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Hand (New York, N.Y.) May 2017Mallet finger is a common injury of the extensor tendon insertion causing an extension lag of the distal interphalangeal joint. (Review)
Review
BACKGROUND
Mallet finger is a common injury of the extensor tendon insertion causing an extension lag of the distal interphalangeal joint.
METHODS
We reviewed the most current literature on the epidemiology, diagnosis, and management of mallet finger injuries focusing on the indications and outcomes of surgical intervention.
RESULTS
Nonoperative management has been advocated for almost all mallet finger injuries; however, complex injuries are usually treated surgically. There is still controversy regarding the absolute indications for surgical intervention.
CONCLUSIONS
Although surgery is generally indicated in the case of mallet fractures involving more than one-third of the articular surface as well as in all patients who develop volar subluxation of the distal phalanx, a significant advantage of surgical management even in those complicated cases has yet to be clearly proven.
Topics: Finger Injuries; Finger Joint; Humans; Radiography; Soccer; Tendon Injuries
PubMed: 28453357
DOI: 10.1177/1558944716642763 -
Journal of Plastic Surgery and Hand... 2023Mallet finger is a commonly encountered condition in daily practice. However, there is currently no consensus on whether surgical intervention or conservative treatment... (Meta-Analysis)
Meta-Analysis Review
Mallet finger is a commonly encountered condition in daily practice. However, there is currently no consensus on whether surgical intervention or conservative treatment with orthosis splint is superior. In this systematic review and meta-analysis, we compare the treatment outcomes between surgery and orthosis for bony and tendinous mallet finger. We searched PubMed, Embase, and the Cochrane Library according to the PRISMA guidelines from inception to January 15, 2021. The primary outcome was distal interphalangeal (DIP) joint extension lag angle, and secondary outcomes were DIP joint flexion and range of motion (ROM) angle. A total of 297 studies were initially identified, of which 13 (ten retrospective non-randomized controlled studies (non-RCTs) and three RCTs) were included in the final analysis. The results of this systematic review and meta-analysis showed that there was no high level of evidence supporting the superiority of surgery over orthosis in the treatment of mallet finger. Based on the available evidence, surgical intervention and conservative treatment with splint may offer similar clinical outcomes in both bony and tendinous mallet finger.
Topics: Humans; Splints; Retrospective Studies; Orthotic Devices; Finger Injuries; Treatment Outcome; Tendon Injuries; Finger Joint; Hand Deformities, Acquired; Range of Motion, Articular
PubMed: 36625383
DOI: 10.1080/2000656X.2022.2164291 -
The Pan African Medical Journal 2022
Topics: Humans; Contracture; Hand; Finger Joint; Fingers
PubMed: 36845230
DOI: 10.11604/pamj.2022.42.239.36313 -
Sensors (Basel, Switzerland) Sep 2022The quantitative measurement of finger-joint range of motion plays an important role in assessing the level of hand disability and intervening in the treatment of...
The quantitative measurement of finger-joint range of motion plays an important role in assessing the level of hand disability and intervening in the treatment of patients. An industrial monocular-vision-based knuckle-joint-activity-measurement system is proposed with short measurement time and the simultaneous measurement of multiple joints. In terms of hardware, the system can adjust the light-irradiation angle and the light-irradiation intensity of the marker by actively adjusting the height of the light source to enhance the difference between the marker and the background and reduce the difficulty of segmenting the target marker and the background. In terms of algorithms, a combination of multiple-vision algorithms is used to compare the image-threshold segmentation and Hough outer- and inner linear detection as the knuckle-activity-range detection method of the system. To verify the accuracy of the visual-detection method, nine healthy volunteers were recruited for experimental validation, and the experimental results showed that the average angular deviation in the flexion/extension of the knuckle was 0.43° at the minimum and 0.59° at the maximum, and the average angular deviation in the adduction/abduction of the knuckle was 0.30° at the minimum and 0.81° at the maximum, which were all less than 1°. In the multi-angle velocimetry experiment, the time taken by the system was much less than that taken by the conventional method.
