scholarly journals Case Report: Osteomyelitis of the Proximal Phalanx of the Finger in Patient With Ollier Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Konstantin Lipatov ◽  
George Melkonyan ◽  
Anatoly Shekhter ◽  
Artur Asatryan ◽  
Abduaziz Kholikov ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Rapid Development ◽  
Proximal Phalanx ◽  
Ring Finger ◽  
Bone Destruction ◽  
Mosquito Bite ◽  
Risk Of Malignancy ◽  
Ollier Disease ◽  
Excised Tissues ◽  
Hands And Feet

Ollier disease is a rare congenital pathology characterized by the growth of enchondromas in bones, accompanied with their deformities, fractures, and the risk of malignancy. A 39-year-old patient with Ollier disease (acroform with lesions of hands and feet) suffered a rapid development of osteomyelitis of the proximal phalanx of the ring finger after a mosquito bite. The condition localized in the area of enchondroma. Surgical treatment included osteonecrectomy in the phalanx and enchondroma with excision of non-viable surrounding soft tissues, drainage of the surgical wound and the imposition of primary sutures. Morphological analysis confirmed the presence of ectopic embryonic cartilage specific for Ollier disease and the bone destruction. The excised tissues were infiltrated with immune cells and had signs of periosteal chronic inflammation including fibrosis and hyalinosis. These changes, which occurred long before the mosquito bite, became a favorable background for the development of a purulent infection.

scholarly journals Results of tension band wiring in intra-articular collateral ligament avulsion fractures of the phalanx

2018 ◽  
Vol 6 (2) ◽  
pp. 74-77
Author(s):  
Rajeev Raj Manandhar ◽  
Shishir Lakhey ◽  
Umash Karki
Keyword(s):  
Functional Outcome ◽  
Soft Tissues ◽  
Proximal Phalanx ◽  
Ring Finger ◽  
Ulnar Collateral Ligament ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Collateral Ligament ◽  
Avulsion Fractures ◽  
Radial Collateral Ligament

Background: Avulsion fractures of the base of proximal phalanx associated with ulnar or radial collateral ligament instability are relatively rare. The small size of the fragment and strong deforming pull of the attached soft tissues make the process of reduction and maintenance difficult.Objective: The purpose of this study was to assess the functional outcome of tension band wiring in intra-articular avulsion fractures of the base of the proximal phalanx.Methodology: A prospective study was performed on ten patients with intra-articular collateral ligament avulsion fractures of the proximal phalanx (Jupiter’s classification Type III). A tension band construct was performed using a dorsal approach. The functional outcome was assessed at six months with the quick Disability of Arm, Shoulder and Hand score.Results: The mean age of the patients was 25.8 years (Mean ± SD: 25.80). Six avulsion fractures were of the ulnar collateral ligament of the proximal phalanx of the index finger, one involved the radial collateral ligament of the ring finger and three, the radial collateral ligament of the little finger suggesting an abduction injury. All fractures had united at three months. Eight patients were graded as excellent and two as good. All patients were satisfied with the surgery and the functional outcome of the injured digit. There were no perioperative complications.Conclusion: The functional outcome of tension band wiring in intra-articular collateral ligament avulsion fractures of the base of the proximal phalanx was good to excellent.

APPLICATION OF A TRANS-WEB APPROACH TO PLATING TECHNIQUE FOR AN EXTRA-ARTICULAR FRACTURE OF THE PROXIMAL PHALANX

Hand Surgery ◽  
2013 ◽  
Vol 18 (01) ◽  
pp. 129-131 ◽  
Author(s):  
Eichi Itadera ◽  
Daisuke Himeno
Keyword(s):  
Soft Tissues ◽  
Screw Fixation ◽  
Proximal Phalanx ◽  
Ring Finger ◽  
Lateral Approach ◽  
Operative Field ◽  
Articular Fracture ◽  
Plating Technique ◽  
Operative Outcome

We report the case of an extra-articular fracture at the base of the proximal phalanx of the ring finger treated by plate and screw fixation using a modified trans-web approach. The combination of trans-web and mid-lateral approach provided a wide operative field and adequate visualization without marked damage to the soft tissues, and the operative outcome was excellent.

