scholarly journals Radiographic analysis of the angle in the lateromedial projection of the metacarpophalangeal joint and the distal interphalangeal joint in metacarpophalangeal flexural deformities in calves

2018 ◽  
Vol 5 (1) ◽  
pp. e000271 ◽  
Author(s):  
Ayano Sato ◽  
Osamu Ishii ◽  
Motoshi Tajima
Keyword(s):  
Proximal Phalanx ◽  
Metacarpophalangeal Joint ◽  
Metacarpal Bone ◽  
Interphalangeal Joint ◽  
Clinical Severity ◽  
Middle Phalanx ◽  
Distal Interphalangeal Joint ◽  
Lateral Angle ◽  
Significant Difference ◽  
Distal Interphalangeal

The bone alignment of the metacarpophalangeal joint (MPJ) of the distal interphalangeal joint (DIPJ) in metacarpophalangeal flexural deformity (MPFD) in calves was evaluated by radiography. This study was designed by retrospective study of radiographs. Lateral to medial radiographs of distal forelimbs were taken from 19 MPFD affected calves (35 forelimbs) and 21 normal calves (42 forelimbs). Based on the radiographs, the lateral angles of MPJ were measured from the metacarpal bone axis and proximal phalanx axis, and lateral angles of DIPJ were measured from the middle phalanx axis and distal phalanx axis. Mean lateral angle of MPJ in the normal limbs was 175.9 (95% CI 174.5 to 177.4). Mean lateral angles of MPJ in MPFD were as follows: mild: 167.1 (158.9–175.2), moderate: 165.1 (158.5–171.7) and severe: 150.6 (146–155.1). MPJ angle in MPFD limbs was narrower than that in the normal limbs (mild, moderate and severe: P=0.017, P=0.003 and P<0.001, respectively). Mean lateral angle of DIPJ in the normal limbs was 211.9 (210.7–213.2). Mean lateral angles of DIPJ in moderate: 200.6 (195.2–206.1) and severe: 204.9 (203.3–206.5) MPFD were narrower than that in the normal limbs (both P<0.001). There was no significant difference between the normal limbs and mild: 210.3 (206.9–213.7) MPFD limbs (P=0.7). The clinical severity of MPFD corresponded well with the lateral angle of MPJ. The flexion of DIPJ in moderate and severe MPFD was similar to the flexion of MPJ in MPFD. This suggested that the lateral to medial radiographs accurately reflected the MPJ flexion and the DIPJ in MPFD in calves, providing useful information for the treatment of MPFD.

The Effect of Ring Finger Distal Interphalangeal Joint Stiffness on Grip Strength: A Simulated Study in Normal Participants

2020 ◽  
Vol 25 (03) ◽  
pp. 296-300
Author(s):  
Robert J. Lambert ◽  
Thomas FM. Yeoman ◽  
Chaoyang Wang ◽  
Jaime Grant ◽  
Philippa A. Rust
Keyword(s):  
Grip Strength ◽  
Ring Finger ◽  
Significant Loss ◽  
Hand Grip Strength ◽  
Interphalangeal Joint ◽  
Rank Test ◽  
Distal Interphalangeal Joint ◽  
Hand Grip ◽  
Significant Difference ◽  
Distal Interphalangeal

