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Luis R Ramos-Pascua, Víctor Bárcena-Tricio, Sergio Sánchez Herráez, Paula Casas-Ramos, Francisco M Izquierdo-García
PURPOSE: To describe the results of nonsurgical and surgical treatment of enchondromas of the distal phalanx of the hand. METHODS: Eleven enchondromas of the distal phalanx were retrospectively reviewed. Five patients underwent surgery (curettage and autogenous cancellous bone graft from the iliac crest) and 6 patients were treated nonsurgically. Clinical records and radiographs were reviewed for each patient. We recorded complications and cosmetic and functional results...
March 15, 2018: Journal of Hand Surgery
Steven S Shin, Carola F van Eck, Carlos Uquillas
PURPOSE: This study aimed to evaluate and compare the biomechanical strength of repair of the thumb ulnar collateral ligament (UCL) alone and repair augmented with suture tape. METHODS: Twelve fresh-frozen cadaveric specimens (6 matched pairs) had the UCL divided at its attachment on the base of the proximal phalanx and repaired with or without suture tape augmentation. A material testing machine was used to provide valgus stress at a rate of 0.1 mm/s until failure...
March 15, 2018: Journal of Hand Surgery
Flavio Pereira, Roger de Moraes, Diogo Van Bavel, Andrea De Lorenzo, Eduardo Tibirica
Introduction: The main aim of the present study is to evaluate the effects of strenuous exercise, related to special military training for riot control, on systemic microvascular endothelial function and skin capillary density. Materials and Methods: Endothelium-dependent microvascular reactivity was evaluated in the forearm skin of healthy military trainees (age 23.4 ± 2.3 yr; n = 15) using laser speckle contrast imaging coupled with cutaneous acetylcholine (ACh) iontophoresis and post-occlusive reactive hyperemia (PORH)...
March 14, 2018: Military Medicine
Nebojsa Jovanovic, Ehab Aldlyami, Basem Saraj, Mohamed Fm Seidam, Hamed Badawi, Ahmed Shaat, Khalid Alawadi Facharzt, Chaitanya Dodakundi
Multiple methods have been described for treating unstable proximal and middle phalangeal fractures. Irrespective of using an open or closed technique of fixation, stiffness and extensor lag at the proximal/distal interphalangeal joint almost always occur. This issue can be avoided by allowing the patients to mobilize the fingers out of plaster or splint as early as possible from the day of surgery. We describe a technique of intramedullary percutaneous fixation of extra-articular proximal and middle phalanx fractures allowing immediate mobilization of fingers, concurrent stabilization with progressive healing and thus preventing such complications...
March 2, 2018: Techniques in Hand & Upper Extremity Surgery
A R Saied, M Sabet Jahromi
INTRODUCTION: For extraarticular proximal phalanx fractures, two methods are employed, transarticular fixation in which the metacarpophalangeal joint is crossed and the extraarticular method in which the pins are introduced through the base of the proximal Phalanx. MATERIALS AND METHODS: This study was a prospective one on patients with proximal phalanx transverse or short oblique fractures. In one of the groups we used parallel pins from metacarpal head through MCP joint to proximal phalanx...
February 27, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Philip Rosinsky, Oren Sarig, Yehuda David, Amir Oron
Mallet finger is a common injury involving the extensor mechanism of the finger. It presents as an inability to extend the distal phalanx of the digit. In the right clinical setting, a thorough examination should be performed and supplemented by adequate radiographs. The mechanism of injury is usually a direct blow to an extended finger causing hyperflexion or hyperextension of the distal phalanx. Common occurrences are in young adults during sporting activities or in minor falls or trauma in osteoporotic individuals...
February 2018: Harefuah
Georgi Tchernev, Yavor Grigorov, Stanislav Philipov, Anastasiya Chokoeva, Uwe Wollina, Torello Lotti, Jose Cardoso, Irina Yungareva, Ilia Lozev, Georgi Konstantinov Maximov
BACKGROUND: Subungual exostosis is a relatively uncommon, benign osteocartilaginous tumor of the distal phalanx of the toes or fingers in young adults, considered as a rare variant of osteochondroma. Differential diagnoses include subungual verruca (viral wart), pyogenic granuloma, osteochondroma, amelanotic subungual melanoma and glomus tumour. Misdiagnosis and total onychodystrophy frequently occur as a result of late treatment or inadequate treatment strategy. Dermoscopy could be a useful technique, involved in the diagnostic process, although X-ray examination and histopathology are mandatory for the diagnosis...
