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Biomechanical characteristics of suture techniques in extensor zone IV.

This study was designed to investigate several biomechanical parameters involved in repair of extensor tendons in Zone IV (over the proximal phalanx). Typical suture techniques over the proximal phalanx did not shorten the tendon significantly nor was there significant loss of flexion at the metacarpophalangeal or proximal interphalangeal joints. The Kleinert modification of the Bunnell technique and modified Kessler technique seemed to be the strongest and provided evidence that dynamic or active range of motion, under controlled conditions and in short arcs, might be physiologically tolerated by repaired tendons.

Biomechanical Phenomena↗

Roentgenological arthrosis of the hand in dentists with reference to manual function.

Arthrosis of the hand was studied in 136 dentists 33-69 yr of age on a joint-by-joint basis. A random sample of 940 persons of similar age from the general population served as controls. The prevalence of arthrosis was significantly higher in male than female dentists. Male dentists tended to have a higher and female dentists a similar prevalence of arthrosis as compared to the respective controls. The proportion of arthrotic distal interphalangeal (DIP) joints of all arthrotic joints of the hands was in both male and female dentists greater than that in controls, especially below the age 50, suggesting that arthrosis of the DIP joints of fingers develops earlier in dentists than in controls. This might result from the extensive use of the precision grip in dentistry. Arthrosis of the DIP joint of the index finger was not associated with the pinch power between the thumb and index finger, indicating good preservation of manual function in spite of increasing degenerative changes in hand joints with advancing age.

Adult↗

Brachymesophalangy and loose bodies in the metacarpophalangeal joints.

A family with autosomal inherited brachymesophalangy is presented. Some of the family members also had loose bodies in the metacarpophalangeal joints. This condition is similar to osteochondritis in other joints. New loose bodies may be formed after operative removal and arthrotic changes may occur. The patients were not able to perform hard physical work with their hands.

Abnormalities, Multiple↗

Small marker chromosomes in two patients with segmental aneusomy for proximal 17p.

We report a nine-year-old girl (patient 1934) and a five-year-old boy (patient 2170) with small, de novo supernumerary marker chromosomes (SMCs) derived from proximal 17p. The clinical features of patient 1934 include developmental delay, triangular face, prominent forehead, low set ears, dental abnormalities, a high arched palate, long, flexible fingers, and joint laxity. Patient 2170 is affected with developmental delay, oral-motor dyspraxia/verbal apraxia, thick upper and lower lips, bilateral fifth finger clinodactyly, joint laxity and mild hypotonia. G-banded chromosome analysis of patient 1934 revealed mosaicism for a SMC in 72% of peripheral lymphocytes analyzed, whereas analysis of patient 2170 identified a smaller SMC present in 100% of cells analyzed. Fluorescence in situ hybridization (FISH) studies demonstrated that both of the SMCs derived from 17p10-p11.2. Using FISH and array-CGH analysis, the proximal breakpoints mapped within the centromere and the distal breakpoints were both located within the Smith-Magenis syndrome (SMS) common deletion region. We compare the clinical characteristics of our patients with those previously reported to have either SMC including 17p or duplications of proximal 17p in an effort to further delineate the phenotype of trisomy 17p10-p11.2 and to elucidate genotype-phenotype correlations.

Abnormalities, Multiple↗

[Replacement of intrinsic muscle function following the modified Zancolli procedure].

The authors recommend corrective procedures for the absence of intrinsic muscle function after irreversible injury to the ulnar nerve. The modified Zancolli capsulodesis was utilized in four cases with ulnar and in one case with combined ulnar and median nerve injury. The modification consists of a temporary fixation of the metacarpophalangeal joint with a Kirschner wire and the use of a transosseous absorbable suture. Two personal cases are reported.

Adolescent↗