Silicone arthroplasty versus screw arthrodesis in distal interphalangeal joint osteoarthritis

2020 ◽  
Vol 45 (6) ◽  
pp. 615-621 ◽  
Author(s):  
Lisa Neukom ◽  
Miriam Marks ◽  
Stefanie Hensler ◽  
Sylvia Kündig ◽  
Daniel B. Herren ◽  
...  
Keyword(s):  
Rating Scale ◽  
Numeric Rating Scale ◽  
Interphalangeal Joint ◽  
Joint Motion ◽  
Distal Interphalangeal Joint ◽  
Extension Deficit ◽  
Level Of Evidence ◽  
Distal Interphalangeal ◽  
Interphalangeal Arthrodesis ◽  
Numeric Rating

The aim of this study was to evaluate patient satisfaction after distal interphalangeal joint silicone arthroplasty and compare this outcome to that achieved with screw arthrodesis. On average 4.4 years after surgery, range of motion of the distal interphalangeal joint, pain on a numeric rating scale, satisfaction, and hand appearance of 48 patients (78 treated fingers) were assessed. For arthroplasty patients, mean distal interphalangeal joint motion was 28° with an extension deficit of 17°. Pain was low for arthroplasty and arthrodesis patients with scores of 0.2 and 0.6 out of a total of 10 points, respectively. The patients in both groups were satisfied with their outcomes, but arthroplasty patients were less satisfied with the appearance. Twenty-one per cent of the arthroplasties and 15% of the arthrodeses underwent reoperation. We suggest the motion-preserving distal interphalangeal arthroplasty as an alternative to distal interphalangeal arthrodesis for patients with higher functional demands and whose joints are stable preoperatively. In patients attaching importance to hand aesthetics and for unstable joints, distal interphalangeal joint arthrodesis is preferable. Level of evidence: III

Surface replacing arthroplasty of the proximal interphalangeal joint using the CapFlex-PIP implant: a prospective study with 5-year outcomes

2020 ◽  
pp. 175319342097724
Author(s):  
Vanessa Reischenböck ◽  
Miriam Marks ◽  
Daniel B. Herren ◽  
Stephan Schindele
Keyword(s):  
Prospective Study ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Implant Loosening ◽  
Level Of Evidence ◽  
A Prospective Study ◽  
Numeric Rating

The purpose of this prospective study was to evaluate the 5-year outcomes in patients after proximal interphalangeal joint arthroplasty using the surface replacing implant, CapFlex-PIP. Ninety-two prosthesis were implanted and 65 patients with 68 implants were available for follow-up. The brief Michigan Hand Outcomes Questionnaire score improved significantly from 45 (SD 15) before surgery to 71 (SD 17) at 5 years. On the numeric rating scale, pain during activities decreased significantly from 6.4 (SD 1.9) to 1.8 (SD 1.9). Range of motion of the joints increased significantly from 45° (SD 21) to 54° (SD 24). An axis deviation of more than 5° was found in 65% of the joints before surgery, but only in 25% at 5 years. Soft tissue reoperations were performed on eight patients. Four out of 92 implants underwent revision for stiffness or implant loosening. In three implants, the distal component migrated without needing revision. Overall, the CapFlex-PIP implant demonstrates favourable medium-term results in surface replacing arthroplasty of the proximal interphalangeal joint. Level of evidence: IV

Mallet Fractures: A Novel Approach to Internal Fixation Using A Hook Plate

2007 ◽  
Vol 32 (1) ◽  
pp. 24-30 ◽  
Author(s):  
L. C. TEOH ◽  
J. Y. L. LEE
Keyword(s):  
Internal Fixation ◽  
Rating Scale ◽  
Interphalangeal Joint ◽  
Hook Plate ◽  
Patient Comfort ◽  
Modular System ◽  
Consecutive Series ◽  
Distal Interphalangeal Joint ◽  
Active Motion ◽  
Distal Interphalangeal

