Metacarpophalangeal Joint Arthroplasty Based on the Osseointegration Concept

1993 ◽  
Vol 18 (6) ◽  
pp. 693-703 ◽  
Author(s):  
G. LUNDBORG ◽  
P.-I. BRÅNEMARK ◽  
I. CARLSSON
Keyword(s):  
Range Of Motion ◽  
Hand Function ◽  
Clinical Signs ◽  
Hand Surgery ◽  
Metacarpophalangeal Joint ◽  
Active Range Of Motion ◽  
Good Cosmetic ◽  
Primary Osteoarthrosis ◽  
Post Traumatic

The osseointegration concept has been used for fixation of 68 MP joint endoprostheses in 31 patients operated on at the Department of Hand Surgery, Malmö General Hospital during the period 1988–1992. The indications were rheumatoid arthritis (50 joints), primary osteoarthrosis (three joints), post-traumatic osteoarthrosis (three joints), post-traumatic osteoarthrosis (five joints), post-infectious osteoarthrosis (seven joints) and joint deformities secondary to spastic conditions (three joints). The average follow-up time was 2.5 years (6–54 months). The surgical procedure included resection of the joint followed by introduction of screw-shaped titanium fixtures into the bone marrow cavities of the metacarpal and the phalangeal base. Rheumatoid cases usually required grafting of cancellous bone and marrow from the iliac crest. At the same time a flexible constrained silicone spacer was connected to the titanium fixtures in such a way as to allow later replacement of the spacer if accessory. The average active range of motion (ROM) was 57° in the rheumatoid cases and 50° in all cases. Radiological and clinical osseointegration occurred in every case, and there were no clinical signs of loosening. In four cases (6%) there was a fracture of the joint mechanism. Patient satisfaction was high, with pain relief, increased range of motion, improved hand function and good cosmetic appearance.

Arthroplasty of the Proximal Interphalangeal Joint Using the Sutter Implant for Traumatic Joint Destruction

1999 ◽  
Vol 24 (5) ◽  
pp. 565-569 ◽  
Author(s):  
C. MATHOULIN ◽  
A. GILBERT
Keyword(s):  
Range Of Motion ◽  
Joint Destruction ◽  
Functional Results ◽  
Proximal Interphalangeal Joint ◽  
Dorsal Approach ◽  
Active Range Of Motion ◽  
Post Traumatic ◽  
Traumatic Arthritis ◽  
Better Than

We report the functional results in a series of 21 Sutter arthroplasties for post-traumatic arthritis with an average follow-up of more than 2 years. The dorsal approach was used in every case. Pain was always present preoperatively and mobility was reduced to an average range of motion of 15°. Postoperatively, pain was absent in 18 cases. The average active range of motion was 55°. There were two fractures of implants. Although the follow-up is limited, the Sutter arthroplasty has given results that are similar to, or better than, those reported for other techniques.

Chronic Post-Traumatic Radial Instability of the Metacarpophalangeal Joint of the Finger

1998 ◽  
Vol 23 (4) ◽  
pp. 503-506 ◽  
Author(s):  
S. RIEDERER ◽  
L. NAGY ◽  
U. BÜCHLER
Keyword(s):  
Retrospective Study ◽  
Range Of Motion ◽  
Metacarpophalangeal Joint ◽  
Tendon Graft ◽  
Degenerative Changes ◽  
Normal Range ◽  
Collateral Ligament ◽  
Post Traumatic ◽  
Graft Reconstruction

Chronic painful post-traumatic instability of the radial collateral ligament complex of the metacarpophalangeal joint of a finger was treated by tendon graft reconstruction in 24 patients. Seventeen patients (20 joints) were available for a retrospective study at a mean follow-up time of 105 months. Eighty percent of the joints showed excellent or good results, with relief of pain, return of adequate stability, a near normal range of motion and absence of degenerative changes.

Surgical Correction of Extensor Tendon Subluxation and Ulnar Drift in the Rheumatoid Hand: Long-Term Results

2001 ◽  
Vol 26 (6) ◽  
pp. 560-564 ◽  
Author(s):  
P. C. DELL ◽  
K. J. RENFREE ◽  
R. BELOW DELL
Keyword(s):  
Range Of Motion ◽  
Extensor Tendon ◽  
Metacarpophalangeal Joint ◽  
Long Term Results ◽  
Complication Rates ◽  
Active Range Of Motion ◽  
Distally Based ◽  
Extensor Lag

Subluxation of the extensor digitorum communis tendons in the rheumatoid hand causes ulnar digital drift. If passively correctable, the digit may be realigned by soft tissue rebalancing and extensor centralization, which may preserve a more functional arc of motion than achieved with arthroplasty. A total of 71 centralization procedures were done in 15 rheumatoid patients with a mean age of 55 years and an average follow-up of 9 years. A distally based central-third strip of extensor tendon was used. Correction of ulnar drift deformity was from an average of 47° preoperatively to 7.9° postoperatively, and correction of active range of motion of the metacarpophalangeal joints was from an average of 38° to 56.2°. Reoperation and complication rates were low. This technique corrects and maintains ulnar drift in the rheumatoid hand. Range of motion at the metacarpophalangeal joint level is improved and converted to a more functional one by decreasing the extensor lag.

