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American Journal of Clinical Dermatology Dec 2018Psoriatic arthritis (PsA) is an inflammatory arthritis that is estimated to affect approximately 30% of patients with psoriasis. Enthesitis and dactylitis, two hallmarks... (Review)
Review
Psoriatic arthritis (PsA) is an inflammatory arthritis that is estimated to affect approximately 30% of patients with psoriasis. Enthesitis and dactylitis, two hallmarks of PsA, are associated with radiographic peripheral/axial joint damage and severe disease. Clinical symptoms of enthesitis include tenderness, soreness, and pain at entheses on palpation, whereas dactylitis is recognized by swelling of an entire digit that is different from adjacent digits. Both ultrasound and magnetic resonance imaging can be used to diagnose enthesitis and dactylitis, especially in patients in whom symptoms may be difficult to discern. Delayed treatment of PsA can result in irreversible joint damage and reduced quality of life. Thus, it is recommended that dermatologists monitor patients with psoriasis for these two early and important manifestations of PsA.
Topics: Antirheumatic Agents; Arthritis, Psoriatic; Dermatology; Enthesopathy; Finger Joint; Humans; Magnetic Resonance Imaging; Practice Guidelines as Topic; Quality of Life; Toe Joint; Treatment Outcome; Ultrasonography
PubMed: 30117018
DOI: 10.1007/s40257-018-0377-2 -
Journal of General Internal Medicine Sep 2018
Topics: Female; Finger Joint; Hand Deformities, Acquired; Humans; Joint Diseases; Lupus Erythematosus, Systemic; Radiography; Young Adult
PubMed: 29987749
DOI: 10.1007/s11606-018-4559-7 -
Hand Clinics May 2018Proximal interphalangeal (PIP) joint arthritis is a debilitating condition. The complexity of the joint makes management particularly challenging. Treatment of PIP... (Review)
Review
Proximal interphalangeal (PIP) joint arthritis is a debilitating condition. The complexity of the joint makes management particularly challenging. Treatment of PIP arthritis requires an understanding of the biomechanics of the joint. PIP joint arthroplasty is one treatment option that has evolved over time. Advances in biomaterials have improved and expanded arthroplasty design. This article reviews biomechanics and arthroplasty design of the PIP joint.
Topics: Arthroplasty, Replacement, Finger; Biomechanical Phenomena; Carbon; Chromium Alloys; Finger Joint; Humans; Joint Prosthesis; Polyethylene; Prosthesis Design; Silicones
PubMed: 29625638
DOI: 10.1016/j.hcl.2017.12.008 -
Hand Surgery & Rehabilitation Jun 2018Thanks to its remarkable mechanical properties and excellent biocompatibility, pyrocarbon is an ideal material for articular use. Various pyrocarbon implants for the... (Review)
Review
Thanks to its remarkable mechanical properties and excellent biocompatibility, pyrocarbon is an ideal material for articular use. Various pyrocarbon implants for the hand and wrist have been developed over the past 25 years, with about 15 currently available for hemi-, total and interposition arthroplasty. This article describes the production methods and mechanical properties of pyrocarbon. The author summarizes the various implants available for each type of joint, their reported results in the literature, as well as his team's experience.
Topics: Arthroplasty, Replacement; Biocompatible Materials; Carbon; Finger Joint; Humans; Joint Prosthesis; Prosthesis Design; Wrist Joint
PubMed: 29628356
DOI: 10.1016/j.hansur.2018.03.001 -
American Family Physician Feb 2021
Topics: Diagnosis, Differential; Epidermal Cyst; Finger Joint; Humans; Thumb
PubMed: 33507048
DOI: No ID Found -
The Journal of the American Academy of... Feb 2013Fracture-dislocations of the proximal interphalangeal joint encompass a spectrum of injury severity, ranging from injuries that require little intervention to those that... (Review)
Review
Fracture-dislocations of the proximal interphalangeal joint encompass a spectrum of injury severity, ranging from injuries that require little intervention to those that require advanced reconstructive surgery for optimal outcome. Three fracture-dislocation patterns are recognized: dorsal, volar, and pilon. Acceptable outcome is dependent on achieving and maintaining a well-aligned and well-reduced joint, re-establishing normal joint kinematics, and restoring motion. Anatomic articular surface reduction is desirable but not absolutely necessary for a good outcome. Treatment depends on both the type of injury and patient-dependent factors. Optimal outcome for a specific injury is predicated on expedient diagnosis and recognition of injury severity, which enables initiation of appropriate management.
Topics: Finger Injuries; Finger Joint; Fracture Fixation, Internal; Fractures, Bone; Humans; Joint Dislocations; Treatment Outcome
PubMed: 23378372
DOI: 10.5435/JAAOS-21-02-88 -
Archives of Orthopaedic and Trauma... Jan 2020Finger proximal interphalangeal joint (PIP) reconstruction after the destruction of parts of the joint remains challenging. Surgical techniques include implant...
INTRODUCTION
Finger proximal interphalangeal joint (PIP) reconstruction after the destruction of parts of the joint remains challenging. Surgical techniques include implant arthroplasty, arthrodesis, free vascularized joint transfer, and non-vascularized bone and joint transfer. This study analyzes our experience after non-vascularized transfer in terms of range of motion, postoperative rehabilitation, and patient satisfaction.
