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At least 145 records · Page 8Linked to original sources
PubMed1997

Internal fixation sets for use in the hand. A comparison of available instrumentation.

Optimal clinical results of internal fixation in the hand depend on appropriate patient selection criteria, good surgical techniques, and appropriate implant selection. A variety of implant sets with plates and screws from different manufacturers are available for hand bone fixation. Traditionally, such sets have been made of stainless steel, but more recently, implants have been manufactured from titanium. Sizes and configurations vary significantly between manufacturers. In this article, commonly available internal fixation sets are compared. Plate, screw, and instrument design are considered. These comparisons should help the surgeon make an enlightened choice of implant sets.

Fracture Fixation, Internal↗
PubMed1976

[Advances in osteosynthesis of hand fractures].

In recent years stable internal fixation of hand fractures has become more commonly used though the majority of fractures of the hand bones are still treated successfully by other orthopedic means. We feel that in selected fractures internal fixation achieves better results than conservative treatment. Operative methods with less traumatic skin incisions for the fixation of multiple metacarpal fractures are proposed. A retrograde screw fixation technique is presented which permitts application of compression in very small bone fragments, which risk to be crashed by standard screwing. Results of 60 internal fixations of carpometacarpal fractures of the first metacarpal are reported. Follow-up examination of 41 patients between 1-7 years following surgery, revealed posttraumatic arthritis only in 3 joints, although remaining small articular irregularities were frequently seen on X-ray. Secondary angulation occured in four cases in spite fixation. This was due to poor cortical fixation on the palmar side of the fracture, thus in such cases temporary plaster cast should entirely be applied.

Accidents↗
PubMed2004

Bilateral hand transplantation: bone healing under immunosuppression with tacrolimus, mycophenolate mofetil, and prednisolone.

PURPOSE: Little is known about bone healing after composite tissue transplantation that requires pharmacologic immunosuppression. Bone integration and callus development were assessed in bilateral hand transplantation. METHODS: In this study the course of callus development and callus maturation were assessed by color Doppler sonography and radiography in a double hand transplant and compared with forearm replantation. RESULTS: After hand transplantation, ingrowth of small vessels at the bone junction was observed at week 3, calcified callus became visible at month 4, and bone union was completed at month 11. A similar time course of bone integration was observed after replantation. Plating offered sufficient stability. A recipient periostal flap is thought to have improved blood supply and favored development and induction of callus. CONCLUSIONS: Bone healing after hand transplantation under immunosuppression with tacrolimus, mycophenolate mofetil, and prednisolone is identical to that after forearm replantation.

Amputation, Traumatic↗
PubMed1997

Bone mass and subsequent risk of hip fracture.

We examined prospectively the associations of bone density and bone dimensions with risk of hip fracture using data from the first National Health and Nutrition Examination Survey and its three follow-up studies. A cohort of 1,489 white women age 45 years or older who received detailed medical examinations in the baseline survey in 1971-1975 were subsequently contacted in 1982-1984, 1986, and 1987. Bone density and hand bone dimensions at several sites were measured at baseline. Fifty incident hip fractures were identified during the follow-up studies. Using Cox regression analyses, we found a relative risk of 11 for women with bone density below the 5th percentile, compared with those above the 75th percentile (95% confidence interval = 2.2-58). Women with smaller external bone dimensions also faced increased risk of hip fracture (relative risk = 4.6 for dimensions below the 5th percentile vs above the 75th percentile; 95% confidence interval = 1.5-14). On the other hand, internal bone dimensions were not associated materially with hip fracture.

Age Distribution↗
PubMed2004

Brachydactyly in 14 genetically characterized pseudohypoparathyroidism type Ia patients.

Brachydactyly, classically described as shortening of III, IV, and V metacarpals and I distal phalanx, is the typical and most specific sign of Albright's hereditary osteodystrophy, a peculiar phenotype reported in subjects with pseudohypoparathyroidism type Ia (PHP-Ia) caused by mutations in the GNAS gene, which encodes for the alpha-subunit of the stimulatory G protein (Gsalpha). It has been reported in 70% of PHP subjects from routine radiological examinations, but there are no specific data for hand alterations in genetically characterized PHP-Ia subjects. We evaluated the metacarpophalangeal pattern profile in 14 GNAS-mutated PHP-Ia subjects and determined the prevalence and patterns of left hand bone shortening. To search for genotype/phenotype correlations, we compared metacarpophalangeal pattern profiles in subjects with identical mutations. Shortening below -2 SD score (SDS) was present in at least one bone in each subject, with a prevalence of 100%; however, great variability existed between subjects and between hand bone segments. Between subjects, shortening ranged from -2 to -10.4 SDS and involved 1-19 hand bones (5.3-100%). Between segments, III-IV metacarpals were the most compromised (-10.4 and -10.0 SDS, respectively); V metacarpals and I-IV distal phalanges were the most frequently shortened (85.7%). Overall, bone length median values revealed shortening below -2 SDS in all metacarpals and all distal phalanges, i.e. brachymetacarpia and brachytelephalangy, that cluster together. These segments were shortened in 64.3-85.7% of patients, significantly differing from proximal and middle phalanges, which were shortened in 21.4-50%. Even if these hand alterations were a constant and typical finding in our PHP-Ia population, cluster analysis in subjects with the same genotypes did not generally show a genotype/phenotype correlation. Variability between subjects may be the result of complex interactions between GNAS defects and other genetic or epigenetic factors. In conclusion, hand shortening analysis in 14 genetically characterized patients showed typical brachymetacarpia and brachytelephalangy. Further studies in PHP-Ia subjects without GNAS mutations and in other brachydactyly syndromes will determine whether the pattern described is also specific.

