Proximal Interphalangeal Joint Dimensions for the Design of a Surface Replacement Prosthesis

1996 ◽  
Vol 210 (2) ◽  
pp. 95-108 ◽  
Author(s):  
H E Ash ◽  
A Unsworth
Keyword(s):  
Sagittal Plane ◽  
Middle Finger ◽  
Proximal Interphalangeal Joint ◽  
Sagittal Profile ◽  
Radius Of Curvature ◽  
Surface Replacement ◽  
Articular Surfaces ◽  
Phalangeal Bone ◽  
Best Fit ◽  
Replacement Prosthesis

The bones from 83 proximal interphalangeal joints (PIPJs) were dissected in order to determine the shape and size of the articular surfaces. The bones were modelled in acrylic dental bone cement and the original bones and replicas were then sectioned and shadow-graphed. Dimensions were taken from these shadowgraphs to be used in the design of a surface replacement prosthesis for the PIPJ. It was found that the bi-condylar heads of the proximal and middle phalanges were circular in the sagittal plane as was the base of the middle phalanx. However, the radius of curvature of the middle phalangeal base was greater than that of the proximal phalangeal head indicating that the PIPJ is not a conforming joint. The alignment of the radial and ulnar condyles of the proximal phalangeal bones was investigated and it was found that the index and middle finger bones tended to have a more prominent ulnar condyle while the ring and little finger bones tended to have a more prominent radial condyle. This was due to a slight difference in diameters of the two condyles. The proximal phalangeal bone lengths L ranged from 29–52 mm, maximum head widths W from 8.5–15.5 mm and maximum diameters D of the best-fit circles to the sagittal profile of the bone head from 6–11 mm. The middle phalangeal bone lengths ranged from 16–35 mm, maximum head widths from 8.5–12 mm and maximum diameters from 5–7.5 mm. The relationships and ratios between these dimensions for the proximal and middle phalanges have been calculated.

Further studies into proximal interphalangeal joint dimensions for the design of a surface replacement prosthesis: Medullary cavities and transverse plane shapes

1997 ◽  
Vol 211 (5) ◽  
pp. 377-390 ◽  
Author(s):  
H E Ash ◽  
A Unsworth
Keyword(s):  
Sagittal Plane ◽  
Proximal Phalanx ◽  
Frontal Plane ◽  
Medullary Canal ◽  
Transverse Plane ◽  
Maximum Depth ◽  
Surface Replacement ◽  
The Mean ◽  
Middle Ring ◽  
Replacement Prosthesis

The proximal and middle phalanges from 83 proximal interphalangeal joints (PIPJs) were set in clear plastic and sectioned in the transverse plane leaving the heads whole. The sections were cleaned, shadowgraphed and measured. The medullary canals were marked on sagittal and frontal plane shadowgraphs of the intact bones and analysed. The information was then used in the design of a surface replacement prosthesis for the PIPJs. The main dorsal surface of the proximal phalanx (PP) was found to be angled to the longitudinal baseline of the bone by a mean of 5.19°. This angle increased just proximal to the phalangeal head to a mean of 11.84°. The mean ratio between these angles was 2.71. The phalangeal shaft bone was thicker laterally than dorsally and palmarly, and thicker dorsally than palmarly for the proximal and middle phalanges throughout the length of the bone. The shape and size of the transverse cross-section of the medullary canal changed throughout the length of the shaft. The centreline of the PP medullary canal coincided with the midline of the bone in the frontal plane and was approximately a straight line along the length of the canal. In the sagittal plane the centreline was slightly palmar to the midline and the angle between it and the longitudinal baseline of the bone changed along the length of the canal. In the region of the shaft just proximal to the PP head (where the stem of a surface replacement prosthesis would fit) the mean angle was 10.63°. The centreline was offset dorsally from the centre of rotation of the PIPJ by a mean of 0.83 mm, 0.83 mm, 0.80 mm and 0.57 mm for the index, middle, ring and little fingers respectively, with an overall mean of 0.76 mm. The mean PP head heights (transverse plane) were 9.17 mm, 9.33 mm, 8.73 mm and 7.40 mm and the mean PP widths (transverse plane) were 12.86 mm, 13.25 mm, 12.75 mm and 10.54 mm for the index, middle, ring and little fingers respectively. The mean angle between the lateral sides of the condyles to the transverse baseline was 78.35° and the mean distance from the centreline of the PP head (transverse plane) to the bases of the two condyles was 4.69 mm. The mean maximum depth of the PP head intercondylar sulcus in the frontal plane was 0.72 mm and in the transverse plane, the mean maximum depth of the intercondylar sulcus on the anterior face was 0.82 mm.

