Flexion contracture of the fingers caused by sarcoidosis: An 11-year follow-up

2009 ◽  
Vol 43 (3) ◽  
pp. 171-173 ◽  
Author(s):  
Kaoru Tada ◽  
Kazuo Ikeda ◽  
Katsuro Tomita
Keyword(s):  
Flexion Contracture

Flexor digitorum profundus with or without flexor digitorum superficialis tendon repair in acute Zone 2B injuries

2020 ◽  
Vol 45 (10) ◽  
pp. 1034-1044
Author(s):  
Ahmed F. Sadek
Keyword(s):  
Tendon Repair ◽  
Flexion Contracture ◽  
Flexor Digitorum Profundus ◽  
Flexor Digitorum Superficialis ◽  
Level Of Evidence ◽  
Power Grip ◽  
Contralateral Hand ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon

A total of 53 patients with complete cuts of two flexor tendons in Zone 2B treated over a 9-year period was reviewed. Twenty-three patients (28 fingers) had only flexor digitorum profundus repair, while 30 patients (36 fingers) had both flexor digitorum profundus and flexor digitorum superficialis repairs, with a mean follow-up of 21 months (range 12–84). The decision to repair the flexor digitorum superficialis was made according to intraoperative judgement of ease of repair and gliding of the flexor digitorum profundus tendon. Two groups of patients showed no significant differences in total range of active or passive digital motion and power grip percentage to the contralateral hand. However, the values of power grip were statistically superior in the patients with both tendons repaired. The patients after flexor digitorum profundus-only repairs showed significantly greater but still mild flexion contracture (mean 20 °) of the operated digits. The Tang gradings were the same with 89% good and excellent rates in both groups. The conclusion is that although repair of both flexor digitorum profundus and flexor digitorum superficialis tendons is slightly more preferable based on increased grip strength, the repair of the flexor digitorum superficialis together with flexor digitorum profundus is not mandatory. Whether or not to repair flexor digitorum superficialis is an intraoperative decision based on the ease of gliding of the repaired tendon(s). Level of evidence: III

scholarly journals Adult Hip Flexion Contracture due to Neurological Disease: A New Treatment Protocol—Surgical Treatment of Neurological Hip Flexion Contracture

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Alberto Nicodemo ◽  
Chiara Arrigoni ◽  
Andrea Bersano ◽  
Alessandro Massè
Keyword(s):  
Surgical Treatment ◽  
Neurological Diseases ◽  
Treatment Protocol ◽  
Flexion Contracture ◽  
Walking Ability ◽  
Hip Range Of Motion ◽  
Muscular Function ◽  
New Treatment ◽  
Hip Flexion

Congenital, traumatic, or extrinsic causes can lead people to paraplegia; some of these are potentially; reversible and others are not. Paraplegia can couse hip flexion contracture and, consequently, pressure sores, scoliosis, and hyperlordosis; lumbar and groin pain are strictly correlated. Scientific literature contains many studies about children hip flexion related to neurological diseases, mainly caused by cerebral palsy; only few papers focus on this complication in adults. In this study we report our experience on surgical treatment of adult hip flexion contracture due to neurological diseases; we have tried to outline an algorithm to choose the best treatment avoiding useless or too aggressive therapies. We present 5 cases of adult hips flexion due to neurological conditions treated following our algorithm. At 1-year-follow-up all patients had a good clinical outcome in terms of hip range of motion, pain and recovery of walking if possible. In conclusion we think that this algorithm could be a good guideline to treat these complex cases even if we need to treat more patients to confirm this theory. We believe also that postoperation physiotherapy it is useful in hip motility preservation, improvement of muscular function, and walking ability recovery when possible.

Anterior Tenoarthrolysis for Severe Flexion Contracture of the Fingers (The “Tata” Operation): A Review of 50 Cases

2007 ◽  
Vol 32 (2) ◽  
pp. 224-229 ◽  
Author(s):  
P. LOREA ◽  
J. MEDINA HENRIQUEZ ◽  
R. NAVARRO ◽  
P. LEGAILLARD ◽  
G. FOUCHER
Keyword(s):  
Flexion Contracture ◽  
Salvage Procedure ◽  
Extension Deficit ◽  
Salvage Operation ◽  
Active Range Of Motion ◽  
Pip Joint ◽  
Distal Interphalangeal ◽  
Joint Flexion ◽  
The Mean

