Common Congenital Hand Differences

2018 ◽  
Author(s):  
Francisco Soldado ◽  
Scott Kozin
Keyword(s):  
Genetic Counseling ◽  
Global Health ◽  
Upper Limb ◽  
Hand Function ◽  
Treatment Algorithm ◽  
Hand Surgery ◽  
Thumb Hypoplasia ◽  
Thumb Duplication ◽  
Hand Defects ◽  
Reoperation Rates

Congenital differences of the hand are common in a pediatric hand surgery practice. The child’s global health and genetic counseling should be addressed before focusing on the upper limb disorder. Appropriate referral is necessary to facilitate education about the congenital difference and its effect on subsequent generations. The physician must be comfortable and have a sound understanding of the diagnosis and treatment algorithm. Reoperation rates are high for even the most common congenital hand defects treated by experienced surgeons. Syndactyly, polydactyly, thumb hypoplasia, and symbrachydactyly are particularly commonplace and are discussed in this review. The main aim when treating these disorders is improving hand function; however, aesthetics must also be considered when planning surgery. This review contains 36 figures, 3 tables and 50 references  Key words: congenital hand differences, pediatric hand, symbrachydactyly, syndactyly, thumb duplication, thumb hypoplasia

scholarly journals ANALIZA WSKAZAŃ DO I OCENA WYNIKÓW PO WTÓRNYCH OPERACJACH PO PIERWOTNYM ZAOPATRZENIU URAZÓW W OBRĘBIE KOŃCZYNY GÓRNEJ

2016 ◽  
Vol 60 (2) ◽  
Author(s):  
Andrzej Żyluk ◽  
Agnieszka Mazur
Keyword(s):  
Upper Limb ◽  
Primary Repair ◽  
Hand Function ◽  
Tertiary Care ◽  
Hand Surgery ◽  
Finger Movement ◽  
Tertiary Institution ◽  
Secondary Interventions ◽  
Limb Injuries ◽  
Medical University

Introduction: The objective of the study was the analysis of the indications for, and assessment of the outcomes of secondary interventions after primary repair of injuries within the upper limb in the authors’ institution – Department of General and Hand Surgery of the Pomeranian Medical University in Szczecin (a tertiary care unit).Material and methods: Answers on questionnaires (including DASH) mailed to 33 patients were the subject of the analysis. The group consisted of 27 men and 6 women, mean age 36 years, in whom secondary interventions were performed at a mean of 8 months after primary surgery.Results: Injuries were grouped in five categories: tendon lacerations, hand or finger amputations, nerve sections, complex tissue injuries, and isolated finger fractures. The most common cause of secondary intervention was incomplete finger movement and lack of opposition of the thumb. The most common operations included tenolysis, arthrolysis and opponensplasty. The outcomes of secondary surgery from patients’ perspective were overall good: 13 (39%) patients reported significant improvement, 16 (48%) moderate, and only 4 (13%) patients had no benefit. Twenty­‍‑five patients regained full, or almost full hand function (DASH scores 2–39), and 8 (24%) had moderately to severely impaired function (DASH 40–80). Twenty­‍‑eight patients returned to work.Conclusions: Primary repair of upper limb injuries (even severe) in the tertiary institution was adequate, and secondary interventions rarely necessary. The most common indication was incomplete finger movement caused by ineffective postoperative mobilization. The important role of rehabilitation for the final outcome of the treatment of hand injuries was emphasized.

scholarly journals Hand Surgery in Saudi Arabia

2020 ◽  
Author(s):  
Abdullah E. Kattan ◽  
Mohammad M. Al-Qattan
Keyword(s):  
Saudi Arabia ◽  
Orthopedic Surgery ◽  
Significant Contribution ◽  
Hand Surgery ◽  
Fellowship Program ◽  
Novel Mutations ◽  
Work Related ◽  
The Past ◽  
Aesthetic Results ◽  
Hand Defects

AbstractHand surgery is a unique field that incorporates multiple specialties, aiming to provide the patient with a best possible functional and aesthetic results. Hand surgeons deal with different pathologies that require skills in several aspects of surgery. The field of hand surgery has evolved significantly over the past decades across the globe. This specialty has also been evolving in Saudi Arabia over the past 25 years. Some of the services offered to patients include specialized centers for brachial plexus, peripheral nerve, and pediatric hand surgery as well as centers for work-related hand injuries. There has also been significant contribution to the hand surgery literature from the hand surgeons working in Saudi Arabia, with hundreds of papers published in journals pertaining to hand surgery, orthopedic surgery, and plastic surgery, as well as the publication of several novel mutations causing congenital hand defects in journals concerned with genetics. The recent approval of a hand and microsurgery fellowship program in Saudi Arabia will also help boost this field in the country and the region.

