Digital Artery Damage Associated with Closed Crush Injuries

2002 ◽  
Vol 27 (4) ◽  
pp. 374-377 ◽  
Author(s):  
D. S. REAGAN ◽  
A. B. GRUNDBERG ◽  
J. M. REAGAN
Keyword(s):  
Retrospective Study ◽  
Clinical Findings ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Digital Artery ◽  
Distal Interphalangeal Joint ◽  
Distal Interphalangeal ◽  
Crush Injuries ◽  
Transverse Fractures ◽  
Symptoms And Signs

This retrospective study describes closed finger crush injuries in seven patients (eight fingers) in which each finger sustained a loss of blood supply. Clinical findings included numbness, decreased two-point and sharp/dull sensation, cyanosis or pallor, and decreased capillary filling. Fractures, especially transverse fractures near the proximal interphalangeal joint or distal interphalangeal joint, were usually present and often showed longitudinal crush fracture lines. Exploration and revascularization were carried out in seven fingers, all of which survived. The only finger not explored progressed to necrosis and amputation. Crush injuries to the fingers, especially those associated with displaced fractures, should be carefully evaluated for symptoms and signs of ischaemia.

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

Resistive testing in a patient with suspected zone I flexor tendon injury

Hand Therapy ◽  
2009 ◽  
Vol 14 (3) ◽  
pp. 83-85
Author(s):  
Gangatharam Sudhagar ◽  
Monique Leblanc
Keyword(s):  
Occupational Therapy ◽  
Flexor Tendon ◽  
Tendon Injury ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Hand Surgeon ◽  
Flexor Tendon Injury ◽  
Distal Interphalangeal

Lacerations are the major cause of flexor tendon injury in zone I and they are most commonly missed due to incomplete examinations. We report a case of lacerated flexor tendon injury in Zone I closed without explorations and which was referred to occupational therapy with the diagnosis of stiff hand. The patient received therapy for his stiff hand following which he could flex the distal interphalangeal joint (DIP) on blocking the proximal interphalangeal joint but failed to flex his DIP joint on making a composite fist. With resistive testing the patient failed to initiate resistance on flexion. The patient was referred back to the hand surgeon and subsquently diagnosed with a flexor tendon injury.

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.

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....

Diagnosis of Closed Central Slip Injuries

1996 ◽  
Vol 21 (5) ◽  
pp. 614-616 ◽  
Author(s):  
J. RUBIN ◽  
D. J. BOZENTKA ◽  
F. W. BORA
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Non Invasive ◽  
Testing Resistance ◽  
Fresh Frozen ◽  
Central Slip ◽  
Distal Interphalangeal ◽  
Joint Flexion ◽  
Joint Rigidity

Four non-invasive tests for central slip integrity were analysed using 20 fresh frozen cadaver fingers. A pre-boutonnière deformity was simulated by dividing the central slip. A passively correctable boutonnière was simulated by dividing the central slip, triangular ligament and oblique fibres of the extensor expansion. The test described by Boyes, which evaluates distal interphalangeal joint flexion, was found not to be reliable for the diagnosis of either injury. The test described by Elson, which evaluates distal interphalangeal joint rigidity while actively extending the flexed proximal interphalangeal joint, was the only manoeuvre which was able to discern central slip integrity in both simulated injuries. The central slip tenodesis test and testing resistance of active proximal interphalangeal joint extension should be performed with the proximal interphalangeal joint in flexion to weaken the effectiveness of the lateral bands.

Use of the Homodigital Adipofascial Turnover Flap for Dorsal Cover of Distal Interphalangeal Joint Defects

1999 ◽  
Vol 24 (2) ◽  
pp. 241-244 ◽  
Author(s):  
S. L. A. JEFFERY ◽  
M. A. PICKFORD
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Distal Interphalangeal

The homodigital adipofascial turnover flap was originally described by Voche and Merle (1994) for dorsal cover of the proximal interphalangeal joint. We present three patients in whom this flap was used to cover dorsal defects of the distal interphalangeal joint, and describe an adaptation to allow greater flap mobility.

Relative ratios of collagen composition of periarticular tissue of joints of the upper limb

2016 ◽  
Vol 42 (6) ◽  
pp. 616-620 ◽  
Author(s):  
A. Cheah ◽  
A. Harris ◽  
W. Le ◽  
Y. Huang ◽  
J. Yao
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
The Other ◽  
Paired Comparisons ◽  
Distal Interphalangeal Joint ◽  
Palmar Plate ◽  
Fresh Frozen ◽  
Distal Interphalangeal ◽  
The Mean ◽  
Periarticular Tissue

We investigated the relative ratios of collagen composition of periarticular tissue of the elbow, wrist, metacarpophalangeal, proximal and distal interphalangeal joints. Periarticulat tissue, which we defined as the ligaments, palmar plate and capsule, was harvested from ten fresh-frozen cadaveric upper limbs, yielding 50 samples. The mean paired differences (95% confidence interval) of the relative ratios of collagen between the five different joints were estimated using mRNA expression of collagen in the periarticular tissue. We found that the relative collagen composition of the elbow was not significantly different to that of the proximal interphalangeal joint, nor between the proximal interphalangeal joint and distal interphalangeal joint, whereas the differences in collagen composition between all the other paired comparisons of the joints had confidence intervals that did not include zero.

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