A new treatment of mallet fractures of the distal phalanx is presented. Open reduction and internal fixation was performed using a “hook” plate fabricated from a 1.3 mm AO hand modular system straight plate. This technique avoids the need to place implants or wires through the small avulsion fragment while still being able to achieve a stable “tension-plate” type of fixation construct strong enough to allow protected early active motion of the distal interphalangeal joint. In minimising the need for prolonged splinting, patient comfort is also improved. In a consecutive series of nine fractures, union was achieved in all cases. At an average follow-up period of 17 months, four had excellent and five had good results using the Crawford rating scale. Using the Warren and Norris scale, all patients had a successful result. The final average active range of flexion of the distal interphalangeal joint was 64° and there was no extensor lag.

Splinting versus extension-block pinning of bony mallet finger: a randomized clinical trial

2020 ◽  
Vol 45 (6) ◽  
pp. 574-581 ◽  
Author(s):  
Janni K. Thillemann ◽  
Theis M. Thillemann ◽  
Pia K. Kristensen ◽  
Anders D. Foldager-Jensen ◽  
Bo Munk
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Interphalangeal Joint ◽  
Joint Surface ◽  
Distal Interphalangeal Joint ◽  
Level Of Evidence ◽  
Pain Scores ◽  
Patient Reported ◽  
Distal Interphalangeal

Surgical treatment of bony mallet fingers is frequently recommended, but the evidence is sparse. This randomized clinical trial aimed to compare nonoperative splinting versus extension-block pinning of bony mallet fingers with involvement of more than one-third of the joint surface but without primary joint subluxation. Thirty-two patients were randomized and 28 fulfilled the protocol. At 6 months follow-up, there were no significant differences in active extension lag in the distal interphalangeal joint (the primary outcome) or in patient-reported function and pain scores. Flexion and active range of motion in the distal interphalangeal joint and finger-to-palm distance were better in the splinting group, but three patients developed secondary subluxation. We conclude from this study, that splinting these injuries is safe and efficient in restoring joint motion, but splinting does not sufficiently prevent secondary subluxation of the joint. Radiographic follow-up during splinting appears to be necessary. Level of evidence: I

scholarly journals The results of surgical and nonsurgical treatment of mallet finger

2006 ◽  
Vol 134 (11-12) ◽  
pp. 521-525
Author(s):  
Branislav Starcevic ◽  
Marko Bumbasirevic ◽  
Aleksandar Lesic ◽  
Vidosava Radonjic ◽  
Dragan Miric
Keyword(s):  
Interphalangeal Joint ◽  
Nonsurgical Treatment ◽  
Mallet Finger ◽  
Distal Interphalangeal Joint ◽  
Extension Deficit ◽  
Finger Injury ◽  
Clinical Center ◽  
Distal Interphalangeal ◽  
Total Movement

Introduction: The injury of the hand tendon classified as mallet finger presents the loss of continuity of the united lateral band of the extensor apparatus above distal interphalangeal joint, which consequently leads to specific deformity of distal interphalangeal joint which is called mallet (hammer) finger. Objective Our paper had several research Objectives: presentation of the existing Results of surgical and nonsurgical treatment of mallet finger deformities and comparison of our findings and other authors? Results. Method: The study was retro-prospective, and analyzed 62 patients treated in the Clinical Center of Serbia in Belgrade (at the Institute of Orthopedic Surgery and Traumatology, and the Emergency Center) in the period 1998 to 2003. The follow up of these patients lasted at least 8 months (from 8.3 months to 71.7 months). An average follow up was 28.7 months. The Objective parameters used in the study were as follows: sex, age, dominating hand, hand injury, finger injury, mode of treatment, complications, distal interphalangeal joint flexion and total movement of the distal interphalangeal joint. Collected data were analyzed by ?2-test and Student?s t-test. The confidence interval was p=0.05. Results: A total range of motion was 51.9?6.6 for nonsurgically treated patients, and 48.2?4.2 degrees for operated patients. Mean extension deficit of the distal interphalangeal joint was 6.5?3.3 for nonsurgical and 10.0?3.2 for operated patients. Conclusion: The Results confirmed that nonsurgical mode of treatment of mallet finger deformity was much more successful than surgical Method of treating the same deformity.