Background: Pain of the hand distal interphalangeal joints may result from trauma, osteoarthritis or inflammatory arthritis. When symptoms are not controlled by non-operative means, surgical arthrodesis may be performed, resulting in complete stiffness of the joint and possible weakening of grip strength. This study aims to quantify the effect of a stiff ring finger distal interphalangeal joint on overall grip strength. Methods: One hundred participants were screened to exclude upper limb pathology. A Jamar dynamometer was used to assess overall hand grip strength. A splint was used to prevent distal interphalangeal joint flexion, thus replicating a fused distal interphalangeal joint. Participants were tested with and without the splint and the results compared. The mean of three grip strength tests was taken. Results: The participants included 55 females. Mean age was 31 (18–60 years). 76 participants had a reduction in grip strength with splinting, with a significant difference seen (p < 0.05) on Wilcoxon signed rank test. The median reduction in grip strength with splinting was 1.67 kg. However only 10 participants (10%) had a grip strength loss of greater than 6.5 kg, which is the minimal clinically important difference. Conclusions: This study found a significant loss in overall hand grip strength when the ring finger distal interphalangeal joint was stiffened. However, despite this significant change, only 10 (10%) participants experienced a reduction of greater than 6.5 kg. This is the level of weakness felt to be required to reduce function. Thus our results suggest that 90% of patients with a stiff ring finger distal interphalangeal joint are unlikely to have a clinically identifiable functional reduction in grip strength as a result.

scholarly journals Broken Kirschner Wire in Distal Interphalangeal Joint Fixation: A Case Report

2021 ◽  
Vol 26 (3) ◽  
pp. 171-173
Author(s):  
Kyung Jin Lee ◽  
Jung Hyun Park ◽  
Sung Hoon Koh ◽  
Dong Chul Lee ◽  
Si Young Roh ◽  
...  
Keyword(s):  
Kirschner Wire ◽  
Extensor Tendon ◽  
Interphalangeal Joint ◽  
Middle Phalanx ◽  
Distal Interphalangeal Joint ◽  
Protective Measures ◽  
X Ray ◽  
Distal Interphalangeal ◽  
Continued Use

Kirschner wire (K-wire) has been widely used for treatment of fracture for its cost-effectiveness and reliability. This case presents the K-wire breakage in distal interphalangeal joint (DIPJ) fixation. A 55-year-old male patient was injured by a knife and showed rupture of extensor tendon at 1/2 of middle phalanx. A 0.9-mm K-wire was implemented for DIPJ extension, and tenorrhaphy was done. After 6 weeks, we detected breakage of K-wire in the follow-up X-ray. The broken K-wire in the distal phalanx was removed. We removed the remaining K-wire through an incision on volar side of middle phalanx under C-arm after 2 weeks for the patient’s personal reasons. Breakage during postoperative K-wire maintenance is exceedingly rare. This patient is presumed to have ruptured because he continued using his finger. Therefore, while K-wire is present, continued use of finger without protection may cause breakage, so protective measures such as splint are required.

Corrective Step-cut Osteotomy at the Affected Bone for Correction of Rotational Deformity Due to Fracture of the Middle Phalanx

2017 ◽  
Vol 22 (02) ◽  
pp. 240-243 ◽  
Author(s):  
Hiroyuki Fujioka ◽  
Yohei Takagi ◽  
Juichi Tanaka ◽  
Shinichi Yoshiya
Keyword(s):  
Present Report ◽  
Proximal Phalanx ◽  
Ring Finger ◽  
Distal Portion ◽  
Middle Phalanx ◽  
Distal Interphalangeal Joint ◽  
Metacarpal Bones ◽  
Distal Interphalangeal ◽  
Displaced Fracture ◽  
Functional Problems

Malunion at the shaft of the middle phalanx yields less functional problems compared with malunion at the shaft of the proximal phalanx and metacarpal bones. In the present report, the patient sustained a minimally displaced fracture at the distal portion of the distal middle phalanx of the ring finger spraining the finger during playing flag football. Fracture was treated conservatively and fracture union was completed. However, the patient complained of functional problems in activities of daily living due to the malrotational deformity of the finger. We treated the malrotational deformity close to the distal interphalangeal joint of the middle phalanx with step-cut osteotomy at the affected bone successfully.

scholarly journals The Effect of Simulated Total Distal Interphalangeal Joint Stiffness on Grip Strength