Effect of Surface Replacement Arthroplasty on Stability of the Ankle

Foot & Ankle ◽  
1986 ◽  
Vol 7 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Peter Burge ◽  
Mervyn Evans
Keyword(s):  
Sagittal Plane ◽  
External Rotation ◽  
Articular Surface ◽  
Surface Replacement ◽  
Response Characteristics ◽  
Surface Replacement Arthroplasty ◽  
Articular Surfaces ◽  
Replacement Arthroplasty ◽  
Before And After ◽  
And Inversion

Loosening after total ankle arthroplasty may result from absorption of tensile and shear forces by relatively small bone-cement interfaces. A surface replacement arthroplasty similar in principle to the Oxford knee arthroplasty offers theoretical advantages over other designs. The ability of such a prosthesis to provide a stable articulation was tested by examination of ankle laxity before and after replacement of the tibiotalar articular surfaces. The motion response characteristics of four specimens were measured for internal-external rotation moment (±3 nm), inversion-eversion moment (±3 nm), and anteroposterior displacement (±50 N). The prosthesis restored normal internal-external and inversion-eversion rotatory stability, but the mean anteroposterior laxity was increased from 5.5 to 9.7 mm ( P < 0.05). Anteroposterior stability could not be restored by increasing the thickness of the bearing interposed between the prosthetic surfaces. The findings can be explained by consideration of the anatomy of the ligaments in relation to the contour of the normal and prosthetic articular surfaces. The normal tibial articular surface, which is concave in the sagittal plane, provides restraint against anteroposterior motion which is lost when the surface is replaced by the flat prosthetic surface. The findings question the suitability of this type of prosthesis for the ankle.

Morphological Measurements of the Proximal Interphalangeal Joint

2004 ◽  
Vol 29 (3) ◽  
pp. 242-247 ◽  
Author(s):  
T. LAWRENCE ◽  
I. A. TRAIL ◽  
J. NOBLE
Keyword(s):  
Articular Surface ◽  
Proximal Phalanx ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Implant Design ◽  
Radius Of Curvature ◽  
Middle Phalanx ◽  
Photographic Technique ◽  
Articular Surfaces ◽  
Palmar Surface

The morphology of the proximal interphalangeal joint was determined using a photographic technique. The head of the proximal phalanx, viewed end on, has a complex trapezoid appearance characteristic for each named digit. The asymmetric condyles diverge from one another and are separated by an intercondylar groove that increases in depth from the dorsal to the palmar surface. Saggital sections of the head of the proximal phalanx are not circular, but, sections taken in the plane of maximum dimensions of the condyle are circular with a radius of curvature of approximately one half of the height of the condyles. The articular surface of the base of the middle phalanx is not circular in outline in either the saggital or coronal plane. In coronal sections the articular surface is biconcave convex with a prominent median ridge separating the two adjacent concave articular surfaces. The implications of this varied morphology on implant design are discussed.

scholarly journals An Observational Study to Assess the Validity of Anguli Pramana in the Present Era

2021 ◽  
Vol 12 (1) ◽  
pp. 90-93
Author(s):  
Pratibha Visave ◽  
Deepnarayan Shukla ◽  
Deepali Choudhari
Keyword(s):  
Standard Operating Procedure ◽  
Middle Finger ◽  
Proximal Interphalangeal Joint ◽  
Lifestyle Changes ◽  
Age Group ◽  
Evolutionary Changes ◽  
Standard Operating ◽  
Standard Value ◽  
Standard Values ◽  
Ethical Clearance

