INVESTIGATION OF SAFETY AND EFFICACY OF A PNEUMATIC FINGER TOURNIQUET

Hand Surgery ◽  
2008 ◽  
Vol 13 (02) ◽  
pp. 55-59 ◽  
Author(s):  
Mubashir H. Cheema ◽  
Syed N. Ali ◽  
Rosemary Chukwulobelu ◽  
Francis C. Peart
Keyword(s):  
Local Anaesthesia ◽  
Hand Surgery ◽  
Proximal Interphalangeal Joint ◽  
Synthetic Polymer ◽  
Interphalangeal Joint ◽  
Tourniquet Time ◽  
Pneumatic Tourniquet ◽  
Safety And Efficacy ◽  
Finger Injuries

Finger tourniquets are widely used in hand surgery. However, they do not provide an estimate of the amount of pressure exerted and can potentially be left in situ with grave consequences. We assessed the pneumatic finger tourniquet in 57 adult patients in operations under local anaesthesia distal to the proximal interphalangeal joint. The average tourniquet time was 12 minutes. The tourniquet maintained its pressure for the length of the operation in 96.5% of cases. This airtight flat tubing is made of synthetic polymer, designed and manufactured by Barloworld Scientific Ltd (Staffordshire, UK). The tourniquet was easy to use and easily located after the operation. No complications were reported. This study supports the use of a pneumatic tourniquet in finger injuries requiring use of a finger tourniquet.

TWO TO FIVE YEAR FOLLOW-UP OF THE LPM CERAMIC COATED PROXIMAL INTERPHALANGEAL JOINT ARTHROPLASTY

2008 ◽  
Vol 33 (1) ◽  
pp. 38-44 ◽  
Author(s):  
J. FIELD
Keyword(s):  
Clinical Signs ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Pip Joint ◽  
Joint Implants ◽  
Post Traumatic ◽  
Joint Arthroplasties ◽  
Traumatic Arthritis

This paper presents a retrospective series of 20 LPM semi-constrained ceramic coated cobalt chrome proximal interphalangeal joint arthroplasties performed consecutively in 12 patients for arthritis of the proximal interphalangeal joint by a single surgeon between 2000 and 2004. Eleven were performed for osteoarthritis, four for post-traumatic arthritis and five for rheumatoid arthritis. Although 12 joints had an improvement in pain and an increased functional arc of movement, six joints required revision surgery for implant failure at an average of 19 months, with clinical signs of increasing pain, deteriorating motion and radiological signs of implant loosening and subsidence. This rate of revision is higher than in published series for other PIP joint implants and, therefore, close surveillance of all patients with this prosthesis currently in situ is recommended. Use of the prosthesis has ceased in this unit.

Destructive Arthropathy of the Interphalangeal Joint Following Revascularization After Degloving Hand Injury: A Case Report

Hand ◽  
2021 ◽  
pp. 155894472110031
Author(s):  
Akihiro Hirakawa ◽  
Shingo Komura ◽  
Tomihiro Masuda ◽  
Kazu Matsumoto ◽  
Haruhiko Akiyama
Keyword(s):  
Hand Surgery ◽  
Tendon Graft ◽  
Hand Injury ◽  
Proximal Interphalangeal Joint ◽  
Functional Restoration ◽  
Interphalangeal Joint ◽  
Functional Improvement ◽  
X Ray ◽  
Degloving Injury ◽  
Destructive Arthropathy

It is difficult to achieve satisfactory results in the treatment of advanced degloving injury, which is one of the most challenging injuries in hand surgery. In this report, we present a case of marked destructive arthropathy of the interphalangeal joint that developed following revascularization after degloving hand injury. A 37-year-old, right-handed female manual worker sustained a degloving injury of her fingers, including the dorsal hand. We performed revascularization and secondary surgery, which included tenolysis and a tendon graft, to obtain functional improvement. These 2 procedures provided significant improvement in the active range of motion of the respective fingers. However, the patient complained of postoperative pain in the proximal interphalangeal joint. X-ray revealed destructive changes in the interphalangeal joint, which advanced progressively. Destructive changes in the interphalangeal joint following advanced degloving injury should be recognized as a potential complication that could be a limitation of functional restoration. Follow-up X-ray examination is necessary, even in cases with no fracture of the phalanges at the time of injury. In the management of degloving injury, patients should be informed of the potential risk of destructive arthropathy, which could result in restricted motion with pain.

scholarly journals Volar Plate Avulsion of Pip Joint: An Unusual Fielding Injury in Cricket

