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

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.

scholarly journals Comprehensive assessment of alterations in hand deformities over 11 years in patients with rheumatoid arthritis using cluster analysis and analysis of covariance

2021 ◽  
Author(s):  
Shogo Toyama ◽  
Daisaku Tokunaga ◽  
Shinji Tsuchida ◽  
Rie Kushida ◽  
Ryo Oda ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cluster Analysis ◽  
Learning Curves ◽  
Comprehensive Assessment ◽  
Analysis Of Covariance ◽  
Boutonniere Deformity ◽  
Hand Deformities ◽  
Evaluation Point ◽  
Boutonnière Deformity ◽  
Swan Neck Deformity

Abstract BackgroundAlthough drug therapy for rheumatoid arthritis (RA) has recently improved, treating patients with established disease, whose hands have three major deformities (thumb deformity, finger deformities, and ulnar drift), remains a challenge. The underlying complex pathophysiology makes understanding these deformities difficult, and comprehensive assessment methods require accumulated skill with long learning curves. We aimed to establish a simpler composite method to understand the pathophysiology of and alterations in the hand deformities of patients with RA.MethodsWe established a rheumatoid hand cohort in 2004 and clinically evaluated 134 hands (67 patients). We repeated the evaluations in 2009 (100 hands of 52 patients) and 2015 (63 hands of 37 patients) after case exclusion. Thumb deformities, finger deformities (swan-neck and boutonnière deformity), and ulnar drift were semi-quantitated and entered as parameters into a two-step cross-sectional cluster analysis for the data in 2004. The parameters in each cluster were plotted at each evaluation point. Two-way analysis of covariance was used to examine whether differences existed between evaluation points and clusters of deformity parameters.ResultsFive clusters most appropriately described hand deformity: (i) cluster 1, minimal deformity; (ii) cluster 2, type 1 thumb deformity; (iii) cluster 3, thumb deformity and severe boutonnière deformity; (iv) cluster 4, type 2 or 3 thumb deformity and severe ulnar drift; and (v) cluster 5, thumb deformity and severe swan-neck deformity. Clusters 1 and 2 had higher function than cluster 5, and cluster 3 had moderate function. Clusters 1–4 had similar disease duration but showed different paths of deformity progression from disease onset. Clusters 1 and 2 represented conservative deformity parameters and clusters 3, 4, and 5 represented progressive deformity parameters. Over time, thumb deformity evolved into other types of deformities and swan-neck deformity worsened significantly.ConclusionsOur comprehensive analysis identified five deformity patterns and a progressive course in the rheumatoid hand. Knowledge of the characteristics of progressive deformity parameters may allow rheumatologists to more easily implement practical interventions and determine functional prognosis.

scholarly journals PREVALENCE AND FACTORS ASSOCIATED WITH INJURIES IN RECREATIONAL RUNNERS: A CROSS-SECTIONAL STUDY

2020 ◽  
Vol 26 (3) ◽  
pp. 215-219 ◽  
Author(s):  
Maria Eduarda Ferreira Costa ◽  
Jader Barbosa Fonseca ◽  
Ana Izabela Sobral de Oliveira ◽  
Kryslly Danielle de Amorim Cabral ◽  
Maria das Graças Rodrigues de Araújo ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Musculoskeletal Injuries ◽  
Sectional Study ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Factors Associated ◽  
Demographic Questionnaire ◽  
Chi Squared ◽  
Running Injuries ◽  
History Of

ABSTRACT Introduction The increased number of people who choose running as a form of exercise has been associated with a higher prevalence of musculoskeletal injuries. Objectives To determine the prevalence and the factors that could be correlated with injuries among amateur runners in Recife, in the State of Pernambuco (PE), Brazil. Methods An observational, cross-sectional study, in which 300 (three hundred) amateur runners answered a social demographic questionnaire, as well as questions about training characteristics, footstrike and landing pattern, and history of running injuries. The data were analyzed by descriptive statistics, the student-t test to compare means, and the Chi-squared to compare prevalences. Results The prevalence of injuries amongst runners in Recife-PE was 58.5% (n= 175), the knee being the most commonly injured site (37.3%). In both groups - runners with and without injuries – there was a higher number of male runners, with 72.4% and 72.6% respectively. There was no difference in relation to the weekly frequency of running between the groups (p<0.63). However, runners with a history of injuries ran around 7 kmh a week more than the runners without injuries (p<0.03). A neutral footstrike (F=0.87; p=0.99) and hindfoot landing (F=4.13; p=0.90) were the most reported running patterns in both groups. It was found that wear was the main criterion used for changing running shoes in both groups (F = 8.35, p = 0.4). Conclusion There was a high prevalence of musculoskeletal injuries among amateur runners in Recife-PE. Among the factors associated with the injuries, one variable was significant: a higher weekly volume of training. Level of evidence II; Study type: Cross-sectional study.

scholarly journals Comprehensive assessment of alterations in hand deformities over 11 years in patients with rheumatoid arthritis using cluster analysis and analysis of covariance

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Shogo Toyama ◽  
Daisaku Tokunaga ◽  
Shinji Tsuchida ◽  
Rie Kushida ◽  
Ryo Oda ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cluster Analysis ◽  
Learning Curves ◽  
Comprehensive Assessment ◽  
Analysis Of Covariance ◽  
Boutonniere Deformity ◽  
Hand Deformities ◽  
Evaluation Point ◽  
Boutonnière Deformity ◽  
Swan Neck Deformity

