Hand Function, Biomechanics and Disability

1980 ◽  
Vol 9 (4) ◽  
pp. 215-220
Author(s):  
W K Purves ◽  
N Berme ◽  
J P Paul
Keyword(s):  
Rheumatoid Arthritis ◽  
Functional Assessment ◽  
Joint Replacement ◽  
Index Finger ◽  
Hand Function ◽  
Three Dimensional ◽  
Normal Subjects ◽  
Metacarpophalangeal Joint ◽  
Biomechanical Analysis ◽  
Biomechanical Tests

A functional assessment and biomechanical analysis of certain joints of the fingers are presented. The functional assessment has been carried out on rheumatoid arthritis patients who were assessed pre- and post-surgically after metacarpophalangeal joint replacement. Twenty normal subjects have been assessed in the biomechanical tests as they carried out two activities, tap turning and jar closing. The load actions applied by the index finger were measured by a six component transducer and the three-dimensional coordinates of the joint centres were derived from external markers attached to the skin of the index finger. From this information the forces and components of moment to be transmitted at the proximal interphalangeal and metacarpophalangeal joints have been calculated.

A modified Terrono classification for Type 1 thumb deformity in rheumatoid arthritis: a cross-sectional analysis

2019 ◽  
Vol 45 (2) ◽  
pp. 187-192
Author(s):  
Shogo Toyama ◽  
Ryo Oda ◽  
Maki Asada ◽  
Satoru Nakamura ◽  
Masato Ohara ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Hand Function ◽  
Metacarpophalangeal Joint ◽  
Interphalangeal Joint ◽  
Strongly Correlated ◽  
Range Of Movement ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Joint Preserving Surgery

The most common thumb deformity in rheumatoid arthritis is Nalebuff Type 1 deformity (boutonniere deformity). Type 1 deformity severely impairs hand function, and this impairment is evaluated by the Terrono classification. In some cases, the Terrono classification incorrectly categorizes advanced thumb deformity into earlier stages. We modified the Terrono classification by assessing the active range of motion of the interphalangeal joint prior to assessing the passive range of movement of the metacarpophalangeal joint. An active range of movement of the interphalangeal joint was strongly correlated with hand function. In 55 hands that we treated between 2004 and 2015, we compared the modified classification with the original Terrono classification. Our modified classification could detect advanced deformity earlier, and was more strongly correlated with hand function. Additionally, correlation analysis showed that advanced Type 1 deformity should be treated first, even in cases with severe ulnar drift. Our results suggest that the modified classification may benefit the treatment of Type 1 deformity, including joint-preserving surgery. Level of evidence: III

REVISION METACARPOPHALANGEAL JOINT REPLACEMENT 30 YEARS AFTER PRIMARY SWANSON FLEXIBLE SILICONE IMPLANT ARTHROPLASTY IN A RHEUMATOID PATIENT: A CASE REPORT

Hand Surgery ◽  
2009 ◽  
Vol 14 (01) ◽  
pp. 25-29 ◽  
Author(s):  
Katsumitsu Arai ◽  
Hajime Ishikawa ◽  
Takehiro Murai ◽  
Junichi Fujisawa ◽  
Naoto Endo
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Report ◽  
Joint Replacement ◽  
Revision Surgery ◽  
Metacarpophalangeal Joint ◽  
Joint Arthroplasty ◽  
Implant Removal ◽  
Silicone Implant ◽  
Rheumatoid Patient ◽  
Swanson Implant

We report a case of a patient with rheumatoid arthritis undergoing revision surgery 30 years after primary metacarpophalangeal joint arthroplasty using a Swanson implant. Removal and replacement of the implant were successfully performed, and the patient was satisfied with the revision surgery.

Metacarpophalangeal Joint Replacement in Rheumatoid Arthritis. A Search for Prognostic Indicators

1994 ◽  
Vol 19 (1_suppl) ◽  
pp. 39-39
Author(s):  
C. Chauhan ◽  
A. Howard ◽  
S. H. Norris ◽  
N. Noden ◽  
J. Winfield
Keyword(s):  
Rheumatoid Arthritis ◽  
Joint Replacement ◽  
Metacarpophalangeal Joint ◽  
Prognostic Indicators

BIOMECHANICS OF THE NORMAL AND DISEASED METACARPOPHALANGEAL JOINT: IMPLICATIONS ON THE DESIGN OF JOINT REPLACEMENT IMPLANTS

2007 ◽  
Vol 07 (02) ◽  
pp. 163-174 ◽  
Author(s):  
T. PYLIOS ◽  
DUNCAN E. T. SHEPHERD
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Joint Replacement ◽  
Large Range ◽  
Hand Function ◽  
Metacarpophalangeal Joint ◽  
Careful Consideration ◽  
Hand Strength ◽  
Flexion Extension

The metacarpophalangeal (MCP) joint is crucial for hand function, but is frequently affected by arthritis, leading to pain and disability. This paper reviews the biomechanics of the normal and diseased joint in order to help consider the design of improved MCP joint replacement implants. The normal MCP joint enables a large range of motion in flexion/extension and abduction/adduction as well as a few degrees of rotation. A normal joint typically allows 90° flexion, with a grip strength of up to 672 N. The diseased joint has a reduced range of motion (typically 30° flexion) and reduced hand strength compared to the normal joint. Current MCP joint replacement implants generally try to recreate the range of motion of the normal joint; however, many designs are prone to fracture, as they are unable to withstand the conditions of the diseased joint. It may be beneficial for future implant designs to provide just a functional range of motion. Future designs of MCP joint replacement implants need to be more durable and last longer. Careful consideration of the diseased joint, rather than the normal joint, may help to better define the requirements for such implants.

