An Anatomical Study of the Dorsal Cutaneous Branches of the Digital Arteries

2002 ◽  
Vol 27 (6) ◽  
pp. 577-579 ◽  
Author(s):  
J. BRAGA-SILVA ◽  
C. R. KUYVEN ◽  
F. FALLOPA ◽  
W. ALBERTONI
Keyword(s):  
Anatomical Study ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Human Cadaver ◽  
Digital Artery

This study describes the anatomy of the dorsal digital arteries in the 144 fingers of 18 pairs of fresh human cadaver hands. Previous studies have shown two constant branches in the proximal and middle pulp spaces from each proper digital artery. We have shown that these branches have consistent sites of origin at predictable distances from the proximal interphalangeal joint. Thus cutaneous flaps can be safely planned on these dorsal vessels.

Maximal advancement of homodigital neurovascular island flaps

2019 ◽  
Vol 44 (10) ◽  
pp. 1008-1012 ◽  
Author(s):  
Jin Xi Lim ◽  
Alphonsus Khin Sze Chong ◽  
Sandeep Jacob Sebastin
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Island Flap ◽  
Digital Artery ◽  
Full Extension ◽  
Finger Length

We investigated the maximal advancement of the homodigital neurovascular island flap with the digit in full extension and its correlation to the digital length. In 32 adult cadaveric digits, flaps measuring 1 × 1 cm were sequentially elevated to different dissection points. Dissection of the flap to the proximal interphalangeal joint crease, palmo-digital crease, division of adjacent digital artery and the superficial arch resulted in flap advancement of 8, 12, 15 and 18 mm, respectively. The degree of advancement correlated to the length of the finger and was approximately 19% of the finger length. We conclude that dissection of a homodigital antegrade neurovascular island flap to the proximal interphalangeal joint, palmo-digital crease, after ligation of adjacent digital artery and the superficial arch allows progressively more advancement. The advancement obtained by flap dissection to the palmo-digital crease was about 19% of the finger length.

Contracture of the Proximal Interphalangeal Joint in Dupuytren’s Disease

1991 ◽  
Vol 16 (4) ◽  
pp. 446-448 ◽  
Author(s):  
J. G. ANDREW
Keyword(s):  
Anatomical Study ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Dupuytren’S Disease ◽  
Corrective Surgery ◽  
Collateral Ligaments ◽  
Flexion Deformity ◽  
Dupuytren's Disease ◽  
Secondary Damage ◽  
Fixed Flexion Deformity

The correction of fixed flexion deformity at the P.I.P. joint in Dupuytren’s disease is often difficult. This paper reports an anatomical study of this joint in fingers amputated because of this condition. All the joints would extend fully after release of the accessory collateral ligaments and volar plate. Lateral and dorsal structures showed severe secondary damage and it is suggested that these changes may explain the poor results of corrective surgery to this joint in Dupuytren’s disease.

Design of a surface replacement prosthesis for the proximal interphalangeal joint

2000 ◽  
Vol 214 (2) ◽  
pp. 151-163 ◽  
Author(s):  
H E Ash ◽  
A Unsworth
Keyword(s):  
Anatomical Study ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Joint Prosthesis ◽  
Surface Replacement ◽  
Cross Sectional ◽  
Wear Rates ◽  
Complex Shapes ◽  
Centre Of Rotation ◽  
Sectional Shape

A surface replacement finger joint prosthesis was designed specifically for the proximal interphalangeal joint (PIPJ). The two-piece design consisted of a bi-condylar proximal phalangeal head and a conforming bi-concave middle phalangeal base. The bearing surfaces were designed as close to the original anatomy of the PIPJs as possible, using detailed information obtained from a previous anatomical study of 83 PIPJs by the present authors. Four sizes of prosthesis were designed with maximum head diameters of 7, 8, 9 and 10 mm. Fixation of the joint prosthesis was achieved by an interference fit between the stems of semicircular crosssection and the phalangeal bone shafts. The main considerations for the stem designs were the offset from the centre of rotation, angle of inclination, length, and cross-sectional shape and size. It is proposed that the two components will be made from cross-linked polyethylene (XLPE) because it can be injection moulded to produce the complex shapes of the joint prosthesis. In addition, XLPE against itself has shown comparable wear rates with stainless steel against ultra-high molecular weight polyethylene from previous work by Joyce et al.

Innervation of the Proximal Interphalangeal Joint: An Anatomical Study

2019 ◽  
Vol 44 (5) ◽  
pp. 422.e1-422.e5 ◽  
Author(s):  
Martin Jose Pastrana ◽  
Ezequiel Ernesto Zaidenberg ◽  
Dante Palumbo ◽  
Fernando Juarez Cesca ◽  
Carlos Rodolfo Zaidenberg
Keyword(s):  
Anatomical Study ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint

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.