Adolescent↗
PubMed1982

Rater reliability in reading PA films of hands for bone and cartilage changes in rheumatoid arthritis.

Three experiments were conducted to evaluate the rater reliability for scoring osseous defects (articular erosions) and joint space narrowing (cartilage destruction) in patients with rheumatoid arthritis. The experiments show that two raters, using different techniques, obtain similar scores; the scores differing primarily by a multiplicative factor. A single rater achieves reproducible results under similar conditions. But with a change in reading technique, such as using a magnifying lens and intense light, the same rater obtains a change in scores. The problems of measurement must be carefully examined for any proposed measurement technique. The superficial objectivity and precision of a measurement scale are less important than its objectively and precision of a measurement scale are less important than its objectively evaluated reliability. Comparing alternative procedures is a statistical problem, and can be subjected to suitable statistical analysis to evaluate alternatives.

Arthritis, Rheumatoid↗
PubMed1989

Primary malignant bone tumors of the hand.

Malignant bone tumors of the hand are rare and few centers have extensive experience in the care of patients with these lesions. Eighteen patients with 22 lesions were evaluated at our institution. There were nine chondrosarcomas, four hemangioendothelial sarcomas, two cases each of osteosarcoma and fibrosarcoma, and a single case of Ewing's tumor. The average age of the patients was 39 years. Ten lesions each were located in the metacarpals and phalanges, with two lesions in the carpus. There were nine local recurrences, which appeared at an average of 24.5 months (range, 3 to 74 months). Curettage procedures resulted in the highest rate of local recurrence (85%). Three patients died of metastatic disease. Surgical control of these lesions requires careful preoperative planning and wide surgical margins. Regular oncologic follow-up is necessary.

Adolescent↗
PubMed1989

Determination of length of human long bones of hands from their fragments.

In cases of fragment/broken long bones, it becomes difficult to measure the length of bones for the purpose of calculation of total height (stature) of the individual with the help of magnification factors. An attempt has been made to devise a method of calculating the bones length from fragments on three long bones of the upper extremity.

Biometry↗
PubMed2026

Automated segmentation and length measurement of metacarpal and phalangeal bones for hand radiograph evaluation.

Evaluating hand and wrist radiographs is essential in pediatric endocrinology and clinical genetics, particularly for the assessment of suspected skeletal anomalies. In this study, we present Auto-Bone-Caliper, an automated system for the segmentation and length measurement of metacarpal and phalangeal (M&P) bones, trained and evaluated on public datasets comprising both normal and dysmorphic cases. We first introduce InstanceSAM, a two-stage framework that detects and segments all 19 M&P bones in pediatric hand radiographs, achieving Dice scores of 98.7% for normal bones and 95.0% for dysmorphic bones. We further develop and evaluate three methods for bone-length estimation, identifying a k-means-based approach as the most accurate, with relative errors of 2.2% for normal bones and 4.5% for dysmorphic bones. Our automated pipeline, Auto-Bone-Caliper, integrates InstanceSAM with the k-means-based length-estimation method. To enable scale-independent downstream analyses, we derive relative bone-length measures from the automated measurements. Using these relative measures, we statistically compare measurements obtained using Auto-Bone-Caliper on an independent dataset with a healthy reference catalog of normal bone morphologies, observing a high level of agreement (Wasserstein-1 distance = 0.012). Finally, we demonstrate a potential clinical use case of Auto-Bone-Caliper by obtaining relative metacarpophalangeal pattern profiles for three genetic conditions, namely Turner syndrome, achondroplasia, and pseudohypoparathyroidism. Our results highlight the potential of the Auto-Bone-Caliper to streamline and standardize M&P length measurement, providing an objective and reproducible tool suitable for clinical application.

Humans↗
PubMed1982

Radiographic hand abnormalities in fifteen cases of Crouzon syndrome.