scholarly journals Hand tumors: A review of 186 patients at a single institute

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199399
Author(s):  
Taketsugu Fujibuchi ◽  
Hiroshi Imai ◽  
Joji Miyawaki ◽  
Teruki Kidani ◽  
Hiroshi Kiyomatsu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Clinical Features ◽  
Malignant Tumors ◽  
Proximal Phalanx ◽  
Delayed Diagnosis ◽  
Ring Finger ◽  
Soft Tissue Tumors ◽  
Body Parts ◽  
Maximal Diameter ◽  
Benign Soft Tissue Tumors

Purpose: The spectrum of diagnoses and clinical features of hand tumors differ from those of tumors in other body parts. However, only a few reports have comprehensively referenced the diagnosis and clinical features of hand tumors. This study aimed to elucidate the diagnostic distribution and the clinical features of hand tumors undergone surgery in our institute. Patients and methods: A total of 235 lesions in 186 patients diagnosed with hand tumors between 1978 and 2020 were reviewed. Age at surgery, gender, chief complaint, tumor location, and pathological diagnosis were analyzed. Results: There were 121 benign bone tumors, 98 benign soft tissue tumors, and 16 malignant tumors. Chondroma and tenosynovial giant cell tumor were common benign bone and soft tissue tumors at the proximal phalanx of the ring finger and the palm, respectively. Meanwhile, chondrosarcoma and synovial sarcoma were common malignant tumors at the dorsal part of the hand. Local pain and painless mass were the chief complaints in patients with benign bone and soft tissue tumors, respectively. Most patients with malignant tumors were referred after unplanned resection. When patients were classified into two categories by tumor size according to maximal diameter, tumors larger than 19 mm had a significantly higher risk of malignant ( p = 0.031) despite being smaller than other tumors in different body parts. Conclusion: When a tumor malignancy is suspected, the patient should be referred to a specialist to avoid unplanned resection or delayed diagnosis due to misdiagnosis. Knowing the distribution and clinical features should help in diagnosing hand tumors.

The Role of Soft Tissues in Plate Fixation of Proximal Phalanx Fractures

2004 ◽  
Vol 418 ◽  
pp. 213-218 ◽  
Author(s):  
Elizabeth Anne Ouellette ◽  
Jay J Dennis ◽  
Loren L Latta ◽  
Edward L Milne ◽  
Anna-Lena Makowski
Keyword(s):  
Soft Tissues ◽  
Plate Fixation ◽  
Proximal Phalanx

scholarly journals Microvasculature of the Plantar Plate Using Nano–Computed Tomography

2018 ◽  
Vol 40 (4) ◽  
pp. 457-464 ◽  
Author(s):  
Fred T. Finney ◽  
Aaron McPheters ◽  
Natalie V. Singer ◽  
Jaron C. Scott ◽  
Karl J. Jepsen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Soft Tissues ◽  
Proximal Phalanx ◽  
Surgical Techniques ◽  
Phosphomolybdic Acid ◽  
Vascular Density ◽  
Plantar Plate ◽  
Tibial Arteries ◽  
Clinical Conditions ◽  
Mtp Joints

Background: Lesser toe plantar plate attenuation or disruption is being increasingly implicated in a variety of common clinical conditions. A multitude of surgical techniques and devices have been recently developed to facilitate surgical repair of the plantar plate. However, the microvascular anatomy, and therefore the healing potential in large part, has not been defined. We investigated the microvasculature of the plantar plate by employing a novel technique involving microvascular perfusion and nano–computed tomography (nano-CT) imaging. Methods: Twelve human adult cadaveric lower extremities were amputated distal to the knee. The anterior and posterior tibial arteries were perfused with a barium solution. The soft tissues of each foot were then counterstained with phosphomolybdic acid (PMA). The second through fourth toe metatarsophalangeal (MTP) joints of 12 feet were imaged with nano-CT at 14-micron resolution. Images were then reconstructed for analysis of the plantar plate microvasculature and calculation of the vascular density along the length of the plantar plate. Results: A microvascular network extends from the surrounding soft tissues at the attachments of the plantar plate on both the metatarsal and proximal phalanx. The midsubstance of the plantar plate appears to be relatively hypovascular. Analysis of the vascular density along the length of the plantar plate demonstrated a consistent trend with increased vascular density at approximately the proximal 29% and distal 22% of the plantar plate. Conclusion: There is a vascular network extending from the surrounding soft tissues into the proximal and distal attachments of the plantar plate. Clinical relevance: The hypovascular midportion of the plantar plate may play an important role in the underlying pathoanatomy and pathophysiology of this area. These findings may have significant clinical implications for the reparative potential of this region and the surgical procedures currently described to accomplish anatomic plantar plate repair.