THE RECALL DASH SCORE — A NOVEL RESEARCH TOOL

Hand Surgery ◽  
2013 ◽  
Vol 18 (01) ◽  
pp. 11-14 ◽  
Author(s):  
Nicholas Reynolds ◽  
Sunil Thirkannad
Keyword(s):  
Statistical Analysis ◽  
Patient Population ◽  
Hand Function ◽  
Hand Surgery ◽  
Clinic Visit ◽  
Research Tool ◽  
Time Interval ◽  
Dash Score ◽  
Pre Treatment

The DASH score is a universally accepted method for assessment of hand function. However, there are occasions when a pre-treatment DASH score is unavailable. This study provides a solution to this situation. An initial DASH score was obtained from all patients at the time of their first clinic visit. A second score was obtained at the time of final follow-up asking the patient to "Recall" their pre-treatment status. The two scores were compared with appropriate statistical analysis. Thirty-eight patients were included in the study and scores were obtained at an average time interval of 32 weeks (6–121 weeks). Excellent agreement was noted for the ability of the patient population to recall their scores with a group correlation of 0.86. This proves that the Recall DASH score is an excellent and useful research tool for use in hand surgery.

Biceps-to-Triceps Transfer in Tetraplegia

1999 ◽  
Vol 24 (2) ◽  
pp. 235-237 ◽  
Author(s):  
M. REVOL ◽  
E. BRIAND ◽  
J. M. SERVANT
Keyword(s):  
Range Of Motion ◽  
Nerve Injury ◽  
Radial Nerve ◽  
Elbow Flexion ◽  
Active Range Of Motion ◽  
The Mean ◽  
Radial Nerve Injury

Eight tetraplegic patients (13 elbows) were treated by biceps-to-triceps transfer. To avoid the risk of radial nerve injury, we chose a medial routing of the biceps. The mean follow-up after surgery was 17.8 months (range, 4–47 months). No complications were encountered. Active extension of the elbow was achieved in each case. The mean postoperative active range of motion of the elbow was 6° extension and 137° flexion. After the biceps-to-triceps transfer mean extension torque of the elbow was 3.7 Nm and mean flexion torque was 10 Nm. In eight elbows in which it was measured, there was a 47% reduction in elbow flexion power. Nevertheless no patient complained about that reduction, and all of them were satisfied.

LONG TERM FOLLOW-UP AFTER FINGER REPLANTATION

2008 ◽  
Vol 33 (1) ◽  
pp. 59-64 ◽  
Author(s):  
I. WALASZEK ◽  
A. ZYLUK
Keyword(s):  
Blood Flow ◽  
Range Of Motion ◽  
Grip Strength ◽  
Long Term Results ◽  
Functional Score ◽  
Pinch Grip ◽  
Active Range Of Motion ◽  
Long Term Follow Up

The aim of this retrospective study was to assess objective and subjective aspects of the long-term results of finger replantations and revascularisations. Forty patients with 59 successfully replanted or revascularised fingers, who had a mean age of 38 years, were followed-up over an average of 3.5 years. The assessment included: the profile of the blood flow in the digital arteries of replanted fingers with Doppler ultrasound, active range of motion, total grip strength, pinch grip, static two-point discrimination test and Semmes–Weinstein monofilament testing. The dexterity of the hand was evaluated subjectively with the Carlsson’s questionnaire and cold intolerance with a modified McCabe’s questionnaire. Statistical analysis was performed and a statistically significant correlation was found between the Carlsson’s functional score, active range of motion and total grip strength. In 28 fingers (74%), blood flow in the digital arteries showed an undisturbed profile, while ten fingers showed mild stenosis or impaired microcirculation.

