Interposition of the dorsal interosseous tendon in a fracture of the base of the proximal phalanx of the right ring finger

Background: Arthroscopy is a widely used minimally invasive technique. Nevertheless, no report describes the arthroscopic anatomy of the proximal interphalangeal (PIP) joint for portal creation. To facilitate arthroscopy, this study elucidated the anatomy of the lateral bands of the extensor mechanism and collateral ligaments of PIP joints. Methods: A total of 39 fingers from the right hands of 10 cadavers (4 males, 6 females) were evaluated in this study. We defined the extension line from the proximal interphalangeal volar crease as the C-line. We also defined an imaginary line along the distal edge of the proximal phalanx, which is parallel to the C-line, as the J-line. The distance between J-line and C-line was measured. On the C-line and J-line, we measured the following: from the dorsal skin to the lateral edge of the lateral band (LB), the dorsal edge of the collateral ligament (CL) and from the lateral band and the collateral ligament (D), the width of the finger (W). The finger half-width (M) was measured on the J-line. Comparison between the digits and comparison between radial and ulnar distance were measured and statistical analysis was performed. Results: All PIP joint spaces were distal from the C-line, except for one ring finger. The average distances between the J-line and C-line were 1.8–3.2 mm. On the C-line, only 11 cases (14.1%) showed an interval between the lateral bands and the collateral ligaments, but, on the J-line 72, cases (92.3%) had such an interval. The interval was located 1.6–2.9 mm in a dorsal direction from the midlateral on the J-line. Conclusions: Portal creation at the J-line is safer than at the C-line. This study revealed that safe portals for arthroscopy of the PIP joint are 2 mm dorsal to the midlateral line of the finger on the J-line.

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Hand tumors: A review of 186 patients at a single institute

Journal of Orthopaedic Surgery ◽

10.1177/2309499021993994 ◽

2021 ◽

Vol 29 (1) ◽

pp. 230949902199399

Author(s):

Taketsugu Fujibuchi ◽

Hiroshi Imai ◽

Joji Miyawaki ◽

Teruki Kidani ◽

Hiroshi Kiyomatsu ◽

...

Keyword(s):

Soft Tissue ◽

Clinical Features ◽

Malignant Tumors ◽

Proximal Phalanx ◽

Delayed Diagnosis ◽

Ring Finger ◽

Soft Tissue Tumors ◽

Body Parts ◽

Maximal Diameter ◽

Benign Soft Tissue Tumors

Purpose: The spectrum of diagnoses and clinical features of hand tumors differ from those of tumors in other body parts. However, only a few reports have comprehensively referenced the diagnosis and clinical features of hand tumors. This study aimed to elucidate the diagnostic distribution and the clinical features of hand tumors undergone surgery in our institute. Patients and methods: A total of 235 lesions in 186 patients diagnosed with hand tumors between 1978 and 2020 were reviewed. Age at surgery, gender, chief complaint, tumor location, and pathological diagnosis were analyzed. Results: There were 121 benign bone tumors, 98 benign soft tissue tumors, and 16 malignant tumors. Chondroma and tenosynovial giant cell tumor were common benign bone and soft tissue tumors at the proximal phalanx of the ring finger and the palm, respectively. Meanwhile, chondrosarcoma and synovial sarcoma were common malignant tumors at the dorsal part of the hand. Local pain and painless mass were the chief complaints in patients with benign bone and soft tissue tumors, respectively. Most patients with malignant tumors were referred after unplanned resection. When patients were classified into two categories by tumor size according to maximal diameter, tumors larger than 19 mm had a significantly higher risk of malignant ( p = 0.031) despite being smaller than other tumors in different body parts. Conclusion: When a tumor malignancy is suspected, the patient should be referred to a specialist to avoid unplanned resection or delayed diagnosis due to misdiagnosis. Knowing the distribution and clinical features should help in diagnosing hand tumors.

