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https://www.readbyqxmd.com/read/27886832/thumb-injuries-in-athletes
#1
REVIEW
Tiffany R Kadow, John R Fowler
Thumb injuries are common in athletes and present a challenging opportunity for upper extremity physicians. Common injuries include metacarpal base fractures (Bennett and Rolando types), ulnar and radial collateral ligament injuries, dislocation of the carpometacarpal and metacarpophalangeal joints, and phalanx fractures. This review, although not exhaustive, highlights some of the most common thumb injuries in athletes. The treating physician must balance pressure from athletes, parents, coaches, and executives to expedite return to play with the long-term well-being of the athlete...
February 2017: Hand Clinics
https://www.readbyqxmd.com/read/27843670/kirschner-wire-breakage-during-removal-requiring-retrieval
#2
Kai Yuen Wong, Rosalind Mole, Patrick Gillespie
Kirschner wires (K-wires) are widely used for fixation of fractures and dislocations in the hand as they are readily available, reliable, and cost-effective. Complication rates of up to 18% have been reported. However, K-wire breakage during removal is rare. We present one such case illustrating a simple technique for retrieval. A 35-year-old male presented with a distal phalanx fracture of his right middle finger. This open fracture was treated with K-wire fixation. Postoperatively, he developed a pin site infection with associated finger swelling...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27781977/treatment-of-unstable-distal-phalanx-fractures-by-extra-articular-dip-pinning-a-series-of-12-cases
#3
G Prunières, S Gouzou, S Facca, A-S Matheron, N Maire, J-J Hidalgo Díaz, P Liverneaux
: Unstable distal phalanx fractures are typically treated by pinning of the distal phalanx or the distal interphalangeal joint (DIP). Complications include unstable fixation, K-wire migration, septic arthritis and osteoarthritis. To limit these complications, we wanted to explore the benefits of using locked extra-articular DIP pinning. The cohort consisted of 12 patients (mean age 36.3 years) who had an extra-articular (6 cases) or intra-articular distal phalanx fracture (6 cases). All patients were treated surgically with a construct consisting of two connected K-wires: one was placed inside the shaft of the distal phalanx and the other was placed perpendicular to the middle phalanx...
October 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27774329/two-extension-block-kirschner-wires-technique-for-bony-mallet-thumb
#4
Yutaka Mifune, Atsuyuki Inui, Fumiaki Takase, Yasuhiro Ueda, Issei Shinohara, Ryosuke Kuroda, Takeshi Kokubu
Mallet fingers with an avulsion fracture of the distal phalanx or rupture of the terminal tendon of the extensor mechanism is known as a common injury, while mallet thumb is very rare. In this paper, the case of a 19-year-old woman with a sprained left thumb sustained while playing basketball is presented. Plain radiographs and computed tomography revealed an avulsion fracture involving more than half of the articular surface at the base of the distal phalanx. Closed reduction and percutaneous fixation were performed using the two extension block Kirschner wires' technique under digital block anesthesia...
2016: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/27769216/kirner-s-deformity-of-the-fifth-finger-a-case-report
#5
Melkamu Adeb, Daichi Hayashi, Yogesh Kumar
BACKGROUND: Kirner's deformity is a rare bony deformity that is characterized by radial and volar curvature of the distal phalanx of the fifth finger. Affected patients usually present after the age of 5 years, with girls more affected than boys and bilateral involvement more common than unilateral. CASE PRESENTATION: We report a case of an eight-year-old girl who presented with progressive deformity of the right little finger. Radiographic evaluation revealed volar and radial curvature of the distal phalanx of the right fifth digit...
October 21, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27765865/treatment-of-unstable-proximal-interphalangeal-joint-fractures-with-hemi-hamate-osteochondral-autografts
#6
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
https://www.readbyqxmd.com/read/27755266/pediatric-phalanx-fractures
#7
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
https://www.readbyqxmd.com/read/27685761/effect-of-cortical-screw-diameter-on-reduction-and-stabilization-of-type-iii-distal-phalanx-fractures-an-equine-cadaveric-study
#8
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
https://www.readbyqxmd.com/read/27672063/correction-of-hallux-valgus-interphalangeus-with-an-osteotomy-of-the-distal-end-of-the-proximal-phalanx-distal-akin-osteotomy
#9
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
https://www.readbyqxmd.com/read/27638548/-fractures-of-the-thumb-ray
#10
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
https://www.readbyqxmd.com/read/27603196/multiple-enchondromas-of-the-hand-in-children-long-term-follow-up-of-mean-15-4-years
#11
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
https://www.readbyqxmd.com/read/27595966/simultaneous-volar-dislocation-of-distal-interphalangeal-joint-and-volar-fracture-subluxation-of-proximal-interphalangeal-joint-of-little-finger-a-new-mechanism-of-injury
#12
Kamran Mozaffarian, Abdollah Bayatpour, Amir Reza Vosoughi
Simultaneous volar dislocation of distal interphalangeal (DIP) joint and volar fracture-subluxation of proximal interphalangeal (PIP) joint of the same finger has not been reported yet. A 19-year-old man was referred due to pain on the deformed left little finger after a ball injury. Radiographs showed volar dislocation of the DIP joint and dorsal lip fracture of the middle phalanx with volar subluxation of PIP joint of the little finger. This case was unique in terms of the mechanism of injury which was hyperflexion type in two adjacent joints of the same finger...
