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Elizabeth A Newman, Maria C Orbay, Fiesky A Nunez, Fiesky Nunez
Proximal interphalangeal (PIP) joint arthritis causes debilitating hand pain and instability leading to significant functional impairment. Arthrodesis remains the gold standard for treatment of PIP arthritis. We present a minimally invasive PIP arthrodesis that provides rigid fixation with a headless compression screw. Seven patients who presented to the senior author with PIP joint arthritis underwent PIP arthrodesis by minimally invasive technique. A 1 cm transverse incision is made over the PIP joint, incising skin, central band, and articular capsule...
June 2018: Techniques in Hand & Upper Extremity Surgery
B Karslıoğlu, M Uzun, C Tetik, E Tasatan, A C Tekin, C D Buyukkurt
Mallet fracture is an avulsion of the extensor tendon and fracture of the dorsal rim of the articular surface of distal phalanx at the same time. If a part of the mallet fracture is angled or rotated to such a degree that prevents full anatomic reduction, malunion and deformities may occur as a result. The objective of this study was to describe a new surgical technique to provide derotation of the mallet fracture. A 22G or 21G needle is used like a joystick to reduce the mallet fracture with small, gentle movements...
May 14, 2018: Hand Surgery and Rehabilitation
C Sandow, L A Fugler, B Leise, L Riggs, W T Monroe, N Totaro, J Belknap, S Eades
BACKGROUND: Laminitis has a considerable impact on the equine industry. Endocrinopathic laminitis is the most common form and affected horses often have hyperinsulinaemia due to an underlying metabolic disorder. OBJECTIVES: To determine if insulin weakens the structural integrity of digital lamellae and to develop an ex vivo model for the study of hyperinsulinaemia-induced lamellar failure. STUDY DESIGN: Ex vivo experiment. METHODS: Biomechanical testing was used to assess the structural integrity of lamellar explants exposed to either medium alone (control) or medium supplemented with insulin...
May 14, 2018: Equine Veterinary Journal
Zengbing Liu, Kai Ma, Dong Huang
OBJECTIVE: To investigate the clinical effect of treating mallet finger deformity using a modified palmaris longus tendon graft through a bone tunnel. METHODS: Altogether, 21 patients with mallet finger deformity (16 men, 5 women; average age 31 years, range 19-47 years) were treated with a modified palmaris longus tendon graft through a bone tunnel during 18 months (2014-2016). Four index fingers, seven middle fingers, eight ring fingers, and two little fingers were treated for four cutting injuries, eleven finger sprains, four crush injuries, and two twist injuries (7 open and 14 closed injuries)...
2018: International Journal of Burns and Trauma
Laura E Quiney, Joanne L Ireland, Sue J Dyson
There is good correlation between increased radiopharmaceutical uptake anywhere in the feet of sports or leisure horses and the presence of foot pain. However, low sensitivity of scintigraphy for identifying lesions contributing to foot pain as determined by magnetic resonance imaging (MRI) has been reported. The aim of this retrospective, cross-sectional, analytical study was to assess the accuracy of scintigraphy for identifying the cause(s) of foot pain, using MRI as the reference standard. Sports and leisure horses that underwent both skeletal scintigraphy and MRI of the front feet between March 2008 and December 2014 and for which a definitive diagnosis of the cause(s) of front foot pain was reached were included (121 feet of 70 horses)...
May 11, 2018: Veterinary Radiology & Ultrasound
Jessica Lauren MacDonald, Ruth-Anne Richter, Christine L Wimer
Ultrasonography is an established diagnostic test for evaluating horses with foot pain due to suspected podotrochlear apparatus pathology. However, variations from the previously reported normal appearance of the distal sesamoidean impar ligament have not always coincided with lameness. The objective of this prospective, cross-sectional, descriptive study was to characterize variations in the ultrasonographic appearance of the distal sesamoidean impar ligament in sound horses using the transcuneal approach...
May 11, 2018: Veterinary Radiology & Ultrasound
Xiaolong Wang, Wei Zhao, Lin Li, Jian You, Biao Ni, Xia Chen
Four small oval populations and five large intensive populations of Rhododendron aureum growing at the alpine in Changbai Mountain (China) were studied in two types of habitat (in the tundra and in Betula ermanii forest). Identification and delimitation of genets were inferred from excavation in small populations and from amplified fragment length polymorphism (AFLP) markers by the standardized sampling design in large populations. Clonal architecture and clonal diversity were then estimated. For the four small populations, they were monoclonal, the spacer length (18...