January 25, 2018: Open Access Macedonian Journal of Medical Sciences
Kenichiro Nakajima
Arthroscopic treatments for the first metatarsophalangeal joint have not spread fully owing to a number of factors. First, in the common arthroscopic view, the joint is observed from above, which makes the structures difficult to grasp and the dorsal aspect of the joint difficult to visualize and treat. Second, techniques for widening the view have not yet been reported. Third, the portals necessary for observation and treatment with hallux sesamoids have not yet been established. Finally, techniques for detecting the sesamoids have not been previously reported...
March 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Bojan V Stimec, Jérémy Dash, Mathieu Assal, Richard Stern, Jean H D Fasel
Despite the fact that there are numerous reports on muscular variations in the sole of the foot, routine dissection in a formaldehyde-fixed cadaver revealed an accessory flexor digiti quinti muscle, which to the best of our knowledge is a very unusual variant. This was in the form of a slender, 38 mm long muscular slip, with a proximal and distal tendon extending from the common flexor digitorum longus tendinous plate out to the distal phalanx of the fifth toe. An associated finding was the absence of the musculotendinous portion of the flexor digitorum brevis to the same toe...
February 22, 2018: Surgical and Radiologic Anatomy: SRA
Baoheng Gui, Yanning Song, Xuyun Hu, Hongdou Li, Zailong Qin, Jiasun Su, Chuan Li, Xin Fan, Mengting Li, Jingsi Luo, Ying Feng, Liping Song, Shaoke Chen, Chunxiu Gong, Yiping Shen
BACKGROUND: Rothmund-Thomson syndrome (RTS) is a rare autosomal recessive disorder mainly characterized by cutaneous poikiloderma, sparse hair, short stature and skeletal defects. Deleterious mutations in the RecQ-like DNA helicase type 4 (RECQL4) gene have been detected in approximately two-thirds of RTS cases. METHODS: Three Chinese patients from two unrelated families were enrolled for clinical evaluation. Targeted next-generation sequencing (NGS) using a custom panel consisting of 705 short-stature-related genes was performed for the probands...
February 17, 2018: Gene
Fred T Finney, Simon Lee, Jaron Scott, Todd A Irwin, James R Holmes, Paul G Talusan
BACKGROUND: Lesser toe metatarsal-phalangeal (MTP) joint instability can be a major source of pain and dysfunction. Instability occurs when there is incompetence of the plantar plate and/or collateral ligaments. Newer operative treatments focus on performing anatomic repairs of the plantar plate. The goal of this study was to compare the biomechanical properties of 3 suture configurations that may be used for plantar plate repairs. METHODS: Biomechanical analysis of 27 lesser toe plantar plates from fresh frozen human cadavers was completed...
February 1, 2018: Foot & Ankle International
Jia Tian, Jin Li, Fabin Wang, Zhenbing Chen
Background: Our routine treatment for ingrown toenail was removal of the surrounding soft tissue and shortening the bone of the distal phalanx. We determined the range and volume of excision based on our experience without an objective standard and routinely performed avulsion of the nail plate. Objective: To take the nail plate as an objective mark during surgical treatment of ingrown toenail to ensure accurate excision. Patients and Methods: Fifteen patients with ingrown toenails were treated with this technique...
January 2018: Dermatology Practical & Conceptual
Nikos Solounias, Melinda Danowitz, Elizabeth Stachtiaris, Abhilasha Khurana, Marwan Araim, Marc Sayegh, Jessica Natale
We revisit digit reduction in the horse and propose that all five digits are partially present in the modern adult forelimb. Osteological descriptions of selected tetradactyl, tridactyl and monodactyl equids demonstrate the evolution of the forelimb. Histological, osteological and palaeontological evidence suggest that the Equus distal forelimb is more complex than traditionally conceived. The current understanding is that the horse distal forelimb consists of one complete digit (III) and two reduced splint metacarpals (II and IV)...