October 2016: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/27595958/post-reduction-stability-of-the-proximal-interphalangeal-joint-after-dorsal-fracture-dislocation-a-cadaveric-study
#13
Andre Eu-Jin Cheah, Tun-Lin Foo, Janice Chin-Yi Liao, Min He, Alphonsus Khin-Sze Chong
BACKGROUND: Proximal interphalangeal joint (PIPJ) dorsal fracture dislocations (DFD) are challenging injuries. Treatment aims to achieve stability of the PIPJ after reduction so that early motion can be initiated. We studied how increasing articular destruction would affect post reduction stability and investigate the amount of traction and PIPJ flexion needed to maintain the reduction. METHODS: Increasing amounts (20%, 40% and 60%) of damage to the volar lip of the middle phalanx in cadaveric specimens were created to represent PIPJ DFD that were stable, of tenuous stability and frankly unstable...
October 2016: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/27595952/post-operative-contracture-of-the-proximal-interphalangeal-joint-after-surface-replacement-arthroplasty-using-a-volar-approach
#14
Ken Shirakawa, Masahiko Shirota
BACKGROUND: Postoperative contracture as a major complication of surface replacement arthroplasty (SRA) remains an unresolved problem. Contracture after SRA can occur early in the postoperative period due to mechanical dysfunction, and tardy contracture where ROM declines with time postoperatively is also reported. METHODS: 13 fingers with degenerative osteoarthritis and two fingers with post-traumatic arthritis where SRA was performed using volar approach were involved...
October 2016: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/27555971/ultrasound-guided-forearm-nerve-blocks-a-novel-application-for-pain-control-in-adult-patients-with-digit-injuries
#15
Richard Amini, Parisa Patricia Javedani, Albert Amini, Srikar Adhikari
Phalanx fractures and interphalangeal joint dislocations commonly present to the emergency department. Although these orthopedic injuries are not complex, the four-point digital block used for anesthesia during the reduction can be painful. Additionally, cases requiring prolonged manipulation or consultation for adequate reduction may require repeat blockade. This case series reports four patients presenting after mechanical injuries resulting in phalanx fracture or interphalangeal joint dislocations. These patients received an ultrasound-guided peripheral nerve block of the forearm with successful subsequent reduction...
2016: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/27544986/-climbing-higher-common-injuries-in-rock-climbers
#16
Dafna Sobel, Naama Constantin, Omer Or
Rock climbing is becoming an increasingly popular sport in Israel with more and more climbing walls being built in the cities and new routes being traced on cliffs around the country. Our account describes the case of a 15 years old climber with chronic pain (without trauma) in the 3rd finger of the right hand. A stress fracture, involving the proximal interphalangeal joint (SH3) of the middle phalanx, was diagnosed. The fracture healed following two months of rest with gradual return to activity. As this sport becomes more common, there is an increasing need for knowledge about the characteristic injuries, their diagnosis and treatment...
June 2016: Harefuah
https://www.readbyqxmd.com/read/27499878/analogous-cellular-contribution-and-healing-mechanisms-following-digit-amputation-and-phalangeal-fracture-in-mice
#17
Lindsay A Dawson, Jennifer Simkin, Michelle Sauque, Maegan Pela, Teresa Palkowski, Ken Muneoka
Regeneration of amputated structures is severely limited in humans and mice, with complete regeneration restricted to the distal portion of the terminal phalanx (P3). Here, we investigate the dynamic tissue repair response of the second phalangeal element (P2) post amputation in the adult mouse, and show that the repair response of the amputated bone is similar to the proximal P2 bone fragment in fracture healing. The regeneration-incompetent P2 amputation response is characterized by periosteal endochondral ossification resulting in the deposition of new trabecular bone, corresponding to a significant increase in bone volume; however, this response is not associated with bone lengthening...
February 2016: Regeneration
https://www.readbyqxmd.com/read/27451079/stability-of-the-distal-phalanx-fracture-a-biomechanical-study-on-the-importance-of-the-nail-and-the-influence-of-fixation-by-crossing-kirschner-wires
#18
Wei Wang, Jia Yu, Cun-Yi Fan, Shen Liu, Xianyou Zheng
BACKGROUND: With respect to the stability of displaced distal-phalanx fracture, the relevance of nail loss and the biomechanical effects of fixation using crossed Kirschner wires have not been investigated. The present study aimed to determine whether the nail or the type of fixation contributes to stabilizing distal-phalanx fracture. METHODS: In 48 specimens (fingers), a model of the comminuted fracture of the distal phalanx (AO type A3) was created by resecting a 1-mm osseous segment from the distal phalanx...
August 2016: Clinical Biomechanics
https://www.readbyqxmd.com/read/27446396/prostate-cancer-metastasis-to-the-distal-phalanx-of-the-left-hallux-the-first-confirmed-case-and-literature-review
#19
Xinbing Sui, Yan Hu, Cheng Zhang, Hongming Pan, Da Li
Prostate cancer is one of the most common carcinomas in Asia, as well as all over the world. The vast majority of prostate cancer patients present with bone metastases, which mainly involve the axial bones, with pain as the most common symptom. The present study reports the first case of prostate cancer metastasis to the hallux in a 73-year-old man who presented with pain and a swollen phalanx of the left hallux. This symptom developed gradually over a period of several months and could not be improved with the common treatments...
August 2016: Oncology Letters
https://www.readbyqxmd.com/read/27441767/6-outcome-of-low-intensity-pulsed-ultrasound-lipus-treatment-for-adult-phalanx-delayed-union
#20
Tsuyoshi Ota
INTRODUCTION: In adult phalanx fractures with delayed union, we obtained good results from low-intensity pulsed ultrasound (LIPUS) fracture treatment. METHODS: The subjects were 10 patients (7 male and 3 female) presenting with adult phalanx fracture with delayed union. The average age was 38.3-year-old. Eight cases presented with distal phalanx fracture and 2 with proximal phalanx fracture. Six cases involved a closed fracture and 4 cases an open fracture. The average LIPUS start time was 3...
August 2016: Journal of Orthopaedic Trauma
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