scholarly journals Modified Proximal Interphalangeal Joint Arthrodesis in a Yearling Filly with an Osseous Cyst-Like Lesion in the Proximal Phalanx

Animals ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 948
Author(s):  
Filip Kol’vek ◽  
Lenka Krešáková ◽  
Katarína Vdoviaková ◽  
Ľubomír Medvecký ◽  
Zdeněk Žert
Keyword(s):  
Convex Surface ◽  
Femoral Condyle ◽  
Technical Problem ◽  
Proximal Phalanx ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Joint Surface ◽  
Dynamic Examination ◽  
Clinically Significant ◽  
Distal Joint

After the medial femoral condyle (MFC), the phalanges are the second most common site for osseous cyst-like lesions (OCLLs). Conservative treatment of phalangeal cysts on the convex surface of proximal phalanx presents a technical problem with access to the stoma of the cyst. Surgical therapy options usually aim to avoid cyst enlargement through drilling or screw placement or to encourage lesion filling with osteoconductive material. This paper describes a case of treatment of the OCLL in a yearling Czech warmblood filly with surgical arthrodesis, together with the packing of the OCLL with calcium phosphate biocement (CPB). The filly showed a chronic, moderate to severe, intermittent left hindlimb lameness. Dynamic examination combined with regional anesthesia and radiography confirmed a clinically significant large OCLL on the distal joint surface of the first phalanx. Treatment of the OCLL was performed by surgical arthrodesis of the proximal interphalangeal joint, using two paraxial and one axial crossed lag screw, after curetting of the cyst and filling with CPB.

scholarly journals Minimally invasive management of dorsiflexion contracture at the metatarsophalangeal joint and plantarflexion contracture at the proximal interphalangeal joint of the fifth toe

2011 ◽  
Vol 1 (2) ◽  
pp. 27
Author(s):  
Mariano De Prado ◽  
Pedro-Luis Ripoll ◽  
Pau Golanó ◽  
Javier Vaquero ◽  
Nicola Maffulli
Keyword(s):  
Minimally Invasive ◽  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Invasive Technique ◽  
Wedge Osteotomy ◽  
Invasive Approach ◽  
Fifth Toe ◽  
Toe Deformity

Several surgical options have been described to manage persistent dorsiflexion contracture at the metatarsophalangeal joint and plantarflexion contracture at the proximal interphalangeal joint of the fifth toe. We describe a minimally invasive technique for the management of this deformity. We perform a plantar closing wedge osteotomy of the 5th toe at the base of its proximal phalanx associated with a lateral condylectomy of the head of the proximal phalanx and at the base of the middle phalanx. Lastly, a complete tenotomy of the deep and superficial flexor tendons and of the tendon of the extensor digitorum longus is undertaken. Correction of cock-up fifth toe deformity is achieved using a minimally invasive approach.

Radiographic Assessment of the Relative Lengths of the Bones of the Fingers of the Human Hand

2002 ◽  
Vol 27 (6) ◽  
pp. 546-548 ◽  
Author(s):  
R. HAMILTON ◽  
R. A. DUNSMUIR
Keyword(s):  
Fibonacci Sequence ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Human Hand ◽  
X Rays ◽  
Radiographic Assessment ◽  
Finger Tip ◽  
Distal Joint ◽  
Little Finger

The study assessed whether a relationship existed between the lengths of the phalanges of the fingers of the hand. The centres of rotation of the joints in each finger were determined by dissection of cadaveric hands. Using these data, the distances between the joint centres was determined on anteroposterior hand X-rays taken for clinical purposes. The study has shown that, for all the fingers, there is a ratio of1 for the distance between the metacarpophalangeal and proximal interphalangeal joint and the distance between the proximal interphalangeal joint and the finger tip. The ratio for the distances between the interphalangeal joints and the distal joint and the tip approximates to 1.3 for the index, middle and ring fingers and to 1.0 for the little finger. No evidence was found to support Littler’s hypothesis that the interarticular distances of the finger follow the Fibonacci sequence.

Morphology of the proximal and middle phalanx of fingers with regard to the Ascension PyroCarbon PIP total joint

2014 ◽  
Vol 39 (6) ◽  
pp. 596-603 ◽  
Author(s):  
C. Ries ◽  
W. Zhang ◽  
K. J. Burkhart ◽  
W. F. Neiss ◽  
L. P. Müller ◽  
...  
Keyword(s):  
Potential Risk ◽  
Proximal Phalanx ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Critical Examination ◽  
Middle Phalanx ◽  
Bone Morphology ◽  
Component Size ◽  
Base Insertion

The Ascension PyroCarbon prosthesis has been used in proximal interphalangeal joint osteoarthritis. The dimensions of the intramedullary distal metadiaphyseal canal (isthmus) of the proximal phalanx and the base of the middle phalanx of cadaver fingers were investigated radiographically ( n = 304) and macroscopically ( n = 152). In up to 30% of the phalanges, the isthmus was smaller than the stem of the smallest proximal component size. The distal component head was always smaller than the middle phalanx base. Insertion and success of the Ascension PyroCarbon prosthesis is strongly dependent on bone morphology. A critical examination of the isthmus in radiographs is recommended in planning. If the isthmus is clearly smaller than the smallest proximal component, insertion of the prosthesis could be inadvisable. A clear mismatch between the distal component and the middle phalanx base should be avoided due to the potential risk for late subsidence and failure of the prosthesis.