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Anatomical work-up of an individual with multiple muscular variants on both forearms

Anatomical Science International ◽

10.1007/s12565-021-00621-y ◽

2021 ◽

Author(s):

Peter S. Hagedorn ◽

Bernhard Hirt ◽

Thomas Shiozawa ◽

Peter H. Neckel

Keyword(s):

Carpal Tunnel ◽

Proximal Phalanx ◽

Neurovascular Compression ◽

Male Body ◽

Muscle Belly ◽

Left Hand ◽

Palmaris Longus ◽

Palmar Aponeurosis ◽

The Right ◽

Work Up

AbstractMuscular variants of the forearm are common and frequently cause neurovascular compression syndromes, especially when interfering with the compact topography of the carpal tunnel or the Canalis ulnaris. Here, we report on a male body donor with multiple muscular normal variations on both forearms. The two main findings are (1) an accessory variant muscle (AVM) on the right forearm originating from the M. brachioradialis, the distal radius, and the M. flexor pollicis longus. It spanned the wrist beneath the Fascia antebrachia and inserted at the proximal phalanx of the digitus minimus. (2) Moreover, we found a three-headed palmaris longus variant on the left arm with proximal origin tendon and a distal, trifurcated muscle belly, with separated insertions at the palmar aponeurosis, the flexor retinaculum, and, in analogy to the accessory muscle on the contralateral arm, at the base of the proximal phalanx of the digitus minimus. We found a considerable thickening of the left-hand median nerve right before entering the carpal tunnel indicative of a possible chronic compression syndrome adding clinical relevance to this anatomical case. We also discuss the notion that both, the AVM and the contralateral three-headed palmaris variant are developmental descendants of the M. palmaris longus. Additionally, we found a previously not recorded variant of the M. palmaris brevis on the left hand.

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Results of tension band wiring in intra-articular collateral ligament avulsion fractures of the phalanx

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v6i2.19807 ◽

2018 ◽

Vol 6 (2) ◽

pp. 74-77

Author(s):

Rajeev Raj Manandhar ◽

Shishir Lakhey ◽

Umash Karki

Keyword(s):

Functional Outcome ◽

Soft Tissues ◽

Proximal Phalanx ◽

Ring Finger ◽

Ulnar Collateral Ligament ◽

Tension Band ◽

Tension Band Wiring ◽

Collateral Ligament ◽

Avulsion Fractures ◽

Radial Collateral Ligament

Background: Avulsion fractures of the base of proximal phalanx associated with ulnar or radial collateral ligament instability are relatively rare. The small size of the fragment and strong deforming pull of the attached soft tissues make the process of reduction and maintenance difficult.Objective: The purpose of this study was to assess the functional outcome of tension band wiring in intra-articular avulsion fractures of the base of the proximal phalanx.Methodology: A prospective study was performed on ten patients with intra-articular collateral ligament avulsion fractures of the proximal phalanx (Jupiter’s classification Type III). A tension band construct was performed using a dorsal approach. The functional outcome was assessed at six months with the quick Disability of Arm, Shoulder and Hand score.Results: The mean age of the patients was 25.8 years (Mean ± SD: 25.80). Six avulsion fractures were of the ulnar collateral ligament of the proximal phalanx of the index finger, one involved the radial collateral ligament of the ring finger and three, the radial collateral ligament of the little finger suggesting an abduction injury. All fractures had united at three months. Eight patients were graded as excellent and two as good. All patients were satisfied with the surgery and the functional outcome of the injured digit. There were no perioperative complications.Conclusion: The functional outcome of tension band wiring in intra-articular collateral ligament avulsion fractures of the base of the proximal phalanx was good to excellent.

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Giant Cell Tumour of Proximal Phalanx of Ring Finger: Case Report and Review of Literature

Cureus ◽

10.7759/cureus.835 ◽

2016 ◽

Cited By ~ 1

Author(s):

Rishit Soni ◽

Chirag Kapoor ◽

Malkesh Shah ◽

Amit Patel ◽

Paresh Golwala

Keyword(s):

Case Report ◽

Giant Cell ◽

Giant Cell Tumour ◽

Proximal Phalanx ◽

Ring Finger ◽

Cell Tumour ◽

Review Of Literature

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Bilateral anatomical variations of the hand extensors

