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M Burnier, T Awada, F Marin Braun, P Rostoucher, M Ninou, L Erhard
: The primary aim of this study was to assess the clinical and radiological results after hemi-hamate resurfacing arthroplasty in patients with acute or chronic unstable fractures of the base of the middle phalanx and to describe technical features that can facilitate the surgical procedure. Hemi-hamate arthroplasties were done in 19 patients (mean age 39 years) with an isolated fracture at the base of the middle phalanx that involved more than 40% of the articular surface. We assessed ten chronic cases (treated >6 weeks after fracture) and nine acute ones (<6 weeks) at a mean of 24 months...
October 19, 2016: Journal of Hand Surgery, European Volume
Joshua M Abzug, Karan Dua, Andrea Sesko Bauer, Roger Cornwall, Theresa O Wyrick
Phalangeal fractures are the most common type of hand fracture that occurs in the pediatric population and account for the second highest number of emergency department visits for fractures in the United States. The incidence of phalangeal fractures is the highest in children aged 10 to 14 years, which coincides with the time that most children begin playing contact sports. Younger children are more likely to sustain a phalangeal fracture in the home setting as a result of crush and laceration injuries. Salter-Harris type II fractures of the proximal phalanx are the most common type of finger fracture...
November 2016: Journal of the American Academy of Orthopaedic Surgeons
Yojhan Edilberto Izquierdo, Enrique Calvo Páramo, Luisa María Castañeda, Sandra Viviana Gómez, Fernán Santiago Zambrano
OBJECTIVE: To determine abnormal plain radiograph findings of the distal phalanx tuft of the hand (DPTH) associated with systemic sclerosis in adults. METHODS: A systematic review was developed following the parameters of the PRISMA guidelines in databases: MEDLINE, EMBASE, BIREME, Scielo, Google Scholar and others including as primary outcomes alterations of DPTH (erosions, resorption, sclerosis and proliferation) detected by simple radiography in subjects with systemic sclerosis...
October 13, 2016: Reumatología Clinica
M Balasubramanian, H Lord, S Levesque, H Guturu, F Thuriot, G Sillon, A M Wenger, D L Sureka, T Lester, D S Johnson, J Bowen, A R Calhoun, D H Viskochil, G Bejerano, J A Bernstein, D Chitayat
BACKGROUND: In 1993, Chitayat et al., reported a newborn with hyperphalangism, facial anomalies, and bronchomalacia. We identified three additional families with similar findings. Features include bilateral accessory phalanx resulting in shortened index fingers; hallux valgus; distinctive face; respiratory compromise. OBJECTIVES: To identify the genetic aetiology of Chitayat syndrome and identify a unifying cause for this specific form of hyperphalangism. METHODS: Through ongoing collaboration, we had collected patients with strikingly-similar phenotype...
October 13, 2016: Journal of Medical Genetics
M T Letsch, M Kreulen, H A Rakhorst
Infections of the hand can result in significant limitation of the function of the hand, and may even require partial amputation of a digit. A felon is an abscess of the distal pulp of the fingertip, which can spread rapidly through the flexor tendon sheath when not treated appropriately. Knowledge of the anatomy and the correct method of physical examination are essential when assessing a patient suspected of having a felon or flexor tendon sheath infection. Here we present two patients with a complicated felon resulting in palmar necrosis of the distal phalanx of the thumb, in which a groin flap was used to reconstruct the thumb...
2016: Nederlands Tijdschrift Voor Geneeskunde
Sean Booth, Abhijit Bhosale, Abubakar Mustafa, Ravi Shenoy, Anand Pillai
BACKGROUND: Symptomatic Hallux valgus can be treated with metatarsal osteotomy combined with proximal phalangeal osteotomy, however this might not be sufficient to treat severe HV deformities. METHODS: Fifteen feet in eleven female patients treated with double first metatarsal and proximal phalanx osteotomies without lateral release were prospectively studied and outcome measures including radiological angles and validated patient reported outcome scores collected...
September 20, 2016: Foot
Bau-Lin Huang, Anna Trofka, Aki Furusawa, Jacqueline L Norrie, Adam H Rabinowitz, Steven A Vokes, M Mark Taketo, Jozsef Zakany, Susan Mackem
The number of phalanges and joints are key features of digit 'identity' and are central to limb functionality and evolutionary adaptation. Prior chick work indicated that digit phalanges and their associated joints arise in a different manner than the more sparsely jointed long bones, and their identity is regulated by differential signalling from adjacent interdigits. Currently, there is no genetic evidence for this model, and the molecular mechanisms governing digit joint specification remain poorly understood...