The OMT Classification of Congenital Anomalies of the Hand and Upper Limb

Hand Surgery ◽  
2015 ◽  
Vol 20 (03) ◽  
pp. 336-342 ◽  
Author(s):  
Michael A. Tonkin ◽  
Kerby C. Oberg
Keyword(s):  
Upper Limb ◽  
Congenital Anomalies ◽  
Limb Development ◽  
Main Group ◽  
International Federation ◽  
Scientific Committee ◽  
Current Status ◽  
Thumb Duplication ◽  
The Common

The Oberg, Manske and Tonkin (OMT) Classification of congenital anomalies of the hand and upper limb uses dysmorphological terminology, placing conditions in one of three groups: Malformations, Deformations and Dysplasias. The main group, Malformations, is further subdivided according to whether the whole of the limb is affected or the hand plate alone, and whether the primary insult involves one of the three axes of limb development and patterning or is non-axial. The common surgical diagnoses, such as thumb duplication and thumb hypoplasia, are then placed within this framework. Recently the International Federation of Societies for Surgery of the Hand Scientific Committee for Congenital Conditions approved the OMT Classification as a timely and appropriate replacement of the previously accepted Swanson Classification. This review charts the development of and modifications to the OMT Classification and its current status.

scholarly journals Ischemic Hand Complications From Intra-Arterial Injection of Sublingual Buprenorphine/Naloxone Among Patients With Opioid Dependency

Hand ◽  
2016 ◽  
Vol 12 (5) ◽  
pp. 507-511 ◽  
Author(s):  
Ryan M. Wilson ◽  
Shady Elmaraghi ◽  
Brian D. Rinker
Keyword(s):  
Treatment Algorithm ◽  
Hand Surgery ◽  
Tissue Loss ◽  
Opioid Dependency ◽  
Sublingual Buprenorphine ◽  
Review Period ◽  
Intravenous Heparin ◽  
Oral Agents ◽  
Clinical Records

Background: Sublingual buprenorphine/naloxone, a common treatment for opioid dependence, is frequently abused by intravenous injection. Inadvertent intra-arterial injection of buprenorphine/naloxone can produce acute ischemic insult to the hand due to gelatin embolism. Our purpose was to review a series of these patients in order to describe the clinical entity, review the outcomes, and propose a rational treatment algorithm. Methods: Clinical records of all patients evaluated by the hand surgery team between 2011 and 2015 for ischemia of the hand after buprenorphine/naloxone injection were reviewed. Treatment, complications, and amount of tissue loss were recorded. Patients presenting within 48 hours of the injection were treated with intravenous heparin for 5 days, followed by oral aspirin and clopidogrel for 30 days. Those presenting after 48 hours were treated with aspirin and clopidogrel only. Results: Ten patients presented during the review period. Average follow-up time was 13 weeks. Eight had ischemia of the radial side of the hand, 1 of the ulnar side, and 1 had bilateral ischemia. Three patients were treated with intravenous heparin and 5 with oral agents. Two presented with dry gangrene and did not receive anticoagulation. All patients experienced tissue loss. There was no difference in outcome regardless of treatment. Conclusions: With the increasing use of sublingual buprenorphine/naloxone in opioid dependency, ischemic hand injuries will be seen with greater frequency. Whereas outcomes did not vary with treatment modality in this series, further study is needed to determine the most effective treatment of these injuries.

Is Asymmetry of the Pons Associated with Hand Function and Manual Ability after Arterial Ischemic Stroke in Children?

2019 ◽  
Vol 50 (03) ◽  
pp. 138-145
Author(s):  
Nedelina Slavova ◽  
Max Shojai ◽  
Regula Everts ◽  
Roland Wiest ◽  
Maja Steinlin ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Upper Limb ◽  
Hand Function ◽  
Limb Movement ◽  
Typically Developing ◽  
Arterial Ischemic Stroke ◽  
Cross Sectional ◽  
Indirect Measure ◽  
The Asymmetry

Aim This study was designed to investigate how the asymmetry of the brain stem is related to hand function and manual ability after arterial ischemic stroke (AIS) diagnosed during childhood. Method Patients diagnosed with AIS during childhood (> 5 years old, diagnosis > 2 years before recruitment) and typically developing peers were recruited by the Swiss Neuropediatric Stroke Registry. Brainstem cross-sectional areas of each side at the level of the pons were measured. Pinch and grip strength were measured with a dynamometer, quality of upper limb movement by the Melbourne Assessment 2 and manual ability by the ABILHAND-kids. An asymmetry index was calculated for all measures (except the ABILHAND-kids). Differences between groups and correlations were calculated using nonparametric statistics. Results Fourteen AIS survivors without hemiparesis, 10 AIS survivors with hemiparesis, and 47 typically developing peers were assessed. Patients with hemiparesis showed the highest brainstem asymmetry. There was a significant positive correlation between brainstem asymmetry, the asymmetry of strength and quality of upper limb movement, and a significant negative correlation between brainstem asymmetry and manual ability. Interpretation In pediatric AIS survivors, brainstem asymmetry can serve as an indirect measure of corticospinal tract integrity. It is significantly correlated with strength, quality of movement, and manual ability.

Arm function after stroke - can we make a difference?

