An Improved Splint Design for Boutonniere Deformity

2009 ◽  
Author(s):  
Scott A. Macdonald ◽  
Mark E. Rentschler
Keyword(s):  
Blood Flow ◽  
Surgical Procedures ◽  
Finger Joint ◽  
Nonsurgical Treatment ◽  
Extensor Mechanism ◽  
Increase Blood Flow ◽  
Therapeutic Techniques ◽  
Boutonniere Deformity ◽  
Boutonnière Deformity

Boutonniere deformities are a common injury to the extensor mechanism of the finger. The deformity results in fixed contraction in the medial finger joint, and is severely debilitating to functionality. Due to the complexity of the mechanism, surgical procedures are difficult, expensive, and often unsuccessful. However, nonsurgical treatment of the deformity has not changed in many years and remains time consuming and mostly ineffective. The goal of this work is to develop an improved mechanical brace, to correct the deformity, by utilizing unconventional materials such as Nitinol and proven therapeutic techniques such as heat and motion to increase blood flow to the damaged tissue.

Reconstructive Surgery of the Post-Burn Boutonnière Deformity

1986 ◽  
Vol 11 (1) ◽  
pp. 23-30
Author(s):  
F. GROENEVELT ◽  
R. SCHOORL
Keyword(s):  
Retrospective Study ◽  
Surgical Procedures ◽  
Reconstructive Surgery ◽  
Primary Treatment ◽  
Operative Results ◽  
Boutonniere Deformity ◽  
Boutonnière Deformity

A retrospective study of fifty-four longstanding post-burn boutonnière deformities was carried out to evaluate the problems associated with the surgical procedures. The aim is to describe the pathophysiological changes of the burned fingers, the primary treatment, the reconstructive principles, the patients and materials and the final post-operative results.

Thumb boutonnière deformity without rheumatoid arthritis or trauma

2017 ◽  
Vol 43 (3) ◽  
pp. 324-330 ◽  
Author(s):  
T. Hara ◽  
H. Yoneda ◽  
S. Kurimoto ◽  
M. Yamamoto ◽  
K. Iwatsuki ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Range Of Motion ◽  
Hand Injury ◽  
Extensor Mechanism ◽  
Hand Dominance ◽  
Level Of Evidence ◽  
Factors Associated ◽  
Boutonniere Deformity ◽  
History Of ◽  
Boutonnière Deformity

Boutonnière deformity of the thumb without rheumatoid arthritis or trauma is not widely recognised. This study aimed to investigate its prevalence, relation to sex and age, and identifying factors associated with the extensor mechanism using ultrasonography. We examined 248 thumbs from 127 participants who were asymptomatic for hand disorders and had no history of hand injury. Boutonnière deformity was identified in 20 thumbs of 17 participants and was significantly more prevalent among elderly participants than among young participants. No significant differences in sex or hand dominance were noted. The deformity had a significant effect on range of motion and grip and pinch strengths. The extensor pollicis brevis (EPB) tendon was significantly narrower in affected thumbs than in non-affected thumbs. The prevalence of boutonnière deformity without rheumatoid arthritis or trauma was 13%, and the deformity was associated with advanced age and a narrow EPB tendon. Level of evidence: III

General anesthesia and hepatic circulation

1987 ◽  
Vol 65 (8) ◽  
pp. 1762-1779 ◽  
Author(s):  
Simon Gelman
Keyword(s):  
Blood Flow ◽  
General Anesthesia ◽  
Surgical Procedures ◽  
Hepatic Blood Flow ◽  
Portal Blood Flow ◽  
Arterial Blood Flow ◽  
Hepatic Circulation ◽  
Arterial Blood ◽  
Total Hepatic Blood Flow ◽  
Circulatory Disturbances

This article describes hepatic circulatory disturbances associated with anesthesia and surgical intervention. The material is presented in three parts: part 1 describes the effects of general anesthetics on the hepatic circulation; part 2 deals with different factors related to surgical procedures and anesthesia; and part 3 analyzes the role of hepatic circulatory disturbances and hepatic oxygen deprivation in anesthesia-induced hepatotoxicity. The analysis of available data suggests that general anesthesia affects the splanchnic and hepatic circulation in various directions and to different degrees. The majority of anesthetics decreases portal blood flow in association with a decrease in cardiac output. However, hepatic arterial blood flow can be preserved, decreased, or increased. The increase in hepatic arterial blood flow, when it occurs, is usually not enough to compensate for a decrease in portal blood flow and therefore total hepatic blood flow is usually decreased during anesthesia. This decrease in total hepatic blood flow-has certain pharmacokinetic implications, namely a decrease in clearance of endogenous and exogenous substances with a high hepatic extraction ratio. On the other hand, a reduction in the hepatic oxygen supply might play a certain role in liver dysfunction occurring perioperatively. Surgical procedures–preparations combined with anesthesia have a very complex effect on the splanchnic and hepatic circulation. Within this complex, the surgical procedure–preparation plays the main role in developing circulatory disturbances, while anesthesia plays only a modifying role. Hepatic oxygen deprivation may play an important role in anesthesia-induced hepatotoxicity in different experimental models.

The Central Slip Tenodesis Test for Early Diagnosis of Potential Boutonnière Deformities

1994 ◽  
Vol 19 (1) ◽  
pp. 88-90 ◽  
Author(s):  
P. J. SMITH ◽  
D. A. ROSS
Keyword(s):  
Early Diagnosis ◽  
Conservative Management ◽  
Primary Defect ◽  
Non Invasive ◽  
Boutonniere Deformity ◽  
Invasive Method ◽  
Central Slip ◽  
Boutonnière Deformity

Disruption of the central slip is the primary defect leading to boutonnière deformity. In the closed injury early diagnosis of this lesion is rarely achieved due to the limitations of current methods and difficulties encountered in assessing a painful finger. We describe a simple, non-invasive method of diagnosis which can be carried out on all patients and with minimal discomfort. This test is also beneficial in monitoring the progress of conservative management of central slip disruption.

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