2018 ◽  
Vol 26 (3) ◽  
pp. 160-164 ◽  
Author(s):  
Kitty Wu ◽  
Romeet Ahluwalia ◽  
Shrikant J. Chinchalkar ◽  
Joshua I. Vincent ◽  
Robert S. Richards ◽  
...  
Keyword(s):  
Grip Strength ◽  
Repeated Measures ◽  
Systemic Disease ◽  
Univariate Analysis ◽  
Interphalangeal Joint ◽  
Hand Dominance ◽  
Distal Interphalangeal Joint ◽  
Full Extension ◽  
Significant Difference ◽  
Distal Interphalangeal

Purpose: Production of a functional grip pattern requires the concerted action of numerous structures within the hand. This study quantifies the effect of total distal interphalangeal joint (DIPJ) stiffness to grip strength. Methods: Fifty (25 men, 25 women, 100 hands) individuals with a mean age of 38 years (range: 17-69 years) were recruited. Exclusion criteria included history of previous upper limb injury, neuropathies, or systemic disease. Custom thermoplastic orthoses were used to splint participants’ DIPJ in full extension simulating stiffness. Grip strength before and after splinting was measured using a calibrated Jamar dynamometer. Data were analyzed using paired and independent sample t tests and 2 × 2 repeated-measures analysis of variance with hand dominance and configuration (splinted or unsplinted) as within-subject factors. Results: Restriction of DIPJ flexion led to a 20% decrease in grip strength ( P < .001). There was no significant difference in this decrease between dominant and non-dominant hands. Univariate analysis did not demonstrate any interaction between hand dominance and testing configuration. Post hoc analysis revealed no statistical difference in baseline grip strength between the dominant and non-dominant hands. Furthermore, men had significantly stronger grip strength than women in all configurations ( P < .001). Conclusions: Flexion at the DIPJ contributes significantly to grip strength, and stiffness at this joint greatly limits functional capabilities of the hand. This necessitates the need for targeted rehabilitation in DIPJ injuries to minimize adverse effects on grip strength.

Osteoarthritis of the hand

2011 ◽  
Author(s):  
David Warwick ◽  
Roderick Dunn ◽  
Erman Melikyan ◽  
Jane Vadher
Keyword(s):  
Operative Treatment ◽  
Biomechanical Properties ◽  
Metacarpophalangeal Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Common Disease ◽  
Distal Interphalangeal Joint ◽  
Progressive Degeneration ◽  
Diarthrodial Joints ◽  
Distal Interphalangeal

Introduction 254Digital joint replacement 256Scaphoid–trapezium–trapezioid joint 258Thumb CMCJ arthritis 260Non-operative treatment for thumb CMC OA 262Operative treatment for thumb CMCJ OA 264Finger carpometacarpal joint 269Metacarpophalangeal joint 270Proximal interphalangeal joint 272Distal interphalangeal joint 274Common disease of diarthrodial joints. Primary aetiology is characterized by progressive degeneration of articular cartilage: a manifestation of an abnormal state of chondrocyte metabolism, loss of certain tissue components, alterations in microstructure and changes in biomechanical properties....

scholarly journals Use of Gamithromycin for the Treatment of Osteomyelitis Secondary to Foot Rot in a Sheep

2018 ◽  
Vol 46 ◽  
pp. 5
Author(s):  
Geórgia Camargo Góss ◽  
Claudia Acosta Duarte ◽  
Tiago Galinna Correa ◽  
Ingrid Rios Lima Machado ◽  
Fabricio Desconsi Mozzaquatro ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Active Ingredient ◽  
Proximal Phalanx ◽  
Interphalangeal Joint ◽  
Foot Rot ◽  
Distal Interphalangeal Joint ◽  
Thoracic Limb ◽  
Distal Interphalangeal ◽  
The Right ◽  
Interdigital Phlegmon