October 7, 2016: Nature Communications
Bruna Burko Rocha Chu, Giorgina Falcão Brandão Côrtes Gobbo, Rafaela Copês, Glênio Gutjahr, Erick Cavalcanti Cossa, Eduardo Dos Santos Paiva
Leprosy is a chronic infectious disease with a wide spectrum of clinical manifestations. Musculoskeletal impairment is the third most frequent clinical manifestation, the most common being arthritis. Cases misdiagnosed as lupus erythematosus, vasculitis, rheumatoid arthritis, and systemic sclerosis have already been described. We report a case of leprosy with skin thickening, distal phalanx resorption and facial telangiectasia, simulating systemic sclerosis. Due to a considerable prevalence in Brazil, and also considering the deformities that can be caused by a delay in diagnosis and treatment, leprosy should be put forward by the rheumatologist as a diagnostic hypothesis in patients with musculoskeletal involvement...
September 17, 2016: Revista Brasileira de Reumatologia
Alastair T Kay, Sushmitha Durgam, Matthew Stewart, Stephen Joslyn, David J Schaeffer, Gavin Horn, Richard Kesler, Peter Chew
OBJECTIVE: To compare reduction of type III distal phalangeal fractures using 4.5 and 5.5 mm cortical screws placed in lag fashion and an intact hoof capsule model. STUDY DESIGN: Cadaveric experimental study. SAMPLE POPULATION: Hooves from 12 adult horses (n=24). METHODS: Sagittal fractures were created in pairs of distal phalanges after distal interphalangeal joint disarticulation and were reduced with either 4.5 or 5...
September 29, 2016: Veterinary Surgery: VS
Giuseppe Perinetti, Valentina Sbardella, Luca Contardo
BACKGROUND/OBJECTIVES: The use of the sole third finger middle phalanx for a maturational method has been proposed but not fully investigated. Herein, the diagnostic reliability of an improved five-stage third finger middle phalanx maturation (MPM) method in the identification of mandibular growth peak has been investigated. SUBJECTS/METHODS: From the files of the Burlington Growth Study, 35 subjects (20 males, 15 females) with at least 7 annual lateral cephalograms taken from 9 to 16 years were included...
September 27, 2016: European Journal of Orthodontics
Fatma Mujgan Sonmez, Eyyup Uctepe, Mehmet Gunduz, Zeliha Gormez, Seval Erpolat, Murat Oznur, Mahmut Samil Sagiroglu, Huseyin Demirci, Esra Gunduz
Coffin-Siris syndrome (CSS) (MIM 135900) is characterized by developmental delay, severe speech impairment, distinctive facial features, hypertrichosis, aplasia or hypoplasia of the distal phalanx or nail of the fifth digit and agenesis of the corpus callosum. Recently, it was shown that mutations in the ARID1B gene are the main cause of CSS, accounting for 76% of identified mutations. Here, we report a 15 year-old female patient who was admitted to our clinic with seizures, speech problems, dysmorphic features, bilaterally big, large thumb, café-au-lait (CAL) spots, obesity and hyperinsulinism...
August 2016: Intractable & Rare Diseases Research
Robert Vander Griend
BACKGROUND: Operative correction of a symptomatic hallux valgus interphalangeus (HVI) deformity is often achieved with an osteotomy at the proximal end of the proximal phalanx (Akin osteotomy). However, the apex of the typical HVI deformity (center of rotation angle) is at the interphalangeal joint of the hallux. This study was done to evaluate the results of performing a medial closing wedge osteotomy at the distal end of the proximal phalanx. METHODS: Thirty-three patients (33 feet) underwent an osteotomy at the distal end of the proximal phalanx for correction of HVI...
September 26, 2016: Foot & Ankle International
Klára Molnár, Gergő Józsa, Zsolt Oberritter, Eszter Cholnoky, Péter Pankovics, Gábor Reuter, Erika Tornóczky
Dirofilariasis is a zoonosis affecting dogs and cats. It can be transmitted to human by mosquito bites. Because of the local inflammation caused by the parasite, a lump may develop. The authors present a case of a 13-year-old boy, who was diagnosed with dirofilariasis in association with a cyst located on the middle finger of the right hand. During physical examination, a lump on the extensor surface of the middle phalanx of the right middle finger was found. Soft tissue ultrasound was performed, which indicated the presence of a worm in the cyst...
