrees pronation to 26 degrees supination. The index finger was in a global pronation position (five of the six specimens). The fourth and fifth fingers were in a global supination position in every case. The third finger was in a more variable global rotation (pronation in four of the six specimens). An experimental protocol using an optoelectronic system (VICON) has been developed for a kinematic analysis of three-joint finger. A global measure study should be initiated among a wider sample of adults. A database should be created with direct clinical applications. Patients' kinematic deficits could be graded either for standard movements (flexion/extension and abduction/adduction) or for longitudinal axial rotations.

Adult↗
PubMed2006

The efficacy of self-administered stretching for finger joint motion in Japanese patients with systemic sclerosis.

OBJECTIVE: To determine the efficacy of self-administered stretching of each finger in Japanese patients with systemic sclerosis (SSc). METHODS: Forty-five patients with SSc (32 with diffuse cutaneous SSc and 13 with limited cutaneous SSc) were given instructions on self-administered stretching and were directed to perform it every day. Individual fingers were maintained in a stretched position using the opposite hand for 10 seconds and this was repeated 3-10 times. To evaluate the effect of the stretching program, finger passive range of motion (ROM) was assessed using a goniometer on the first visit and after 1 month and 1 year of the stretching program. The Health Assessment Questionnaire (HAQ) was also assessed on the first visit and 1 year afterward. RESULTS: The total passive ROM was significantly improved in each finger after 1 month of finger stretching. The total passive ROM was further improved or maintained within 1 year after the first visit. Although ROM was less in patients with diffuse cutaneous SSc than in those with limited cutaneous SSc at the first visit, ROM increased significantly irrespective of disease duration or severity of skin sclerosis. Finger stretching may improve the finger function, since the HAQ score for hand functions such as eating and gripping was significantly decreased. CONCLUSION: Our original self-administered stretching program may be useful for improving finger joint motion in patients with SSc; future studies in various ethnic populations will be needed to determine the universal efficacy of this method.

Female↗
PubMed2005

Movement of finger joints induced by synergistic wrist motion.

BACKGROUND: An experiment has recently been conducted to evaluate and compare the differences in tendon excursions between the flexor digitorum profundus and superficialis using three mobilization techniques. No previous studies deal with the total joint excursions with constant tendon length. The purpose of this study was to investigate the coordinated motion between the finger and wrist joints resulting from passive tension of the muscles while performing synergistic wrist motion. METHODS: The relative joint positions of the hand and wrist were measured using a three-dimensional motion analysis system with external retroreflective markers 2 mm in diameter placed on the dorsal surface of the hand. Fifty normal subjects, with a 1:1 gender ration, ranging in age from 20 to 40 years, and with no previous history of upper extremity injury, were recruited for the experiment. FINDINGS: The relationships of synergistic motion between the wrist and finger joints due to passive tension in the muscles were approximately linear. The ranges of wrist motion averaged 60 degrees extension and 60 degrees flexion. Moving the wrist from flexion into extension induced synergistic finger joint motion as follows: the distal interphalangeal joint angles changed from an average of 12 degrees of flexion to 31 degrees; proximal-interphalangeal joint angles changed from 19 degrees to 70 degrees; and metacarpal phalangeal joints changed from 27 degrees to 63 degrees of flexion. INTERPRETATION: The relationships of synergistic motion between the wrist and finger joints were systematically documented. Such a relationship could be considered in optimizing the design of dynamic splints used for rehabilitation in post-surgical tendon repair, as well as providing useful information about potential diagnoses of problems with the integrity of the flexor and extensor mechanisms.

Adult↗
PubMed1993

Optimal design of a six-bar linkage with one degree of freedom for an anthropomorphic three-jointed finger mechanism.

This research concerns the design of a three-jointed, anthropomorphic, finger mechanism for use as a prosthesis or robotic end-effector. Based on a study of finger configurations for the human hand, a six-bar linkage with one degree of freedom is proposed. A model of the fingertip displacement of the mechanism is derived by a vector analysis approach. The effects of joint friction on the transmission efficiency are analysed. By measuring the joint positions of a human finger, a mathematical model of the pinching and holding configurations are developed. Optimal parameters for the finger mechanism are obtained by non-linear programming based on an objective functional involving motion posture and locus, transmission efficiency and weight subject to geometric and bionic constraints. Simulation results indicate that the mechanism is useful for a variety of prosthetic and robotic applications.

Biomechanical Phenomena↗
PubMed1975

[2 Kirschner wires as simplified external fixation devices in finger joint arthrosis].

A new technique for arthrodesis of the PIP joint is described; after resection of the joint two percutaneous Kirschner wires of diameter 1.2-1.3 mm are placed transversely through the two phalanges. The wires are twisted together on each side of the finger to produce a compression effect on the bone surface. Additional external immobilisation is used for five days only, but the wires are left in place for six weeks. The method has been used without complication in ten patients. The average length of time off work was seven and a half weeks. In the author's view the advantages of this method lie in its technical simplicity and in the free movement of other finger joints.

Arthrodesis↗
PubMed1983

Release of cobalt and nickel from a new total finger joint prosthesis made of vitallium.

An in vivo study of a new total finger joint prosthesis was performed to evaluate a biological ingrowth system of attachment of the device to bone. The prosthesis consisted of two conical ribbed ultrahigh molecular weight polyethylene plugs that were fixed by impaction into the medullary cavity after reaming. A cobalt--chromium alloy metal stemmed hinge slides inside the plugs with the joint articulation at the end of the stem. The focus of this study was to measure the concentration of cobalt and nickel in the serum, erythrocytes, and periarticular tissue (muscle from the sartorius and vastus medialis) resulting from the implantation of this device in the knee of the cat for periods of up to 1 year. The results indicate significant elevation in serum cobalt concentrations only after 5 months and increased concentrations in serum nickel which, were more pronounced after two months. Column chromatographic separations on cross-linked Dextran (G-200) shows a different distribution across the three principal protein peaks for each metal.

Animals↗
PubMed2001

[Effects of shaft length of finger joint prostheses on tension distribution in the bone].

In order to investigate the influence of stem length in finger joint prostheses on stress in the surrounding bone area, finite element (FEM) calculations of finger bones before and after prosthetic replacement of metacarpophalangeal joints with cementless implants of different stem length were performed. CT scans of the metacarpal bone and proximal phalanx before and after implantation of a prototype of a noncemented semiconstrained implant for the MP joint, which has been developed to replace metacarpophalangeal joints destroyed by rheumatoid arthritis, were analysed. The FEM calculations showed comparatively decreased differences of the von-Mises stress after implantation of intramedullary stems reaching the middle of the diaphysis. At the metaphysis of the metacarpal head we found an increase of the von-Mises stress of 1.3 MPa (Mega Pascal = 10(6) Pa), an increase of 18.9 MPa around the shortest prosthesis and a decrease of 21.4 MPa around the prosthesis with the longest stem.

Adult↗