Three-dimensional printed prosthesis demonstrates functional improvement in a patient with an amputated thumb: A technical note

2016 ◽  
Vol 42 (1) ◽  
pp. 107-111 ◽  
Author(s):  
Keun Ho Lee ◽  
Sung Jae Kim ◽  
Yong Ho Cha ◽  
Jae Lim Kim ◽  
Dong Kyu Kim ◽  
...  
Keyword(s):  
Low Cost ◽  
Hand Function ◽  
Three Dimensional ◽  
Metacarpophalangeal Joint ◽  
Technical Note ◽  
Functional Improvement ◽  
Fused Filament Fabrication ◽  
Left Hand ◽  
Finger Prosthesis ◽  
The Right

Background and Aim: Three-dimensional printer is widely used in industry, biology, and medical fields. We report a finger prosthesis produced by a three-dimensional scanner and printer for a 67-year-old man with a right thumb amputation above the metacarpophalangeal joint. Technique: His right amputated and left intact hands were scanned with a three-dimensional scanner, and the left-hand image was rotated to the right side to design the right thumb prosthesis. The designed prosthesis was printed with a three-dimensional printer using the fused filament fabrication output system. Discussion: The Jebsen–Taylor hand function test and Box and Block Test scores improved after application of the prosthesis. Most Quebec User Evaluation of Satisfaction with Assistive Technology results were “very satisfied,” and most Orthotics and Prosthetics Users’ Survey results were “very easy.” Preparing the prosthesis made by three-dimensional scanner and three-dimensional printer was faster and cheaper than preparing a conventional prosthesis. Clinical relevance Using three-dimensional scanning and printing technique, we can easily produce specifically shaped finger prostheses for specific movements in amputated patients with low cost.

Functional Assessment After Pollicisation

1986 ◽  
Vol 11 (3) ◽  
pp. 399-403
Author(s):  
B. A. ROPER ◽  
T. J. TURNBULL
Keyword(s):  
Functional Assessment ◽  
Index Finger ◽  
Hand Function ◽  
Power Grip ◽  
Pinch Grip ◽  
Congenital Aplasia

Nine children with congenital aplasia or hypoplasia of the thumb were treated by pollicisation of the index finger. Functional assessment was performed on average five years after surgery. It demonstrated normal sensation and a power grip, pinch grip and adductor grip of the thumb of 63%, 56% and 63% respectively of the unoperated hand. Efficient use of the hand increased after surgery and continued to improve for some years. The results indicate that pollicisation benefits hand function and should be performed early.

Outcome Measures Following Metacarpophalangeal Joint Replacement

2000 ◽  
Vol 25 (6) ◽  
pp. 601-603 ◽  
Author(s):  
K. SYNNOTT ◽  
H. MULLETT ◽  
H. FAULL ◽  
E. P. KELLY
Keyword(s):  
Patient Satisfaction ◽  
Pain Relief ◽  
Outcome Measures ◽  
Joint Replacement ◽  
Hand Function ◽  
Metacarpophalangeal Joint ◽  
Assessment System ◽  
High Rate ◽  
Modest Improvement ◽  
Objective Outcome

We used the Jebsen–Taylor hand function assessment system to prospectively study the effect of metacarpophalangeal joint replacement on overall hand function in 29 hands. In addition pain relief, subjective improvement in hand function, appearance and overall patient satisfaction were assessed. There was modest improvement in the number of Jebsen–Taylor tasks performed (1.8 to 3.1), and pain relief was good or excellent in 18 of 24 patients. Eleven patients felt their hand function had improved by more than 50%, and the majority of patients (22 of 24) were very satisfied with the procedure. This study demonstrates that despite limited improvements in objective outcome measures, this procedure is reliable in producing a very high rate of patient satisfaction.

Proprioceptive sensitivity to imposed finger deflections

2022 ◽  
Author(s):  
Katie H Long ◽  
Kristine R McLellan ◽  
Maria Boyarinova ◽  
Sliman J Bensmaia
Keyword(s):  
Joint Angle ◽  
Index Finger ◽  
Human Subjects ◽  
Hand Function ◽  
Sensory Modality ◽  
Three Dimensional ◽  
Dimensional Structure ◽  
Vibratory Stimulus ◽  
Proprioceptive Sensitivity

Hand proprioception - the sense of the posture and movements of the wrist and digits - is critical to dexterous manual behavior and to stereognosis, the ability to sense the three-dimensional structure of objects held in the hand. To better understand this sensory modality and its role in hand function, we sought to characterize the acuity with which the postures and movements of finger joints are sensed. To this end, we measured the ability of human subjects to discriminate changes in posture and speed around the three joints of the index finger. In these experiments, we isolated the sensory component by imposing the postures on an otherwise still hand, to complement other studies, in which subjects made judgments on actively achieved postures. We found that subjects could reliably sense 12-16% changes in joint angle and 18-32% changes in joint speed. Furthermore, the acuity for posture and speed was comparable across the three joints of the finger. Finally, task performance was unaffected by the presence of a vibratory stimulus, calling into question the role of cutaneous cues in hand proprioception.

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