The “hook finger”, with both proximal interphalangeal (PIP) and distal interphalangeal (DIP) joint flexion contractures, often after multiple previous operations, is difficult to treat. This paper reports the results of 50 fingers in 49 patients in which the TATA (Téno-Arthrolyse Totale Antérieure) salvage procedure, described by Saffar in 1978, was carried out. Thirty-seven of 50 (74%) of these fingers had had at least one previous operation, most on the flexor apparatus. The mean PIP and DIP extension deficit pre-operatively was 133° with a mean PIP lag of extension of 83°. With a mean follow-up of 7.8 years, 45 fingers were improved, five were not and none was worsened. The mean PIP and DIP extension deficit postoperatively was 47°, with a mean PIP lack of extension of 31°. The overall gain in extension deficit of both joints was 86° and of the PIP was 52°. One PIP joint developed septic arthritis immediately after surgery. The benefit of this salvage operation is mainly in the change of the active range of motion to a more functional arc.

A comparative analysis of the outcome of flexor tendon repair in the index and little fingers: does the little finger fare worse?

2011 ◽  
Vol 37 (1) ◽  
pp. 20-26 ◽  
Author(s):  
K. S. Orkar ◽  
C. Watts ◽  
F. C. Iwuagwu
Keyword(s):  
Flexor Tendon ◽  
Index Finger ◽  
Tendon Repair ◽  
Flexion Contracture ◽  
Hand Therapy ◽  
Flexor Tendon Repair ◽  
Single Digit ◽  
Significant Difference ◽  
Little Finger

The clinical and hand therapy notes of 180 patients who had single digit flexor tendon repairs in zones I and II from January 2000 to December 2004 were reviewed. Data from 60 index and 108 little fingers at 5 weeks, 8 weeks and 12 weeks follow-up visits were included. In zone I injuries, there was a statistically significant difference in flexion contracture (worse in the little fingers ) at all follow-up points. Although the range of motion and percentage of patients in the excellent category of the Strickland and Glogovac criteria were greater in the index finger group than the little finger for zone I and II injuries, these differences were not statistically significant. The rupture rate was also higher in the little finger group.

scholarly journals Dynamic Manugraphy as a Promising Tool to Assess the Outcome of Limited Aponeurectomy in Patients With Dupuytren's Contracture

2021 ◽  
Vol 7 ◽  
Author(s):  
Angelina Garkisch ◽  
Thomas Mittlmeier ◽  
Axel Kalpen ◽  
Marion Mühldorfer-Fodor ◽  
Dagmar-C. Fischer ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Grip Force ◽  
Flexion Contracture ◽  
Dupuytren’S Contracture ◽  
Base Line ◽  
Dash Score ◽  
Force Transmission ◽  
Additional Tool ◽  
Dupuytren's Contracture

Background: Dupuytren's contractures interfere with physiological gripping. While limited aponeurectomy is an accepted treatment modality to restore finger mobility, methods to objectify functional outcome beyond determination of the range of motion are scarce.Methods: Patients with Dupuytren's contracture being scheduled for unilateral limited aponeurectomy were invited to participate. Clinical data were gathered prospectively by chart review and interview. The DASH-score and flexion contracture for fingers were registered prior to surgery, 3 and 6 months afterwards. At the same time, dynamic manugraphy for simultaneous recording of the grip pattern and forces generated by the affected hand and anatomic areas (i.e., thumb, index finger, middle finger, ring finger, little finger and palm) were performed. All findings obtained during the follow-up period were compared to the situation at baseline. Comparison between paired samples was done using Wilcoxon rank test. All p-values are two-sided and p < 0.05 was considered to be significant.Results: Out of 23 consecutively enrolled patients, 19 (15 men, 4 women) completed follow-up examinations. Manugraphy confirmed the impairment of physiological gripping with concomitant pathological load distribution at base line. Limited aponeurectomy significantly reduced flexion contractures. However, the DASH-score remained at an excellent level in one patient, indicated improvement in 11 and worsening in seven patients. Six patients had lower grip force at t6 compared to the preoperative condition, although the preoperative flexion contracture (≥110°) was considerably improved in all of them. In four of those, the DASH-score improved while it turned worse in two of them. The force of surgically treated fingers remained unchanged in three patients while it was improved and worsened in half of the remaining patients, respectively. Manugraphy revealed physiological gripping by enlargement of contact area and higher force transmission by the fingertips in 10 of 12 patients with constant or even improved DASH-score and in three of seven patients with a worsened DASH-score.Conclusions: Assessing the reduction of flexion contracture and grip force alone is not sufficient to comprehensively reflect the functional outcome of aponeurectomy for Dupuytren's disease. Visualizing physiological grip pattern provides an additional tool to objectify the success of surgical treatment.

