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Results for “Hand Deformities”

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At least 163 records · Page 9Linked to original sources
PubMed2001

Release of flexors and intrinsic muscles for finger spasticity in cerebral palsy.

Between April 1987 and March 1996, 32 deformed hands of 31 patients with cerebral palsy were treated with combined release of the flexor digitorum profundus, flexor digitorum superficialis, and intrinsic muscles. Of these 31 patients, 26 patients (27 hands) were followed up after treatment. Improvements were evaluated by the modified classification of Zancolli et al, the classification of House et al, the object handling score, and the activity of daily living score. Improvements of more than one level on an average were observed in the modified classification of Zancolli et al and the classification of House et al. The ability to grasp, pinch, and release increased with improvement of 2.5 points in the object handling score, and activities of daily living were enhanced with improvement of 2.4 points. The fine motor skills could be facilitated, and dexterity was restored in most patients.

Adolescent↗
PubMed1990

Combined flexor and extensor release for activation of voluntary movement of the fingers in patients with cerebral palsy.

Twenty deformed hands of 19 Japanese patients with cerebral palsy were treated with release of the flexor digitorum profundus, the flexor digitorum sublimis, and the extensor digitorum communis. The results were satisfactory and included enhanced daily activities, voluntary grasp, and release of the fingers. Simultaneous cocontraction of the multiarticular muscles inhibits voluntary movement of the fingers and causes rigidity and involuntary movements. Use of the intrinsic muscles is facilitated by reducing hypertonicity of the multiarticular muscles and by activation of voluntary movements of the fingers. Many such patients can then become functionally independent.

Adolescent↗
PubMed1994

Successful surgical management and long-term follow-up of epidermolysis bullosa.

BACKGROUND: Esophageal stenosis and hand deformity are serious complications of recessive dystrophic epidermolysis bullosa that influence the prognosis of patients. To control such complications we have used surgical treatments with favorable results. Additional objectives were to summarize the results of long-term follow-up. METHODS: Six patients with esophageal stenosis and nine patients (13 hands) with hand deformity (contracted fingers, mitten-like deformity) were treated surgically after anemia and malnutrition were corrected by intravenous iron infusion, high-energy diet, and blood transfusion. As intubation was contraindicated, topical anesthesia was used (eg., lidocaine spray to the nasopharyngeal mucosa for esophageal dilatation and brachial block, ketamine drip, and nitrous oxide inhalation for reconstruction of contracted fingers). We established a new method for esophageal dilatation using a microvasive rigiflex balloon catheter. This catheter was advanced to the stenotic area under radiography and then expanded by injecting contrast medium into the balloon. For reconstruction of hand deformities, the epidermal glove was initially peeled off, and then the combined digits separated carefully by hand. If the release of the contracture was not sufficient, a skin incision was made avoiding injury to nerves and blood vessels. Any skin defects that appeared after the release of the contracture were covered with skin grafts taken from the abdominal wall. K-wire fixation was used to maintain the extended position of the fingers. Three weeks after the operation, the K-wires were removed and rehabilitation was commenced. RESULTS: The esophageal stenosis was successfully dilated with the balloon catheter; in all six cases the dysphagia was relieved immediately. There was no recurrence in any of the patients on long-term follow-up. After reconstruction of the hand, daily activity improved in 12 of the 13 hands. The remaining hand was difficult to reconstruct due to severe mutilation and bone deformity. During follow-up, 6 of the 12 hands maintained successful reconstruction, whereas the remaining 6 hands showed slight to moderate recontraction of the fingers. CONCLUSION: Esophageal dilatation with a balloon catheter is safer and has fewer side effects compared to other surgical procedures. This method can provide favorable results and can be carried out repeatedly in a short time. Daily and social activities of patients can be improved upon reconstruction of hand deformities.

Adolescent↗
PubMedDate not supplied

[The Freeman-Sheldon Syndrome].