2018: PloS One
M Thomas, M Jordan
OBJECTIVE: Atraumatic and joint-sparing procedure for the correction of lesser toe deformities by using a linear or perpendicular osteotomy of the proximal and/or middle phalanx of the lesser toes with additional capsulotomies or tendon dissection for soft tissue realignment. Metatarsalgia is addressed via an extracapsular distal metaphyseal crescentic-like metatarsal osteotomy. INDICATIONS: Symptomatic lesser toe deformities, painful pseudoexostosis, metatarsalgia, symptomatic metatarsal malalignment, metatarsus adductus...
May 8, 2018: Operative Orthopädie und Traumatologie
Anastasiya Svirkova, Anna Turyanskaya, Lukas Perneczky, Christina Streli, Martina Marchetti-Deschmann
Matrix-assisted laser desorption/ionisation mass spectrometric imaging (MALDI MSI) is a technique that provides localized information on intact molecules in a sample. Micro X-ray fluorescence (μXRF) imaging allows the examination of the spatial distribution of elements in a sample without any morphological changes. These methods have already been applied separately to different tissues, organs, plants and bacterial films, but, to the best of our knowledge, they have yet to be coupled in a multimodal analysis...
May 8, 2018: Analyst
Ulrich Mennen
We have performed 14 pollicisations without creating a "pseudo-trapezium" from the metacarpal head. The entire metacarpal of the intended finger to be pollicised is removed and the proximal phalanx of the finger is inserted into the space left by the base of the excised metacarpal. The results are good to excellent in all 14 cases followed for 2-9 years. The advantages are that the operation is much simpler, thus also much quicker. The new thumb looks more like a thumb (not too long) and is more stable (ball-and-socket joint), with no long term complications often seen with the pseudo-trapezium...
June 2018: Journal of Hand Surgery Asian-Pacific Volume
N Prashant, A Azuhairy
Actinomycosis is a chronic granulomatous suppurative infection caused by anaerobic bacteria from genus Actinomyces which are normal flora of mouth, colon and vagina. Actinomycosis of upper extremity is rare. We report a case of actinomycosis of the distal phalanx of finger many years after flap reconstruction. The patient presented with two months' history of chronic discharging sinus from the tip of his right index finger, which had sustained a degloving injury 20 years previously. It had been treated with an anterior chest wall flap which had healed uneventfully but was bulky due to excess tissue from the donor site...
March 2018: Malaysian Orthopaedic Journal
Jenny Hagen, Kaid Kojah, Michael Geiger
The angulation of the equine fetlock determines the load of associated tendons and probably their predisposition for injuries. However, it is questionable how the individual toe conformation and tendon properties interact with the dorsal metacarpophalangeal joint angle (DMPJ). Data are needed for a tangible evaluation of the equine limb conformation for more specific orthopaedic treatment. The aim was to evaluate the correlation between the DMPJ, toe conformation and cross-sectional area (CSA) of both flexor tendons; the superficial digital flexor tendon (SDFT) and deep digital flexor tendon (DDFT)...
2018: Open Veterinary Journal
Michal Brichacek, Julian Diaz-Abele, Sarah Shiga, Christian Petropolis
Closed reduction and percutaneous pinning (CRPP) of hand fractures can be a deceptively challenging procedure that requires significant hands-on time to teach and learn. We created a realistic three-dimensional simulator that can be used for teaching junior residents the CRPP. Computer-aided design and computer-aided manufacturing (CAD/CAM) software was used to create a three-dimensional hand model incorporating several common hand fractures: Bennett's fracture, transverse fifth metacarpal neck, and transverse second proximal phalanx...
March 2018: Plastic and Reconstructive Surgery. Global Open
Andrew J Miller, Christopher M Jones, Dennis P Martin, Fred E Liss, Jack Abboudi, William H Kirkpatrick, Pedro K Beredjiklian
Background: Thumb metacarpal subsidence after trapeziectomy can affect clinical function over time. Methods for measuring subsidence after trapeziectomy have been described, and they rely on an intact thumb metacarpal or proximal phalanx for measurement. The authors evaluated the reliability and reproducibility of measuring the trapezial space ratio, using previously described methods. In addition, the authors evaluated a new method that measures trapezial space on a posteroanterior (PA) hand/wrist radiograph that does not rely on an intact thumb metacarpal or proximal phalanx for measurement, which can often be altered by degenerative changes or in cases in which metacarpophalangeal arthrodesis is performed during carpometacarpal (CMC) joint arthroplasty to correct excessive hyperextension...
