Arthrodesis of Ring Finger and Little Finger Metacarpal Bases for Little Finger Carpometacarpal Joint Arthritis

2004 ◽  
Vol 29 (5) ◽  
pp. 449-452 ◽  
Author(s):  
GREGORY I. BAIN ◽  
P.M. RAGHAVAN UNNI ◽  
JANAK A. MEHTA ◽  
MICHAEL H.A. EAMES
Keyword(s):  
Pain Relief ◽  
Daily Living ◽  
Ring Finger ◽  
Carpometacarpal Joint ◽  
Interposition Arthroplasty ◽  
Finger Length ◽  
Capsular Flap ◽  
Good Cosmesis ◽  
Joint Arthritis ◽  
Little Finger

Five patients with localized little finger carpometacarpal arthritis were treated by excision of the little finger metacarpal base and arthrodesis of the little and ring metacarpals. A dorsal periosteal/capsular flap was used as an interposition graft. All patients achieved significant pain relief, good cosmesis and satisfactory grip strength. All returned to activities of daily living. This procedure, the Dubert procedure, is indicated for localized pathology of the hamate-little finger metacarpal joint. It has theoretical advantages over arthrodesis and resection or interposition arthroplasty as it preserves little finger length, rotation and alignment and maintains some mobility of the transverse carpal arch and the little finger ray.

MEDIUM-TERM OUTCOME FOLLOWING INTRA-ARTICULAR CORTICOSTEROID INJECTION IN FIRST CMC JOINT ARTHRITIS USING FLUOROSCOPY

Hand Surgery ◽  
2009 ◽  
Vol 14 (02n03) ◽  
pp. 99-104 ◽  
Author(s):  
Wies Maarse ◽  
Adam C. Watts ◽  
Gregory I. Bain
Keyword(s):  
Pain Relief ◽  
Surgical Intervention ◽  
Corticosteroid Injection ◽  
Carpometacarpal Joint ◽  
Medium Term ◽  
Short Term ◽  
Term Outcome ◽  
Joint Arthritis ◽  
Local Corticosteroid Injection

First carpometacarpal joint osteoarthritis (1st CMCJ OA) is a common condition with variable results reported from local corticosteroid injection. This study aims to explore the medium-term outcome with respect to pain relief, patient satisfaction and the need for subsequent surgical intervention. A prospective review was performed of patients undergoing fluoroscopically guided corticosteroid injection by one surgeon, with postal questionnaires for medium-term follow-up. Forty-one patients were included. Thirty-one were female and ten male, with a mean age of 60 years. In the short term 76% of patients reported pain relief with an average duration of four weeks and 69% of the patients reported benefit from injection. After a median follow-up of 36 months 76% of patients reported continuing pain but 59% reported satisfaction with the outcome. Twenty-eight per cent of the patients had undergone surgery. Local corticosteroid injection of the CMCJ provides only short-term pain relief, but few patients go on to surgical intervention.

INTERPOSITION ARTHROPLASTY FOR OSTEOARTHRITIS OF TRAPEZIO METACARPAL JOINT: RESULTS OF A MODIFIED INCISION AND TECHNIQUE OF INTERPOSING WITH EARLY MOBILISATION

Hand Surgery ◽  
2002 ◽  
Vol 07 (02) ◽  
pp. 201-206 ◽  
Author(s):  
M. Maqsood ◽  
N. R. Chenthil Kumar ◽  
B. S. W. Noorpuri
Keyword(s):  
Daily Living ◽  
Reflex Sympathetic Dystrophy ◽  
Early Mobilisation ◽  
Interposition Arthroplasty ◽  
Power Grip ◽  
Pinch Grip ◽  
Superficial Branch ◽  
Tendon Interposition ◽  
Little Finger

Sixty flexor carpi radialis (FCR) tendon interposition arthroplasties were done using a modified incision from Froimson's approach for osteoarthritis (OA) of thumb carpo metacarpal joint (CMCJ) The tendon was made to resemble an anchovy fillet to preserve pillar length (average 7.5 mm). There was no incidence of injury to the superficial branch of the radial nerve. Graded mobilisation was commenced at two weeks. Our average follow-up for five and a half years shows good results, viz. pain relief (100%), power grip (21 kg), pinch grip (4.2 kg), tripod grip (5.5 kg), key grip (6.5 kg), ability to touch base and tip of little finger (91.6%) and (96.6%), respectively. Activities of daily living (ADL) without pain in turning a key (96.7%), opening jar top (100%), bottle top (93.4%), wringing cloth (86.7%), and using scissors (88.4%). None of them suffered reflex sympathetic dystrophy (RSD) and mobility was almost equal to the non-operated hand. Our experience with this modified incision and technique of interposing with early mobilisation has shown good functional outcome with no significant operative or postoperative complications.