Advantages and Drawbacks of Proximal Interphalangeal Joint Fusion Versus Flexor Tendon Transfer in the Correction of Hammer and Claw Toe Deformity. A Finite-Element Study

2010 ◽  
Vol 132 (5) ◽  
Author(s):  
Javier Bayod ◽  
Marta Losa-Iglesias ◽  
Ricardo Becerro de Bengoa-Vallejo ◽  
Juan Carlos Prados-Frutos ◽  
Kevin T. Jules ◽  
...  
Keyword(s):  
Finite Element ◽  
Tendon Transfer ◽  
Proximal Phalanx ◽  
Delayed Union ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
The Finite Element Method ◽  
Flexor Digitorum Brevis ◽  
Flexor Digitorum ◽  
Toe Deformity

Correction of claw or hammer toe deformity can be achieved using various techniques, including proximal interphalangeal joint arthrodesis (PIPJA), flexor digitorum longus tendon transfer (FDLT), and flexor digitorum brevis transfer. PIPJA is the oldest technique, but is associated with significant complications (infection, fracture, delayed union, and nonunion). FDLT eliminates the deformity, but leads to loss of stability during gait. Flexor digitorum brevis tendon transfer (FDBT) seems to be the best surgical alternative, but it is a recent technique with still limited results. In this work, these three techniques have been analyzed by means of the finite-element method and a comparative analysis was done with the aim of extracting advantages and drawbacks. The results show that the best technique for reducing dorsal displacement of the proximal phalanx is PIPJA (2.28 mm versus 2.73 mm for FDLT, and 3.31 mm for FDBT). However, the best technique for reducing stresses on phalanges is FDLT or FDBT (a reduction of approximately 35% regarding the pathologic case versus the increase of 7% for the PIPJA in tensile stresses, and a reduction of approximately 40% versus 25% for the PIPJA in compression stresses). Moreover, the distribution of stresses in the entire phalanx is different for the PIPJA case. These facts could cause problems for patients, in particular, those with pain in the surgical toe.

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.

IRREDUCIBLE OPEN DORSAL DISLOCATION OF THE PROXIMAL INTERPHALANGEAL JOINT: A CASE REPORT

Hand Surgery ◽  
2010 ◽  
Vol 15 (01) ◽  
pp. 61-64 ◽  
Author(s):  
Shizuka Muraoka ◽  
Yukihiro Furue ◽  
Mahito Kawashima
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Relevant Literature ◽  
Proximal Phalanx ◽  
Middle Finger ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Volar Plate ◽  
Normal Position ◽  
Flexor Tendons

We report a rare case of open dorsal dislocation of the proximal interphalangeal joint which needed operative reduction. A 39-year-old man injured his right middle finger while playing baseball. There was a laceration on the proximal interphalangeal crease, and the condyles of the proximal phalanx protruded through the wound. The flexor tendons had slipped behind the radial condyle, and made reduction impossible. After the flexor tendons and volar plate were replaced back into their normal position, the reduction was successful. Finally, the patient had full and painless motion of the digit. We review the reported cases of this injury in the relevant literature.

The Proximal Interphalangeal Joint in Dupuytren’s Disease

1985 ◽  
Vol 10 (3) ◽  
pp. 358-364
Author(s):  
M. A. TONKIN ◽  
F. D. BURKE ◽  
J. P. W. VARIAN
Keyword(s):  
Surgical Approach ◽  
Proximal Phalanx ◽  
Flexion Contracture ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Joint Contracture ◽  
Dupuytren’S Disease ◽  
Dupuytren's Disease ◽  
Average Percentage ◽  
Percentage Improvement

In one hundred patients with Dupuytren’s disease, one hundred and fifty-four operations were performed. The average pre-operative proximal interphalangeal joint contracture was 42° and the average percentage improvement in proximal interphalangeal joint extension at post­operative review was 41%. Fourteen amputations were performed (9.1%). The primary deformity is caused by disease involvement of the palmar fascial structures. Secondary changes may prevent correction of the deformity despite excision of the contracted fascia. The anatomy of the joint is reviewed together with the primary and secondary mechanisms of joint contracture in Dupuytren's disease. Arthrodesis, osteotomy of the proximal phalanx and joint replacement are considered as alternatives to amputation when a systematic surgical approach fails to correct the flexion contracture.

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