Background: Lameness is one of the main causes of economic losses in sheep breeding, especially in the distal region of the limbs. Poor sanitation management, especially in terms of hygiene conditions and the introduction of animals without previous preventive care, is an important predisposing factor in sheep flocks. Interdigital phlegmon (foot rot) is a bacterial disease that causes pain, heat, edema, hyperemia in the region, and can lead to secondary processes such as osteomyelitis. This case report describes the use of gamithromycin for the treatment of osteomyelitis secondary to foot rot in a sheep.Case: An Ile-de-France ewe exhibiting signs of lameness, pain, heat, hyperemia and edema in the four digits was treated at the Veterinary Hospital of UNIPAMPA. The lesions were characterized by interdigital phlegmon, commonly known as foot rot, and the right thoracic limb was more affected, exuding a foul odor and purulent secretion. The affected limbs were treated topically with an antiseptic solution. The lesions healed completely except for the right thoracic limb, whose clinical condition worsened. Osteitis was suspected, and was confirmed by radiographic evaluation of the region. Treatment with ceftiofur was introduced, but proved to be ineffective. Nevertheless, the lesion was found to have worsened, and a new X-ray evaluation was made, which revealed dislocation of the distal phalanx as well as involvement of the middle and proximal phalanges. Thus, we decided to perform chemical arthrodesis of the distal interphalangeal joint. Before beginning this procedure, contrast X-rays were taken that revealed the development of a fistulous pathway connecting the distal interphalangeal joint to the proximal interphalangeal joint, which precluded this procedure. In view of the worsening of the condition, amputation of the distal and middle phalanges was performed, as well as scraping of the distal edge of the proximal phalanx. In the postoperative period, ceftiofur was used as antibiotic therapy and flunixin meglumine as analgesic, in addition to daily dressings with topical iodine. After this procedure, there was no improvement in lameness and the radiographic images showed worsening of the clinical condition. At this time, the antimicrobial therapy was replaced with tylosin. After beginning treatment with this antimicrobial, there was a slight decrease in lameness, but a fistulous pathway with purulent secretion was formed in the region corresponding to the distal portion of the first phalanx, as well as an increase in the bone lesion, which was observed radiographically. Due to the ineffectiveness of the drug therapy, it was replaced by gamithromycin, which was applied three times. After beginning this treatment, lameness receded and the wound stopped producing purulent secretion, and at the end of the applications of this active ingredient, there was complete resolution of lameness and improvement of the radiographic signs of the animal of this case report.Discussion: Antimicrobial therapy is an important factor in the treatment of interdigital phlegmon and of osteomyelitis, and should be performed properly using broad-spectrum antibiotics. In the case reported here, although antibiotics with those characteristics were used, the active ingredient had to be changed more than once. In this particular case, there was an improvement in the lameness and the wound, and in the radiographic signs of the proximal phalanx, only after the application of gamithromycin. Therefore, this drug can be considered as an alternative for the treatment of osteomyelitis in ruminants, especially in cases unresponsive to treatment with other antibiotics.

K-Wire Fixation for Extraarticular Transverse/Short Oblique Fractures of the Shaft of the Middle Phalanx Associated with Extensor Tendon Injury

2008 ◽  
Vol 33 (5) ◽  
pp. 561-565 ◽  
Author(s):  
M. M. AL-QATTAN
Keyword(s):  
Extensor Tendon ◽  
Tendon Injury ◽  
Interphalangeal Joint ◽  
Middle Phalanx ◽  
Distal Interphalangeal Joint ◽  
Active Motion ◽  
Total Active Motion ◽  
Distal Interphalangeal ◽  
A Prospective Study

In a prospective study, 22 cases of extraarticular transverse/short oblique fractures of the shaft of the middle phalanx associated with extensor tendon injury had fixation of the fracture as well as immobilisation of the distal interphalangeal joint using a K-wire. Mobilisation of the proximal interphalangeal and metacarpophalangeal joints was started immediately after surgery. The wires were removed after 6 weeks. No post-operative complications were noted. At final follow-up (mean = 15 weeks, range = 12–24 weeks), 18 of 22 patients obtained excellent and good total active motion (TAM) scores. Stiffness was confined to the distal interphalangeal joint, and hence when the results were re-analysed for motion at that joint only, only 11 patients had excellent and good outcomes.

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