scholarly journals Boutonniere Deformity: A Review of Considerations before Treatment and Current Treatment Options

2020 ◽  
Vol 25 (4) ◽  
pp. 249-258
Author(s):  
Jun-Ku Lee ◽  
Choongki Kim ◽  
Soo-Hong Han
Keyword(s):  
Functional Limitations ◽  
Treatment Options ◽  
Current Treatment ◽  
Boutonniere Deformity ◽  
Appropriate Treatment ◽  
Pip Joint ◽  
Central Slip ◽  
Clear Guideline ◽  
Surgical Treatments ◽  
Boutonnière Deformity

Central slip injury is a common occurrence in hand trauma. When the base of the middle phalanx, which is the contact part of the central tendon, is weakened or damaged, extension lag or restriction would be found in the proximal interphalangeal (PIP) joint and the distal interphalangeal joint becomes hyperextended, presenting buttonhole or boutonniere deformation. Buttonhole deformation has limited cases that a hand surgeon can experience, and there is still no clear guideline for treatment, so treatment tends to depend on the knowledge and experience of the treating doctor. In this review, the factors to be considered in determining the treatment of boutonniere deformity are discussed, and nonsurgical or surgical treatment is considered. Treatment of the PIP joint in boutonniere deformity is a difficult task. Understanding the cause of the deformity, the time point and the stage of deformity, the relationship to the biomechanical changes in adjacent joints, the patient’s functional limitations, and the condition of the joint will improve treatment decisions and outcomes. Based on these considerations, an appropriate treatment should be chosen among nonsurgical or surgical treatments. Various surgical options were introduced but none of method guarantee the optimal outcome. Sufficient understanding of deformity and sufficient consultation and cooperation with the patient regarding the treatment process, outcome, and rehabilitation are necessary.

The Central Slip Tenodesis Test for Early Diagnosis of Potential Boutonnière Deformities

1994 ◽  
Vol 19 (1) ◽  
pp. 88-90 ◽  
Author(s):  
P. J. SMITH ◽  
D. A. ROSS
Keyword(s):  
Early Diagnosis ◽  
Conservative Management ◽  
Primary Defect ◽  
Non Invasive ◽  
Boutonniere Deformity ◽  
Invasive Method ◽  
Central Slip ◽  
Boutonnière Deformity

Disruption of the central slip is the primary defect leading to boutonnière deformity. In the closed injury early diagnosis of this lesion is rarely achieved due to the limitations of current methods and difficulties encountered in assessing a painful finger. We describe a simple, non-invasive method of diagnosis which can be carried out on all patients and with minimal discomfort. This test is also beneficial in monitoring the progress of conservative management of central slip disruption.

Restoration of the Central Slip in Congenital Form of Boutonniere Deformity: Case Report

2014 ◽  
Vol 39 (10) ◽  
pp. 1978-1981 ◽  
Author(s):  
Jong-Pil Kim ◽  
Jai-Hyang Go ◽  
Chang-Hwan Hwang ◽  
Won-Jeong Shin
Keyword(s):  
Case Report ◽  
Congenital Form ◽  
Boutonniere Deformity ◽  
Central Slip ◽  
Boutonnière Deformity

scholarly journals Current Treatment Options for Patients with Myotonic Dystrophy Type 2

2021 ◽  
Vol 23 (9) ◽  
Author(s):  
Federica Montagnese
Keyword(s):  
Myotonic Dystrophy ◽  
Treatment Options ◽  
Current Treatment ◽  
Standards Of Care ◽  
Myotonic Dystrophy Type ◽  
Myotonic Dystrophy Type 2 ◽  
Appropriate Treatment ◽  
Symptomatic Management ◽  
The Moment

Abstract Purpose of the review Myotonic dystrophy types 1 and 2 are frequent forms of muscular dystrophies in adulthood. Their clinical differences need to be taken into account for the most appropriate treatment of patients. The aim of this article is to provide an overview on the current and upcoming therapeutic options for patients with myotonic dystrophy type 2 (DM2). Recent findings At the moment, no disease-modifying therapies are available for DM2; next-generation therapies may however be available in the near future. In the meanwhile, the symptomatic management of patients has greatly improved, thank to the production of consensus-based standards of care and the growing evidence of efficacy of anti-myotonic drugs, promising employment of cannabinoids for symptom’s relief, regular monitoring, and early detection of treatable extra-muscular manifestations. Summary The treatment of DM2 is currently symptomatic and relies on the coordinated intervention of a multidisciplinary team. It remains to be determined whether upcoming causal therapies for myotonic dystrophy type 1 will be applicable also in DM2.