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v15i2.19481 ◽

2016 ◽

Vol 15 (2) ◽

pp. 278-282

Author(s):

Humberto Ferreira Arquez

Keyword(s):

Anatomical Variation ◽

Medical Science ◽

Ring Finger ◽

Anatomical Variations ◽

Extensor Digitorum ◽

Left Hand ◽

Extensor Tendons ◽

Right Hand ◽

The Right ◽

Little Finger

Background: The purpose of this paper is to describe an anatomical variation of the hand extensor on the little finger of the right hand which receives four tendons, condition unknown, as it is the first case reported so far in the literature. The human extensor tendons of hand often display an array of variations. Awareness of the anatomy and variations of the extensor tendons on the dorsum of the hand is necessary not only for the anatomist but also for surgeons when considering tendons for hand surgery, tendon rerouting or transplants. Materials and Methods: Bilateral anatomical variation in the upper limb was found during routine dissection in a 75-year-old male cadaver in the Morphology Laboratory at the University of Pamplona. The variations were recorded and photographed. Result: In the left hand the extensor digitorum there was a single tendon to the index, double tendon to the middle, triple tendon to the ring finger, a single tendon to the little finger or digiti minimi. The extensor digiti minimi has double tendon. In the right hand the extensor digitorum there was a single tendon to the index, triple tendon to the middle finger, triple tendons to the ring finger, a double tendon to the little finger. The extensor digiti minimi has double tendon. The little finger receives four tendons, 2 of extensor digitorum and 2 of extensor digiti minimi. The dorsum of the left hand and right showed juncturae tendinum type 2, between the extensors tendons in the 3rd intermetacarpal space; type 3, between the extensors tendons in the 4th inter metacarpal space. Conclusion: The presence of multiple tendons may alter the kinematics around the site of attachment to the phalanx. Knowledge of anatomical variations and normal anatomy of the extensor tendons, may be helpful while performing graft and tendon transfer operations.Bangladesh Journal of Medical Science Vol.15(2) 2016 p.278-282

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Bilateral Opponens Replacement in Post Polio Thenar Paralysis, Using Different Techniques. A Case Report.

HAND ◽

10.1016/s0072-968x(83)80019-9 ◽

1983 ◽

Vol os-15 (2) ◽

pp. 221-222 ◽

Cited By ~ 1

Author(s):

J. G. Andersen ◽

J. W. Brandsma

Keyword(s):

Case Report ◽

Ring Finger ◽

Flexor Digitorum Superficialis ◽

Left Hand ◽

Right Hand ◽

Abductor Digiti Minimi ◽

The Right ◽

Flexor Digitorum

A patient is presented with bilateral thenar paralysis, due to poliomyelitis. On the right hand a successful abductor digiti minimi transfer was performed. On the left hand weakness of the hypothenar muscles prevented a good result. Subsequently an opponens replacement, using flexor digitorum superficialis from the ring finger, yielded a good result.

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The pitch of babies’ cries predicts their voice pitch at age 5

Biology Letters ◽

10.1098/rsbl.2018.0065 ◽

2018 ◽

Vol 14 (7) ◽

pp. 20180065 ◽

Cited By ~ 5

Author(s):

Florence Levrero ◽

Nicolas Mathevon ◽

Katarzyna Pisanski ◽

Erik Gustafsson ◽

David Reby

Keyword(s):