scholarly journals Giant Cell Tumour of Proximal Phalanx of Ring Finger: Case Report and Review of Literature

Cureus ◽  
2016 ◽  
Author(s):  
Rishit Soni ◽  
Chirag Kapoor ◽  
Malkesh Shah ◽  
Amit Patel ◽  
Paresh Golwala
Keyword(s):  
Case Report ◽  
Giant Cell ◽  
Giant Cell Tumour ◽  
Proximal Phalanx ◽  
Ring Finger ◽  
Cell Tumour ◽  
Review Of Literature

Anatomical Basis for Arthroscopy of the Proximal Interphalangeal Joints

2018 ◽  
Vol 23 (03) ◽  
pp. 342-346 ◽  
Author(s):  
Hideki Okamoto ◽  
Isato Sekiya ◽  
Jun Mizutani ◽  
Nobuyuki Watanabe ◽  
Takanobu Otsuka
Keyword(s):  
Proximal Phalanx ◽  
Ring Finger ◽  
Invasive Technique ◽  
Collateral Ligaments ◽  
Collateral Ligament ◽  
Lateral Band ◽  
Dorsal Edge ◽  
Anatomical Basis ◽  
Pip Joint ◽  
The Right

Background: Arthroscopy is a widely used minimally invasive technique. Nevertheless, no report describes the arthroscopic anatomy of the proximal interphalangeal (PIP) joint for portal creation. To facilitate arthroscopy, this study elucidated the anatomy of the lateral bands of the extensor mechanism and collateral ligaments of PIP joints. Methods: A total of 39 fingers from the right hands of 10 cadavers (4 males, 6 females) were evaluated in this study. We defined the extension line from the proximal interphalangeal volar crease as the C-line. We also defined an imaginary line along the distal edge of the proximal phalanx, which is parallel to the C-line, as the J-line. The distance between J-line and C-line was measured. On the C-line and J-line, we measured the following: from the dorsal skin to the lateral edge of the lateral band (LB), the dorsal edge of the collateral ligament (CL) and from the lateral band and the collateral ligament (D), the width of the finger (W). The finger half-width (M) was measured on the J-line. Comparison between the digits and comparison between radial and ulnar distance were measured and statistical analysis was performed. Results: All PIP joint spaces were distal from the C-line, except for one ring finger. The average distances between the J-line and C-line were 1.8–3.2 mm. On the C-line, only 11 cases (14.1%) showed an interval between the lateral bands and the collateral ligaments, but, on the J-line 72, cases (92.3%) had such an interval. The interval was located 1.6–2.9 mm in a dorsal direction from the midlateral on the J-line. Conclusions: Portal creation at the J-line is safer than at the C-line. This study revealed that safe portals for arthroscopy of the PIP joint are 2 mm dorsal to the midlateral line of the finger on the J-line.

scholarly journals Resurfacing of Two Separate Digital Defects Using a Single Fascial Free Flap with Neosyndactylization

2018 ◽  
Vol 03 (02) ◽  
pp. e87-e90
Author(s):  
Fernando Herrera ◽  
Karen Horton ◽  
Ryan Brennan ◽  
Gregory Buncke ◽  
Rudolph Buntic
Keyword(s):  
Soft Tissue ◽  
Free Flap ◽  
Proximal Phalanx ◽  
Ring Finger ◽  
Soft Tissue Coverage ◽  
Left Hand ◽  
Fascial Flap ◽  
Aesthetic Results ◽  
Radial Forearm ◽  
Thorough Debridement

