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.

scholarly journals Clinical results of the BoneWelding®Fiji® anchor for the treatment of Stener lesions of the thumb

2020 ◽  
Author(s):  
Tobias Kastenberger ◽  
Peter Kaiser ◽  
Gernot Schmidle ◽  
Kerstin Stock ◽  
Stefan Benedikt ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Range Of Motion ◽  
Traumatic Event ◽  
Ulnar Collateral Ligament ◽  
Metacarpophalangeal Joint ◽  
Contralateral Side ◽  
Pinch Strength ◽  
Dash Score ◽  
Collateral Ligament

Abstract Introduction A new technology (Sportwelding®) was recently presented, which uses ultrasonic energy to meld a resorbable suture anchor at the interface with the host bone. A standardized clinical use was not investigated yet. This study prospectively evaluated the surgical and clinical outcomes of the Fiji Anchor® (Sportwelding®, Schlieren, Switzerland) in the repair of an ulnar collateral ligament lesion of the metacarpophalangeal joint of the thumb. Material and methods The range of motion, grip and pinch strength, disability of arm, shoulder and the hand (DASH) and patient rated evaluation (PRWE) score, pain, satisfaction, complications and adverse events were assessed in 24 patients after surgical treatment for an acute displaced rupture or avulsion of the ulnar collateral metacarpophalangeal ligament of the thumb using the Fiji Anchor® after 6, 12 and 52 weeks. Results At final follow up, the range of motion of the metacarpophalangeal joint reached almost the contralateral side (49.3° SD 11.7°). Thumb opposition showed a Kapandji score of 9.7 (SD 0.5; range 9–10). Grip strength, the lateral, tip and the three jaw pinch showed nearly similar values compared to the contralateral side (83–101%). Pain was low (0.2 SD 0.7 at rest and 0.6 SD 1.0 during load). The DASH score was 5.0 (SD 7.3) and the PRWE score was 4.1 (SD 9.0). 81% of patients were very satisfied at final follow-up. Two patients were rated unstable during the follow-up period due to a second traumatic event. Three cases experienced difficulties during anchor insertion, whereby incorrect anchor insertion resulted in damage to the suture material; however, this was resolved after additional training. Conclusion One advantage of this anchor appears to be its stable fixation in cancellous bone. The surgical treatment of an ulnar collateral ligament lesion of the thumb using the Fiji Anchor® can lead to an excellent clinical outcome with a minor complication rate; however, long-term dangers and the cost effectiveness of the procedure are not known yet.

Modified retrograde tendon flap technique for reconstructing the extensor tendon defect in zone Ⅱ of a finger

2020 ◽  
Author(s):  
Li Wang ◽  
Jingyu Zhang ◽  
Linjie Feng ◽  
Guoyong Yuan
Keyword(s):  
Range Of Motion ◽  
Extensor Tendon ◽  
Passive Motion ◽  
Finger Joints ◽  
Flap Technique ◽  
Tendon Defect ◽  
Nail Deformity ◽  
Active Flexion ◽  
Extensor Lag

Abstract Purpose: To evaluate the effect of the modified retrograde tendon flap technique for reconstructing the extensor tendon defect in zone Ⅱ of a finger.Methods: 12 patients with the extensor tendon defect in zone Ⅱ were investigated retrospectively. They were all treated surgically by the modified retrograde tendon flap technique, featuring the creation of a new terminal slip to bridge the extensor tendon defect using extensor tendon inner lateral bands. At the final follow-up, the range of motion at each joint of the injured finger was recorded.Results: Average follow-up was 18 months (ranging from 11 to 26 mos). Eight patients achieved full active DIPJ extension, whereas one patient had an extensor lag of 10° and three had a lag of 5°. All patients achieved normal active flexion ranges and full passive motion ranges of DIPJ compared with their uninjured side. All the involved finger joints were clinically stable, with no tenderness, pain, nail deformity, or limitation using their hands for daily life.Conclusions: The modified retrograde tendon flap technique, which is easy to operate and popularize, may be the procedure of choice in patients with a gap deficiency in Zone Ⅱ of the extensor tendon of a finger.

