Arthrodesis of Little Finger Distal Interphalangeal Joint in Flexion to Regain Sporting Ability

2017 ◽  
Vol 22 (01) ◽  
pp. 83-87
Author(s):  
S.M. Beecher ◽  
D.E. O’Briain ◽  
J.P. Ng ◽  
E. Murphy ◽  
M.E. O’Sullivan
Keyword(s):  
Grip Strength ◽  
Hand Function ◽  
Interphalangeal Joint ◽  
Bony Union ◽  
Posttraumatic Arthritis ◽  
Distal Interphalangeal Joint ◽  
Full Extension ◽  
Distal Interphalangeal ◽  
Post Traumatic ◽  
Little Finger

Background: Finger injuries are common in the sport of hurling. Injury to the little finger distal interphalangeal joint (DIPJ) often occurs when a high dropping ball impacts on the outstretched finger. The little finger contributes to approximately 15% of grip strength. Injury therefore results in reduced grip strength and may impair the ability of players to grip or catch a ball. Methods: Six elite hurlers with post-traumatic arthritis of their non-dominant little finger DIPJ underwent arthrodesis in 30 degrees of flexion. Kirchner wires were inserted for up to 8 weeks to achieve fusion of the joint. Patients were evaluated after recovery using a dynamometer to assess grip strength, the DASH questionnaire and a sport specific questionnaire. Results: All arthrodeses achieved bony union without complication. All patients reported a resolution of their pain and recovery in their ability to catch & retain a ball. Measurements of grip strengths were comparable between hands. DASH scores improved by up to 47 points. All scores were less than 5 at final follow-up. Conclusions: Grip strength decreases when fingers are immobilized in full extension. In sports that require catching or gripping a ball or a bat, arthrodesis of the DIP joint in flexion can improve grip strength and hand function. Fusion in 30 degrees of flexion for hurlers results in restoration of function and resolution of pain. Little finger DIPJ arthrodesis is a valid method of treating posttraumatic arthritis in ball and bat sports.

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.

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.

The Impact of Simulated Distal Interphalangeal Joint Fusion on Grip Strength

Orthopedics ◽  
2000 ◽  
Vol 23 (3) ◽  
pp. 239-241
Author(s):  
William J Morgan ◽  
Lisa A Schulz ◽  
Joseph L Chang
Keyword(s):  
Grip Strength ◽  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Joint Fusion ◽  
Distal Interphalangeal ◽  
The Impact

Irreducible Palmar Dislocation of the Distal Interphalangeal Joint Due to Closed Degloving of the Distal Phalanx of the Little Finger

Hand Surgery ◽  
2015 ◽  
Vol 20 (02) ◽  
pp. 304-306
Author(s):  
Naohito Hibino ◽  
Yoshitaka Hamada ◽  
Shyunichi Toki ◽  
Shinji Yoshioka ◽  
Masahiro Yamano ◽  
...  
Keyword(s):  
Operative Treatment ◽  
Distal Phalanx ◽  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Degloving Injury ◽  
Closed Degloving Injury ◽  
Distal Interphalangeal ◽  
Closed Degloving ◽  
Little Finger

Since irreducible dislocation of the distal interphalangeal joint (DIP joint) is dorsal dislocation, irreducible palmar dislocation of the DIP Joint is very rare. This case was associated with a closed degloving injury of the distal phalanx of the little finger and required operative treatment.

Miniplate Fixation for Avulsion Injuries of the Flexor Digitorum Profundus Insertion

2003 ◽  
Vol 28 (4) ◽  
pp. 363-368 ◽  
Author(s):  
N. KANG ◽  
A. PRATT ◽  
N. BURR
Keyword(s):  
Interphalangeal Joint ◽  
Flexor Digitorum Profundus ◽  
Bony Union ◽  
Distal Interphalangeal Joint ◽  
Type Iii ◽  
Type Iv ◽  
Distal Interphalangeal ◽  
Joint Congruity ◽  
Flexor Digitorum ◽  
Tendon Avulsion

This article describes the use of a miniplate and cortical screws in the treatment of five cases of flexor digitorum profundus (FDP) tendon avulsion. One case was type II, three cases were type III and one case was type IV. Near normal joint congruity was restored together with bony union in all cases. Six months after surgery four cases had near normal range of motion at the distal interphalangeal joint compared with the contralateral uninjured finger. These four patients were to return to their previous activities without restriction by 3 months. One repair of a type III avulsion ruptured but the distal interphalangeal joint was pain free and stable and the patient declined further surgery. Miniplate fixation offers some advantages over existing methods of repair and adds to the range of techniques available for reattachment of the FDP tendon in these injuries.

Effect of immobilization of the distal interphalangeal joint of fingers on grip strength

2018 ◽  
Vol 43 (5) ◽  
pp. 554-557
Author(s):  
Feiran Wu ◽  
Saurabh Sagar Mehta ◽  
David Dickson ◽  
Dee Catchpole ◽  
Chye Yew Ng
Keyword(s):  
Grip Strength ◽  
Clinical Application ◽  
Salvage Treatment ◽  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Distal Interphalangeal ◽  
Middle Ring ◽  
The Individual ◽  
End Stage ◽  
Healthy Participants

Arthrodesis of the distal interphalangeal joint of the finger is an effective salvage treatment for end-stage arthropathy of the joint. This study aimed to evaluate the effect of simulated fusion of individual distal interphalangeal joints on the overall grip strength of the hand. Custom moulded thermoplastic splints were used to simulate fusion by immobilizing the index, middle, ring and little fingers’ distal interphalangeal joints in turn in both hands of 56 healthy participants. Testing was performed with no immobilization and after immobilization of each of the individual digits. Grip strengths reduced significantly following immobilization of the distal interphalangeal joint. The degree of reduction became progressively more pronounced from the index to the little fingers (12%, 18%, 24% and 25%, respectively) and was similar for the dominant and non-dominant hands. This information may have clinical application when counselling patients regarding fusion of the distal interphalangeal joint of the fingers.

Simultaneous Volar Dislocation of Distal Interphalangeal Joint and Volar Fracture-Subluxation of Proximal Interphalangeal Joint of Little Finger: A New Mechanism of Injury

2016 ◽  
Vol 21 (03) ◽  
pp. 422-424
Author(s):  
Kamran Mozaffarian ◽  
Abdollah Bayatpour ◽  
Amir Reza Vosoughi
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Mechanism Of Injury ◽  
Full Extension ◽  
Joint Fracture ◽  
Pip Joint ◽  
Distal Interphalangeal ◽  
Full Flexion ◽  
Loss Of Motion ◽  
Little Finger

Simultaneous volar dislocation of distal interphalangeal (DIP) joint and volar fracture-subluxation of proximal interphalangeal (PIP) joint of the same finger has not been reported yet. A 19-year-old man was referred due to pain on the deformed left little finger after a ball injury. Radiographs showed volar dislocation of the DIP joint and dorsal lip fracture of the middle phalanx with volar subluxation of PIP joint of the little finger. This case was unique in terms of the mechanism of injury which was hyperflexion type in two adjacent joints of the same finger. The patient was treated by closed reduction of DIP joint dislocation and open reduction and internal fixation of the PIP joint fracture-subluxation and application of dorsal external fixator due to instability. Finally, full flexion of the PIP joint and full extension of the DIP joint were obtained but with 10 degree extension lag at the PIP joint and DIP joint flexion ranging from 0 degree to 30 degrees. Some loss of motion in small joints of the fingers after hyperflexion injuries should be expected.

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