The outcomes of zone 1 flexor tendon injuries treated using micro bone suture anchors

2013 ◽  
Vol 38 (9) ◽  
pp. 973-978 ◽  
Author(s):  
S. Huq ◽  
S. George ◽  
D. E. Boyce
Keyword(s):  
Range Of Motion ◽  
Flexor Tendon ◽  
Proximal Interphalangeal Joint ◽  
Tendon Injuries ◽  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Flexor Tendon Injuries ◽  
Distal Interphalangeal ◽  
Bone Anchors ◽  
The Mean

This article evaluates the outcome of 42 consecutive zone 1 flexor tendon injuries treated by using micro bone anchors during the period 2003–2008. Patients were rehabilitated using the modified Belfast Regime. The range of motion at the distal interphalangeal joint was assessed using Moiemen’s classification. A total of 56% of patients achieved excellent or good results for range of motion at the distal interphalangeal joint and 23% had a poor outcome. The mean distal interphalangeal joint and proximal interphalangeal joint range of motion were 48° and 96°, respectively. A total of 94% of patients returned back to work by 12 weeks. One patient sustained a tendon rupture and one developed osteomyelitis. The mean QuickDASH score was 13.5 and 81% of patients were satisfied with their outcomes. This is the largest clinical study on the use of bone anchors for zone 1 tendon injuries. Our study demonstrated a low rate of complications and outcomes that compare favourably with other published techniques.

Resistive testing in a patient with suspected zone I flexor tendon injury

Hand Therapy ◽  
2009 ◽  
Vol 14 (3) ◽  
pp. 83-85
Author(s):  
Gangatharam Sudhagar ◽  
Monique Leblanc
Keyword(s):  
Occupational Therapy ◽  
Flexor Tendon ◽  
Tendon Injury ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Hand Surgeon ◽  
Flexor Tendon Injury ◽  
Distal Interphalangeal

Lacerations are the major cause of flexor tendon injury in zone I and they are most commonly missed due to incomplete examinations. We report a case of lacerated flexor tendon injury in Zone I closed without explorations and which was referred to occupational therapy with the diagnosis of stiff hand. The patient received therapy for his stiff hand following which he could flex the distal interphalangeal joint (DIP) on blocking the proximal interphalangeal joint but failed to flex his DIP joint on making a composite fist. With resistive testing the patient failed to initiate resistance on flexion. The patient was referred back to the hand surgeon and subsquently diagnosed with a flexor tendon injury.

Treatment of Mallet Fractures Using Compression Fixation Pins

1999 ◽  
Vol 24 (3) ◽  
pp. 358-360 ◽  
Author(s):  
K. YAMANAKA ◽  
T. SASAKI
Keyword(s):  
Range Of Motion ◽  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Anatomical Reduction ◽  
Active Motion ◽  
Active Range Of Motion ◽  
Motion Exercise ◽  
Distal Interphalangeal ◽  
The Mean ◽  
Good Range

Fifteen patients who underwent percutaneous fixation of mallet fractures of the distal phalanx using compression fixation pins were assessed. Anatomical reduction was achieved in all patients. There were no nonunions. The mean active range of motion of the distal interphalangeal joint was 1° of hyperextension to 69° of flexion. The fixation was stable enough to allow early active motion exercise of the distal interphalangeal joint. This technique results in a good range of motion in a shorter period of time than other treatments.

Relative ratios of collagen composition of periarticular tissue of joints of the upper limb

2016 ◽  
Vol 42 (6) ◽  
pp. 616-620 ◽  
Author(s):  
A. Cheah ◽  
A. Harris ◽  
W. Le ◽  
Y. Huang ◽  
J. Yao
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
The Other ◽  
Paired Comparisons ◽  
Distal Interphalangeal Joint ◽  
Palmar Plate ◽  
Fresh Frozen ◽  
Distal Interphalangeal ◽  
The Mean ◽  
Periarticular Tissue

We investigated the relative ratios of collagen composition of periarticular tissue of the elbow, wrist, metacarpophalangeal, proximal and distal interphalangeal joints. Periarticulat tissue, which we defined as the ligaments, palmar plate and capsule, was harvested from ten fresh-frozen cadaveric upper limbs, yielding 50 samples. The mean paired differences (95% confidence interval) of the relative ratios of collagen between the five different joints were estimated using mRNA expression of collagen in the periarticular tissue. We found that the relative collagen composition of the elbow was not significantly different to that of the proximal interphalangeal joint, nor between the proximal interphalangeal joint and distal interphalangeal joint, whereas the differences in collagen composition between all the other paired comparisons of the joints had confidence intervals that did not include zero.

The Modified Kleinert Splint in Zone II Flexor Tendon Injuries

1988 ◽  
Vol 13 (3) ◽  
pp. 273-276
Author(s):  
P. G. SLATTERY
Keyword(s):  
Wound Healing ◽  
Range Of Motion ◽  
Flexor Tendon ◽  
Proximal Phalanx ◽  
Tendon Injuries ◽  
Compound Fracture ◽  
Flexor Tendon Injuries ◽  
Distal Interphalangeal ◽  
Zone Ii ◽  
Kleinert Splint

The Kleinert controlled passive mobilisation splint has been modified to increase the passive range of motion of the proximal and distal interphalangeal joints to near normal. 12 fingers with complete divisions of both flexor tendons in Zone II treated by this method have been reviewed after six months. Nine regained full motion and two good motion while one, with an associated crush compound fracture of the proximal phalanx, had a poor result. The increased mobilisation did not adversely affect wound healing or associated repair of digital nerves.