Fingertip defect reconstruction with a modified pivot flap

2020 ◽  
Vol 46 (1) ◽  
pp. 75-79
Author(s):  
Giovanna Petrella ◽  
Daniele Tosi ◽  
Gianluca Sapino ◽  
Roberto Adani
Keyword(s):  
Vascular Supply ◽  
Interphalangeal Joint ◽  
Discrimination Test ◽  
Distal Interphalangeal Joint ◽  
Level Of Evidence ◽  
Cold Intolerance ◽  
Reliable Technique ◽  
Defect Reconstruction ◽  
Distal Interphalangeal ◽  
Average Size

The pivot flap can treat volar oblique defects of the fingers distal to the distal interphalangeal joint. We present our experience in 11 fingers (11 patients) using this flap, including some modifications that optimize flap harvesting, mobilization, inset, and vascular supply and outcomes. The flaps harvested had an average size of 2.4 × 2.0 cm. The patients were followed for an average of 21 months (range 12 to 36) after surgery. Sensitivity of the flap was evaluated with the Semmes–Weinstein monofilaments test and static two-point discrimination test. Cold intolerance was also evaluated. The pivot flap with the modifications demonstrates a reliable technique for fingertip defect reconstruction. The results, in terms of sensitivity and functional recovery, seem promising. Level of evidence: IV

Comparison of outcomes of three surgical approaches for proximal interphalangeal joint arthroplasty using a surface-replacing implant

2019 ◽  
Vol 45 (6) ◽  
pp. 608-614 ◽  
Author(s):  
Elvira Bodmer ◽  
Miriam Marks ◽  
Stefanie Hensler ◽  
Stephan Schindele ◽  
Daniel B. Herren
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Joint Arthroplasty ◽  
Interphalangeal Joint ◽  
Surgical Approaches ◽  
Joint Motion ◽  
Extension Deficit ◽  
Level Of Evidence ◽  
Volar Approach ◽  
The Mean

The objective was to compare outcomes of the volar, Chamay and tendon splitting approaches for proximal interphalangeal joint arthroplasty using a surface-replacing implant (CapFlex-PIP). One-hundred prospectively documented patients with a 2-year follow-up were included. Range of proximal interphalangeal joint motion, the brief Michigan Hand Outcomes Questionnaire and complications were analysed. Between baseline and follow-up, mean proximal interphalangeal joint motion increased for the volar (53° to 54°), Chamay (38° to 53°) and tendon splitting (40° to 61°) approaches. The volar approach yielded the greatest flexion and the highest extension deficit. The mean brief Michigan Hand Outcomes Questionnaire scores at baseline and 2 years were 45 and 74 (volar), 45 and 66 (Chamay) and 41 and 75 (tendon splitting). Seven patients in the Chamay group and two in the volar group required a reoperation consisting of teno-/arthrolysis. The tendon splitting approach tended to result in the best outcomes that were associated with fewer complications compared with the volar and Chamay approaches. Level of evidence: IV

Evaluation of the diffusion of corticosteroids between the distal interphalangeal joint and navicular bursa in horses

2008 ◽  
Vol 232 (9) ◽  
pp. 1343-1343
Author(s):  
Frederik E. Pauwels ◽  
James Schumacher ◽  
Fernando A. Castro ◽  
Troy E. Holder ◽  
Roger C. Carroll ◽  
...  
Keyword(s):  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Distal Interphalangeal

Foot Massage Menurunkan Nyeri Post Operasi Sectio Caesarea Pada Post Partum

2020 ◽  
Vol 6 (2) ◽  
pp. 164-170
Author(s):  
Dewi Nurlaela Sari ◽  
Aay Rumhaeni
Keyword(s):  
Daily Living ◽  
Rating Scale ◽  
Post Partum ◽  
Numeric Rating Scale ◽  
Sectio Caesarea ◽  
P Value ◽  
Test Design ◽  
Purposive Sampling ◽  
Post Test ◽  
Numeric Rating

