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At least 1,117 records · Page 62Linked to original sources
PubMed2001

Anatomical attachments to the proximal phalangeal base--a case for stability.

Transverse midshaft fractures of the proximal phalanx are often unstable and require open reduction and internal fixation. In contrast, fractures of the base of the proximal phalanx are occasionally amenable to conservative treatment in the form of manipulation and a graded mobilisation programme. This stability may be the result of splinting of the fracture by the surrounding anatomical structures, but to our knowledge this has not been previously elucidated anatomically. In this study we define the extent of attachment of the various anatomical structures to the base of the proximal phalanx. The contribution of the joint capsule, collateral ligaments, accessory collateral ligaments, interosseous muscles, and volar (palmar) plate may confer stability to fractures in the proximal 6-9 mm range at the base of the proximal phalanx, once they are reduced and immobilised in the correct positions.

Finger Injuries↗
PubMed2003

Primary repair of the collateral ligament of the proximal interphalangeal joint using a suture anchor.

Ten out of 12 complete ruptures of the collateral ligament of the proximal interphalangeal joint were repaired primarily using a suture anchor. Active finger exercise was started gently by taping the injured finger to adjacent one one week postoperatively. All patients returned to their original occupation or sports activities within seven weeks of operation. No patients complained of pain on the involved finger at rest or during movement. There was no instability of the proximal interphalangeal joint on manual lateral stress test postoperatively.

Adolescent↗
PubMed1998

Isolation of Mycoplasma species from a patient with seal finger.

The etiologic agent of seal finger (speck finger) is unknown. Seal finger occurs after a seal bite, and the symptoms include acute pain, swelling, discharge, and, in some cases, there is joint involvement. The discovery of Mycoplasma species in epidemics of seal disease prompted attempts to link seal finger to mycoplasma. Mycoplasma species were isolated in cultures of a specimen from the finger of an aquarium trainer who was bitten by a seal and of a specimen from the front teeth of the biting seal. The two Mycoplasma isolates were identical biochemically; they were serum-dependent and hydrolyzed arginine. The isolates were susceptible to tetracycline but resistant to erythromycin. By growth inhibition and immunofluorescent antibody tests, both strains were identified as Mycoplasma phocacerebrale, a mycoplasma isolated in an epidemic of seal disease occurring in the Baltic Sea. The patient's infection was treated successfully with tetracycline. To our knowledge, this is the first case in which a mycoplasma has been associated with seal finger.

Animals↗
PubMed1986

An unusual case of sarcoid dactylitis.

A woman presented with sarcoid dactylitis involving a single phalanx with an atypical radiological image. The only other features of sarcoid were subcutaneous nodules.

Bone and Bones↗
PubMed1981

Replantaion of portions of four fingers-long-term functional results.

We present a seven-year follow-up of a previously published case of 4-finger replantation in one hand. Replantation of the digits proved justified, yielding favorable results in sensory return, motor function, and appearance. We note that finger replantations distal to the proximal interphalangeal joint are associated with better functional results than those at more proximal levels. Impaired motion of the distal interphalangeal joint does not appreciably restrict the function of the hand, provided adequate range of active movement is preserved at the metacarpophalangeal and proximal interphalangeal joints. An uninjured proximal interphalangeal joint is critical in achieving favorable motor return after finer replantation. Technical excellence in digital nerve repair contributes to favorable sensory axonal regrowth. Digital replantation distal to the proximal interphalangeal joint may be viewed as primary microneurovascular reconstruction of a problem finger amputation stump. We believe, in the case of sharp amputation distal to an intact proximal interphalangeal joint, that single-digit replantation is indicated, given the likelihood of favorable functional and aesthetic results.

Adult↗
PubMed1985

Continuous plexus blockade for improved circulation in microvascular surgery.

Five patients are presented who were fitted with an axillary plexus catheter for postoperative sympathetic blockade: 1 finger replantation, 3 toe-finger transfers, and 1 finger-finger transfer. This catheter caused spasmolysis and an increase in the circulation and in the acral systolic blood pressure. Simultaneously an adequate analgesic effect was achieved through the administration of local anesthetic. The muscle relaxation helped immobilize the extremity. The improved circulation, the analgesic effect, and the suppression of muscular activity through continuous plexus anesthesia help healing in replanted or transferred digits.

Adolescent↗
PubMed1985

Digital replantation in children.

This article reports a series of 21 cases of digital replantation in children between 14 months and 10 years of age (mean age, 3 1/2 years) who had a total of 32 digits traumatically amputated. The amputation levels were proximal phalanx in 15 digits, proximal interphalangeal joint in 3 digits, middle phalanx in 3 digits, and distal interphalangeal joint in 11 digits. All but one digit survived after replantation, for an overall survival rate of 96.6%. The longest ischemic time was 28 hours. Several technical points related to the success of this series of cases are discussed in detail.

Accidents↗
PubMed1985

Replantation of digits amputated at or about the distal interphalangeal joint.

