The Effect of Simulated Total Distal Interphalangeal Joint Stiffness on Grip Strength

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.

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The Effect of Ring Finger Distal Interphalangeal Joint Stiffness on Grip Strength: A Simulated Study in Normal Participants

The Journal of Hand Surgery (Asian-Pacific Volume) ◽

10.1142/s2424835520500319 ◽

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.

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

The Journal of Hand Surgery (Asian-Pacific Volume) ◽

10.1142/s0218810417500149 ◽

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.

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The Impact of Simulated Distal Interphalangeal Joint Fusion on Grip Strength

Orthopedics ◽

10.3928/0147-7447-20000301-19 ◽

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

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Simulated Distal Interphalangeal Joint Fusion of the Index and Middle Fingers in 0° and 20° of Flexion: A Comparison of Grip Strength and Dexterity

The Journal Of Hand Surgery ◽

10.1016/j.jhsa.2014.06.021 ◽

2014 ◽

Vol 39 (10) ◽

pp. 1986-1991 ◽

Cited By ~ 11

Author(s):

Eitan Melamed ◽

Daniel B. Polatsch ◽

Steven Beldner ◽

Charles P. Melone

Keyword(s):

Grip Strength ◽

Interphalangeal Joint ◽

Distal Interphalangeal Joint ◽

Joint Fusion ◽

Distal Interphalangeal

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

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193418765068 ◽

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.

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Radiographic analysis of the angle in the lateromedial projection of the metacarpophalangeal joint and the distal interphalangeal joint in metacarpophalangeal flexural deformities in calves

Veterinary Record Open ◽

10.1136/vetreco-2017-000271 ◽

2018 ◽

Vol 5 (1) ◽

pp. e000271 ◽

Cited By ~ 1

Author(s):

Ayano Sato ◽

Osamu Ishii ◽

Motoshi Tajima

Keyword(s):

Proximal Phalanx ◽

Metacarpophalangeal Joint ◽

Metacarpal Bone ◽

Interphalangeal Joint ◽

Clinical Severity ◽

Middle Phalanx ◽

Distal Interphalangeal Joint ◽

Lateral Angle ◽

Significant Difference ◽

Distal Interphalangeal

The bone alignment of the metacarpophalangeal joint (MPJ) of the distal interphalangeal joint (DIPJ) in metacarpophalangeal flexural deformity (MPFD) in calves was evaluated by radiography. This study was designed by retrospective study of radiographs. Lateral to medial radiographs of distal forelimbs were taken from 19 MPFD affected calves (35 forelimbs) and 21 normal calves (42 forelimbs). Based on the radiographs, the lateral angles of MPJ were measured from the metacarpal bone axis and proximal phalanx axis, and lateral angles of DIPJ were measured from the middle phalanx axis and distal phalanx axis. Mean lateral angle of MPJ in the normal limbs was 175.9 (95% CI 174.5 to 177.4). Mean lateral angles of MPJ in MPFD were as follows: mild: 167.1 (158.9–175.2), moderate: 165.1 (158.5–171.7) and severe: 150.6 (146–155.1). MPJ angle in MPFD limbs was narrower than that in the normal limbs (mild, moderate and severe: P=0.017, P=0.003 and P<0.001, respectively). Mean lateral angle of DIPJ in the normal limbs was 211.9 (210.7–213.2). Mean lateral angles of DIPJ in moderate: 200.6 (195.2–206.1) and severe: 204.9 (203.3–206.5) MPFD were narrower than that in the normal limbs (both P<0.001). There was no significant difference between the normal limbs and mild: 210.3 (206.9–213.7) MPFD limbs (P=0.7). The clinical severity of MPFD corresponded well with the lateral angle of MPJ. The flexion of DIPJ in moderate and severe MPFD was similar to the flexion of MPJ in MPFD. This suggested that the lateral to medial radiographs accurately reflected the MPJ flexion and the DIPJ in MPFD in calves, providing useful information for the treatment of MPFD.

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

Journal of the American Veterinary Medical Association ◽

10.2460/javma.232.9.1343 ◽

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

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Development and evaluation of two different lameness models in meat goats, a pilot study

Translational Animal Science ◽

10.1093/tas/txaa193 ◽

2020 ◽

Vol 4 (4) ◽

Author(s):

Emily J Reppert ◽

Michael D Kleinhenz ◽

Abbie Viscardi ◽

Shawnee R Montgomery ◽

Alison R Crane ◽

...

Keyword(s):

Pilot Study ◽

Plasma Cortisol ◽

Interphalangeal Joint ◽

Health Concern ◽

Distal Interphalangeal Joint ◽

Livestock Species ◽

Meat Goats ◽

Distal Interphalangeal ◽

Maximum Temperatures

Abstract Lameness is a serious health concern for livestock species. Understanding individual animal response to pain and characterization of lameness are critical when developing appropriate treatments. The objectives of this pilot study was to evaluate two different lameness models and measures for determining response to induced lameness in meat goats. Lameness was induced by intraarticular injection into the left hind lateral claw distal interphalangeal joint with either amphotericin B (Amp-B) or kaolin-carrageenan (K-C). Response to lameness was characterized by behavior scoring, visual lameness scoring (VLS), infrared thermography (IRT) of the affected digit, pressure mat gait analysis (PMT), and plasma cortisol (CORT) analysis. Lame goats had higher VLS compared to controls (P = 0.003). Maximum temperatures measured in hooves from lame vs control goats were significantly higher (P = 0.003). Pressure mat analysis demonstrated, when compared to controls, lame goats had decreased force (P = 0.013), impulse (P = 0.007), contact pressure (P = 0.007), and contact area of the left hind limb (P = 0.009). Mean CORT levels 4 and 6 h after lameness induction were higher in lame goats (P = 0.005, P = 0.01). The two lameness methods reliably induced lameness of varying severity in healthy meat goats.

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