April 2018: Journal of Hand and Microsurgery
Rachel Pedreira, Brian H Cho, Angela Geer, Ramon A DeJesus
Background: The difficulties in surgical treatment of pilon fractures of the finger include fragment reconstitution and posthealing stiffness. In adults, external fixation with traction and early active range of motion (AROM)/passive range of motion (PROM) during healing is considered necessary for avoiding joint stiffness and attaining realignment. The authors present a unique approach to pediatric pilon fractures that uses open reduction and multivector external fixation with delayed AROM/PROM...
April 2018: Journal of Hand and Microsurgery
Ignacio Roger de Oña, Andrea Garcia Villanueva, Alexis Studer de Oya
Thumb amputation at the carpometacarpal level is very incapacitating. Pollicization may be considered. We describe an alternate technique for thumb reconstruction at the level of the metacarpal base using a trimmed great toe along with a vascularized second metatarsophalangeal joint, including the second metatarsal, all supplied on a single vascular pedicle. Two patients who had a combined soft tissue defect and amputation of the thumb close to the carpometacarpal joint were reconstructed with this method. A transposition of the second toe was performed on top of the remaining proximal phalanx of the great toe to decrease donor site morbidity...
April 25, 2018: Journal of Hand Surgery
Fatih Göktay, Güldehan Atış, Pembegül Güneş, Betül Macit, Nil Su Çelik, Esra Gürdal Kösem
BACKGROUND: Subungual exostosis (SE) and subungual osteochondroma (SO) are an uncommon, benign tumor of the distal phalanx. The purpose of this retrospective study was to evaluate clinical, demographical, and radiological features; treatment modalities; and follow-up results in SE and SO cases. METHODS: Twenty-five cases were confirmed histopathologically as SE or SO. At the time of admission, clinical data were obtained on the age and sex of the patient, duration of symptoms, presence of pain, previous diagnoses and treatments, concomitant systemic diseases, family history, lesional localization, clinical and radiological features of the lesion, surgical treatment methods, and duration of follow-up...
April 27, 2018: International Journal of Dermatology
Taku Suzuki, Takuji Iwamoto, Kazuki Sato
A variety of surgical options for chronic tendon mallet fingers have been reported. There are advantages and disadvantages to current surgical approaches. We introduce a surgical treatment for chronic tendon mallet injury that involves anatomical reconstruction of the terminal tendon and lateral band with palmaris longus (PL) tendon grafting. Harvested PL tendon is folded in 2 or divided into 2 slips. The graft is attached to a remnant of the original terminal tendon at the distal interphalangeal joint. Both half-slip tendons are passed under the transverse retinacular ligament and sutured side to side to the lateral band at the level of the proximal phalanx...
April 24, 2018: Journal of Hand Surgery
Kim A Bjorklund, Dahlia M Rice, Ashley N Amalfi
BACKGROUND: Pediatric digital necrosis resulting in revision amputation is a devastating outcome following digital dressing application. METHODS: We report a series of 4 pediatric patients (age: 21 months-11 years) who presented for surgical consultation related to digital ischemia and irreversible necrosis following the application of Coban digital dressings. A review of the literature demonstrated that such injuries had not previously been described. RESULTS: In our case series, Coban dressing was utilized as a deterrent for thumb sucking, fingertip tuft fractures with nail bed lacerations, and a phalanx fracture secondary to crush injury...
April 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Zi Wang, Yuting Zou, Yu Chen, Yue Chen
RATIONALE: Metachondromatosis (MC) is a very rare genetic disease, which is infrequently reported worldwide, which leads to osteochondroma and enchondromatosis. The disease has been shown to be associated with loss of function of the tumor suppressor gene "protein tyrosine phosphatase, non-receptor type 11" (PTPN11). PATIENT CONCERNS: A 12-year-old female was admitted to the hospital with pain due to an enlarged mass in her left fifth finger. DIAGNOSIS: Examination of the left hand by computed tomography (CT) revealed an expanding type of round and low-density lesion in the fifth proximal phalanx...
April 2018: Medicine (Baltimore)
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