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[Anti-arthrosis treatments: efficacy and tolerance of chondroitin sulfates (CS 4&6)].

CHONDROPROTECTIVE DRUGS: Long-acting chondroprotective drugs have a symptomatic effect. They are only effective in subjects with osteoarthritis and have no pure pain relieving effect. They act within several weeks, improve functional manifestations and have a remnant effect. CHONDROITIN SULFATES 4&6: CS 4&6 are glycosaminoglycans which participate in the matrix structure of cartilage. They are well absorbed after oral intake. They have a dose-dependent inhibitor effect in vitro on proteoglycan and collagen catabolism and have been shown to stimulate matrix synthesis. Several clinical studies have demonstrated the chondroprotective efficacy of CS 4&6 in osteoarthritis involving the hip, knee and finger joints. OSTEOARTHRITIS OF THE KNEE: A controlled randomized double-blind study versus placebo was conducted in 104 patients with femorotibial osteoarthritis. The objective was to demonstrate that CS 4&6 given orally in a sequential regimen at the dose of 800 mg/d has a beneficial effect both in terms of clinical manifestations and in terms of the anatomic progression in patients with osteoarthritis of the knee. The main efficacy criteria was the Lequesne functional score. After 1 year of treatment with CS 4&6, the functional impairment was reduced by approximately 50%, a significant improvement over placebo for all clinical criteria. Tolerance was excellent or good in more than 90% of the cases. A STRUCTURE MODULATOR: This study suggests that chondroitin sulfates act as structure modulators as shown by the improvement in the interarticular space visualized on the x-rays of patients treated with CS 4&6.

Administration, Oral↗

Chronic post-traumatic radial instability of the metacarpophalangeal joint of the finger. Long-term results of ligament reconstruction.

Chronic painful post-traumatic instability of the radial collateral ligament complex of the metacarpophalangeal joint of a finger was treated by tendon graft reconstruction in 24 patients. Seventeen patients (20 joints) were available for a retrospective study at a mean follow-up time of 105 months. Eighty percent of the joints showed excellent or good results, with relief of pain, return of adequate stability, a near normal range of motion and absence of degenerative changes.

Chronic Disease↗

Double dislocation of the interphalangeal joints in the finger.

A case of simultaneous dislocation of the proximal and distal interphalangeal joints of the same digit is described. The case presented at Princess Basma Teaching Hospital after athletic trauma. It was treated successfully with close reduction followed by two weeks immobilization in slight flexion position. The condition is described in this report with review of the relevant literature.

Adult↗

Volar dislocation of the metacarpophalangeal joint of the ring finger. Report of two cases.

Volar dislocation of the metacarpophalangeal joint of the finger is a rare injury. Two cases of an isolated volar dislocation of the ring finger metacarpophalangeal joint are reported. The dislocation was treated successfully by closed reduction shortly after injury in both cases. Closed reduction should be attempted in all cases of this injury because successful reduction may be possible.

Adult↗

Spontaneous thrombosis of palmar digital veins.

Five cases of spontaneous thrombosis of a palmar digital vein are presented. The patients, all female, complained of a tender and unsightly lump over the digital palmar surface at the proximal interphalangeal joint level. Two fingers were affected in one patient. None could recall any history of trauma. In four cases a surgical excision was carried out. Histology confirmed the intraoperative findings of thrombosis of a superficial digital vein in every case. All patients are free from recurrence at a mean follow-up of 2.5 years.

Adult↗

Carpometacarpal joint injuries of the fingers.

Injuries to the carpometacarpal joints are uncommon and are sometimes overlooked on initial radiographs. Their recognition depends on a careful physical and radiographic examination that may require trispiral tomograms and CT scans. Most injuries can be treated successfully by closed reduction and percutaneous fixation of the joint(s) using Kirschner wires. Chronic joint injuries can also be effectively treated, and if surgery is required, an arthrodesis will restore stability and eliminate discomfort.

Acute Disease↗

Toward direct biocontrol using surface EMG signals: control of finger and wrist joint models.

Increased interest in virtual reality (VR) and telemanipulation has created a growing need for the development of new interfacing devices for measuring controlling actions of the human hand. The objective of the present study was to determine if surface electromyography signals (SEMG) from the flexor digitorum superficialis (FDS), and flexor carpi ulnaris (FCU) generated during flexion-extension of the human index finger and wrist can be used for controlling the flexion-extension of the finger and wrist of a simple geometric computer model. A simple geometric computer model of finger and wrist joints was developed. Eighteen subjects controlled the computer model using the SEMG signals from their FDS and FCU. The results indicate that the SEMG signals from the FDS and FCU muscles can be used as a direct biocontrol technique for controlling the finger and wrist models. This study establishes the proof of concept for direct biological control of the dynamic motion of the finger and wrist models for use in virtual reality environments and telemanipulation.

Computer Simulation↗