Surgical Treatment of Congenital Metacarpal Synostosis of the Ring and Little Fingers

1998 ◽  
Vol 23 (5) ◽  
pp. 691-694 ◽  
Author(s):  
E. HORII ◽  
T. MIURA ◽  
R. NAKAMURA ◽  
E. NAKAO ◽  
H. KATO
Keyword(s):  
Surgical Treatment ◽  
Range Of Motion ◽  
Average Length ◽  
Metacarpophalangeal Joint ◽  
Block Method ◽  
Active Flexion ◽  
Distraction Device ◽  
Little Finger

Fifteen hands with congenital metacarpal fusions were treated operatively by osteotomy combined either with the use of a silicone block or a distraction device. The aim of the silicone block was to separate the fused metacarpals, but it was buried in the metacarpals at follow-up, with recurrence of fusion. By the distraction technique, 13 mm of lengthening was obtained. The average length of the little metacarpal was 88% of that of the long finger metacarpal. Both methods were effective in correcting the abduction deformity of the little finger by a mean of 34°, and increasing the range of motion of the metacarpophalangeal joint to 28° of active flexion. Although the distraction method took longer than the silicone block method, the final appearance of the hand was better.

TWO TO FIVE YEAR FOLLOW-UP OF THE LPM CERAMIC COATED PROXIMAL INTERPHALANGEAL JOINT ARTHROPLASTY

2008 ◽  
Vol 33 (1) ◽  
pp. 38-44 ◽  
Author(s):  
J. FIELD
Keyword(s):  
Clinical Signs ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Pip Joint ◽  
Joint Implants ◽  
Post Traumatic ◽  
Joint Arthroplasties ◽  
Traumatic Arthritis

This paper presents a retrospective series of 20 LPM semi-constrained ceramic coated cobalt chrome proximal interphalangeal joint arthroplasties performed consecutively in 12 patients for arthritis of the proximal interphalangeal joint by a single surgeon between 2000 and 2004. Eleven were performed for osteoarthritis, four for post-traumatic arthritis and five for rheumatoid arthritis. Although 12 joints had an improvement in pain and an increased functional arc of movement, six joints required revision surgery for implant failure at an average of 19 months, with clinical signs of increasing pain, deteriorating motion and radiological signs of implant loosening and subsidence. This rate of revision is higher than in published series for other PIP joint implants and, therefore, close surveillance of all patients with this prosthesis currently in situ is recommended. Use of the prosthesis has ceased in this unit.

Delayed Single Kirschner Wire Compression Technique for Mallet Fracture

2005 ◽  
Vol 30 (2) ◽  
pp. 180-184 ◽  
Author(s):  
D. FRITZ ◽  
M. LUTZ ◽  
R. ARORA ◽  
M. GABL ◽  
M. WAMBACHER ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Articular Surface ◽  
Kirschner Wire ◽  
Compression Technique ◽  
Active Range Of Motion ◽  
Mallet Fracture ◽  
Strenuous Work ◽  
Distal Interphalangeal ◽  
The Mean

Twenty-four mallet fractures which involved at least one third % of the articular surface of the distal interphalangeal joint were treated by open reduction and internal fixation using a single double-ended Kirschner wire at a mean of 9 days after injury (range 4–15). At a mean follow-up of 43 (range 12–18) months the active range of motion, pain and the Warren and Norris criteria were evaluated. The mean active range of motion was from −2° extension (range 0–10°) to 72° flexion (range 50–90°). Nineteen patients were pain free and five suffered from mild pain during strenuous work. The Warren and Norris results were successful in 22 and improved in two cases. Radiographs showed, that all the fractures united in a near-anatomic position but with joint narrowing in six digits.

scholarly journals Diagnosis and Surgical Treatment of Idiopathic Primary Sino-Nasal Obstruction in Miniature Horse Breeds: Long-Term Follow-Up of Seven Cases

2021 ◽  
Vol 8 ◽  
Author(s):  
Lieven Vlaminck ◽  
Elke Pollaris ◽  
Katrien Vanderperren ◽  
W. Henry Tremaine ◽  
Els Raes
Keyword(s):  
Surgical Treatment ◽  
Nasal Obstruction ◽  
Clinical Signs ◽  
Nasal Discharge ◽  
Cosmetic Appearance ◽  
Median Period ◽  
Long Term Follow Up ◽  
Good Cosmetic

Idiopathic sino-nasal obstruction resulting in retention of large amounts of liquid in the paranasal sinus compartments was diagnosed in seven young (2. 2 ± 0.7 years) miniature-breed horses based on clinical, endoscopic, radiographic, and CT scan examinations. The most prevalent clinical signs included decreased or no airflow from the nostril(s) (7/7) and nasal discharge (6/7). The problem presented bilaterally in six of seven cases. An alternative sino-nasal communication was created through bone flap osteotomy surgery and perforation of the ventromedial floor of the dorsal conchae in all cases, followed by fixation of silicone irrigation tubes/Foley catheters in six of seven cases to keep the newly created ostium patent. This resulted in long-term resolution of the problem with good cosmetic appearance in all animals following a median period of 19 months. Premature loss of fixed tubes was reported in three cases.

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