Topics: Finger Joint; Hand; Humans; Metacarpophalangeal Joint; Movement; Range of Motion, Articular
PubMed: 36236375
DOI: 10.3390/s22197276 -
Hand (New York, N.Y.) Nov 2022Vascularized joint transfer (VJT) from the proximal interphalangeal joint (PIPJ) of the toe is an attractive reconstructive option in cases of nonsalvageable finger PIPJ... (Review)
Review
Vascularized joint transfer (VJT) from the proximal interphalangeal joint (PIPJ) of the toe is an attractive reconstructive option in cases of nonsalvageable finger PIPJ but is limited by equivocal functional outcomes. This systematic review aims to provide an update on vascularized toe-to-finger PIPJ transfers, examining functional outcomes, complications, and the latest refinements in operative technique. A systematic review of the available literature was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies examining vascularized toe-to-finger PIPJ transfer for post-traumatic indications were included for analysis. Outcomes assessed included postoperative active range of motion, extension lag, and complications. Thirteen studies examining 210 VJTs were analyzed. Five VJTs experienced microsurgical failure giving an overall survival rate of 97.6%. Average postoperative PIPJ active range of motion (ROM) was 40.3° ± 12.9°, with an average extensor lag of 29° ± 10.5° and mean flexion of 68.9° ± 10.9°. For studies reporting complication outcomes, 59/162 complications were seen. No significant differences were seen between studies published prior to 2013 and after 2013 when comparing digital ROM ( = .123), flexion ( = .602), and extensor lag ( = .280). Studies using a reconstructive algorithm based on prior assessment of the donor toe central slip and recipient finger anatomy had significantly improved ROM outcomes ( = .013). Although VJT provides a reliable option for autologous reconstruction in posttraumatic joints, it is limited by impaired postoperative ROM. Careful assessment of the donor toe and recipient finger anatomy followed by systematic and meticulous reconstruction may lead to improved functional outcomes.
Topics: Humans; Toe Joint; Finger Joint; Fingers; Range of Motion, Articular; Toes
PubMed: 33511878
DOI: 10.1177/1558944720988081 -
Deutsches Arzteblatt International Apr 2018Primary finger and thumb joint arthritis is common, with a markedly rising prevalence from age 50 onward. As the population as a whole ages, the need for effective,... (Review)
Review
BACKGROUND
Primary finger and thumb joint arthritis is common, with a markedly rising prevalence from age 50 onward. As the population as a whole ages, the need for effective, stage-appropriate treatment of this condition is increasing.
METHODS
This review is based on pertinent publications retrieved by a selective search in the PubMed and Cochrane Library databases.
RESULTS
Pain on movement and morning stiffness are commonly reported symptoms. Thorough physical examination and plain x-rays are mandatory. In the early stages of primary finger and thumb joint arthritis, a conservative, multimodal treatment approach involving the use of splints, physiotherapy, and non-steroidal anti-inflammatory drugs can be helpful. The intraarticular injection of hyaluronic acid or cortisone seems to relieve pain in the short term, but its long-term efficacy in primary finger and thumb joint arthritis is questionable. Arthrodesis (joint fusion) is a reliable surgical treatment option for arthritis of the metacarpophalangeal and interphalangeal joints of the thumb. For mobility-preserving surgery of the metacarpophalangeal joints of the second through fifth fingers, silicone implant arthroplasty remains the gold standard. Symptomatic, advanced arthritis of the distal interphalangeal joint is most effectively treated with arthrodesis.
CONCLUSION
The efficacy of conservative treatment has been documented in high-quality clinical trials, while that of surgical treatment has not. The various surgical methods have yielded benefits in routine clinical use, but these remain to be assessed in randomized and controlled trials.
Topics: Arthritis; Cysts; Finger Joint; Humans; Injections, Intra-Articular; Radiography; Treatment Outcome
PubMed: 29739493
DOI: 10.3238/arztebl.2018.0269 -
American Family Physician Apr 2012Finger fractures and dislocations are common injuries that are often managed by family physicians. A systematic physical examination is imperative to avoid complications... (Review)
Review
Finger fractures and dislocations are common injuries that are often managed by family physicians. A systematic physical examination is imperative to avoid complications and poor outcomes following these injuries. Radiography (commonly anteroposterior, true lateral, and oblique views) is required in the evaluation of finger fractures and dislocations. Dorsal dislocation of the proximal interphalangeal joint is the most common type of finger dislocation. Finger dislocations should be reduced as quickly as possible and concurrent soft tissue injuries treated appropriately. Referral to a hand specialist is needed if a dislocation cannot be reduced; is unstable following reduction; or involves significant ligament, tendon, or soft tissue injury. Some common finger fractures can be treated conservatively with appropriate reduction and immobilization. Referral to a hand specialist is required if a fracture is unstable, involves a large portion (greater than 30 percent) of the intra-articular surface, or has significant rotation.
Topics: Finger Injuries; Finger Joint; Fingers; Fractures, Bone; Humans; Joint Dislocations; Manipulation, Orthopedic; Medical History Taking; Physical Examination; Radiography; Referral and Consultation; Splints
PubMed: 22534390
DOI: No ID Found -
Revista Da Associacao Medica Brasileira... Jul 2022Finger splints are used as a treatment option in tendon, bone, and soft tissue injuries. For immobilization, custom-made splints and prefabricated finger splints are... (Comparative Study)
Comparative Study
OBJECTIVE
Finger splints are used as a treatment option in tendon, bone, and soft tissue injuries. For immobilization, custom-made splints and prefabricated finger splints are used. In splints made for immobilization, it is aimed to limit joint movement. The aim of our study is to reveal how much custom-made splints and prefabricated finger splints limit joint motion (flexion angle in proximal interphalangeal and distal interphalangeal joints).