Fifteen patients with Crouzon syndrome were evaluated for abnormalities of hand bone length via metacarpophalangeal pattern profile analysis. Data from this group were compared to that from a normal control sample. A discriminant function, utilizing Z scores based on the lengths of three hand bones, was derived and distinguished between the two samples at a rate of 88.3%. The discriminant variables selected in the function represented hand bones that are prominently involved in ACS type V and ACPS type II, syndromes that feature craniofacial abnormalities not unlike those in Crouzon syndrome. The possibility of a common developmental mechanism affecting the hand skeleton in all three of these different conditions is raised.

Craniofacial Dysostosis↗
PubMed1996

Bone mass measurement and bone metabolism in rheumatoid arthritis: a review.

The involvement of bone in rheumatoid arthritis (RA) is well recognized, and hand bone densitometry appears to be a promising new technique to monitor disease progression by assessing serial changes in hand bone mass in patients with RA. New biochemical markers of bone formation (i.e. osteocalcin) show contradictory results in different studies, although markers of bone resorption (i.e. urinary collagen cross-links) have shown significant increase in patients with RA. Bone histomorphometric studies suggest that the periarticular osteopenia in RA could be related to increased bone turnover locally, whereas generalized osteoporosis could be due to a global negative remodelling balance. The important factors implicated in the pathogenesis of the bone loss are circulating cytokines [e.g. tumour necrosis factor alpha (TNF alpha), interleukin (IL) 1 and IL6] produced by the inflammatory process, use of oral corticosteroids (in the dose of > or = 5 mg) and reduced mobility due to functional impairment. Apart from this underlying osteoporosis, patients with RA have an increased risk of falls secondary to functional impairment and there is an increased risk of fractures in patients with RA. Very few studies are presently available looking at the therapeutic measures to prevent osteoporosis in RA. Future drug trials on the treatment of RA should include bone mass measurement, especially of the hand, as one of the outcome measures.

Arthritis, Rheumatoid↗
PubMed1984

[Rare localization of Paget's osteodystrophia deformans in the skeleton].

Frequency of rare skeletal lesions in Paget's disease is compared with normal localisations. Radiological morphology of rare localisations of Paget's disease of the scapula, of the lower arm bones, of the hand bones, of the patella and the calcaneus are described. Thickening of trabeculae in the spongy bone and porosity of compact bone, deformation and enlargement of the bones are typical; this has to be differentiated and related to a small number of other bone diseases.

Bone and Bones↗
PubMed2001

Relationship between bone mineral density and radiologic scores of hands in rheumatoid arthritis.

This study proposed to assess the relationship between hand bone mineral density (BMD) and radiographic scoring methods, important measures to assess the course of rheumatoid arthritis. Hand, spine, and femur BMD of 49 patients with rheumatoid arthritis and 34 age- and sex-matched healthy control subjects were measured using dual X-ray absorptiometry and the results were compared. Standard hand films of patients were scored according to five different scoring methods--Larsen method, modified Larsen method, Sharp/van der Heijde modified method, carpo:metacarpal ratio, and simple erosion narrowing score (SENS)--and were correlated with hand BMD. There was a moderate relationship between hand BMD measurements and radiologic scores. SENS was the method that correlated significantly with the highest correlation coefficient. Hand BMD correlated significantly with disease duration and c-reactive protein levels. Hand BMD in patients with rheumatoid arthritis was significantly lower than in control subjects, whereas there was no significant difference in axial BMD measurements. The advantages and disadvantages of hand BMD and radiographic scoring methods were determined. Our results indicate that hand BMD measurements may be as useful is assessing the course of rheumatoid arthritis as radiologic scoring methods. However to prove this, a well-designed reference population for hand BMD and longitudinal studies are required.

Absorptiometry, Photon↗
PubMed1998

Hand function and tool behavior in early hominids.

Prompted by the discovery of the Olduvai Hominid 7 hand (Homo habilis) in 1960, studies of primate hands were conducted in order to understand better the functional morphology of the earliest hominids and the evolution of tool behavior. Since Napier's work in the early 1960's, the hand bones of a number of other species have been recovered in East and South Africa. New hominid finds and a prolific archaeological record have broadened our perspective on the evolution of tool behavior in Australopithecus, Paranthropus, and early Homo. A debate is underway at this time on the questions of what exactly we can glean from the fossil record regarding the evolution of tool behavior and what are the best approaches to interpreting the evidence. I support the model of Napier that identified morphological correlates of precision and power grasping in the hands of extant primates and in early hominid hand bones. At the same time, I question both the underlying rationale and attempts to identify more subtle aspects of precision grasping, based on present evidence.

Animals↗
PubMed1987

"Disappearing bone disease" in the hand.

"Disappearing bone disease" is a rare entity that is characterized by extensive osteolysis associated with hemangiomatosis. A case affecting a 13-year-old girl, with wide-spread hand involvement is reported. She did not respond to bone grafting but the condition was arrested after a course of radiation therapy.

Adolescent↗