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At least 1,531 records · Page 85Linked to original sources

Update: palmar dislocation of the trapezoid--a case report.

A case is presented of an open palmar dislocation of the trapezoid in conjunction with dorsal dislocations of the carpometacarpal joints of the index and long fingers. Open reduction and a primary limited wrist arthrodesis were performed with good results.

Adult↗

Reliability of torque range of motion: a preliminary study.

The clinical reliability of torque range of motion (TROM) has not been tested. This preliminary review was performed to determine the intra- and interrater reliability of TROM. The proximal interphalangeal joints of the index and middle fingers of 14 normal subjects, 56 digits, were tested by applying extension forces of 200 g, 400 g, 600 g, and 800 g. Data were collected using both the hand-held Haldex orthotic gauge with the dial goniometer (manual) and the cantilever-beam force transducer and electrogoniometer (digital) as testing instruments. The testing order of digits, sides, and devices was randomized and tested separately by three different test teams. Results of the analysis of variance showed a significant difference of the means between raters at all force levels (p < 0.0001) and between instruments at 600-g and 800-g forces (p < 0.01). The Pearson product-moment correlation coefficient test, used to test the consistency, resulted in moderate consistency of measures of intrarater reliability between trials, and between instruments used (digital and manual). Intraclass correlation coefficients (ICCs) were calculated with results that were nearly identical to those of the Pearson. Intrarater reliability was in more consistent agreement at the 600-g and 800-g levels. There was significantly high agreement between the tests of tester B, compared with moderate correlations of the tests of testers A and C.

Adult↗

Recurrent giant cell tumors of the tendon sheath.

Seventy patients underwent surgical excision of a giant cell tumor of the tendon sheath. The patients were monitored for an average of 3 years 4 months. Nineteen of the 70 patients (27%) had a surgically and histologically documented recurrence at an average of 2 years 3 months (range, 3 months to 10 years) following the initial procedure. Eight of 19 patients (42%) with recurrence had a prior recurrence. Statistically significant risk factors for recurrence included presence of adjacent degenerative joint disease, location at the distal interphalangeal joint of the finger or interphalangeal joint of the thumb, and radiographic presence of an osseous pressure erosion. Age, gender, size, and location within the digit (volar vs. dorsal) were not risk factors for recurrence. Awareness of these associations should be reflected in the surgeon's approach and preoperative discussion with the patient.

Adolescent↗

Multisystem presentation of eosinophilic fasciitis.

A 20-year-old man experienced the onset of progressive scleroderma-like skin changes with eosinophilia and hypergammaglobulinaemia after strenuous military activity. A biopsy showed faciitis. Concomitant splenomegaly, polysynovitis, restrictive lung function, myositis, decrease hepatic clotting factors and proteinuria were documented. He responded well to corticosteroids, relapse upon their discontinuation and had a complete remission of both skin and systemic features while on penicillamine and azathioprine. He is new in good health and has received no medication for the past two years.

Adult↗

Acute gout of the right sacroiliac joint.

An eighty-year-old woman suffered from acute idiopathic gout of the right sacroiliac joint and tophaceous deposits in two fingers of her right hand. Hyperuricemia and findings consistent with gout detected by histological examination of a biopsy specimen taken from the digital nodules supported the diagnosis. The radiological workup revealed osteolytic changes at the bases of the phalanges in Roentgenograms of the feet. Various aspects of the very rare incidence of sacroiliac gout are discussed.

Acute Disease↗

Camptodactyly in a neurology outpatient clinic.

Camptodactyly is a non-neurogenic flexion deformity of the proximal interphalangeal joint, most commonly affecting the little finger. The frequency of camptodactyly in patients referred to three general neurology outpatient clinics, two in district general hospitals and one in a regional neuroscience centre, over the course of one year (2000) was measured. Five out of 978 consecutive new outpatients (0.5%) had camptodactyly (2 M, 3 F); four had bilateral deformity. In only one was camptodactyly the reason for referral. In two cases, camptodactyly was entirely incidental to the neurological symptoms; in two others it was incidental but might have been confused with the neurological features. In three cases other family members were affected, in a manner consistent with autosomal dominant inheritance with variable penetrance. Camptodactyly is not infrequently observed in the general neurology outpatient clinic. It merits attention in order to avoid confusion with other, neurogenic, causes of clawing, and so avoid unnecessary investigation.

Adolescent↗