Digital artery deformation on movement of the proximal interphalangeal joint

2018 ◽  
Vol 44 (2) ◽  
pp. 187-195
Author(s):  
Susumu Saito ◽  
Ryoma Bise ◽  
Aya Yoshikawa ◽  
Hiroyuki Sekiguchi ◽  
Itaru Tsuge ◽  
...  
Keyword(s):  
Index Finger ◽  
Three Dimensional ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Three Dimensions ◽  
Morphological Data ◽  
Photoacoustic Tomography ◽  
Digital Artery ◽  
Specific Mechanism

This study aimed to characterize in vivo human digital arteries in three-dimensions using photoacoustic tomography in order to understand the specific mechanism underlying arterial deformation associated with movement of the proximal interphalangeal joint. Three-dimensional morphological data were obtained on the radialis indicis artery (radial artery of the index finger) at different angles of the joint. The association between increased curvature of the deformation and the anatomical region was assessed. Characteristic morphological deformations in areas of major deformation were determined. The deformation of the artery was characterized by three consecutive curves in juxta-articular regions, which were particularly noticeable when the joint was flexed at an angle of ≥ 60°. The change in the curvature of the deformation during 30°–90° of flexion was lower in middle-aged individuals than in young individuals. Better understanding of the mechanism underlying deformation of the digital arteries may contribute to advancements in flap procedures and rehabilitation strategies after digital artery repair.

Arthroplasty in the hand: what works and what doesn’t?

2021 ◽  
pp. 175319342110177
Author(s):  
Daniel B. Herren ◽  
Hajime Ishikawa ◽  
Marco Rizzo ◽  
Mark Ross ◽  
Michael Solomons
Keyword(s):  
Surgical Technique ◽  
Metacarpophalangeal Joint ◽  
Distal Radioulnar Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Carpometacarpal Joint ◽  
Thumb Carpometacarpal Joint ◽  
Radioulnar Joint ◽  
What Works ◽  
Thumb Carpometacarpal

This review describes the different possibilities for arthroplasties at the proximal interphalangeal joint, thumb carpometacarpal joint, distal radioulnar joint, metacarpophalangeal joint and the wrist. For each joint, the indication for arthroplasty is explained, the surgical technique with the suitable implant is described and a brief summary of the outcomes reported in the literature is given.

A proximal interphalangeal joint custom-made orthosis in trigger finger: Functional outcome

Hand Therapy ◽  
2021 ◽  
pp. 175899832110187
Author(s):  
Kawee Pataradool ◽  
Chayanin Lertmahandpueti
Keyword(s):  
Outcome Measures ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Mean Difference ◽  
Trigger Finger ◽  
Symptom Improvement ◽  
Dash Score ◽  
Full Time ◽  
Custom Made ◽  
Quick Dash

Introduction Trigger finger is a common and functionally limiting disorder. Finger immobilization using an orthotic device is one of the conservative treatment options for treating this condition. The most common orthosis previously described for trigger finger is metacarpophalangeal joint immobilization. There are limited studies describing the effectiveness of proximal interphalangeal joint orthosis for treatment of trigger finger. Methods This study was a single group pretest-posttest design. Adult patients with single digit idiopathic trigger finger were recruited and asked to wear a full-time orthoses for 6 weeks. The pre- and post-outcome measures included Quick-DASH score, the Stages of Stenosing Tenosynovitis (SST), the Visual Analogue Scale (VAS) for pain, the number of triggering events in ten active fists, and participant satisfaction with symptom improvement. Orthotic devices were made with thermoplastic material fabricated with adjustable Velcro tape at dorsal side. All participants were given written handouts on this disease, orthotic care and gliding exercises. Paired t-tests were used to determine changes in outcome measures before and after wearing the orthosis. Results There were 30 participants included in this study. Evaluation after the use of PIP joint orthosis at 6 weeks revealed that there were statistically significant improvements in Quick-DASH score from enrolment (mean difference −29.0 (95%CI −34.5 to −23.4); p < 0.001), SST (mean difference −1.4 (95%CI −1.8 to −1.0); p < 0.001) and VAS (mean difference −3.4 (95%CI −4.3 to −2.5); p < 0.001). There were no serious adverse events and patient satisfaction with the treatment was high. Conclusions Despite our small study size, the use of proximal interphalangeal joint orthosis for 6 weeks resulted in statistically significant improvements in function, pain and triggering, and also high rates of acceptance in patients with isolated idiopathic trigger finger.

Post-Reduction Stability of the Proximal Interphalangeal Joint after Dorsal Fracture Dislocation—A Cadaveric Study

2016 ◽  
Vol 21 (03) ◽  
pp. 382-387 ◽  
Author(s):  
Andre Eu-Jin Cheah ◽  
Tun-Lin Foo ◽  
Janice Chin-Yi Liao ◽  
Min He ◽  
Alphonsus Khin-Sze Chong
Keyword(s):  
Traction Force ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Fracture Dislocation ◽  
Treatment Modalities ◽  
Full Extension ◽  
Early Motion ◽  
Fracture Dislocations ◽  
Reduction Stability ◽  
The One

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. Traction forces and PIPJ flexion needed to maintain the reduction were then measured. Results: The PIPJ DFD with 20% damage were stable and did not subluxe while the one with 40% articular involvement was stable after reduction. For unstable the PIPJ with 60% involvement, the more the PIPJ was flexed, the less traction force was needed to hold the joint in reduction. For PIPJ flexion of 20 degrees, a minimum 4.4N of force is needed to maintain reduction while PIPJ flexion of 10 degrees required a minimum 5.0N of force. No amount of force could maintain PIPJ reduction if traction was performed in full extension. Conclusions: In our model, PIPJ DFD with less than 30% articular damage are stable while those with 30% to 50% of involvement have tenuous stability. For the unstable PIPJ DFD, traction obviates the need for excessive flexion of the PIPJ to maintain joint reduction. This information should be considered in treatment modalities for PIPJ DFD, as well in the design of external traction devices for the treatment of PIPJ DFD.

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