ABSTRAK Sectio caesarea merupakan tindakan alternatif dalam proses persalinan untuk menyelamatkan ibu dan janin. Ibu Bersalin dengan operasi sectio caesarea dilakukan pembedahan pada dinding abdomen dan dinding rahim. Dampak yang paling sering muncul dirasakan oleh postpartum dengan post operasi sectio caesarea adalah  nyeri. Nyeri akan berdampak pada bounding attachment terganggu, mobilisasi terbatas, Activity Daily Living (ADL) terganggu serta berpengaruh  terhadap Inisiasi Menyusui Dini (IMD). Asuhan yang diberikan terbatas pada terapi farmakologi dibandingkan  non farmakologi. Foot massage adalah salah satu terapi non farmakologi yang dapat membantu menutup gerbang di posterior horns dari sumsum tulang belakang dan memblokir bagian dari nyeri ke sistem saraf pusat. Tujuan penelitian ini untuk mengetahui pengaruh foot massage terhadap skala nyeri pada klien post operasi sectio caesarea di RS AMC. Penelitian ini merupakan penelitian pre eksperimen dengan pendekatan one group pre test post test design. Jumlah sampel yang digunakan berjumlah 27 orang dengan menggunakan teknik purposive sampling. Instrumen yang digunakan adalah Numeric Rating Scale (NRS) dan prosedur kerja foot massage. Responden dilakukan foot massage selama 20 menit selama 2 hari. Data di analisis dengan menggunakan uji wilcoxon. Hasil penelitian menunjukkan lebih dari setengah klien post operasi sectio caesarea berada di skala nyeri 6 sebelum dilakukan foot massage dan hampir setengah memiliki skala nyeri 3 sesudah dilakukan foot massage dan didapatkan nilai p value = 0.000, sehingga disimpulkan ada pengaruh foot massage terhadap skala nyeri pada klien post operasi sectio caesarea. Diharapkan rumah sakit dapat menjadikan foot massage sebagai salah satu alternatif manajemen non farmakologi dalam penanganan nyeri.   Kata kunci: Foot Massage; Post Partum; Nyeri; Sectio Caesarea      

Efektivitas pencucian luka menggunakan daun jambu biji terhadap tingkat malodor klien luka kaki diabetik

2019 ◽  
Vol 8 (2) ◽  
pp. 152
Author(s):  
Adi Antoni ◽  
Yanna Wari Harahap
Keyword(s):  
Diabetic Foot ◽  
Rating Scale ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Numeric Rating Scale ◽  
P Value ◽  
Consecutive Sampling ◽  
Guava Leaves ◽  
Guava Leaf ◽  
Numeric Rating

