scholarly journals Effectiveness of adaptive silverware on range of motion of the hand

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e1667 ◽  
Author(s):  
Susan S. McDonald ◽  
David Levine ◽  
Jim Richards ◽  
Lauren Aguilar
Keyword(s):  
Range Of Motion ◽  
Repeated Measures ◽  
Hand Function ◽  
Metacarpophalangeal Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Distal Interphalangeal ◽  
Main Effects ◽  
Minimal Research

Background.Hand function is essential to a person’s self-efficacy and greatly affects quality of life. Adapted utensils with handles of increased diameters have historically been used to assist individuals with arthritis or other hand disabilities for feeding, and other related activities of daily living. To date, minimal research has examined the biomechanical effects of modified handles, or quantified the differences in ranges of motion (ROM) when using a standard versus a modified handle. The aim of this study was to quantify the ranges of motion (ROM) required for a healthy hand to use different adaptive spoons with electrogoniometry for the purpose of understanding the physiologic advantages that adapted spoons may provide patients with limited ROM.Methods.Hand measurements included the distal interphalangeal joint (DIP), proximal interphalangeal joint (PIP), and metacarpophalangeal joint (MCP) for each finger and the interphalangeal (IP) and MCP joint for the thumb. Participants were 34 females age 18–30 (mean age 20.38 ± 1.67) with no previous hand injuries or abnormalities. Participants grasped spoons with standard handles, and spoons with handle diameters of 3.18 cm (1.25 inch), and 4.45 cm (1.75 inch). ROM measurements were obtained with an electrogoniometer to record the angle at each joint for each of the spoon handle sizes.Results.A 3 × 3 × 4 repeated measures ANOVA (Spoon handle size by Joint by Finger) found main effects on ROM of Joint (F(2, 33) = 318.68, Partialη2= .95,p< .001), Spoon handle size (F(2, 33) = 598.73, Partialη2= .97,p< .001), and Finger (F(3, 32) = 163.83, Partialη2= .94,p< .001). As the spoon handle diameter size increased, the range of motion utilized to grasp the spoon handle decreased in all joints and all fingers (p< 0.01).Discussion.This study confirms the hypothesis that less range of motion is required to grip utensils with larger diameter handles, which in turn may reduce challenges for patients with limited ROM of the hand.

The outcomes of zone 1 flexor tendon injuries treated using micro bone suture anchors

2013 ◽  
Vol 38 (9) ◽  
pp. 973-978 ◽  
Author(s):  
S. Huq ◽  
S. George ◽  
D. E. Boyce
Keyword(s):  
Range Of Motion ◽  
Flexor Tendon ◽  
Proximal Interphalangeal Joint ◽  
Tendon Injuries ◽  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Flexor Tendon Injuries ◽  
Distal Interphalangeal ◽  
Bone Anchors ◽  
The Mean

This article evaluates the outcome of 42 consecutive zone 1 flexor tendon injuries treated by using micro bone anchors during the period 2003–2008. Patients were rehabilitated using the modified Belfast Regime. The range of motion at the distal interphalangeal joint was assessed using Moiemen’s classification. A total of 56% of patients achieved excellent or good results for range of motion at the distal interphalangeal joint and 23% had a poor outcome. The mean distal interphalangeal joint and proximal interphalangeal joint range of motion were 48° and 96°, respectively. A total of 94% of patients returned back to work by 12 weeks. One patient sustained a tendon rupture and one developed osteomyelitis. The mean QuickDASH score was 13.5 and 81% of patients were satisfied with their outcomes. This is the largest clinical study on the use of bone anchors for zone 1 tendon injuries. Our study demonstrated a low rate of complications and outcomes that compare favourably with other published techniques.

Flexion and Extension Capable Motor Tendon Actuated Exosuit Glove With Open Palm

2019 ◽  
Author(s):  
Georgia S. Patterson ◽  
Tyler D. Zell ◽  
David E. Parker ◽  
John Grieve ◽  
Samuel C. Watson ◽  
...  
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Human Hand ◽  
Flexion Extension ◽  
Tactile Interaction ◽  
Distal Interphalangeal ◽  
Hand Impairment ◽  
Flexion And Extension ◽  
Experience Difficulty

Abstract Patients suffering from medical conditions resulting in hand impairment experience difficulty in performing simple daily tasks, like getting dressed or using a pencil, resulting in a poorer quality of life. Rehabilitation attempts to help such individuals regain a sense of control and normalcy. In this context, recent advances in robotics have manifested in multiple designs of hand exoskeletons and exosuit gloves for assistance and rehabilitation. These designs are typically actuated using pneumatic, shape memory alloys and motor-tendon actuators. The proposed Motor Tendon Actuated Exosuit Glove (MTAEG) with an open palm is a soft material glove capable of both flexion and extension of all four fingers of the human hand. Its minimally invasive design maintains an open palm to facilitate haptic and tactile interaction with the environment. The MTAEG achieves flexion-extension motion with joint angles of 45° at the metacarpal joint which is 57% of the desired motion; 90° at the proximal interphalangeal joint which is 100% of the desired motion; and 50° at the distal interphalangeal joint which is 96% of the desired motion. The paper discusses the challenges in achieving the desired motion without the ability to directly model human tendons, and the inability to actuate joints individually.