Treatment of unstable proximal interphalangeal joint fractures with hemi-hamate osteochondral autografts

2016 ◽  
Vol 42 (2) ◽  
pp. 188-193 ◽  
Author(s):  
M. Burnier ◽  
T. Awada ◽  
F. Marin Braun ◽  
P. Rostoucher ◽  
M. Ninou ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Articular Surface ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Pinch Strength ◽  
Middle Phalanx ◽  
Level Of Evidence ◽  
Active Flexion ◽  
The Mean

The primary aim of this study was to assess the clinical and radiological results after hemi-hamate resurfacing arthroplasty in patients with acute or chronic unstable fractures of the base of the middle phalanx and to describe technical features that can facilitate the surgical procedure. Hemi-hamate arthroplasties were done in 19 patients (mean age 39 years) with an isolated fracture at the base of the middle phalanx that involved more than 40% of the articular surface. We assessed ten chronic cases (treated >6 weeks after fracture) and nine acute ones (<6 weeks) at a mean of 24 months. Pain scores, QuickDASH scores, grip strengths, range of motion and radiological findings were recorded at follow-up. At follow-up, the mean active flexion at the proximal interphalangeal joint was to 83° with a mean fixed flexion of 17° (active range of motion 66°). The mean active distal interphalangeal motion was 41°. The mean visual analogue scale score was 1.1. The mean QuickDASH score was 11. The mean pinch strength was 82% of the opposite side. Radiographs revealed one partial graft lysis. Level of evidence: IV

scholarly journals Functional and Radiographic Outcomes of the Sauvé-Kapandji and Darrach Procedures in Rheumatoid Arthritis

2018 ◽  
Vol 11 (02) ◽  
pp. 071-079 ◽  
Author(s):  
Hannah M. Carl ◽  
Scott D. Lifchez
Keyword(s):  
Rheumatoid Arthritis ◽  
Range Of Motion ◽  
Average Length ◽  
Distal Radioulnar Joint ◽  
Functional Improvement ◽  
Single Institution ◽  
Radioulnar Joint ◽  
Radiographic Outcomes ◽  
Radiocarpal Joint

Abstract Background Deterioration of the distal radioulnar joint (DRUJ) in rheumatoid arthritis (RA) manifests as pain, weakness, and reduced range of motion. The Darrach and Sauvé-Kapandji (S-K) procedures are used when medical management fails to control these symptoms. However, there is a paucity of literature comparing the outcomes of these procedures. The purpose of this study is to compare the clinical and radiographic outcomes of the Darrach and S-K procedures in RA patients. Materials and Methods This is a retrospective, single institution cohort study of RA patients who underwent the Darrach or S-K procedure between 2008 and 2016. Ulnar translation, range of motion, and functional improvement were compared. Results Nine patients (13 wrists) underwent the Darrach procedure, and nine patients (11 wrists) underwent the S-K procedure. The average length of follow-up was 1.3 years. Pain, function, and range of motion improved in both groups. The degree of ulnar translation did not significantly change after either procedure. Conclusion Given their similar outcomes, we found no evidence that the S-K procedure is superior to the Darrach procedure or vice versa. However, when surgery is indicated for younger RA patients with DRUJ disease and ulnar translation, the S-K may be better suited to prevent radiocarpal joint dislocation.

A Comparative Study of Outcome between the Neuflex and Swanson Metacarpophalangeal Joint Replacements

2005 ◽  
Vol 30 (1) ◽  
pp. 3-7 ◽  
Author(s):  
R. DELANEY ◽  
I. A. TRAIL ◽  
D. NUTTALL
Keyword(s):  
Grip Strength ◽  
Early Stage ◽  
Metacarpophalangeal Joint ◽  
Implant Failure ◽  
Range Of Movement ◽  
Double Blind ◽  
Joint Replacements ◽  
Active Flexion ◽  
Significant Difference

