scholarly journals The Nottingham Palmar Plate Arthroplasty for Metacarpophalangeal Joint Noninflammatory Arthritis

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ryan W. Trickett ◽  
John A. Oni
Keyword(s):  
Metacarpophalangeal Joint ◽  
Palmar Plate

Chronic Finger Joint Instability Reconstructed With Bone–Ligament–Bone Graft from the Iliac Crest

2004 ◽  
Vol 29 (5) ◽  
pp. 494-501 ◽  
Author(s):  
W. C. WU ◽  
T. C. WONG ◽  
T. H. YIP
Keyword(s):  
Bone Graft ◽  
Functional Disability ◽  
Iliac Crest ◽  
Ulnar Collateral Ligament ◽  
Metacarpophalangeal Joint ◽  
Interphalangeal Joint ◽  
Collateral Ligament ◽  
Chronic Instability ◽  
Radial Collateral Ligament ◽  
Palmar Plate

Five patients with chronic instability of digital joints presented with instability and functional disability. Two patients had ulnar collateral ligament damage of the thumb metacarpophalangeal joint and another had chronic multidirectional instability due to radial collateral ligament, dorsal capsule and palmar plate laxity of the metacarpophalangeal joint of the thumb. The fourth patient had a lax radial collateral ligament and palmar plate of the proximal interphalangeal joint of the little finger and the fifth had chronic laxity of the ulnar collateral ligament of the interphalangeal joint of the thumb. All were reconstructed with bone–ligament–bone graft harvested from the iliac crest. The graft was fixed with screws and joint stability was achieved intra-operatively in all patients. All patients achieved a stable joint with improved functional performance at final followup.

Dislocations of the Metacarpophalangeal Joint of the Thumb

1997 ◽  
Vol 22 (4) ◽  
pp. 499-504 ◽  
Author(s):  
M. PATEL ◽  
J. DAVÉ
Keyword(s):  
Ulnar Collateral Ligament ◽  
Metacarpophalangeal Joint ◽  
Adductor Pollicis ◽  
Flexor Pollicis Longus ◽  
Collateral Ligament ◽  
Abductor Pollicis Brevis ◽  
Extensor Pollicis Longus ◽  
Palmar Plate ◽  
Cadaver Studies

We report 13 cases of thumb metacarpophalangeal dislocations, ten dorsal and three palmar. Eleven had complex dislocations requiring open reductions. With dorsal dislocations the palmar plate, the tendon of flexor pollicis longus and the “thenar trap” (adductor pollicis, flexor pollicis brevis and abductor pollicis brevis) were the main impediments to reduction. The dorsal capsule, extensor expansion and extensor pollicis longus and brevis prevented reduction with the uncommon palmar dislocations. Cadaver studies showed that dorsal dislocations are hyperextension and pronation injuries and palmar dislocations are hyperflexion and supination injuries. The unique “handlebar grip” injury which can cause either dorsal or palmar dislocations is also discussed. The palmar plate is the single most important stabilizer of the metacarpophalangeal joint and it is impossible to sustain a dislocation without tearing it. It is most likely to get entrapped within the joint in dorsal dislocations. Ulnar collateral ligament tears are more common with palmar dislocations.

The Extensor Retinacular System at the Metacarpophalangeal Joint

1997 ◽  
Vol 22 (5) ◽  
pp. 585-590 ◽  
Author(s):  
G. M. RAYAN ◽  
D. MURRAY ◽  
K. W. CHUNG ◽  
M. ROHRER
Keyword(s):  
Soft Tissue ◽  
Single Unit ◽  
Cylindrical Tube ◽  
Metacarpophalangeal Joint ◽  
Radial Component ◽  
Extensor Digitorum ◽  
Metacarpal Head ◽  
Palmar Plate ◽  
Annular Pulley

The anatomy of the sagittal bands was studied in 56 cadaver digits. The sagittal band is part of an extensor retinacular system which is integrated with the extrinsic and intrinsic musculotendinous structures. The extensor retinacular system is a single unit with radial and ulnar components and has transverse, sagittal and oblique fibres. The transverse-sagittal fibres, along with the palmar plate, form a closed cylindrical tube which surrounds the metacarpal head. The oblique fibres form the triangular lamina distal to the sagittal band. The radial component of the sagittal band is often thinner and longer than the ulnar component. The sagittal band envelops the extensor digitorum tendon and the superficial fibres are thinner than deep fibres, especially in the central digits. The central digits have palmar soft tissue confluence on each side consisting of the sagittal band, palmar plate, annular pulley and deep transverse metacarpal ligament. The sagittal band also appears to envelop the superficial interosseous tendons on both sides. Our findings explain the propensity for radial sagittal band injuries and suggest that the sagittal band is the primary stabilizer of the extensor digitorum at the metacarpophalangeal joint.