METHODS
Custom-made splints and prefabricated finger splints were applied to the second fingers of the dominant side in a total of 40 individuals, 20 women and 20 men, not having any health problems. Individuals were asked to flex and joint motion was measured with the iPhone compass application.
RESULTS
The mean distal interphalangeal joint angle values of the participants measured by prefabricated finger splints were found to be 24.27±8.29, and the mean distal interphalangeal joint angle values measured by custom-made splints was 0.52±1.50. There was a difference between the participants' distal interphalangeal joint angle values measured by prefabricated finger splints and custom-made splints (p<0.001). distal interphalangeal joint angle values measured with custom-made splints were significantly smaller than those measured with prefabricated finger splint. The mean of the participants' proximal interphalangeal joint angle values measured by prefabricated finger splints was 16.55±7.90, and the proximal interphalangeal joint angle values measured by custom-made splints was "0" for all participants. There was a difference between the participants' proximal interphalangeal joint angle values measured by prefabricated finger splints and custom-made splints (p<0.001). Distal interphalangeal joint angle values measured with custom-made splints were significantly smaller than those measured with prefabricated finger splints.
CONCLUSION
According to our study, custom-made splints can significantly reduce the flexion of the finger interphalangeal joints compared to prefabricated finger splints.
Topics: Female; Finger Joint; Fingers; Humans; Male; Range of Motion, Articular; Splints; Tendons
PubMed: 35946771
DOI: 10.1590/1806-9282.20220093 -
Ugeskrift For Laeger Nov 2017Extension of the fingers is a complex act. Boutonnière deformity is defined by flexion at the proximal inter-phalangeal (PIP) joint and hyperextension at the distal... (Review)
Review
Extension of the fingers is a complex act. Boutonnière deformity is defined by flexion at the proximal inter-phalangeal (PIP) joint and hyperextension at the distal interphalangeal (DIP) joint due to disruption of the central slip of the extensor tendon. Swan neck deformity is defined by hyperextension at the PIP joint and flexion at the DIP joint, and the pathology is divided into intrinsic, extrinsic, and articular. The deformities are a result of imbalance of the tendons and ligaments in the fingers. Treatment is depending on the underlying cause and includes surgery and non-operative treatment. Functional gain and risk must be realistically assessed.
Topics: Finger Injuries; Finger Joint; Hand Deformities, Acquired; Humans; Tendon Injuries
PubMed: 29208202
DOI: No ID Found -
Hand (New York, N.Y.) May 2022Proximal interphalangeal joint (PIPJ) arthrodesis can provide reliable pain relief and restore hand function in patients with PIPJ arthritis. However, there is a paucity...
BACKGROUND
Proximal interphalangeal joint (PIPJ) arthrodesis can provide reliable pain relief and restore hand function in patients with PIPJ arthritis. However, there is a paucity of literature on patient-specific preoperative risk factors that are associated with adverse outcomes after PIPJ arthrodeses. Therefore, the primary purpose of this study was to assess preoperative predictors of nonunion and reoperation after PIPJ arthrodesis.
METHODS
This study identified all patients who underwent PIPJ arthrodesis at a single community practice between 1987 and 2013. The final analysis included 415 PIPJs treated with arthrodesis. The mean follow-up was 1.3 years. Data on preoperative diagnosis, demographics, comorbidities, and operative techniques were recorded, as well as the occurrence of nonunions and reoperations. Logistic regression models were used to identify independent risk factors of nonunion and reoperation.
RESULTS
There were 40 nonunions (10%) and 62 reoperations (15%). Of the reoperations, there were 39 incidences of isolated hardware removal, 9 irrigation and debridement, 8 amputations, 5 revision arthrodeses, and 1 corrective osteotomy. The highest number of nonunions occurred in the traumatic diagnosis group (37%), followed by the rheumatoid group (23%) and the scleroderma group (15%). The highest number of reoperations occurred within the traumatic joint disorder group (40%), followed by the rheumatoid group (24%) and the scleroderma group (11%). Multivariate analysis revealed that male sex ( < .01) and hepatic disease ( = .03) were significant risk factors of nonunion. Male sex was also significantly associated with increased reoperation risk ( < .01).
CONCLUSION
Risks of nonunions and reoperations after PIPJ arthrodeses are low; however, these findings may guide clinicians and patients in the preoperative decision-making process and help with targeted postoperative surveillance to mitigate these risks.
Topics: Arthritis; Arthrodesis; Finger Joint; Humans; Male; Postoperative Complications; Reoperation
PubMed: 32772578
DOI: 10.1177/1558944720939196