This prospective double blind trial compares the clinical findings of Swanson and Neuflex metacarpophalangeal joint replacements in patients with rheumatoid arthritis, up to 2 years follow-up. There were 37 joints (10 patients) in the Swanson group and 40 joints (12 patients) in the Neuflex group. Assessments of range of movement, grip strength and hand function were undertaken in a double blind fashion, preoperatively and up to 2 years following implantation. The mean and standard deviation of the data were calculated. A two-tailed student’s t-test was used when comparing groups of data. An X-ray analysis was also undertaken to identify any implant failure. There was no significant difference between the two groups with respect to flexion and extension before surgery. At follow-up there was also no significant difference in the extensor lag, with mean extension lags of 19° and 16° for the Swanson and Neuflex implants, respectively. However, there was a significant difference in flexion, with mean active flexion values of 59° and 72° for the Swanson and Neuflex implants, respectively. There were no differences between the two groups in respect to arc of metacarpophalangeal joint motion, ulnar deviation, grip strength or the SODA function test at follow-up. At this early stage there was no evidence of any case of implant failure. In conclusion, patients who underwent Neuflex metacarpophalangeal joint replacements obtained greater flexion than those who underwent a Swanson replacement.

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.

Early Motion After Repair of Achilles Tendon Ruptures

1995 ◽  
Vol 16 (11) ◽  
pp. 705-709 ◽  
Author(s):  
Randal L. Troop ◽  
Gary M. Losse ◽  
John G. Lane ◽  
Daniel B. Robertson ◽  
Pamela S. Hastings ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Achilles Tendon ◽  
Range Of Motion ◽  
Average Length ◽  
Lateral Motion ◽  
Early Motion ◽  
Active Range Of Motion ◽  
Increased Risk ◽  
Tendon Ruptures

The purpose of this study was to evaluate the clinical outcome of patients treated with limited immobilization and early motion after repair of acute Achilles tendon ruptures. Thirteen consecutive patients with complete ruptures of the Achilles tendon were identified, repaired, and rehabilitated with early motion starting an average of 10 days after surgery. Active range of motion was begun at an average of 23 days and weightbearing in a walking boot was started at an average of 3.5 weeks after surgery. The average length of follow-up was 27 months. Twelve of 13 patients returned to running activities in an average of 3 months. All 12 patients who participated in lateral motion activities before their injury returned to similar activities in an average of 7 months. The patients rated their overall status at an average of 93% of their preinjury level. Follow-up Cybex testing demonstrated plantarflexion strength averaging 92%, plantarflexion power averaging 88%, and plantarflexion endurance averaging 88% of the nonindexed extremity. Early range of motion after Achilles repair is safe and there is no increased risk of rerupture in compliant patients. The patients achieved good return of plantarflexion strength, power, and endurance.

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.

scholarly journals EXPERIENCE IN ARTHROSCOPIC TREATMENT OF ACUTE ACROMIOCLAVICULAR JOINT INJURIES

2018 ◽  
pp. 42-46
Author(s):  
I. V. Grigor’ev ◽  
N. V. Zagorodniy ◽  
F. L. Lazko ◽  
A. P. Prizov ◽  
E. A. Belyak ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Range Of Motion ◽  
Acromioclavicular Joint ◽  
Shoulder Arthroscopy ◽  
Constant Score ◽  
Early Postoperative Period ◽  
Arthroscopic Treatment ◽  
Brachial Plexopathy ◽  
Joint Injuries

Purpose of study: to evaluate surgical treatment results in patients with closed dislocation of the acromial end of the clavicle.Patients and methods. Eighteen patients, aged 23-54 years, with acute acromioclavicular joint injuries of IIIIV type by Rockwood were operated on during 2015 – 2018. Surgical treatment was performed at terms up to 2 weeks after injury. Reduction of the acromial end of the clavicle, arthroscopic fixation and stabilization of acromioclavicular joint by TightRope system was performed. Postoperative follow-up was cjnducted in 4 and 6 weeks, 3 months and subsequently every 6 months after surgical intervention. To evaluate the results the Constant Score and radiographs were used.Results.Follow-up period made up 1 year. Functional result, i.e. range of motion and quality of life, by Constant Score was good already on day 14 after surgery and excellent (89.6±2.9 points) at the end of treatment course (2 months after intervention). Brachial plexopathy (reduction of the thumb and 2nd finger sensitivity and muscular force in the early postoperative period) was observed in 1 case. Six months conservative treatment resulted in positive effect. In 6 months range of motion in the operated joint was equal to that in a healthy one.Conclusion.Arthroscopic treatment of acromioclavicular joint injuries by TightRope system is a highly effective and minimum invasive method but requires experience and practical skills in shoulder arthroscopy.

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