Extensor Indicis Opposition Transfer in The Ulnar and Median Palsied Thumb in Leprosy

Twenty seven opponensplasties for ulnar and median paralysis in 25 leprosy patients were performed using extensor indicis proprius. An additional transfer of the radial half of flexor pollicis longus to extensor pollicis longus was done to stabilize the metacarpophalangeal joint of the thumb. The biomechanical aspects of extensor indicis proprius tendon transfer were studied and results evaluated using various anatomical and functional parameters. Extensor indicis proprius provides adequate strength to position the thumb. However, sometimes it does not reach its new insertion. There is no significant deficit at the donor site but in a few cases the index finger may lose its capability for independent extension and sometimes a proximal interphalangeal joint contracture may develop.

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Pollicization of the index finger requiring secondary fusion of the new metacarpophalangeal joint

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193415587242 ◽

2015 ◽

Vol 41 (3) ◽

pp. 295-300 ◽

Cited By ~ 3

Author(s):

M. M. Al-Qattan

Keyword(s):

Index Finger ◽

Case Series ◽

Metacarpophalangeal Joint ◽

Flexion Contracture ◽

Proximal Interphalangeal Joint ◽

Interphalangeal Joint ◽

Long Term Study ◽

Current Series ◽

Early Functional Outcome

In children with absent thumbs, some authors have stated that ‘relative’ contraindications of pollicization include severe fixed flexion contracture and instability of the proximal interphalangeal joint of the index finger. The current author does not consider severe proximal interphalangeal joint deformities of the index finger as a contraindication to pollicization; and hence these children are offered the procedure. A literature review did not reveal any study that specifically documents the outcome of pollicization in these cases. The current series included five children: four with severe (over 80°) fixed flexion contracture of the proximal interphalangeal joint of the index finger and one with instability of the proximal interphalangeal joint. All children were initially assessed during infancy at their local hospitals and the parents were informed that a pollicization procedure would yield a poor outcome. Presentation to the author was relatively late at a mean of 9.3 years (range 2.5–12). All children underwent two surgical procedures: a pollicization followed by fusion of the new metacarpophalangeal joint. The overall early functional outcome was good and all children/parents were satisfied with the procedure. These encouraging results warrant a prospective long term study on various conditions that are considered as ‘relative’ contraindications to the pollicization procedure. Level evidence: IV Therapeutic (case series)

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Arthroplasty in the hand: what works and what doesn’t?

Journal of Hand Surgery (European Volume) ◽

10.1177/17531934211017703 ◽

2021 ◽

pp. 175319342110177

Author(s):

Daniel B. Herren ◽

Hajime Ishikawa ◽

Marco Rizzo ◽

Mark Ross ◽

Michael Solomons

Keyword(s):

Surgical Technique ◽

Metacarpophalangeal Joint ◽

Distal Radioulnar Joint ◽

Proximal Interphalangeal Joint ◽

Interphalangeal Joint ◽

Carpometacarpal Joint ◽

Thumb Carpometacarpal Joint ◽

Radioulnar Joint ◽

What Works ◽

Thumb Carpometacarpal

This review describes the different possibilities for arthroplasties at the proximal interphalangeal joint, thumb carpometacarpal joint, distal radioulnar joint, metacarpophalangeal joint and the wrist. For each joint, the indication for arthroplasty is explained, the surgical technique with the suitable implant is described and a brief summary of the outcomes reported in the literature is given.

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LINBURG-COMSTOCK PHENOMENON FOLLOWING FOREARM LACERATION

Hand Surgery ◽

10.1142/s0218810412720203 ◽

2012 ◽

Vol 17 (02) ◽

pp. 221-224 ◽

Cited By ~ 6

Author(s):

B. Lin ◽

S. Sreedharan ◽

Andrew Y. H. Chin

Keyword(s):

Index Finger ◽

Interphalangeal Joint ◽

Penetrating Injury ◽

Flexor Digitorum Profundus ◽

Flexor Pollicis Longus ◽

Distal Interphalangeal Joint ◽

Distal Interphalangeal ◽

The Right ◽

Flexor Digitorum ◽

Wide Awake

A 20-year-old man presented with an inability to flex the interphalangeal joint of the right thumb without simultaneous flexion of the distal interphalangeal joint of the index finger following a penetrating injury to the right forearm. With a clinical suspicion of intertendinous adhesions between the flexor pollicis longus and the flexor digitorum profundus to the index finger, surgical exploration under wide-awake anesthesia was performed. Intraoperatively, the intertendinous adhesions were identified and divided completely. Postoperatively, the patient achieved good, independent flexion of the interphalangeal joint of the thumb. This case demonstrates a clinical picture similar to that of Linburg-Comstock syndrome, which occurred following a forearm penetrating injury. We call this the Linburg-Comstock (LC) phenomenon.

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The Second Dorsal Metacarpal Artery Neurovascular Island Flap

Journal of Hand Surgery (European Volume) ◽

10.1016/0266-7681_89_90162-9 ◽

1989 ◽

Vol 14 (4) ◽

pp. 434-440

Author(s):

M. J. EARLEY

Keyword(s):

Donor Site ◽

Proximal Interphalangeal Joint ◽

Interphalangeal Joint ◽

Island Flap ◽

Arterial Supply ◽

Flap Necrosis ◽

Local Skin ◽

Skin Defects ◽

Dorsal Metacarpal Artery

Eleven patients have had second dorsal metacarpal sensate island flaps used to cover local skin defects in the hand. The arterial supply is reliable but if the flap is extended beyond the proximal interphalangeal joint, distal flap necrosis or donor site difficulties may occur. Possible applications for this flap are demonstrated and some untried variations to increase its range are suggested. Its main use appears to be in the release of first web contractures and for resurfacing radio-palmar and thumb defects.

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Arthroplasty of the proximal interphalangeal joint with the Tactys® modular prosthesis: Results in case of index finger and clinodactyly

Hand Surgery and Rehabilitation ◽

10.1016/j.hansur.2019.03.001 ◽

2019 ◽

Vol 38 (3) ◽

pp. 179-185

Author(s):

A. Griffart ◽

H. Agneray ◽

T. Loubersac ◽

E. Gaisne ◽

P. Bellemère

Keyword(s):

Index Finger ◽

Proximal Interphalangeal Joint ◽

Interphalangeal Joint ◽

Modular Prosthesis

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Immediate Free Vascularized Joint Transfer from Second Toe to Index Finger Proximal Interphalangeal Joint: A Case Report

Journal of Hand Surgery (European Volume) ◽

10.1016/s0266-7681(85)80026-7 ◽

1985 ◽

Vol 10 (1) ◽

pp. 85-89 ◽

Cited By ~ 8

Author(s):

T. M. TSAI ◽

R. SINGER ◽

E. ELLIOTT ◽

H. KLEIN

Keyword(s):

Index Finger ◽

Extensor Tendon ◽

Proximal Interphalangeal Joint ◽

Interphalangeal Joint ◽

Severe Injuries ◽

Immediate Reconstruction ◽

Joint Reconstruction ◽

Results Of Treatment ◽

Second Toe

The results of treatment of severe injuries to the proximal interphalangeal joint are unsatisfactory. The methods of joint reconstruction are discussed, including fusion, implant arthroplasty, perichondrial grafting and vascularized joint transfer. A patient is presented with a severe crush injury to the dorsum of the index finger with loss of skin and extensor tendon and proximal interphalangeal joint disruption. Immediate reconstruction of the finger is described using a composite free flap of skin, extensor tendon and proximal interphalangeal joint from the second toe. Follow-up at two years is described, demonstrating proximal interphalangeal motion and finger function.

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