Critical Angles of Deformity in Dupuytren’s Contracture of the Little and Ring Fingers

Hand Surgery ◽  
2015 ◽  
Vol 20 (02) ◽  
pp. 290-297 ◽  
Author(s):  
Antony Raymond ◽  
Michael Parry ◽  
Rouin Amirfeyz
Keyword(s):  
Daily Living ◽  
Operating Characteristic ◽  
Assessment Tool ◽  
Hand Function ◽  
Ring Finger ◽  
Flexion Deformity ◽  
Receiver Operating Characteristic Curves ◽  
Hand Disability ◽  
Healthy Participants ◽  
Little Finger

Background: We aimed to determine the degree of contracture in the ring and little fingers at which hand function became importantly impaired. Methods: Five activities of daily living were incorporated into a newly developed and validated Dupuytren’s assessment tool (DAT). Sixty healthy participants were assessed with the DAT wearing a range of 12 dorsal blocking splints. Half wore them on their right little finger, the other half on their ring finger. These induced flexion deformities mimicking DC of the MCPJ, PIPJ and a combination of the two. The angles of flexion deformity at which important hand disability occurred were calculated using receiver operating characteristic curves. Results: Clinically important hand disability occurred for the little finger MCPJ, PIPJ and combined MCPJ and PIPJ angulation at 52.5, 67.5, and 75 degrees respectively. For the ring finger joint, the angulations were 52.5, 67.5 and 75 degrees respectively. Conclusions: This information will provide information for clinicians and patients as to when clinically important disability tends to occur in DC.

Is It Possible to Perform Fifth Carpometacarpal Joint Arthroscopy? Cadaveric Study on Its Feasibility, Safety, and Potential Hazards in Portal Creation

2022 ◽  
Author(s):  
Siu Cheong Jeffrey Justin Koo ◽  
Henry Pang ◽  
Pak Cheong Ho
Keyword(s):  
Spatial Relationship ◽  
Ring Finger ◽  
Fracture Dislocation ◽  
Joint Surface ◽  
Carpometacarpal Joint ◽  
Level Of Evidence ◽  
Rare Injury ◽  
Anatomical Dissection ◽  
Body Fracture ◽  
Little Finger

Abstract Background Fifth carpometacarpal joint (CMCJ) fracture dislocation is a relatively rare injury and most will require operative treatment because of its unstable nature. Improper reduction and fixation lead to joint surface destruction, pain, and reduced grasping power. Intra-articular fragment reduction is often obscured by dorsally displaced ulnar fragment. Therefore, fifth CMCJ arthroscopy can be advantageous in assisting intra-articular fragment reduction. However, there is no detailed description of the portal landmarks or portals' relationship with adjacent important structures in the literature. Purposes To explore the feasibility and safety of fifth CMCJ arthroscopy, locations of the portals are examined in cadaveric hand specimens. Their proximity to important anatomical structures such as dorsal cutaneous branch of ulnar nerve (DCBUN), ring finger and little finger extensor digitorum communis (EDC), and extensor digiti minimi (EDM) is measured. Methods Fifth CMCJ arthroscopy is performed on 11 cadaveric hand specimens by specialist-level surgeon. The portals are marked and portal positions are further confirmed under the fluoroscopy. Then the cadaveric specimens were undergone anatomical dissection by specialist-level surgeon. During dissection, the spatial relationship between the portal positions and DCBUN, EDC to ring finger and little finger, and EDM is identified. The distance between the portals and the above important structures was measured in millimeters. Results DCBUN was consistently found between fourth metacarpohamate (4-MH) and fifth metacarpohamate (5-MH) portals, with it being closer to the latter (mean distance, 2.03 mm; range, 0–4.43 mm; standard deviation [SD], 1.09 mm). The closest tendon for 4-MH portal is ring finger EDC (mean distance, 2.65 mm; range, 0–5.89 mm; SD, 1.78 mm), while 5-MH portal and accessory portal were closest to EDC (mean distance, 1.88 mm; range, 0–3.69 mm; SD, 1.25 mm) and EDM (mean distance, 7.79 mm; range, 6.63–10.72 mm; SD, 1.49 mm), respectively. During the process of specimen dissection, we found no damage to the above structures after portal introduction. Conclusion The above findings support the use of fifth CMCJ arthroscopy, which can be used for assisted reduction in fifth metacarpal base fracture dislocation and hamate body fracture. Gentle soft tissue spreading technique during portal creation prevents injury to the important structure surrounding the portals. Level of evidence This is a Level V study.

