Preliminary Soft-Tissue Distraction with the Digit WidgetTM in the Management of Advanced Dupuytren Contracture at the Proximal Interphalangeal Joint

2016 ◽  
pp. 285-290 ◽  
Author(s):  
Solomon Azouz ◽  
Atanu Biswas ◽  
Anthony Smith
Keyword(s):  
Soft Tissue ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Dupuytren Contracture

Nonoperative treatment of PIPJ flexion contractures associated with Dupuytren’s disease

2011 ◽  
Vol 37 (8) ◽  
pp. 722-727 ◽  
Author(s):  
J. Larocerie-Salgado ◽  
J. Davidson
Keyword(s):  
Soft Tissue ◽  
Nonoperative Treatment ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Dupuytren’S Disease ◽  
Dupuytren's Disease ◽  
Patient Dissatisfaction ◽  
Flexion Contractures ◽  
Alternative Treatment Option ◽  
Soft Tissue Mobilization

Post-surgical outcomes in patients with Dupuytren’s disease causing flexion contractures of the proximal interphalangeal joint can be inconsistent and are often associated with protracted rehabilitation, reduced flexion, recurrence of the contracture, and patient dissatisfaction. An alternative treatment option, comprised of splinting and soft tissue mobilization techniques, was introduced to stabilize early contractures of the proximal interphalangeal joint in the hopes of delaying or obviating surgery. Over the course of approximately 12.6 months (±7.8), thirteen patients were followed at the hand clinic at Hotel Dieu Hospital in Kingston. One patient was unable to complete the course of therapy. Of the remaining patients, analysis showed significant improvement in active proximal interphalangeal joint extension of approximately 14.6° (SD: ±5.1°; range: 5–25°) over the course of the treatment ( p < .05). Nighttime static extension splinting and soft tissue mobilization techniques appear to delay and possibly prevent the need for surgery in individuals with flexion contractures of the proximal interphalangeal joint due to Dupuytren’s disease.

Irreducible Compound Dorsal Dislocations of the Proximal Interphalangeal Joint of the Finger

1986 ◽  
Vol 11 (1) ◽  
pp. 49-50
Author(s):  
INGER KJELDAL
Keyword(s):  
Soft Tissue ◽  
Open Reduction ◽  
Proximal Phalanx ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Probable Mechanism ◽  
Hand Injuries ◽  
Tissue Structures

Three cases of compound irreducible dorsal dislocation of the proximal interphalangeal joint of the finger are reported. The probable mechanism is discussed. The findings warrant the description “volar capsular boutonnière” as the condyles of the proximal phalanx buttonhole, through the volar structures. Open reduction combined with debridement, is the treatment for such compound irreducible dorsal dislocations. Dislocation of the proximal interphalangeal joints of the fingers are common and can usually be reduced by simple traction. Occasionally reduction by closed methods is unsuccessful because of interposition of volar or dorsal soft tissue structures (Lamb 1981). This study reports three cases of compound dorsal dislocation of the proximal interphalangeal joint with volar soft tissue interposition. Such lesions are sparsely mentioned in text books on fractures and hand injuries and hitherto only a few cases have been published (Lamb 1981, Bunnell 1956).

Repair of a palmar soft tissue defect of the proximal interphalangeal joint with a transposition flap from the dorsum of the proximal phalanx

2011 ◽  
Vol 38 (4) ◽  
pp. 378-385 ◽  
Author(s):  
X. Zhang ◽  
X. Shao ◽  
M. Zhu ◽  
R. Jiang ◽  
Y. Feng ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Proximal Phalanx ◽  
Soft Tissue Defect ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Transposition Flap ◽  
Active Motion ◽  
Dorsal Branch ◽  
Pedicle Length ◽  
Distal Interphalangeal

This article describes the use of a transposition flap raised from the dorsum of the proximal phalanx for coverage of the volar defects at the proximal interphalangeal joint. The flap was based on the first dorsal branch of the proper digital artery. From January 2007 to March 2009, 14 digits in 14 patients (10 males and 4 females) were treated. There were 5 index, 6 middle, 2 ring, and 1 little finger. All patients underwent surgery 2–9 hours (mean 5 hours) after injury. Soft tissue defects ranged in size from 1.2 × 1.7 cm to 2.1 × 2.3 cm (mean 1.7 × 2 cm). Flap size ranged from 1.5 × 1.7 cm to 2.4 × 2.7 cm (mean 2 × 2.4 cm). Mean pedicle length was 1.1 cm (range 0.8–1.4 cm). All flaps completely survived. At final follow-up from 24–29 months (mean 26 months), mean active motion arcs of the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints were 84° (range 75–91°), 86° (range 65–100°) and 54° (range 32–80°), respectively. Our technique is useful and reliable for coverage of a palmar defect over the proximal interphalangeal joint.

Preliminary Soft-Tissue Distraction versus Checkrein Ligament Release after Fasciectomy in the Treatment of Dupuytren Proximal Interphalangeal Joint Contractures

2011 ◽  
Vol 128 (5) ◽  
pp. 1107-1113 ◽  
Author(s):  
Randall O. Craft ◽  
Anthony A. Smith ◽  
Brandon Coakley ◽  
William J. Casey ◽  
Alanna M. Rebecca ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Joint Contractures

IRREDUCIBLE PALMAR DISLOCATION OF THE PROXIMAL INTERPHALANGEAL JOINT OF A FINGER EVALUATED BY MAGNETIC RESONANCE IMAGING: A CASE REPORT

Hand Surgery ◽  
2004 ◽  
Vol 09 (02) ◽  
pp. 253-256 ◽  
Author(s):  
Mitsuhiko Nanno ◽  
Takuya Sawaizumi ◽  
Hiromoto Ito
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Magnetic Resonance ◽  
Soft Tissue ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Resonance Imaging ◽  
Detailed Evaluation ◽  
Central Slip ◽  
Magnetic Resonance Imaging Mri

The irreducible palmar dislocation of the proximal interphalangeal joint (PIPJ) of a finger is rare and central slip rupture with the interposition of the lateral band in the PIPJ is extremely rare. In our present case, magnetic resonance imaging (MRI) enabled a very effective and detailed evaluation of soft tissue damage.

ON-TOP PLASTY USING A FREE METACARPAL HEAD GRAFT FOR LENGTHENING OF PROXIMAL PHALANX IN SYMBRACHYDACTYLY — A CASE REPORT

Hand Surgery ◽  
2013 ◽  
Vol 18 (02) ◽  
pp. 273-275 ◽  
Author(s):  
Kousuke Iba ◽  
Takuro Wada ◽  
Toshihiko Yamashita
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Bone Growth ◽  
Proximal Phalanx ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Soft Tissue Envelope ◽  
Metacarpal Head ◽  
Little Finger

A three-year old patient with symbrachydactyly (didactyly type) presented with a little finger that was too short to allow pinching and consisting of a floppy soft-tissue envelope with hypoplastic phalanges, although the thumb was functional. As the proximal phalanx was too small to permit distraction lengthening or conventional bone grafting, on-top plasty using a 4th metacarpal graft with a cartilage head was undertaken for lengthening the proximal phalanx of the little finger for pinch reconstruction. At ten weeks after surgery, the patient achieved satisfactory pinch function due to the lengthened and bone-stabilised postoperative digit and reconstruction of functional proximal interphalangeal joint. In addition, the grafted metacarpal demonstrated satisfactory bone growth throughout the six-year follow-up period.

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