Palmar plate capsulodesis for thumb metacarpophalangeal joint hyperextension in association with trapeziometacarpal osteoarthritis

2013 ◽  
Vol 39 (3) ◽  
pp. 272-275 ◽  
Author(s):  
N. J. K. Miller ◽  
T. R. C. Davis
Keyword(s):  
Suture Anchor ◽  
Metacarpophalangeal Joint ◽  
Hand Grip ◽  
Trapeziometacarpal Osteoarthritis ◽  
Palmar Plate ◽  
Over Time ◽  
Better Than ◽  
Thumb Metacarpophalangeal Joint ◽  
Median Pain

Hyperextension of the thumb metacarpophalangeal (MCP) joint is frequently seen with trapeziometacarpal osteoarthritis, but there is no consensus on the indication for, or type of, treatment. We re-examined 12 thumbs at a mean of 9 (range 6–13) years following MCP capsulodesis using a suture anchor performed with trapeziectomy. Mean MCP hyperextension improved from 45° pre-operatively to 19° at 1 year post-operatively. At 9 years follow-up, it had increased to 30° but was still significantly better than pre-operatively ( p = 0.007). Mean MCP flexion was 37° and near normal opposition was retained. The median pain score had improved from 5.5 to 1 ( p = 0.002). Thumb key and tip pinch and hand grip strength showed no significant change from pre-operative values. No thumb MCP had symptomatic radiological degeneration. Our results suggest that MCP capsulodesis preserves a useful range of MCP flexion but stretches out over time. However, this did not result in increased pain or thumb weakness.

scholarly journals Verification of Finger Joint Stiffness Estimation Method With Soft Robotic Actuator

2020 ◽  
Vol 8 ◽  
Author(s):  
Xiang Qian Shi ◽  
Ho Lam Heung ◽  
Zhi Qiang Tang ◽  
Kai Yu Tong ◽  
Zheng Li
Keyword(s):  
Estimation Method ◽  
Joint Stiffness ◽  
Ground Truth ◽  
Clinical Score ◽  
Metacarpophalangeal Joint ◽  
Finger Joint ◽  
Joint Torque ◽  
Hand Rehabilitation ◽  
Stiffness Characteristic ◽  
Modified Ashworth Scale

Stroke has been the leading cause of disability due to the induced spasticity in the upper extremity. The constant flexion of spastic fingers following stroke has not been well described. Accurate measurements for joint stiffness help clinicians have a better access to the level of impairment after stroke. Previously, we conducted a method for quantifying the passive finger joint stiffness based on the pressure-angle relationship between the spastic fingers and the soft-elastic composite actuator (SECA). However, it lacks a ground-truth to demonstrate the compatibility between the SECA-facilitated stiffness estimation and standard joint stiffness quantification procedure. In this study, we compare the passive metacarpophalangeal (MCP) joint stiffness measured using the SECA with the results from our designed standalone mechatronics device, which measures the passive metacarpophalangeal joint torque and angle during passive finger rotation. Results obtained from the fitting model that concludes the stiffness characteristic are further compared with the results obtained from SECA-Finger model, as well as the clinical score of Modified Ashworth Scale (MAS) for grading spasticity. These findings suggest the possibility of passive MCP joint stiffness quantification using the soft robotic actuator during the performance of different tasks in hand rehabilitation.

Trans-metacarpal Screw Fixation for Extra-articular Proximal Phalangeal Base Fractures

2017 ◽  
Vol 22 (01) ◽  
pp. 35-38 ◽  
Author(s):  
Eichi Itadera ◽  
Takahiro Yamazaki
Keyword(s):  
Screw Fixation ◽  
Proximal Phalanx ◽  
Metacarpophalangeal Joint ◽  
Fixation Method ◽  
Compression Screw ◽  
Metacarpal Head ◽  
Headless Compression Screw ◽  
Articular Fractures ◽  
Intramedullary Canal ◽  
Cannulated Drill

We developed a new internal fixation method for extra-articular fractures at the base of the proximal phalanx using a headless compression screw to achieve rigid fracture fixation through a relatively easy technique. With the metacarpophalangeal joint of the involved finger flexed, a smooth guide-pin is inserted into the intramedullary canal of the proximal phalanx through the metacarpal head and metacarpophalangeal joint. Insertion tunnels are made over the guide-pin using a cannulated drill. Then, a headless cannulated screw is placed into the proximal phalanx. All of five fractures treated by this procedure obtained satisfactory results.

An Unusual Presentation of Methotrexate-Induced B-Cell Lymphoma of the Metacarpophalangeal Joint: A Case Report and Literature Review

2006 ◽  
Vol 31 (7) ◽  
pp. 1193-1196 ◽  
Author(s):  
J. Woodfin Kennedy ◽  
Lesley K. Wong ◽  
Behrooz Kalantarian ◽  
Leslie Turner ◽  
Cauley W. Hayes
Keyword(s):  
Case Report ◽  
Literature Review ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Metacarpophalangeal Joint ◽  
Unusual Presentation

A volar approach to on-top plasty for correction of radial polydactyly: a case series of 21 patients

2021 ◽  
pp. 175319342098185
Author(s):  
Xia Fang ◽  
Ping-tak Chan ◽  
Shengbo Zhou ◽  
Xinyi Dai ◽  
Ruiji Guo ◽  
...  
Keyword(s):  
Case Series ◽  
Functional Results ◽  
Metacarpophalangeal Joint ◽  
Contralateral Side ◽  
Average Score ◽  
Pinch Strength ◽  
Level Of Evidence ◽  
Volar Approach ◽  
Flexion Extension ◽  
Aesthetic Results

Correction of unequal radial polydactyly in which neither thumb duplicates possess both well-developed proximal and distal components, remains challenging. Current techniques using on-top plasty techniques require circumferential incisions, often resulting in postoperative swelling and dorsal scars. We described our experience using a volar approach to achieve better aesthetic and functional results. Twenty-one patients underwent this surgery between 2008 and 2018, with a mean follow-up of 5.1 years. The mean flexion–extension arc for the metacarpophalangeal joint was 75° and that of the interphalangeal joint was 43°. Mean percentage of key, tripod and tip pinch strength were 77%, 79% and 77%, respectively, when compared with the contralateral side. The Vancouver Scar Scale showed an average score of 1.2. We conclude from our study that the volar approach to on-top plasty is a good technique for the correction of unequal radial polydactyly, with good functional and aesthetic results. Level of evidence: IV

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