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PubMed2006

[Traumatic pseudo-boutonniere of the metacarpophalangeal joint of the little finger. Case report and review of the literature].

Dislocation of the extensor tendon over the metacarpophalangeal joint is common among patients with rheumatoid arthritis. Patients without arthritis are exceptionally involved. The authors describe a new case of traumatic boutonniere-like of the metacarpophalangeal joint of the little finger. This lesion is a rarely, only eleven cases are described in literature. Patients are usually young adults and dislocation is related to a direct axial trauma on their fifth metacarpophalangeal joint. Diagnosis is clinical and relies on an incomplete active extension of the metacarpophalangeal joint, secondary to the dislocation of the extensor apparatus. Diagnosis is often delayed the lesion remaining unnoticed with the occurrence of others hand lesions. Proper treatment is surgery, based on suturing side to side both extensor digiti minimi and common extensor tendon over the fifth metacarpophalangeal joint. Results are excellent, with a complete range of motion and the absence of recurrence.

Adult↗
PubMed1989

The effect of loading on position sense at the proximal interphalangeal joint of the human index finger.

1. Proprioceptive acuity was tested at the proximal interphalangeal joint of the index finger of normal subjects. 2. Examination of the ability of the subjects to match finger positions (position matching procedure) revealed that digital nerve block (DNB) of the finger resulted in characteristic alignment errors at the extremes in all subjects. 3. When one finger (target finger) is positioned close to full extension, all subjects hyperextended the anaesthetized matching finger, whilst target finger positioning towards full flexion resulted in hyperflexion of the matching finger. At intermediate positions the pattern of matching errors was more variable but tended to be consistent for a given subject. 4. When the matching finger was isotonically loaded into flexion, there was little change in matching performance for most subjects. However, when the matching finger was anaesthetized, such loading now produced clear alteration in performance in all subjects. This indicates that muscle receptors contribute to proprioceptive sensations at this joint, but require other afferent sources to optimally resolve position when the finger is loaded. 5. Two other test procedures (angle reproduction and assigned positions) were assessed and compared with the results obtained by the position matching technique. Although alterations in proprioceptive performance during DNB could be detected with these procedures, they tended to be less sensitive than the position matching procedure.

Adult↗
PubMed1979

Open complex metacarpophalangeal joint dislocation. Two cases: index finger and long finger.

Two patients with open complex dislocation of a metacarpophalangeal joint were treated by cleansing of the wound, open reduction, primary wound closure, and early motion. One dislocation occurred in the index finger, the other in the long finger which is only the second such case to be described. Antibiotics were given before and continued for 5 days after operation. There were no infections, and both patients regained an excellent range of motion without pain.

Adolescent↗
PubMed2006

The relationship between nail- and distal phalangeal bone involvement severity in patients with psoriasis.

We aimed to investigate the relationship between nail involvement and joint manifestations and whether there was a correlation between nail psoriasis severity and bone manifestations in psoriatic patients without symptomatic psoriatic arthritis in plaque type psoriasis. Thirty-one patients with nail involvement (16 men, 15 women, mean age 45.29+/-18.73) and 39 patients without nail involvement (16 men, 23 women, mean age 38.41+/-17.33) were enrolled in the study. X-ray of the hands and feet with magnification were performed. The distal interphalangeal (DIP) joint and bone (tuft of terminal phalanx) were evaluated. A scoring method was performed on the patients with nail involvement. There was no difference in DIP joint involvement in patients with or without finger- and toenail involvement (p=0.085 and p=0.062, respectively). However, the prevalence of bone involvement was higher in patients with finger- and toenail involvement than without finger- and toenail involvement (p=0.039 and p=0.021, respectively). A positive correlation was also determined between finger- and toenail psoriasis severity and bone involvement severity (r=0.379, p=0.001 and r=0.288, p=0.015).

Adult↗