Abstrak   Latar belakang: Diabetes mellitus (DM) merupakan penyakit kronik dan menjadi masalah global. Salah satu komplikasi yang ditimbulkan dari DM adalah luka kaki diabetic. Langkah awal dalam perawatan luka kaki diabetic adalah mencuci luka. Tujuan penelitian ini adalah mengetahui keefektifan dari rebusan daun jambu biji sebagai cairan pencuci luka terhadap tingkat malodor pada luka kaki diabetic. Metode: Desain penelitian yang digunakan adalah quasy experiment dengan rancangan one group pretests-posttest only. Teknik sampling yang digunakan adalah consecutive sampling dengan jumlah sampel 16 orang. Kriteria sampel yang digunakan adalah klien luka kaki diabetic, tingkat malodor 1-10 dengan NRS. Alat ukur yang digunakan adalah Numeric Rating Scale (NRS). Analisa data yang digunakan dalam penelitian ini menggunakan uji paired t test. Hasil: tingkat malodor sebelum intervensi pencucuan luka menggunakan rebusan daun jambu biji rata-rata sebesar 4.40 dan sesudah intervensi sebesart 2.44 dengan p value < 0.001. Selisih tingkat malodor antara sebelum dan sesudah intervensi sebesar 1.96. Hasil penelitian ini menunjukkan bahwa daun jambu dapat digunakan sebagai cairan pencuci luka dalam mengatasi tingkat malodor pada luka kaki diabetik. Kesimpulan : daun jambu biji dapat digunakan sebagai cairan pencuci luka pada luka kaki diabetic. Perawat diharapkan dapat memanfaatkan daun jambu biji sebagai salah satu alternatif dalam pencucian luka kronik khususnya luka kaki diabetik.   Kata kunci: Daun Jambu Biji, Tingkat Malodor, Luka Kaki Diabetik   Abstract   Background: Diabetes mellitus (DM) is a chronic disease and a global problem. One of the complications that arise from DM is diabetic foot ulcer. The first step in treating diabetic foot ulcer is washing the wound. The purpose of this study was to determine the effectiveness of guava leaf decoction as a washing fluid for malodor levels in diabetic foot ulcer. Method: The research design used was quasy experiment with one group pretests-posttest only design. The sampling technique used was consecutive sampling with a sample of 16 people. Sample criteria used were diabetic foot ulcer clients, malodor level 1-10 with NRS. The measuring instrument used is the Numeric Rating Scale (NRS). Analysis of the data used in this study used paired t test. Results: the level of malodor before intervening in wound washing using guava leaf decoctions on average was 4.40 and after the intervention was 2.44 with p value <0.001. The difference in the level of malodor between before and after the intervention was 1.96. The results of this study indicate that guava leaves can be used as a washing fluid in dealing with malodor levels in diabetic foot ulcer. Conclusion: Guava leaves can be used as a washing fluid for diabetic foot wounds. Nurses are expected to be able to use guava leaves as an alternative in washing chronic wounds, especially diabetic foot injuries.   Key words: Guava Leaf, Malodor Level, Diabetic foot ulcer.

scholarly journals RCT on the effectiveness of the intraligamentary anesthesia and inferior alveolar nerve block on pain during dental treatment

2021 ◽  
Author(s):  
Bahaa R. Youssef ◽  
Andreas Söhnel ◽  
Alexander Welk ◽  
Mohamed H. Abudrya ◽  
Mohamed Baider ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Nerve Block ◽  
Rating Scale ◽  
Dental Treatment ◽  
Inferior Alveolar Nerve ◽  
Numeric Rating Scale ◽  
Inferior Alveolar Nerve Block ◽  
Posterior Teeth ◽  
Mandibular Posterior Teeth ◽  
Numeric Rating

Abstract Objective To compare the effectiveness and complications of intraligamentary anesthesia (ILA) with conventional inferior alveolar nerve block (IANB) during injection and dental treatment of mandibular posterior teeth. Materials and methods In this randomized, prospective clinical trial, 72 patients (39 males, 33 females), scheduled for dental treatment of mandibular posterior teeth, were randomly allocated to ILA group (n = 35) received ILA injection or IANB group (n = 37) received the conventional IANB. Our primary outcome was to assess pain and stress (discomfort) during the injection and dental treatment, using the numeric rating scale (NRS) from 0 to 10 (0 = no pain, 10= the worst pain imaginable), whereas recording 24-h postoperative complications was our secondary outcomes. Results Patients in ILA group reported significantly less pain during injection when compared with IANB group (p = 0.03), while pain during dental treatment was similar in both groups (p = 0.2). Patients in both groups also reported similar law values of discomfort during treatment (p = 0.7). Although no signs of nerve contact or any other postoperative complications were observed, five patients in IANB group (none in ILA group) reported temporary irritations. Conclusion This study showed equivalent effectiveness of both intraligamentary anesthesia and conventional inferior alveolar nerve block, for pain control during routine dental treatment of mandibular posterior teeth. Nevertheless, ILA showed significantly less pain during injection. No major postoperative complications in both groups were observed. Clinical relevance ILA could be considered as an effective alternative for routine dental treatment. Trial registration NCT04563351

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