Sixty-four digits amputated at or distal to the distal interphalangeal joint were reimplanted in 57 patients with the use of microsurgical techniques. Five patients were children under 3 years of age. The percentage of survival was 96.9%. Before the operation, the surgical anatomy of the amputated digits was studied and particular attention was focused on the microvasculature. Equal emphasis was given to the reinnervation and revascularization of the amputated digits.

Adolescent↗
PubMed1986

Translocation of the fifth finger by intracarpal osteotomy.

We present an original technique of transposition of the fifth ray by intracarpal osteotomy. After a review of various techniques and their disadvantages, the principles of the procedure are described. It includes a resection of the whole fourth ray and translocation of the fifth ray following a wedge-shaped osteotomy of the lateral aspect of the hamate, and an arthrodesis between the capitate and the hamate. The details of this operation are presented. Seventeen cases are reported with a follow-up ranging from 17 months to 34 months, and the results are analyzed.

Adolescent↗
PubMed1986

Flexor tendon lengthening by tenotomy at the musculotendinous junction.

The author presents his experience with an established technique of flexor tendon lengthening by tenotomy at the musculotendinous junction. This technique can be used for digital stiffness of forearm origin when active extension is possible on flexion of the wrist. There must not be adherence in the carpal tunnel or in the digital sheath, and active flexion must be preserved. It can also be used for digital stiffness in addition to other techniques. This kind of lengthening has some advantages: there are no sutures in the tendon itself, and it allows early reeducation in association with dynamic extension splinting. Active flexion is preserved immediately and there is good tendon healing. It is possible to lengthen selectively the superficial flexor or the deep flexor and in some cases both. Results are presented according to cause.

Adult↗
PubMed1987

The treatment of amputation neuromas in fingers with a centrocentral nerve union.

The centrocentral nerve union with an interposed autologous nerve graft was used for the treatment of 32 symptomatic neuromas in the fingers of 18 patients. The technique was applied to bilateral as well as unilateral neuromas, using the dorsal branch of the proper digital nerve in the later. All 18 patients showed definite objective and subjective improvement, and no loss on the early result (approximately thirty-six weeks) was found in the remainder of the follow-up (average, eighteen months).

Amputation Stumps↗
PubMed1989

The reverse digital artery flap for fingertip reconstruction.

Reverse digital artery flaps were performed successfully to resurface the major fingertip defect in 10 patients and the volar defect of the middle phalanx in 1. This thin flap with its long vascular pedicle containing a digital artery and its perivascular cuff tissue has a wide arc of transposition. It can be used to reconstruct the defect located from the proximal phalanx to the fingertip of all fingers. No loss of the flap in this series was noted. The procedure is a time-saving, one-stage operation. Patients who received this procedure had no uncomfortable immobilization of the hand or long hospitalization. It also causes no disfigurement and no functional loss of the involved digit. Our clinical experience showed favorable results.

Adult↗
PubMed1992

Tire explosion injuries to the upper extremity.

Several articles have been published that bring attention to the destructive potential of tire explosions. Although the severity of tire explosion injuries to the head and neck region is well established, only one previous article has reported injuries to the upper extremity. Fourteen patients with upper extremity tire explosion injuries have been treated by us from 1980 to 1988. Each injury was caused by single-piece wheel assemblies, as opposed to multipiece wheel assemblies, which have traditionally been associated with the injury. Three representative patient reports are discussed. Prevention of this injury can be achieved by increased public awareness, formal industrial safety training, tire servicing with dedicated equipment including restraining devices or barriers, complete evaluation of wheel/tire serviceability before tire mounting, separation of servicing of single and multipiece wheels, and complete tire deflation before servicing.

Accidents, Occupational↗
PubMed1993

Long-term follow-up of hand function after digit replantation.

A long-term follow-up study of 26 patients with 28 replanted digits was performed with respect to circulatory, sensory, and motor function. Peripheral circulation in the replanted digits was comparable with corresponding uninjured digits on the opposite hand. Excellent sensory recovery was observed in the territories supplied by 30 of the 36 repaired digital nerves. Best functional results were noted with the thumb and with fingers amputated through the middle phalanx. By objective criteria, 21 of the 28 replanted digits demonstrated satisfactory function. Subjectively, however, only 1 patient was dissatisfied with the outcome.

Adult↗
PubMed1996

Replantation of ring avulsion of index, long, and ring fingers.

The salvage rate of degloved amputation of the fingers is as low as 50%. This case report consists of a multiple-finger degloving amputation characterized by intact tendons, pulleys, and bone, but avulsed neurovascular bundles. After replantation, the range of motion of the fingers was nearly full. Protective-to-light touch sensation was obtained with transpositional digital nerve transfers. Grasp strength was 80% that of the uninjured side. In addition to good functional recovery, the aesthetic appearance obtained by replantation of the degloved skin was far better than that obtained by other reconstruction methods. A first web space flap was used to release a flexion contracture of the proximal interphalangeal joint of the middle finger.

Adult↗