September 2016: Orvosi Hetilap
Hui Lu, Qiang Chen, Hu Yang, Hui Shen
UNLABELLED: The goal of our study was to report the clinical presentation, treatment, and complications of enchondroma in the distal phalanx of the finger. This was a retrospective study of 34 patients (19 women and 15 men) who underwent surgery between May 2004 and September 2012 for enchondroma in the distal phalanx of the finger. The average age of the patients was 39.38 ± 10.97 years old (range 14-59). The presenting symptoms and imaging features were recorded. The surgical procedure was performed under regional or general anesthesia...
September 2016: Medicine (Baltimore)
Christopher Hein, Barry Watkins, Lee M Zuckerman
Primary sarcomas of the thumb metacarpal are rare malignant lesions. Surgical treatment involves amputation versus tumor resection with thumb reconstruction. If complete tumor resection is possible, thumb preservation may be considered, as the thumb is vital to hand function. Following tumor resection, previous reports have described graft reconstruction with fusion to the trapezium or scaphoid. We present two cases of sarcoma necessitating resection of the thumb metacarpal that were reconstructed with an arthrodesis of the proximal phalanx to the second metacarpal shaft...
2016: Case Reports in Orthopedics
Koffi Léopold Krah, Mohamed Béchir Karray, Mouadh Nefiss, Christian Darga, Mohamed Bouabdellah, Mondher Kooli
The late diagnosis of squamous cell carcinoma of the hallux in an aged patient on second-line therapy led to a trans-proximal phalanx amputation. This is a rare lesion affecting the toes which may compromise the functional prognosis of the foot. This clinical case report with review of the literature aims to highlight the difficulties of diagnosis and indications for amputation.
2016: Pan African Medical Journal
I M Mehling, K Schillo, A Arsalan-Werner, J Seegmüller, A C Langheinrich, M Sauerbier
Fractures of the first thumb ray are common and need accurate differential treatment to restore gripping hand functions. Displaced fractures of the distal and proximal phalanx of the thumb are often treated with screws or Kirschner wires. Stable fractures can also be treated non-operatively. Fractures of the base of the first metacarpal should be differentiated into extra-articular Winterstein fractures and intra-articular Bennett or Rolando fractures. Traction forces by the abductor pollicis longus tendon regularly lead to displacement of the shaft of the first metacarpal; therefore, these fractures usually require reduction and fixation...
September 14, 2016: Der Unfallchirurg
James D Russell, Kurt Nance, Julia R Nunley, Ian A Maher
Subungual exostosis is an uncommon bony tumor of the distal phalanx most often seen on the hallux. Although this lesion is completely benign, it must be distinguished from a number of other subungual tumors, both benign and malignant. Radiography of the digit is a noninvasive test that should be part of the initial workup whenever subungual exostosis is in the differential diagnosis. Once identified, surgical removal of the exostosis generally is both effective and well tolerated. We present a case of subungual exostosis that was discovered incidentally during a full-body skin examination...
August 2016: Cutis; Cutaneous Medicine for the Practitioner
Assaf Kadar, Geffen Kleinstern, Mohamed Morsy, Endre Soreide, Steven L Moran
BACKGROUND: Multiple enchodromatosis of bone, termed Ollier's disease, or Maffucci syndrome when associated with hemangiomas, is a rare disease that can affect the pediatric hand. This condition often causes a finger mass, deformity, pain and possible pathologic fractures, and has been associated with malignant transformation to chondrosarcoma. The aim of our study is to describe the long-term sequela of multiple enchondromatosis of the hand in the pediatric population, specifically the rates of malignant transformation, tumor recurrence, rates of pathologic fracture, and phalangeal growth arrest...
September 3, 2016: Journal of Pediatric Orthopedics
Ashley Sweeney, Richard Hammer, Andrea Evenski, Julia Crim
We report a case of fulminant sarcoidosis in a 28-year-old man presenting with skin nodules, multifocal small and large joint arthralgias, and blurred vision. Characteristic bone, soft tissue, articular, and CNS findings were evident on multimodality imaging. Bony abnormalities included near-complete destruction of a distal phalanx, "lace-like" lucent lesions, erosive arthritis, lytic lesions with and without sclerotic margins, and bone marrow replacement visible only on MRI. The extent of bony disease at time of presentation was unusual...
November 2016: Skeletal Radiology
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