scholarly journals Multimodal Non-Surgical Treatments of Aggressive Pituitary Tumors

2021 ◽  
Vol 12 ◽  
Author(s):  
Tae Nakano-Tateno ◽  
Kheng Joe Lau ◽  
Justin Wang ◽  
Cailin McMahon ◽  
Yasuhiko Kawakami ◽  
...  
Keyword(s):  
Treatment Options ◽  
Somatostatin Receptor ◽  
Pituitary Tumors ◽  
Peptide Receptor Radionuclide Therapy ◽  
Current Treatment ◽  
Chemotherapeutic Drugs ◽  
Clinical Level ◽  
Medical Therapies ◽  
Surgical Treatments

Up to 35% of aggressive pituitary tumors recur and significantly affect mortality and quality of life. Management can be challenging and often requires multimodal treatment. Current treatment options, including surgery, conventional medical therapies such as dopamine agonists, somatostatin receptor agonists and radiotherapy, often fail to inhibit pituitary tumor growth. Recently, anti-tumor effects of chemotherapeutic drugs such as Temozolomide, Capecitabine, and Everolimus, as well as peptide receptor radionuclide therapy on aggressive pituitary tumors have been increasingly investigated and yield mixed, although sometimes promising, outcomes. The purpose of this review is to provide thorough information on non-surgical medical therapies and their efficacies and used protocols for aggressive pituitary adenomas from pre-clinical level to clinical use.

Biomechanical Properties of Human Coronary Sinus for Minimally Invasive Mitral Valve Repair

2010 ◽  
Author(s):  
Thuy Pham ◽  
Wei Sun
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Operative Mortality ◽  
Treatment Options ◽  
Mitral Valve Regurgitation ◽  
Biomechanical Properties ◽  
Current Treatment ◽  
Valve Repair ◽  
Surgical Treatments

Mitral valve regurgitation, the leakage of blood back to the left atrium during systole, is a significant cause of morbidity and mortality. The current treatment options for symptomatic mitral regurgitation are mitral valve repair and replacement. However, the operative mortality for both of these treatments remains substantial (1). Furthermore, these treatments are often not referred for elderly patients with comorbidities. Thus, there is a pressing need for less invasive, non-surgical treatments of mitral regurgitation.

scholarly journals Classifying Hydroceles of the Pelvis and Groin: An Overview of Etiology, Secondary Complications, Evaluation, and Management

2016 ◽  
Vol 10 (1) ◽  
pp. 1-14 ◽  
Author(s):  
Gautam Dagur ◽  
Jason Gandhi ◽  
Yiji Suh ◽  
Steven Weissbart ◽  
Yefim R. Sheynkin ◽  
...  
Keyword(s):  
Treatment Options ◽  
Clinical Manifestations ◽  
Diagnostic Techniques ◽  
Current Treatment ◽  
Serous Fluid ◽  
Secondary Complications ◽  
Appropriate Treatment ◽  
Iatrogenic Trauma ◽  
Life Threatening

Introduction: A hydrocele is defined as the pathological buildup of serous fluid in the pelvis and groin due to various etiologies such as diseases or trauma. It has distinct clinical manifestations, particularly discomfort and psychosocial distress. Understanding the anatomy, embryology, and physiology associated with hydrocele formation is crucial to understand its onset and progression. Materials and Methods: A MEDLINE® search was conducted using keywords for the relevant classification of hydrocele and its etiology, complications, sexual barriers, evaluation, and management. Results: Appropriately classifying the hydrocele as primary, secondary communicating, secondary noncommunicating, microbe-induced, inflammatory, iatrogenic, trauma-induced, tumor-induced, canal of Nuck, congenital, and giant is important for identifying the underlying etiology. Often this process is overlooked when the classification or etiology is too rare. A focused evaluation is important for this, so that timely management can be provided. We comprehensively review the classifications, etiology, and secondary complications of hydrocele. Pitfalls of current diagnostic techniques are explored along with recommended methods for accurate diagnosis and current treatment options. Conclusion: Due to the range of classifications and etiologies of hydrocele in the pelvis and groin, a deliberate differential diagnosis is essential to avoiding imminent life-threatening complications as well as providing the appropriate treatment.

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