MATERIALS AND METHODS
Between 2009 and 2014, ten patients underwent non-vascularized partial joint transfer for PIP joint reconstruction. One of them was lost to follow-up. Included patients had osteochondral partial joint transplants of 25-50% of the toes (n = 4) and the hand (n = 5). Range of motion (ROM), grip-, and pinch-strength were measured at the last follow-up control and compared to the healthy side. Patients were asked to score the pain at rest/ on load on a visual scale (VAS: 0 = no pain; 10 = excruciating pain). Satisfaction self-assessment was evaluated by asking the patients to grade their postoperative result as excellent, very good, good or poor.
RESULTS
Mean follow-up period was 4.0 years (range 1.2-7.9 years). Mean PIP joint flexion was 93 ± 26° at the last follow-up control. Mean grip- and pinch-strength of the operated side at the last control were, respectively, 43 ± 18 kg and 8 ± 5 kg, close to the healthy side values (45 ± 15 kg and 9 ± 4 kg). Mean pain at rest/on load measured on a visual scale was, respectively, 0.3 ± 1 and 1.8 ± 2. Eight patients (89%) rated their operation as excellent, and one as poor.
CONCLUSION
In this study, non-vascularized partial joint transfer provides a mobile and stable PIP joint 4 years after reconstruction. The surgical technique presented herein is complex depending on additional injuries but results in great patient satisfaction.
Topics: Finger Injuries; Finger Joint; Humans; Joints; Patient Satisfaction; Pinch Strength; Range of Motion, Articular; Toe Joint
PubMed: 31691006
DOI: 10.1007/s00402-019-03301-9 -
Medical Ultrasonography Nov 2017
Could nail and joint alterations make the difference between psoriatic arthritis and osteoarthritis during the ultrasonographic evaluation of the distal interphalangeal joints?
Topics: Arthritis, Psoriatic; Diagnosis, Differential; Finger Joint; Humans; Nails; Osteoarthritis; Toe Joint; Ultrasonography
PubMed: 29197909
DOI: 10.11152/mu-1266 -
Surgical and Radiologic Anatomy : SRA Oct 2021The innervation of the digital joints as well as the anatomical relationships of the articular branches is present in this anatomical work to determine the technical...
INTRODUCTION
The innervation of the digital joints as well as the anatomical relationships of the articular branches is present in this anatomical work to determine the technical feasibility of a selective and efficient denervation of the digital joints.
MATERIALS AND METHODS
A study of 40 distal interphalangeal (DIP), 40 proximal interphalangeal (PIP), 50 metacarpophalangeal (MCP), 10 interphalangeal (IP) of the thumb, and 10 trapezo-metacarpophalangeal (TMC) joints was performed on ten hands. Under magnification and a proper surgical approach, we collected the course, the source origin, the number of articular nerve branches, and their caliber.
RESULTS
In total, 118 nerve branches arising from the proper palmar digital nerves were found on 10 DIP of each dissected long finger (n = 40). A total of 226 nerve branches were found on 10 PIPs of each long finger (n = 40), of which 204 branches (90.3%) had a palmar origin. Dorsal innervation was found for the ring and little finger, originating from the dorso-ulnar digital nerve. 212 branches were found on 10 MCP of long fingers (n = 40), including 87 branches of palmar origin (41.1%), 107 branches of dorsal origin (50.4%), and 18 branches of the motor branch of the ulnar nerve (8.5%). 42 articular branches directed to the TMC joint (n = 10) were found. 13 branches (31%) originated from the anterior sensory branch of the radial nerve, 13 branches (31%) originated from the lateral cutaneous nerve of the forearm, 5 branches (12%) originated from the palmar cutaneous branch of the median nerve, and 11 (26%) branches originated from the thenar branch of the median nerve. The involvement of the sensory anterior branch of the radial nerve was always present for the innervation of each TMC.
DISCUSSION AND CONCLUSION
Our research shows that finger joints receive their primary innervation from small branches of the digital nerves with the exception of the MCP joint and the TMC joint. To obtain an efficient and a selective digital denervation for articular pain relief, it is necessary to plan the best surgical approach and it is crucial to recognize the articular nervous branch localization and source.
Topics: Cadaver; Female; Finger Joint; Humans; Male; Peripheral Nerves
PubMed: 33956202
DOI: 10.1007/s00276-021-02754-1 -
Hand Clinics May 2018Proximal interphalangeal joint injuries are one of the most common injuries of the hand. The severity of injury can vary from a minor sprain to a complex intra-articular... (Review)
Review
Proximal interphalangeal joint injuries are one of the most common injuries of the hand. The severity of injury can vary from a minor sprain to a complex intra-articular fracture. Because of the complex anatomy of the joint, complications may occur even after an appropriate treatment. This article provides a comprehensive review on existing techniques to manage complications and imparts practical points to help prevent further complications after proximal interphalangeal joint injury.
Topics: Collateral Ligaments; Contracture; Finger Injuries; Finger Joint; Finger Phalanges; Fractures, Malunited; Hand Deformities, Acquired; Humans; Intra-Articular Fractures; Orthopedic Procedures; Physical Examination; Splints; Traction
PubMed: 29625645
DOI: 10.1016/j.hcl.2017.12.014