scholarly journals Total knee arthroplasty in patients with fixed flexion deformity

KYAMC Journal ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. 2-7
Author(s):  
Abdus Salam ◽  
Md Ashraful Islam ◽  
Muhammad Zakir Hossain Khan ◽  
Md Sayeed Bin Sharif ◽  
Md Hafizur Rahman Milon ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Retrospective Study ◽  
Soft Tissue ◽  
Intraoperative Complications ◽  
Flexion Contracture ◽  
Flexion Deformity ◽  
Postoperative Evaluation ◽  
Total Knee ◽  
Fixed Flexion Deformity

Background: Fixed flexion deformity is a common accompaniment in advanced arthritis of the knee joint. Complete correction of fixed flexion deformity at the time of surgery remains challenging and technically demanding.Objectives: The purpose of our study was to assess the result of total knee replacement using a preset algorithm to assess the effect that a preoperative flexion deformity has on postoperative correction.Materials & Methods: This retrospective study reviewed severe flexion contracture of patients who underwent primary TKA and soft tissue balancing from June 2010 to July 2016. The data included preoperative, intraoperative, and postoperative evaluation at standard intervals and annual follow-up reports.Results: There were no intraoperative complications in this study. The average flexion contractures and ROM were not different between SF and MF groups (1.14 ± 0.27 vs. 1.12 ± 0.35 and 115.72 ± 15.13 vs. 118.34 ± 12.68).Conclusion: TKA can be performed successfully in knees with severe flexion contracture.KYAMC Journal Vol. 8, No.-2, Jan 2018, Page 2-7

Elbow Flexion Reconstruction by Steindler Flexorplasty in Obstetric Brachial Plexus Palsy

2005 ◽  
Vol 30 (4) ◽  
pp. 424-427 ◽  
Author(s):  
M. M. AL-QATTAN
Keyword(s):  
Brachial Plexus ◽  
Selection Criteria ◽  
Elbow Flexion ◽  
Drill Hole ◽  
Flexion Contracture ◽  
Brachial Plexus Palsy ◽  
Older Children ◽  
Obstetric Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus

The results of Steindler flexorplasty in nine patients with obstetric brachial plexus palsy are reported. There were 5 girls and 4 boys with a mean age of 6 (range 2–13) years. Selection criteria for the procedure included strong (at least M4) grip strength and wrist and elbow extension, as well as the presence of the “Steindler effect”. Pre-operatively, elbow flexion was rated as M0 or M1 in three patients and M2 in the remaining six patients. Intra-operatively, the detached common flexor origin was advanced 5 to 7 cm and fixation was done to the anterior humerus either with direct suture to the periosteum (in younger children) or suturing into a drill hole in the humerus (in older children). Postoperatively, the elbow was immobilized in flexion and supination for 6 weeks. At a mean follow-up of 5 years, the results in eight patients were good with mean active elbow flexion against resistance of 110° and a mean elbow flexion contracture of 35°. The result in the remaining patient was poor (unsuccessful transfer). It is concluded that the results of the Steindler flexorplasty in obstetric brachial plexus palsy patients are good and reliable, provided patient selection is careful.

Chronic Flexion Contracture of Proximal Interphalangeal Joint Treated with the Compass Hinge External Fixator. A Consecutive Series of 27 Cases

2002 ◽  
Vol 27 (4) ◽  
pp. 356-358 ◽  
Author(s):  
S. HOUSHIAN ◽  
B. GYNNING ◽  
H. A. SCHRØDER
Keyword(s):  
External Fixator ◽  
Flexion Contracture ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Consecutive Series ◽  
Flexion Extension ◽  
The Mean ◽  
Pin Track ◽  
Mean Time

Twenty-seven chronic flexion contractures of the proximal interphalangeal joint were treated with the Compass® hinge external fixator without open surgery. The fixator was removed after a mean of 33 (range, 14–68) days. The mean time from injury to operation was 4 (range, 1–19) years and all patients were reviewed at a mean follow-up of 21 (range, 12–50) months. The mean extension gain was 38° (range, 0–70°), and the mean flexion–extension arc improved by 42° (range, 0–80°). Complications included superficial pin-track infection in 11 cases and pin loosening in four cases.

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