Introduction: The concept of Anguli pramana is one of the hypothetical concepts in Ayurved put forth by acharyas. It mainly deals with the measurements of various parts of the human body. After reviewing the previous research done, it was noticed that, not a single study was being carried out by anyone of the researchers for assessing the validity of Anguli pramana in the present era. Therefore, the present study was planned. Method: After ethical clearance, the study was conducted. In total 770 participants of age group 18-50 years from Ahmednagar and Nashik region were selected. Measurements were taken for selected parameters, recorded and converted into Swa-anguli pramana.  Swa-anguli pramana was measured by taking width of the middle finger at the proximal interphalangeal joint of right hand. All the measurements were taken following Standard Operating Procedure. The data was analyzed with the test of Normality, Z score using Systat 13.0 version software. Result: In the present study, obtained value and standard value stated by Acharya Charaka for the selected parameters were compared and found statistically different. Similarly, obtained value and standard value stated by Acharya Sushruta for the selected parameters were compared and found statistically different. Discussion: The results were negative i.e., non comparable with the standard values stated by acharas for the selected parameters. It was observed that the Anguli pramana mentioned in ancient literature may not be considered valid in the present era. It may be because of evolutionary changes and lifestyle changes of the human being.

scholarly journals Surface Replacement Proximal Interphalangeal Joint Arthroplasty: A Case Series

Hand ◽  
2018 ◽  
Vol 14 (5) ◽  
pp. 669-674
Author(s):  
Pieter W. Jordaan ◽  
Duncan McGuire ◽  
Michael W. Solomons
Keyword(s):  
Patient Satisfaction ◽  
Range Of Motion ◽  
Retrospective Review ◽  
Case Series ◽  
Proximal Interphalangeal Joint ◽  
Joint Arthroplasty ◽  
Interphalangeal Joint ◽  
Surface Replacement ◽  
Significant Difference

Background: In 2012, our unit published our experience with a pyrocarbon proximal interphalangeal joint (PIPJ) implant. Due to high subsidence rates, a decision was made to change to a cemented surface replacement proximal interphalangeal joint (SR-PIPJ) implant. The purpose of this study was to assess whether the change to a cemented implant would improve the subsidence rates. Methods: Retrospective review of all patients who had a cemented SR-PIPJ arthroplasty performed from 2011 to 2013 with at least 12 months follow-up. Results: A total of 43 joints were included with an average follow-up of 26.5 months. There was a significant ( P = .02) improvement in arc of motion with an average satisfaction score of 3.3 (satisfied patient). Subsidence was noted in 26% of joints with a significant difference in range of motion ( P = .003) and patient satisfaction ( P = .001) between the group with and without subsidence. Conclusions: The change to a cemented implant resulted in satisfied patients with an improvement in range of motion. The rate of subsidence improved but remains unacceptably high.

Magnetic Resonance Imaging to Investigate the Clinical Applicability of the Medial Femoral Trochlea Osteochondral Flap Within the Wrist

Hand ◽  
2022 ◽  
pp. 155894472110643
Author(s):  
Jimmy H. Daruwalla ◽  
Jan Skrok ◽  
Mitchell A. Pet ◽  
Aviram M. Giladi ◽  
James P. Higgins
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Sagittal Plane ◽  
Convex Surface ◽  
Radius Of Curvature ◽  
Resonance Imaging ◽  
Femoral Trochlea ◽  
Average Ratio ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri

Background: The medial femoral trochlea (MFT) osteochondral flap is employed for reconstruction of unsalvageable scaphoid proximal pole nonunions. The convex surface of the cartilage-bearing proximal trochlea is used to replace the similarly contoured proximal scaphoid and articulate with the concave scaphoid fossa of the radius. A magnetic resonance imaging (MRI) comparison of the shape of the MFT as it relates to the native proximal scaphoid has not been previously performed. Our study aimed to quantifiably compare the shape of the MFT, proximal scaphoid, and scaphoid fossa. Methods: Using imaging processing software, we measured radius of curvature of the articular segments in MRI scans of 10 healthy subjects’ wrists and knees. Results: Compared with the scaphoid fossa, average ratio of the radius of circumference of the proximal scaphoid was 0.79 and 0.78 in the coronal and sagittal planes, respectively. Compared with the scaphoid fossa, average ratio of the radius of circumference of the MFT was 0.98 and 1.31 in the coronal and sagittal planes, respectively. The radius of curvature of the MFT was larger than the proximal scaphoid, in the coronal and sagittal planes. In the coronal plane, the MFT radius of curvature is nearly identical to the scaphoid fossa, a closer match than the scaphoid itself. In the sagittal plane, the radius of curvature of the MFT was larger than the radius of curvature of the scaphoid fossa. Conclusions: Our data suggest that the radius of curvature, in the sagittal and coronal planes, of the MFT and proximal scaphoid is disparate.

scholarly journals Plant Thorn Synovitis of the Hand in an Adult Patient: A Case Report and Review of the Current Literature

2019 ◽  
Vol 5 ◽  
pp. 2513826X1987650
Author(s):  
Sarah L. Zhu ◽  
Cameron F. Leveille ◽  
Emily E. Dunn ◽  
Michael J. Cooper
Keyword(s):  
Case Report ◽  
Current Literature ◽  
Foreign Bodies ◽  
Middle Finger ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
The Past ◽  
Left Middle ◽  
Exploratory Surgery ◽  
Plum Tree

This is a case of plant thorn synovitis of the hand in an adult following a plum tree thorn injury, the first reported case in the hands in the past decade. The patient initially presented with persistent joint discomfort following removal of a retained plum thorn fragment from the skin overlyin the proximal interphalangeal joint of the left middle finger. Initial radiography and sonography imaging following the removal revealed no foreign bodies. However, the patient’s symptoms were worsening and refractory to anti-inflammatory and antibiotic treatment. An exploratory surgery was carried out, which revealed multiple plant thorn fragments within the synovium, each measuring approximately 1 mm in size. A synovectomy was performed and the patient recovered with full function. Our case of plant thorn synovitis is discussed along with a review of the current literature on plant thorn synovitis in the hands.

Characterization of the Centroidal Geometry of Human Ribs

2013 ◽  
Vol 135 (11) ◽  
Author(s):  
Matthew W. Kindig ◽  
Richard W. Kent
Keyword(s):  
Cross Sections ◽  
Posterior Extremity ◽  
Radius Of Curvature ◽  
Cross Sectional ◽  
Surface Reconstructions ◽  
C1 Continuity ◽  
Best Fit ◽  
Novel Model ◽  
Geometric Primitives

While a number of studies have quantified overall ribcage morphology (breadth, depth, kyphosis/lordosis) and rib cross-sectional geometry in humans, few studies have characterized the centroidal geometry of individual ribs. In this study, a novel model is introduced to describe the centroidal path of a rib (i.e., the sequence of centroids connecting adjacent cross-sections) in terms of several physically-meaningful and intuitive geometric parameters. Surface reconstructions of rib levels 2–10 from 16 adult male cadavers (aged 31–75 years) were first extracted from CT scans, and the centroidal path was calculated in 3D for each rib using a custom numerical method. The projection of the centroidal path onto the plane of best fit (i.e., the “in-plane” centroidal path) was then modeled using two geometric primitives (a circle and a semiellipse) connected to give C1 continuity. Two additional parameters were used to describe the deviation of the centroidal path from this plane; further, the radius of curvature was calculated at various points along the rib length. This model was fit to each of the 144 extracted ribs, and average trends in rib size and shape with rib level were reported. In general, upper ribs (levels 2–5) had centroidal paths which were closer to circular, while lower ribs (levels 6–10) tended to be more elliptical; further the centroidal curvature at the posterior extremity was less pronounced for lower ribs. Lower ribs also tended to exhibit larger deviations from the best-fit plane. The rib dimensions and trends with subject stature were found to be consistent with findings previously reported in the literature. This model addresses a critical need in the biomechanics literature for the accurate characterization of rib geometry, and can be extended to a larger population as a simple and accurate way to represent the centroidal shape of human ribs.

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