Freeman-Sheldon syndrome (FSS) or craniocarpotarsal dysplasia is characterized by a triad of symptoms: 1. Masklike, whistling facial expression (whistling face syndrome), 2. Ulnar deviation of digits II to V and adduction contracture of the thumb and 3. Foot deformities. The pathogenesis of this malformation is unknown. Heredity is autosomal dominant and not sex-linked. Genetic counseling of affected individuals is imperative. The differential diagnosis should exclude the possibility of arthrogryposis multiplex congenita and particularly congenital windmill deformity of the fingers, which can also be accompanied by foot deformities. The foot and hand deformities associated with FSS are resistant to treatment and require consistent conservative and operative measures. Multiple, extensive operative interventions were unavoidable in both cases described.

Abnormalities, Multiple↗
PubMed1990

An unusual case of radial club hand.

An unusual form of congenital hand deformity is described. It consists of radial club hand deformity with the whole of the radius present but dislocated at proximal and distal ends. This best fits "failure of development" group in the conventional classification. The future management will depend on whether the forearm grows at the same rate on the pre-axial and post-axial sides.

Child, Preschool↗
PubMed2004

Hypoplastic synpolydactyly as a new clinical subgroup of synpolydactyly.

A large kindred which was first described in 1995 was investigated again. We present the clinical, radiological, genetic and surgical findings of the hand deformities found in homozygote individuals which we called "hypoplastic synpolydactyly". There were 125 affected (heterozygote or homozygote) people out of 245 subjects in the five last generations. We identified seven marriages of two affected people. Twelve offsprings, of these marriages had a homozygote genetic pattern and "hypoplastic synpolydactyly". From both the clinical and surgical perspectives, their hand deformity was distinctive from that of their parents. We surgically treated both hands of three individuals with this deformity. The hand deformity of these homozygotes was so complicated and distinctive that it can be evaluated as a new subgroup of synpolydactyly.

Bone Wires↗
PubMed2005

[Epidermolysis bullosa dystrophica (Hallopeau-Siemens syndrome) of the hand -- surgical strategy and results].

Dystrophic epidermolysis bullosa is an inherited, blister-forming skin disease. The Hallopeau-Siemens syndrome type is one of the most severe forms. Even minimal trauma to the skin leads to excessive blister formation that always heals with scars because the defect is located in the dermis at the dermoepidermal junction. A genetic defect of collagen VII leads to insufficient or missing anchoring fibrils. The patients suffer from protein loss, anaemia, secondary infections, oesophageal strictures, malignant transformation and hand deformities. These present as pseudosyndactyly, flexion contractures and, in advanced stages, as a mitten-like deformity. This results in the complete loss of function of the hands and consequently to severe psychosocial problems for the young patients. There is no cure for this disease at present, so surgical treatment of the hand deformities is the only option. From 1998 to 2002 seven hands in four patients were operated on in our clinic. Operations included pseudosyndactyly separation, arthrolysis with Kirschner-wire fixation of finger joints, as well as "metacarpolysis" of the thumb. Redressing splints/dressings were applied. Spontaneous epithelialisation was awaited and was complete within four weeks without problems. Afterwards customised silicon splints and cotton gloves are complimented by intensive physiotherapy. There were no serious complications. Recurrence is unavoidable, but we could restore basic hand functions for at least 2.5 years. Postoperative care is important to postpone reoperations. We prefer the most simple operative procedure as described without skin grafts, flaps or keratinocyte transplants, because a comparable outcome is achieved with less trauma and stress for the patients.

Child↗
PubMed1984

Lupus foot: deforming arthropathy of the feet in systemic lupus erythematosus.

Passively correctable joint deformities of the feet were found in 13 of 14 (82.8%) systemic lupus erythematosus (SLE) patients with deforming arthropathy of the hands (Jaccoud's type of arthropathy). These included hallux valgus, subluxation of the metatarsophalangeal joints and widening of the forefoot. Erosive or cystic changes of bone and cartilage were not seen. In contrast, only 4 of 16 (25%) SLE patients without hand deformities, matched for age and duration of the disease, showed similar joint deformities of the feet. Jaccoud's type of arthropathy in SLE is characterized not only by passively correctable joint deformities of the hands but of the feet as well.

Adult↗