An Isolated Ring Finger Metacarpal Shaft Fracture? – Beware An Associated Little Finger Carpometacarpal Joint Dislocation

2004 ◽  
Vol 29 (6) ◽  
pp. 629-631 ◽  
Author(s):  
ALPHONSUS K. S. CHONG ◽  
WINSTON Y. C. CHEW
Keyword(s):  
Ring Finger ◽  
Shaft Fracture ◽  
Metacarpal Fracture ◽  
Carpometacarpal Joint ◽  
Joint Injury ◽  
Joint Dislocation ◽  
Radiological Features ◽  
Metacarpal Shaft ◽  
Joint Dislocations ◽  
Little Finger

Dislocations of the ulnar carpometacarpal joint are easily missed because of a low index of suspicion as well as their subtle clinical and radiological features. Often, the presence of a more obvious adjacent injury also draws attention away from the carpometacarpal joint. Two cases of ring finger metacarpal shaft fractures with associated little finger carpometacarpal joint dislocations are presented. In both cases, the metacarpal fractures were diagnosed but the carpometacarpal joint dislocations were initially overlooked. The presence of an apparently isolated ring finger metacarpal fracture due to an indirect force should raise the possibility of an associated carpometacarpal joint injury.

ARTHROSCOPIC INTERPOSITION ARTHROPLASTY OF THE FIRST CARPOMETACARPAL JOINT

2007 ◽  
Vol 32 (3) ◽  
pp. 268-274 ◽  
Author(s):  
J. E. ADAMS ◽  
S. M. MERTEN ◽  
S. P. STEINMANN
Keyword(s):  
Symptomatic Relief ◽  
Operative Therapy ◽  
Surgical Approaches ◽  
Pinch Strength ◽  
Arthroscopic Debridement ◽  
Carpometacarpal Joint ◽  
Interposition Arthroplasty ◽  
Dermal Matrix ◽  
First Carpometacarpal Joint ◽  
Joint Arthritis

First carpometacarpal joint arthritis is a common condition encountered by hand surgeons. Traditionally, surgical approaches have included arthrodesis, trapeziectomy or reconstructive arthroplasty techniques. Previously, we described a technique for arthroscopic debridement and interposition arthroplasty of the first carpometacarpal joint. Patients with Eaton stages II and III symptomatic first carpometacarpal joint arthritis recalcitrant to >6 months of non-operative therapy underwent arthroscopic debridement of the first carpometacarpal joint with interposition of an acellular dermal matrix allograft (GRAFTJACKET™). In this paper, we describe outcomes following this procedure. Postoperatively, all patients reported symptomatic relief and 94% stated that they were partially, or completely, satisfied. More than 70% of patients reported no to mild difficulty in performing activities of daily living (average grip strength = 18.5 kg, pinch strength = 3.9 kg). Complications were minimal. Outcomes from this study compare favourably to those of other series, demonstrating that this technique is a viable option for treatment of Eaton stages II and III first carpometacarpal arthritis.

scholarly journals Sex determination from hand dimensions and index/ring finger length ratio in North Saudi population: Medico-legal view

2016 ◽  
Vol 6 (4) ◽  
pp. 435-444 ◽  
Author(s):  
Mahrous AbdelBasset Ibrahim ◽  
Athar Mohamed Khalifa ◽  
Abeer Mohamed Hagras ◽  
Naif Ibrahim Alwakid
Keyword(s):  
Sex Determination ◽  
Ring Finger ◽  
Length Ratio ◽  
Saudi Population ◽  
Finger Length ◽  
Finger Length Ratio

scholarly journals Estimation of the Abduction/Adduction Movement of the Metacarpophalangeal Joint of the Thumb

2021 ◽  
Vol 11 (7) ◽  
pp. 3158
Author(s):  
Néstor J. Jarque-Bou ◽  
Margarita Vergara ◽  
Joaquín L. Sancho-Bru
Keyword(s):  
3D Modeling ◽  
Daily Living ◽  
Degrees Of Freedom ◽  
Estimation Error ◽  
Metacarpophalangeal Joint ◽  
Joint Movement ◽  
Carpometacarpal Joint ◽  
Small Space ◽  
Joint Motions

Thumb opposition is essential for grasping, and involves the flexion and abduction of the carpometacarpal and metacarpophalangeal joints of the thumb. The high number of degrees of freedom of the thumb in a fairly small space makes the in vivo recording of its kinematics a challenging task. For this reason, along with the very limited independence of the abduction movement of the metacarpophalangeal joint, many devices do not implement sensors to measure such movement, which may lead to important implications in terms of the accuracy of thumb models. The aims of this work are to examine the correlation between thumb joints and to obtain an equation that allows thumb metacarpophalangeal abduction/adduction movement to be estimated from the other joint motions of the thumb, during the commonest grasps used during activities of daily living and in free movement. The correlation analysis shows that metacarpophalangeal abduction/adduction movement can be expressed mainly from carpometacarpal joint movements. The model thus obtained presents a low estimation error (6.29°), with no significant differences between grasps. The results could benefit most fields that do not typically include this joint movement, such as virtual reality, teleoperation, 3D modeling, prostheses, and exoskeletons.

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