AbstractWe report a case of a 20-year-old patient who sustained a mutilating crush injury to the left-hand index and ring finger volar surface measuring 5 × 6 cm from the distal end of the proximal phalanx to the fingertips. After thorough debridement and stabilization of the skeletal injury, a radial forearm fascia only free flap measuring 6 × 7 cm was used to resurface the distal soft tissue volar defect of two adjacent fingers. Digital nerve grafting was also required, and this was done using autologous nerve graft from the lateral antebrachial cutaneous nerve. This thin fascia only flap allows for stable soft tissue coverage and provides a gliding surface for the underlying tendons. The neosyndactylized digits were safely divided at 3-month follow-up, and excellent functional and aesthetic results were achieved. The radial forearm fascia is a thin, durable, and pliable tissue that is based on the radial artery as a vascular pedicle. We consider this free fascial flap as a valuable option for coverage of multiple complex distal digit injuries using a single flap and highly recommend its use.

OPPONOPLASTY WITHOUT POSTOPERATIVE IMMOBILIZATION

Hand Surgery ◽  
2011 ◽  
Vol 16 (03) ◽  
pp. 295-300 ◽  
Author(s):  
Ichiro Okutsu ◽  
Ikki Hamanaka ◽  
Aya Yoshida
Keyword(s):  
Muscle Function ◽  
Tendon Transfer ◽  
Proximal Phalanx ◽  
Ring Finger ◽  
Outpatient Basis ◽  
Reconstructive Procedure ◽  
Thenar Muscle ◽  
Pneumatic Tourniquet ◽  
Palmaris Longus Tendon ◽  
Flexor Digitorum

Opponoplasty using tendon transfer is a useful reconstructive procedure that restores lost thenar muscle function. Tendon transfers, however, require postoperative immobilization periods of up to four weeks before the sutured tendons reach required strength. We developed an opponoplasty procedure using α-TCP (alpha-tricalcium phosphate) cement that does not require postoperative immobilization and was applied to nine hands out of nine cases. The procedure is performed under local anesthesia without a pneumatic tourniquet and on an outpatient basis. In this procedure, the flexor digitorum superficialis of the ring finger is used as the donor tendon and the palmaris longus tendon is used as a dynamic pulley. The distal end of the transferred tendon is anchored to the inside of a newly formed bone hole in the thumb's proximal phalanx using α-TCP cement. Our opponoplasty procedure was uneventful postoperatively and produced satisfactory results in all nine cases. The α-TCP cement procedure shows potential for other tendon transfer applications.

Modified “On-Top-Plasty” Technique for Restoring Length to Amputation Stumps

2002 ◽  
Vol 27 (3) ◽  
pp. 265-269 ◽  
Author(s):  
V. PISTRE ◽  
P. PELISSIER ◽  
A. BALLANGER ◽  
D. MARTIN ◽  
J. BAUDET
Keyword(s):  
Proximal Phalanx ◽  
Ring Finger ◽  
Middle Finger ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Middle Phalanx ◽  
Secondary Procedure ◽  
Amputation Stumps ◽  
Amputation Stump ◽  
Middle Ring

Five patients were successfully treated with a modified “on-top-plasty” technique, in which a finger stump is lengthened by transfer of an adjacent amputation stump with a reverse blood flow fingerstump. This technique can be performed in the acute phase or as a secondary procedure. A conventional on-top-plasty can be performed by transfer of a partially amputated index or ring finger to the “top” of the proximal phalanx of an amputated middle finger. Alternatively, the transferred part may be used in an intercalated fashion to reconstruct the middle phalanx, using a prosthesis to reconstruct the proximal interphalangeal joint. The results, complications and disadvantages of the technique are reported. We propose this procedure for the reconstruction of the middle ring finger when a free microneurovascular toe-to-hand transfer is contraindicated or refused by the patient.

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