Abstract Background Although drug therapy for rheumatoid arthritis (RA) has recently improved, treating patients with established disease, whose hands have three major deformities (thumb deformity, finger deformities, and ulnar drift), remains a challenge. The underlying complex pathophysiology makes understanding these deformities difficult, and comprehensive assessment methods require accumulated skill with long learning curves. We aimed to establish a simpler composite method to understand the pathophysiology of and alterations in the hand deformities of patients with RA. Methods We established a rheumatoid hand cohort in 2004 and clinically evaluated 134 hands (67 patients). We repeated the evaluations in 2009 (100 hands of 52 patients) and 2015 (63 hands of 37 patients) after case exclusion. Thumb deformities, finger deformities (swan-neck and boutonnière deformity), and ulnar drift were semi-quantitated and entered as parameters into a two-step cross-sectional cluster analysis for the data in 2004. The parameters in each cluster were plotted at each evaluation point. Two-way analysis of covariance was used to examine whether differences existed between evaluation points and clusters of deformity parameters. Results Five clusters most appropriately described hand deformity: (i) cluster 1, minimal deformity; (ii) cluster 2, type 1 thumb deformity; (iii) cluster 3, thumb deformity and severe boutonnière deformity; (iv) cluster 4, type 2 or 3 thumb deformity and severe ulnar drift; and (v) cluster 5, thumb deformity and severe swan-neck deformity. Clusters 1 and 2 had higher function than cluster 5, and cluster 3 had moderate function. Clusters 1–4 had similar disease duration but showed different paths of deformity progression from disease onset. Clusters 1 and 2 represented conservative deformity parameters and clusters 3, 4, and 5 represented progressive deformity parameters. Over time, thumb deformity evolved into other types of deformities and swan-neck deformity worsened significantly. Conclusions Our comprehensive analysis identified five deformity patterns and a progressive course in the rheumatoid hand. Knowledge of the characteristics of progressive deformity parameters may allow rheumatologists to more easily implement practical interventions and determine functional prognosis.

Modified Extensor Pollicis Longus Rerouting Technique for Boutonniere Deformity of the Thumb in Rheumatoid Arthritis

2016 ◽  
Vol 41 (6) ◽  
pp. e129-e134 ◽  
Author(s):  
Takuji Iwamoto ◽  
Yu Sakuma ◽  
Shigeki Momohara ◽  
Noboru Matsumura ◽  
Kensuke Ochi ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Extensor Pollicis Longus ◽  
Boutonniere Deformity ◽  
Boutonnière Deformity

scholarly journals AB0293 FACTORS ASSOCIATED WITH INITIATION OF BIOLOGIC DISEASE-MODIFYING ANTIRHEUMATIC DRUGS IN MOROCCAN PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1445.3-1445
Author(s):  
O. Hammou ◽  
F. Chennouf ◽  
H. Azzouzi ◽  
I. Linda
Keyword(s):  
Rheumatoid Arthritis ◽  
Blood Pressure ◽  
High Blood Pressure ◽  
Biologic Agents ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Biologic Dmards ◽  
Factors Associated ◽  
History Of ◽  
Disease Modifying

Background:Rheumatoid arthritis (RA) is a progressive autoimmune disorder of joints that is associated with high health care costs, yet guidance is lacking on how early to initiate biologic disease-modifying antirheumatic drugs (DMARDs). Few studies have examined the factors associated with the transition from non biologic DMARDs to biologic DMARDs in RA patients.Objectives:to examine the association of patient’s comorbidities with initiation of biologic DMARDs (disease-modifying antirheumatic drugs) in rheumatoid arthritis (RA).Methods:cross-sectional study was designed on a cohort of RA patients. Sociodemographic, clinical data and comorbidities were collected. Logistic regression analysis was used to explore the impact of comorbidities on the initiation of bDMARD. The statistical analysis was done by SPSS. 20, p <0.05 was considered significant.Results:among the 257 patients, 90.5% were females. Their mean age was 54.66 ± 11.9 years. The most frequent comorbidities in our population were: high blood pressure (22.5%), diabetes (16.6%), history of heart disease (5.1%), history of neoplasia (2.4%) and nephropathies (2%). RA patients with comorbidities were more likely to initiate bDMARD: high blood pressure (p = 0.003 OR=2.36, 95% CI: 1.332- 4.181), history of heart disease (p = 0.036 OR=3.01, 95% IC: 1.073-8.468) and history of neoplasia (p = 0.026 OR= 5.07, 95% CI: 1.219- 21.110). In multiple regression models, high blood pressure was associated to the initiation of biologic agents (p= 0.026, OR= 2.07, 95% CI: 1.090-3.932).Conclusion:the probability of initiating therapy with biologic agents in patients with RA is affected by different co-morbidities in our context specifically hypertension.References:[1]Machado-Alba JE, et al. Time to and factors associated with initiation of biological therapy in patients with rheumatoid arthritis in Colombia. Rev Colomb Reumatol. 2018[2]Priyanka Gaitonde et al. Factors associated with use of disease modifying agents for rheumatoid arthritis in the National Hospital and Ambulatory Medical Care Survey. Seminars in Arthritis and Rheumatism. 2017Disclosure of Interests:None declared

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