Osteoarthritis of the hand

2011 ◽  
Author(s):  
David Warwick ◽  
Roderick Dunn ◽  
Erman Melikyan ◽  
Jane Vadher
Keyword(s):  
Operative Treatment ◽  
Biomechanical Properties ◽  
Metacarpophalangeal Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Common Disease ◽  
Distal Interphalangeal Joint ◽  
Progressive Degeneration ◽  
Diarthrodial Joints ◽  
Distal Interphalangeal

Introduction 254Digital joint replacement 256Scaphoid–trapezium–trapezioid joint 258Thumb CMCJ arthritis 260Non-operative treatment for thumb CMC OA 262Operative treatment for thumb CMCJ OA 264Finger carpometacarpal joint 269Metacarpophalangeal joint 270Proximal interphalangeal joint 272Distal interphalangeal joint 274Common disease of diarthrodial joints. Primary aetiology is characterized by progressive degeneration of articular cartilage: a manifestation of an abnormal state of chondrocyte metabolism, loss of certain tissue components, alterations in microstructure and changes in biomechanical properties....

Rheumatology

2019 ◽  
pp. 609-620
Keyword(s):  
Rheumatoid Arthritis ◽  
Soft Tissues ◽  
Clinical Signs ◽  
Metacarpophalangeal Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Autoimmune Conditions ◽  
Osteoporosis Risk Factors ◽  
Drug Treatments ◽  
Distal Interphalangeal

Chapter 31 gives an overview of rheumatology, the study of rheumatic conditions which can involve the joints, soft tissues, and bones and also comprises connective tissue disorders, vasculitides, and a number of autoimmune conditions. The chapter outlines patterns of rheumatological disease (e.g. mono-, oligo-, and polyarthropathies), symmetrical versus asymmetrical presentations of disease, and explains how to try and differentiate between inflammatory and non-inflammatory disorders. The chapter provides information on common drug treatments, including dangerous side effects from improperly prescribed methotrexate. Advice is given on history taking and detailed hand examination, with clinical signs of rheumatoid arthritis: Swan neck deformity, Boutonniere’s deformity, Z deformity of thumb, Bouchard’s nodes (proximal interphalangeal joint), Heberden’s nodes (distal interphalangeal joint, first metacarpophalangeal joint), finger ulnar deviation (metacarpophalangeal joint), and wrist radial deviation and subluxation. The most common rheumatological disorders are discussed, including rheumatoid arthritis, spondyloarthropathy, ankylosing spondylitis, psoriatic arthritis, gout, and osteoporosis (including the ‘MESSAGE’ mnemonic for osteoporosis risk factors). The Chapel Hill classification for vasculitides is also covered.

scholarly journals Outcomes of Secondary Combined Proximal Interphalangeal Joint Release and Zone II Flexor Tenolysis

Hand ◽  
2019 ◽  
Vol 15 (4) ◽  
pp. 502-508 ◽  
Author(s):  
Kevin J. Zuo ◽  
Moaath Saggaf ◽  
Herbert P. von Schroeder ◽  
Paul Binhammer
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Functional Outcomes ◽  
Hand Function ◽  
Joint Stiffness ◽  
Surgical Site Infections ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Active Motion ◽  
Zone Ii

Background: Tendon adhesions and capsular contractures following trauma to the proximal interphalangeal joint (PIPJ) may significantly reduce hand function. Traditional, staged surgical management prioritizes restoration of PIPJ passive range of motion with joint release prior to restoration of active range of motion (AROM) with tenolysis. This is expensive and burdensome for patients. Our objective was to evaluate functional outcomes of combined PIPJ release and zone II flexor tenolysis. Methods: We retrospectively reviewed patients who underwent combined PIPJ release and flexor tenolysis. Replantation and tendon graft cases were excluded. Data were collected on pre- and postoperative AROM, total active motion (TAM), tip to distal palmar crease (DPC) distance, and grip strength. Functional outcomes were graded using the Boyes, American Society for Surgery of the Hand, and modified Strickland scores. Results: Twelve patients (9 men and 3 women, median age = 40 years) with a total of 15 digits underwent combined PIPJ release and flexor tenolysis a median of 10.1 months after injury. At a median follow-up of 4.0 months, there were significant improvements in median PIPJ AROM (15° to 70°), TAM (105° to 223°), tip to DPC distance (6.0 to 2.0 cm), and grip strength (35% to 54% of unaffected hand). Modified Strickland score was good in 46% of digits and excellent in 38%. There were no tendon ruptures, surgical site infections, or devascularized digits. Conclusion: Proximal interphalangeal joint stiffness is a challenging complication of hand trauma. Although a complete return to premorbid range of motion and function is rarely attained with surgery, improved outcomes may be consistently achieved with secondary combined PIPJ release and zone II flexor tenolysis.

Arthroplasty in the hand: what works and what doesn’t?

