- The proximal interphalangeal joint: arthritis and deformity. [Review]
- EOEFORT Open Rev 2019; 4(6):254-262
- Finger joints are of the most common site of osteoarthritis and include the DIP, PIP and the thumb saddle joint.Joint arthroplasty provides the best functional outcome for painful destroyed PIP joint…
Finger joints are of the most common site of osteoarthritis and include the DIP, PIP and the thumb saddle joint.Joint arthroplasty provides the best functional outcome for painful destroyed PIP joints, including the index finger.Adequate bone stock and functional tendons are required for a successful PIP joint replacementFixed swan-neck and boutonnière deformity are better served with PIP arthrodesis rather than arthroplasty.Silicone implants are the gold standard in terms of implant choice. Newer two-component joints may have potential to correct lateral deformities and improve lateral stability.Different surgical approaches are used for PIP joint implant arthroplasty according to the needs and the experience of the surgeon.Post-operative rehabilitation is as critical as the surgical procedure. Early protected motion is a treatment goal.Revision and exchange PIP arthroplasty may successfully be used to treat chronic pain, but will not correct deformity. Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180042.
- Extraordinary grip strength and specialized myology in the hyper-derived hand of Perodicticus potto? [Journal Article]
- JAJ Anat 2019 Jul 15
- Previous behavioral reports of the African lorisid, Perodicticus potto, have speculated that these animals have an extraordinary grip strength. This ability is hypothesized to be facilitated by a ran…
Previous behavioral reports of the African lorisid, Perodicticus potto, have speculated that these animals have an extraordinary grip strength. This ability is hypothesized to be facilitated by a range of anatomical features within the forelimb, ranging from the presence of a retia mirabilia in its wrist to the hyper-abduction of its pollex. Despite numerous behavioral reports, however, this claim of extraordinary grip strength has not been empirically substantiated. This study quantifies the physiological cross-sectional area of the digital flexor muscles within P. potto. These data are compared with a broad primate sample, including several similarly sized strepsirrhines. Contrary to expectation, we found that P. potto actually has relatively below-average digital flexor PCSA. However, we identified other myological characteristics in the upper limb of P. potto that were unexpected, including the largest brachioradialis muscle (an elbow flexor) among our primate sample, and - despite P. potto having only a vestigial second digit - an independent digital extensor indicis that is absent in almost a quarter of our primate sample.
- Rare Presentation of Pilar Cyst of the Thumb. [Case Reports]
- WJWorld J Plast Surg 2019; 8(2):259-261
- Pilar cysts are common cysts on the scalp and hair bearing area of the body. We found one such cyst on the dorsum of the thumb. There have been previous reports of them in the finger tips as a very r…
Pilar cysts are common cysts on the scalp and hair bearing area of the body. We found one such cyst on the dorsum of the thumb. There have been previous reports of them in the finger tips as a very rare occurrence. The site of this lesion supports the theory of a possible origin from the nail matrix. These lesions, even when found at unusual sites should have pilar cyst as a differential diagnosis. They must always be excised and subjected to careful histopathology to rule out proliferating trichilemmal cysts, which carry a rare risk of malignancy.
- Outcome of Percutaneous Release for Trigger Digits in Diabetic and Non-diabetic Patients. [Journal Article]
- CCureus 2019 May 02; 11(5):e4585
- Introduction Trigger finger (TF) is a common cause of hand pain, swelling, and limited motion. It is common in women and in the thumb. Diabetes mellitus (DM) increases the risk of TF. Individuals wit…
Introduction Trigger finger (TF) is a common cause of hand pain, swelling, and limited motion. It is common in women and in the thumb. Diabetes mellitus (DM) increases the risk of TF. Individuals with DM who develop TF are resistant to both medical and surgical interventions. The aim of this study is to compare the outcomes of percutaneous trigger release in diabetic and nondiabetic patients. Methods Fifty diabetic and 50 non-diabetic patients with a clinical diagnosis of TF were included after informed consent. Percutaneous trigger release was performed in all of them. Follow-ups for pain and/or neurovascular complications were taken after one week, one month, and six months. Data were entered and analyzed using SPSS v. 22 (IBM Corp., Armonk, NY, US). Results In the diabetic group, 86% of patients had TF of grade III or above and in the non-diabetic group, 76% of patients had TF of grade III or above. At the one-week follow-up, 79.2% diabetic patients still had mild to severe pain and 60.4% non-diabetic patients had mild to severe pain. By one month, 40% patients in the diabetic group still reported mild to moderate pain, however, all patients in the non-diabetic group reported no pain. By six months, nine (20%) diabetic patients reported mild pain. There was no incidence of infection or neurovascular damage at any follow-up in the non-diabetic group, and in the diabetic group, 4.2% of patients had an infection on the one-week follow-up. Conclusion Percutaneous trigger finger release is a safe, reliable, time-saving, and cost-effective procedure for the management of trigger finger in both diabetic and non-diabetic patients.