Longitudinal Study ◽

Individual Differences ◽

Fundamental Frequency ◽

Ring Finger ◽

Small Sample ◽

Voice Pitch ◽

Same Sex ◽

Before And After ◽

Longitudinal Study Design ◽

The Right

Voice pitch (fundamental frequency, F 0 ) is a key dimension of our voice that varies between sexes after puberty, and also among individuals of the same sex both before and after puberty. While a recent longitudinal study indicates that inter-individual differences in voice pitch remain stable in men during adulthood and may even be determined before puberty (Fouquet et al. 2016 R. Soc. open sci. 3 , 160395. ( doi:10.1098/rsos.160395 )), whether these differences emerge in infancy remains unknown. Here, using a longitudinal study design, we investigate the hypothesis that inter-individual differences in F 0 are already present in the cries of pre-verbal babies. While based on a small sample ( n = 15), our results indicate that the F 0 of babies' cries at 4 months of age may predict the F 0 of their speech utterances at 5 years of age, explaining 41% of the inter-individual variance in voice pitch at that age in our sample. We also found that the right-hand ratio of the length of their index to ring finger (2D : 4D digit ratio), which has been proposed to constitute an index of prenatal testosterone exposure, was positively correlated with F 0 at both 4 months and 5 years of age. These findings suggest that a substantial proportion of between-individual differences in voice pitch, which convey important biosocial information about speakers, may partly originate in utero and thus already be present soon after birth.

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A SWOLLEN MIDDLE FINGER IN A MIDDLE-AGED FARMER

Hand Surgery ◽

10.1142/s0218810412720112 ◽

2012 ◽

Vol 17 (01) ◽

pp. 121-123 ◽

Cited By ~ 1

Author(s):

Somprakas Basu ◽

Shilpi Bhadani ◽

Vijay Kumar Shukla

Keyword(s):

Proximal Phalanx ◽

Middle Finger ◽

Needle Aspiration ◽

Excision Biopsy ◽

Middle Aged ◽

Cytological Examination ◽

Diagnostic Dilemma ◽

X Ray ◽

The Right ◽

Bony Erosion

Hand tumors are not common and a swollen finger poses considerable diagnostic dilemma. We present a case of a middle-aged farmer who had presented with a painless swelling of the middle finger of the right hand without any neurovascular deficit or evidence of metastasis. An X-ray of the finger showed cortical expansion and bony erosion of the proximal phalanx. A fine needle aspiration cytological examination was inconclusive. He underwent a digit amputation in view of subsequent morbidity and chances of recurrence following local excision. Biopsy proved it to be a giant cell tumor of the proximal phalanx. Following six months of treatment he is doing well. We herein highlight an unusual tumor of the finger and its diagnostic and treatment challenges.

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Assessment of Radiation Protection in Hand-Shielding Products With Mini C-Arm Fluoroscopy

Hand ◽

10.1177/1558944719865937 ◽

2019 ◽

pp. 155894471986593 ◽

Cited By ~ 1

Author(s):

Matthew B. Cantlon ◽

Asif M. Ilyas

Keyword(s):

Radiation Exposure ◽

Index Finger ◽

Proximal Phalanx ◽

Left Index Finger ◽

Surgical Glove ◽

Thermoluminescent Dosimeters ◽

Intraoperative Fluoroscopy ◽

The Mean ◽

The Right ◽

Free Metal

Background: Previous studies have highlighted the particular risk of radiation exposure to the surgeon’s hands with intraoperative fluoroscopy. Although evidence exists that shielding equipment for the hands reduces exposure, the extent of protection is not well understood. Therefore, we set out to determine the degree to which radiation exposure to the surgeon’s hands is decreased with hand-shielding products. Methods: An anthropomorphic model was positioned to simulate a surgeon sitting at a hand table. Thermoluminescent dosimeters were placed on the proximal phalanx of each index finger. The right index finger dosimeter was covered with a standard polyisoprene surgical glove (control arm), whereas the left index finger dosimeter was covered with commercially available hand-shielding products (study arm): lead-free metal-oxide gloves, leaded gloves, and radiation-attenuating cream. Mini fluoroscope position, configuration, and settings were standardized. The model was scanned for 15 continuous minutes in each test run, and each comparative arm was run 3 times. Results: The mean radiation dose absorbed by the control and variable dosimeters across all tests was 44.8 mrem (range, 30-54) and 18.6 mrem (range, 14-26), respectively. Each hand-shielding product resulted in statistically lower radiation exposure than a single polyisoprene surgical glove. Conclusions: The mean radiation exposure to the hands was significantly decreased when protected by radiation-attenuating options. Each product individually resulted in a statistically significant decrease in hand exposure compared with the control. We recommend that in addition to efforts to decrease radiation exposure, surgeons consider routine use of hand-shielding products when using mini c-arm fluoroscopy.

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