1999 ◽  
Vol 55 (2) ◽  
pp. 4-7 ◽  
Author(s):  
L. Fearnhead ◽  
C. J. Eales ◽  
V. U. Fritz
Keyword(s):  
Motor Control ◽  
Upper Limb ◽  
Functional Disability ◽  
Hand Function ◽  
Review Of The Literature ◽  
Limb Function ◽  
Upper Limb Rehabilitation ◽  
Upper Limb Function ◽  
Recent Developments ◽  
Limb Rehabilitation

Impairment of upper limb function is a significant cause of functional disability after stroke. Based on a review of the literature this paper defines upper limb function and highlights some of the relevant recent developments in neuropathology. The effects of changes in sensation, muscle recruitment and tone are described. Reliable and valid outcome measures of upper limb impairment and disability are listed. The principles of rehabilitation are described in terms of timing of rehabilitation, sensory reeducation, motor control and functional use. Questions are raised regarding the need for counselling for the loss of fine discriminative hand function and for research into this behavioural aspect of upper limb rehabilitation.

Change in Hand Function and Dexterity with Age after Index Pollicization for Congenital Thumb Hypoplasia

2018 ◽  
Vol 141 (3) ◽  
pp. 691-700 ◽  
Author(s):  
Kathleen M. Kollitz ◽  
Wendy Tomhave ◽  
Ann E. Van Heest ◽  
Steven L. Moran
Keyword(s):  
Hand Function ◽  
Thumb Hypoplasia

Congenital brachial plexus palsy

2011 ◽  
Author(s):  
Marco Sinisi
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Hand Function ◽  
Shoulder Function ◽  
Mechanism Of Injury ◽  
Brachial Plexus Palsy ◽  
Surgical Exploration

♦ The congenital brachial plexus palsy is significantly different from the adult injury♦ The mechanism of injury is invariably traction♦ Classifying the lesion at 1–2 weeks of age aids with prognosis and management♦ Surgical exploration and repair is indicated early in selected cases♦ Good shoulder function is essential for a useful upper limb♦ Recovery of hand function is slow and may continue until age 5 years.

scholarly journals To stimulate or not to stimulate? A rapid systematic review of repetitive sensory stimulation for the upper-limb following stroke

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Rachel C. Stockley ◽  
Kerry Hanna ◽  
Louise Connell
Keyword(s):  
Systematic Review ◽  
Upper Limb ◽  
Meta Analysis ◽  
Hand Function ◽  
Research Priorities ◽  
Sensory Stimulation ◽  
Treatment Session ◽  
Current Evidence ◽  
Serious Adverse Events ◽  
Repetitive Sensory Stimulation

Abstract Background Repetitive sensory stimulation (RSS) is a therapeutic approach which involves repeated electrical stimulation of the skin’s surface to improve function. This rapid systematic review aimed to describe the current evidence for repetitive sensory stimulation (RSS) in rehabilitation of the upper-limb for people who have had a stroke. Main text Methods: Relevant studies were identified in a systematic search of electronic databases and hand-searching in February 2020. The findings of included studies were synthesized to describe: the safety of RSS, in whom and when after stroke it has been used, the doses used and its effectiveness. Results Eight studies were included. No serious adverse events were reported. The majority of studies used RSS in participants with mild or moderate impairments and in the chronic stage after stroke. Four studies used RSS in a single treatment session, reporting significant improvements in strength and hand function. Findings from longitudinal studies showed few significant differences between control and experimental groups. Meta-analysis was not possible due to the heterogeneity of included studies. Conclusions This review suggests that there is insufficient evidence to support the use of RSS for the upper-limb after stroke in clinical practice. However, this review highlights several clear research priorities including establishing the mechanism and in whom RSS may work, its safety and optimal treatment parameters to improve function of the upper-limb after stroke.

THE RECALL DASH SCORE — A NOVEL RESEARCH TOOL

Hand Surgery ◽  
2013 ◽  
Vol 18 (01) ◽  
pp. 11-14 ◽  
Author(s):  
Nicholas Reynolds ◽  
Sunil Thirkannad
Keyword(s):  
Statistical Analysis ◽  
Patient Population ◽  
Hand Function ◽  
Hand Surgery ◽  
Clinic Visit ◽  
Research Tool ◽  
Time Interval ◽  
Dash Score ◽  
Pre Treatment

The DASH score is a universally accepted method for assessment of hand function. However, there are occasions when a pre-treatment DASH score is unavailable. This study provides a solution to this situation. An initial DASH score was obtained from all patients at the time of their first clinic visit. A second score was obtained at the time of final follow-up asking the patient to "Recall" their pre-treatment status. The two scores were compared with appropriate statistical analysis. Thirty-eight patients were included in the study and scores were obtained at an average time interval of 32 weeks (6–121 weeks). Excellent agreement was noted for the ability of the patient population to recall their scores with a group correlation of 0.86. This proves that the Recall DASH score is an excellent and useful research tool for use in hand surgery.

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