2015 ◽  
Vol 49 (4) ◽  
pp. 209-212
Author(s):  
Sharad Prabhakar ◽  
Himmat Singh Dhillon ◽  
Kevin Syam ◽  
Sidak Singh Dhillon ◽  
Mandeep Singh Dhillon
Keyword(s):  
Soft Tissue ◽  
Team Sport ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Hand Injuries ◽  
Volar Plate ◽  
Finger Injuries ◽  
Pip Joint ◽  
Unusual Injury

ABSTRACT Fielding injuries are the predominant contact injury in cricket, with the fingers taking the blunt of the trauma due to direct hit by the ball while taking catches. Many types of hand and finger injuries like soft tissue contusions, fractures/dislocations and ligament and joint sprains have been observed in this popular team sport. One of the unique kind of hand injuries associated with cricket is the avulsion of the volar plate of the proximal interphalangeal joint (PIP). Here, we report this unusual injury in a 24-year-old cricketer, its management and 3-month follow-up along with a review of hand injuries in cricket. How to cite this article Prabhakar S, Dhillon HS, Syam K, Dhillon SS, Dhillon MS. Volar Plate Avulsion of Pip Joint; An Unusual Fielding Injury in Cricket. J Postgrad Med Edu Res 2015;49(4):209-212.

Upper Extremity Injuries in the National Football League

2008 ◽  
Vol 36 (10) ◽  
pp. 1938-1944 ◽  
Author(s):  
Nathan A. Mall ◽  
John C. Carlisle ◽  
Matthew J. Matava ◽  
John W. Powell ◽  
Charles A. Goldfarb
Keyword(s):  
Upper Extremity ◽  
National Football League ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Hand Injuries ◽  
American Football ◽  
Football Players ◽  
Finger Injuries ◽  
First Ray ◽  
Extremity Injuries

Background Very little has been published regarding the incidence of and duration of time lost after hand injuries in professional American football players. Hypotheses (1) Hand, first ray, and finger injuries in professional American football players represent a common cause of missed time from practice and game participation. (2) The effect of upper extremity injuries differs as a function of the anatomic site involved, injury type, and athlete's position. Study Design Descriptive epidemiologic study. Methods A retrospective review of all documented injuries to the hand, first ray, and fingers sustained by American football players in the National Football League over a 10-year period (1996–2005) was performed using the League's injury surveillance database. The data were analyzed from multiple perspectives, with emphasis on the type of injury, athlete position, and activity at the time of injury. Results A total of 1385 injuries occurred to the hand, first ray, and fingers over the 10 seasons studied. Of these injuries, 48% involved the fingers, 30% involved the first ray, and 22% involved the hand, with game injuries more common than practice injuries at each location. Metacarpal fractures and proximal interphalangeal joint dislocations were the 2 most common injuries. Offensive and defensive linemen were the most likely to sustain a hand injury; 80% of hand injuries were metacarpal fractures. The most common injuries to the first ray were fractures (48%) and sprains (36%), which occurred most often in athletes playing a defensive secondary position. Finger injuries were most commonly dislocations at the level of the proximal interphalangeal joint, typically involving the ulnar 2 digits. Finger injuries were most common in wide receivers and defensive secondary players. The act of tackling produced the most injuries (28%). Conclusion Upper extremity trauma, especially injury to the hand, first ray, and fingers, is a significant source of morbidity for professional football players. The results of this study may be used to implement preventive measures to help minimize these injuries.

Surgery of the Hand in Severe Systemic Sclerosis

2004 ◽  
Vol 29 (6) ◽  
pp. 599-603 ◽  
Author(s):  
M. K. GILBART ◽  
B. M. JOLLES ◽  
P. LEE ◽  
E. R. BOGOCH
Keyword(s):  
Systemic Sclerosis ◽  
High Speed ◽  
Hand Surgery ◽  
Metacarpophalangeal Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Non Union ◽  
Joint Fusion ◽  
Lost To Follow Up

Ten patients with scleroderma and severe hand problems required surgery, and seven were available for follow-up (two died from scleroderma-related complications and one was lost to follow-up). The mean duration of follow-up was 4 (range 1.5–9) years. Thirty-three procedures were carried out, including five metacarpophalangeal joint exisional arthroplasties, 13 proximal interphalangeal joint fusions, ten distal interphalangeal joint fusions, and one thumb interphalangeal joint fusion. The metacarpophalangeal joint excision arthroplasties and proximal interphalangeal joint fusions were performed for the correction of severe fixed “finger-in-palm” deformities. Lesions of cutaneous calcinosis were removed in four patients. Fixation was satisfactory in all cases of interphalangeal joint fusion, with no cases of non-union. Wound healing was satisfactory in six of seven patients. A second surgical procedure was required in three patients for the removal of tension band wires following interphalangeal fusion. Calcinosis was effectively removed using a high-speed dental burr. The results of hand surgery for systemic sclerosis are reliable, but goals must be limited and patient expectations should be modest.