A Modified Kleinert Controlled Mobilization Splint Following Flexor Tendon Repair

1984 ◽  
Vol 9 (2) ◽  
pp. 217-218 ◽  
Author(s):  
P. G. SLATTERY ◽  
D. A. McGROUTHER
Keyword(s):  
Range Of Motion ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Interphalangeal Joint ◽  
Flexor Digitorum Profundus ◽  
Distal Interphalangeal Joint ◽  
Normal Range ◽  
Flexor Tendon Repair ◽  
Distal Interphalangeal ◽  
Flexor Digitorum

The Controlled Mobilization Splint as described by Kleinert for use following flexor tendon repair has been modified to more closely simulate the normal range of motion of the fingers and in particular to increase the range of motion at the distal interphalangeal joint and so enhance the relative gliding of the flexor digitorum superficialis and flexor digitorum profundus tendons and hence possibly to reduce potential intertendinous adhesions.

Radioulnar interphalangeal joint angles in children and adolescents aged 0 to 19 years

2021 ◽  
pp. 175319342098612
Author(s):  
Sebastian Tschauner ◽  
Eszter Nagy ◽  
Dominik Hirling ◽  
Sara Fahmy ◽  
Petar Vasilev ◽  
...  
Keyword(s):  
Joint Angle ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Joint Angles ◽  
Distal Interphalangeal Joint ◽  
Ulnar Deviation ◽  
Radial Deviation ◽  
Normal Ranges ◽  
Distal Interphalangeal ◽  
The Mean

The purpose of this study is to determine the normal ranges of radioulnar (i.e. medial-lateral) finger deviations during growth. We retrospectively measured radioulnar interphalangeal joint angles in 6236 properly aligned thumbs and fingers in trauma radiographs of 4720 patients aged 0 to 19 years. The mean interphalangeal joint angle of the thumb was 0.2° (standard deviation 1.5°). The average proximal interphalangeal joint angles were ulnar deviation of 2.5° (1.7°) for the index, ulnar deviation 1.7° (1.5°) for the middle, radial deviation 1.3° (1.8°) for the ring, radial deviation 2.0° (2.8°) for the little fingers. The distal interphalangeal joint angles were ulnar deviation of 2.5° (1.7°), ulnar deviation 2.1° (1.7°), radial deviation 2.1° (1.7°), radial deviation 5.1° (2.8°) from index to the little fingers. Thumbs were typically straight, whereas the index and middle fingers deviated ulnarly, and ring and little fingers radially. There were no relevant differences in sex or laterality.

Volar plating versus external fixation for unstable dorsal fracture-dislocations of the proximal interphalangeal joint

2021 ◽  
pp. 175319342110593
Author(s):  
Atsuhiko Murayama ◽  
Kentaro Watanabe ◽  
Hideyuki Ota ◽  
Shigeru Kurimoto ◽  
Hitoshi Hirata
Keyword(s):  
External Fixation ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Volar Plating ◽  
Distal Interphalangeal Joint ◽  
Active Flexion ◽  
Plate Group ◽  
Fracture Dislocations ◽  
Distal Interphalangeal

We retrospectively compared the results of volar plating and dynamic external fixation for acute unstable dorsal fracture-dislocations of the proximal interphalangeal joint with a depressed fragment. We treated 31 patients (31 fingers), 12 with volar buttress plating and 19 with dynamic external fixation. Follow-up averaged 35 and 40 months in the two groups, with a minimal 6-month follow-up. Average active flexion of the proximal interphalangeal joint was 95° after plate fixation and 87° after external fixation, with an active extension lag of –6° and –9°, respectively. Active flexion at the distal interphalangeal joint averaged 67° in the plate group and 58° in the external fixation group, with active extension lags of 0° and –5°, respectively. We conclude that both methods can obtain a good range of motion at the proximal interphalangeal joint. A limitation of the extension of the distal interphalangeal joint occurred with dynamic external fixation but not with volar buttress plating. Level of evidence: IV

The Surface Anatomy of the Germinal Matrix of the Nail Bed in the Finger

1999 ◽  
Vol 24 (5) ◽  
pp. 531-533 ◽  
Author(s):  
C. M. REARDON ◽  
P. A. McARTHUR ◽  
S. K. SURVANA ◽  
T. M. BROTHERSTON
Keyword(s):  
Histological Study ◽  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Germinal Matrix ◽  
Nail Matrix ◽  
Surface Anatomy ◽  
Angular Extent ◽  
Distal Interphalangeal ◽  
Lateral Extent ◽  
The Mean

Nail spicules result from incomplete excision of the nail matrix of the finger. We report a histological study to delineate the surface anatomy of the nail matrix. Sections were cut longitudinally and transversely in 19 fingertips. The proximal midline extent of the nail matrix was measured and expressed as a ratio of the distance from the nail fold to the distal interphalangeal joint. In the lateral sections, the angle subtended between the midline vertical and the lateral extent of the nail matrix was measured. The mean ratio of the proximal extent was 0.55 in the midline and the lateral angular extent was 66°. The authors recommend that excision of the nail matrix should be rectangular, extending to the midlateral lines and proximally to a point three-quarters of the distance from the nail fold to the distal interphalangeal joint crease.

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