2021 ◽  
pp. 175319342110177
Author(s):  
Daniel B. Herren ◽  
Hajime Ishikawa ◽  
Marco Rizzo ◽  
Mark Ross ◽  
Michael Solomons
Keyword(s):  
Surgical Technique ◽  
Metacarpophalangeal Joint ◽  
Distal Radioulnar Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Carpometacarpal Joint ◽  
Thumb Carpometacarpal Joint ◽  
Radioulnar Joint ◽  
What Works ◽  
Thumb Carpometacarpal

This review describes the different possibilities for arthroplasties at the proximal interphalangeal joint, thumb carpometacarpal joint, distal radioulnar joint, metacarpophalangeal joint and the wrist. For each joint, the indication for arthroplasty is explained, the surgical technique with the suitable implant is described and a brief summary of the outcomes reported in the literature is given.

Osteoarthritis of the Interphalangeal and Metacarpophalagneal Joints of the Hand

2020 ◽  
Author(s):  
Andrew J. Straszewski ◽  
Jennifer Moriatis Wolf
Keyword(s):  
Hyaluronic Acid ◽  
Physical Examination ◽  
Female Gender ◽  
Metacarpophalangeal Joint ◽  
Interphalangeal Joint ◽  
Hand Osteoarthritis ◽  
Progression Of Disease ◽  
Initial Work ◽  
Distal Interphalangeal ◽  
Work Up

Hand surgeons frequently treat osteoarthritis of the interphalangeal (IP) and metacarpophalangeal (MCP) joints. Age, female gender, occupation, genetics, biomechanics, obesity, and joint laxity have been implicated in the progression of disease. Physical examination and standard three-view imaging of the hand aid in initial work up. Many conservative treatments exist, including physical therapy, splinting, anti-inflammatories, and injection of corticosteroid or hyaluronic acid.  With the failure of conservative therapies, surgical management is dictated by the particular joint in question. The distal interphalangeal (DIP) joints of fingers and IP joint of the thumb are more commonly treated by arthrodesis, whereas proximal interphalangeal (PIP) joints are treated with arthroplasty. Likewise, MCP  joints of the fingers are typically managed with arthroplasty. The thumb MCP joint is more commonly fused.  This review contains 7 figures, 4 tables, and 54 references. Keywords: hand osteoarthritis, interphalangeal joint, metacarpophalangeal joint, anatomy, arthroplasty, silicone, arthrodesis, biomechanics, outcomes

Volar plating versus external fixation for unstable dorsal fracture-dislocations of the proximal interphalangeal joint

2021 ◽  
pp. 175319342110593
Author(s):  
Atsuhiko Murayama ◽  
Kentaro Watanabe ◽  
Hideyuki Ota ◽  
Shigeru Kurimoto ◽  
Hitoshi Hirata
Keyword(s):  
External Fixation ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Volar Plating ◽  
Distal Interphalangeal Joint ◽  
Active Flexion ◽  
Plate Group ◽  
Fracture Dislocations ◽  
Distal Interphalangeal

We retrospectively compared the results of volar plating and dynamic external fixation for acute unstable dorsal fracture-dislocations of the proximal interphalangeal joint with a depressed fragment. We treated 31 patients (31 fingers), 12 with volar buttress plating and 19 with dynamic external fixation. Follow-up averaged 35 and 40 months in the two groups, with a minimal 6-month follow-up. Average active flexion of the proximal interphalangeal joint was 95° after plate fixation and 87° after external fixation, with an active extension lag of –6° and –9°, respectively. Active flexion at the distal interphalangeal joint averaged 67° in the plate group and 58° in the external fixation group, with active extension lags of 0° and –5°, respectively. We conclude that both methods can obtain a good range of motion at the proximal interphalangeal joint. A limitation of the extension of the distal interphalangeal joint occurred with dynamic external fixation but not with volar buttress plating. Level of evidence: IV

Extensor Indicis Opposition Transfer in The Ulnar and Median Palsied Thumb in Leprosy

1996 ◽  
Vol 21 (5) ◽  
pp. 617-621 ◽  
Author(s):  
R. MEHTA ◽  
G. N. MALAVIYA ◽  
S. HUSAIN
Keyword(s):  
Index Finger ◽  
Donor Site ◽  
Metacarpophalangeal Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Flexor Pollicis Longus ◽  
Extensor Pollicis Longus ◽  
Extensor Indicis Proprius ◽  
Leprosy Patients ◽  
Significant Deficit

Twenty seven opponensplasties for ulnar and median paralysis in 25 leprosy patients were performed using extensor indicis proprius. An additional transfer of the radial half of flexor pollicis longus to extensor pollicis longus was done to stabilize the metacarpophalangeal joint of the thumb. The biomechanical aspects of extensor indicis proprius tendon transfer were studied and results evaluated using various anatomical and functional parameters. Extensor indicis proprius provides adequate strength to position the thumb. However, sometimes it does not reach its new insertion. There is no significant deficit at the donor site but in a few cases the index finger may lose its capability for independent extension and sometimes a proximal interphalangeal joint contracture may develop.

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.

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