scholarly journals Volar Buttress Plating for Unstable Dorsal Fracture-Dislocations of the Proximal Interphalangeal Joint

2019 ◽  
Vol 11 (02) ◽  
pp. 106-110 ◽  
Author(s):  
Talvinder Singh ◽  
Roshenka Jayawardhana ◽  
Michael Craigen ◽  
Vaikunthan Rajaratnam
Keyword(s):  
Articular Surface ◽  
Pain Syndrome ◽  
Hand Surgery ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Fracture Dislocation ◽  
Bony Union ◽  
Superficial Infection ◽  
Early Return

AbstractThe authors present a series of 11 patients. All of them sustained an unstable dorsal fracture-dislocation of the proximal interphalangeal joint (PIPJ). These were managed with open reduction and internal fixation (ORIF) by use of an eight-hole, 1.3-mm oblique-angled strut plate, cut to shape to produce a four-hole plate, acting as a buttress plate. The operations were performed by orthopaedic surgeons with a special interest in hand surgery. Range of motion (ROM) and fixed flexion deformity (FFD) were measured postoperatively. Outcomes were assessed using the Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH) scoring system. Bony union, articular step-off, degenerative changes, persistent subluxation, or dislocation were confirmed by review of radiographs at latest follow-up. One patient developed a superficial infection and another developed complex regional pain syndrome. However, all patients were pain free at final follow-up. Radiographs at final follow-up confirmed bony union with no step-off, except for one patient who had a 1-mm step-off of the articular surface. Our attractive and novel technique of ORIF allows articular congruity to be restored anatomically with early active mobilization of the affected digit and early return to function.

Arthroplasty in the hand: what works and what doesn’t?

2021 ◽  
pp. 175319342110177
Author(s):  
Daniel B. Herren ◽  
Hajime Ishikawa ◽  
Marco Rizzo ◽  
Mark Ross ◽  
Michael Solomons
Keyword(s):  
Surgical Technique ◽  
Metacarpophalangeal Joint ◽  
Distal Radioulnar Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Carpometacarpal Joint ◽  
Thumb Carpometacarpal Joint ◽  
Radioulnar Joint ◽  
What Works ◽  
Thumb Carpometacarpal

This review describes the different possibilities for arthroplasties at the proximal interphalangeal joint, thumb carpometacarpal joint, distal radioulnar joint, metacarpophalangeal joint and the wrist. For each joint, the indication for arthroplasty is explained, the surgical technique with the suitable implant is described and a brief summary of the outcomes reported in the literature is given.

A proximal interphalangeal joint custom-made orthosis in trigger finger: Functional outcome

Hand Therapy ◽  
2021 ◽  
pp. 175899832110187
Author(s):  
Kawee Pataradool ◽  
Chayanin Lertmahandpueti
Keyword(s):  
Outcome Measures ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Mean Difference ◽  
Trigger Finger ◽  
Symptom Improvement ◽  
Dash Score ◽  
Full Time ◽  
Custom Made ◽  
Quick Dash

Introduction Trigger finger is a common and functionally limiting disorder. Finger immobilization using an orthotic device is one of the conservative treatment options for treating this condition. The most common orthosis previously described for trigger finger is metacarpophalangeal joint immobilization. There are limited studies describing the effectiveness of proximal interphalangeal joint orthosis for treatment of trigger finger. Methods This study was a single group pretest-posttest design. Adult patients with single digit idiopathic trigger finger were recruited and asked to wear a full-time orthoses for 6 weeks. The pre- and post-outcome measures included Quick-DASH score, the Stages of Stenosing Tenosynovitis (SST), the Visual Analogue Scale (VAS) for pain, the number of triggering events in ten active fists, and participant satisfaction with symptom improvement. Orthotic devices were made with thermoplastic material fabricated with adjustable Velcro tape at dorsal side. All participants were given written handouts on this disease, orthotic care and gliding exercises. Paired t-tests were used to determine changes in outcome measures before and after wearing the orthosis. Results There were 30 participants included in this study. Evaluation after the use of PIP joint orthosis at 6 weeks revealed that there were statistically significant improvements in Quick-DASH score from enrolment (mean difference −29.0 (95%CI −34.5 to −23.4); p < 0.001), SST (mean difference −1.4 (95%CI −1.8 to −1.0); p < 0.001) and VAS (mean difference −3.4 (95%CI −4.3 to −2.5); p < 0.001). There were no serious adverse events and patient satisfaction with the treatment was high. Conclusions Despite our small study size, the use of proximal interphalangeal joint orthosis for 6 weeks resulted in statistically significant improvements in function, pain and triggering, and also high rates of acceptance in patients with isolated idiopathic trigger finger.

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