- Novel modification of abductor pollicis longus suspension arthroplasty with trapeziectomy for thumb carpometacarpal osteoarthritis. [Journal Article]
- JNJ Nippon Med Sch 2019 Jul 15
- CONCLUSIONS: The modified Thompson procedure is a simple and effective technique that can improve the thumb radial abduction angle compared with the original technique in patients with advanced thumb CMC osteoarthritis. Additionally, this new technique is as useful as the original procedure in early restoring thumb function and relieving pain.
- Experience of a Brazilian surgeon in a hand transplant case: "What I saw, what I learned". [Case Reports]
- RBRev Bras Ortop 2013 Nov-Dec; 48(6):567-573
- The Louisville VCA (Vascularized Composite Allograft) Program is one of the largest hand transplant programs in the world. During my hand surgery fellowship at the Christine M. Kleinert Institute, th…
The Louisville VCA (Vascularized Composite Allograft) Program is one of the largest hand transplant programs in the world. During my hand surgery fellowship at the Christine M. Kleinert Institute, the team performed the eighth hand transplant on the seventh recipient in Louisville. The Louisville VCA Program has done 9 hand transplants in 8 recipients with one bilateral case. Among these are the first 5 hand transplant cases in the United States. The first case was done in 1999 and has the World's longest follow-up. The seventh case was performed in a 36-year-old male on July 10, 2011. The result achieved so far can be considered excellent with a very good patient satisfaction. There is a large multidisciplinary team involved in such procedures with all members playing a crucial role for the achievement of the best result possible. The present paper focuses on the surgical procedure for the seventh recipient, which was unique due to the level of amputation of the recipient's hand, with preservation of nerve to the thumb.
- Ultrasound power Doppler and gray scale joint inflammation: What they reveal in rheumatoid arthritis. [Journal Article]
- IJInt J Rheum Dis 2019 Jul 15
- CONCLUSIONS: Ultrasound PD joint inflammation is associated with disease activity and is correlated with DAS28. In contrast, GS joint inflammation is associated with structural damage and is correlated with ultrasound-detected bone erosion.
- Avoid the sore thumb of standout composites. [Journal Article]
- BDBr Dent J 2019; 227(1):63
- Nerve transfers in the upper extremity following cervical spinal cord injury. Part 2: Preliminary results of a prospective clinical trial. [Journal Article]
- JNJ Neurosurg Spine 2019 Jul 12; :1-13
- CONCLUSIONS: Motor nerve transfers are a promising treatment option to restore upper-extremity function after SCI. In the authors' experience, nerve transfers for the reinnervation of hand and finger flexors showed variable functional recovery; however, transfers for the reinnervation of arm, hand, and finger extensors showed a more consistent and meaningful return of strength and function.
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- Nerve transfers in the upper extremity following cervical spinal cord injury. Part 1: Systematic review of the literature. [Review]
- JNJ Neurosurg Spine 2019 Jul 12; :1-12
- CONCLUSIONS: Motor nerve transfers are a promising treatment option to restore upper-extremity function after SCI. Flexor reinnervation strategies show variable treatment effect sizes; however, extensor reinnervation may provide more consistent, meaningful recovery. Despite numerous published case reports describing good patient outcomes with nerve transfers, there remains a paucity in the literature regarding optimal timing and long-term clinical outcomes with these procedures.