January 2018: Royal Society Open Science
Masahiko Tohyama, Sadahiko Konishi
We describe 4 cases of irreducible volar rotatory subluxation of the proximal interphalangeal (PIP) joint of the finger that required open reduction. All of the patients had radiographically proven (in lateral-view radiographs) volar rotatory subluxation of the PIP joint, without fracture. The causes of irreducibility were interposition of the lateral band about the condyle of the middle phalanx in 2 cases, interposition of the collateral ligament in 1 case, and scarring of the injured central slip in 1 case...
March 2018: Journal of Hand Surgery Asian-Pacific Volume
V Montiel, M Alfonso, C Villas, A Valentí
BACKGROUND: Exostoses at the base of the distal phalanx of the great toe are usually asymptomatic. The literature has not generally considered them as the origin of a possible problem resulting from a pressure conflict between hallux and shoe (medial aspect) or second toe (lateral aspect) nor a potential complication of surgical correction of hallux valgus deformity. No studies, to our knowledge, have evaluated its possible correlation with other foot disorders. When one of these neglected exostoses became painful after surgical correction of hallux valgus, we decided to start a study to determine their possible origin, prevalence in daily practice and histo-pathological morphology...
November 13, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Andrew T Chen, Keegan T Conry, Allison Gilmore, Jochen P Son-Hing, Raymond W Liu
Background: Many surgeons advocate for surgical intervention of adult mallet fractures that involve either subluxation of the distal interphalangeal (DIP) joint or those that involve more than one-third of the articular surface. However, the efficacy of operative treatment and complication rates are unclear regarding the adolescent population. Questions/Purposes: The goal of this study is to evaluate the clinical outcomes following operative fixation of bony mallet fractures in the adolescent population...
February 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Virginia Galati, Friederike Wortmann, Felix H Stang, Christoph Thorns, Peter Mailänder, Tobias Kisch
Solitary primary non-Hodgkin bone lymphoma of the hand is a rare entity with only 3 cases reported in the literature. We report the case of a 77-year-old patient with isolated large B-cell bone lymphoma of the proximal phalanx of the little finger without rheumatoid arthritis or methotrexate treatment. The patient was treated with digital amputation and at 6 months' follow-up showed no relapse or dissemination of the disease.
February 2, 2018: Journal of Hand Surgery
Tetsuya Sato, Akimoto Nimura, Reiko Yamaguchi, Koji Fujita, Atsushi Okawa, Keiichi Akita
PURPOSE: To identify the layered relationship anatomically between the musculotendinous structures of the adductor pollicis, the ulnar collateral ligament, and the capsule of the metacarpophalangeal joint in terms of understanding the pathomechanism of a Stener lesion. METHODS: We macroscopically analyzed 37 cadaveric thumbs to identify the intramuscular tendon of the adductor pollicis and bony attachments of the joint capsule including the ulnar collateral ligament...
January 23, 2018: Journal of Hand Surgery
Timothy G Marshall, Brahman Sivakumar, Belinda J Smith, Mark S Hile
PURPOSE: It is a common belief that extension of the metacarpophalangeal (MCP) joint of the finger is achieved via the sagittal bands acting as a sling or lasso to attach the extensor tendon to the base of the proximal phalanx. The aim of this study was to test the hypotheses that (1) division of the sagittal bands reduces extension force or torque of the MCP joint, and (2) division of the extensor tendon distal to the sagittal band will not affect the extension force or torque of the MCP joint...
January 25, 2018: Journal of Hand Surgery
Satoshi Yamaguchi, Shuji Taketomi, Yusei Funakoshi, Kan Tsuchiya, Ryuichiro Akagi, Seiji Kimura, Aya Sadamasu, Seiji Ohtori
Background: Adolescent athletes are a high-risk population for stress fractures. We report four cases of stress fractures of the second proximal phalanx, which had not been previously diagnosed as the location of the stress fracture of the foot, in teenage athletes. Case report: All fractures were on the plantar side of the proximal phalangeal base, and the oblique images of the plain radiograph clearly depicted the fractures. Notably, three out of the four patients had histories of stress fracture of other locations...
October 2017: Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology
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