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Acta Bio-medica : Atenei Parmensis Nov 2021Mallet finger describes a fingertip deformity where the distal interphalangeal joint (DIPJ) of the affected digit is held in flexion, unable to extend the distal phalanx... (Review)
Review
Mallet finger describes a fingertip deformity where the distal interphalangeal joint (DIPJ) of the affected digit is held in flexion, unable to extend the distal phalanx actively. The deformity is typically a consequence of traumatic disruption to the terminal extensor tendon at its insertion at the proximal portion of the distal phalanx or slightly proximally at the level of the DIPJ. Patients typically present with a history describing the event of injury with a typical mallet deformity. Common mechanisms include sport activities causing a direct blow to the finger, low energy trauma while performing simple tasks such as pulling up socks or crush injuries from getting the finger trapped in a door. The DIPJ can be passively extended, but this extension of the joint cannot be maintained once the passive extension is stopped. The Doyle classification can be used to categorise and dictate treatment. The extensor lag associated with the deformity does not improve spontaneously without treatment. Inappropriate management can lead to chronic functional loss and stiffness of the finger. The majority of closed mallet splints are Doyle type I, which can be managed non-surgically with external splints, worn full-time to keep the fingertip straight until the tendon injury or fracture heals. Surgical techniques is considered for other types of mallet injuries. Techniques used include closed reduction and Kirschner wire fixation, open reduction and internal fixation, reconstruction of the terminal extensor tendon and correction of swan neck deformity.
Topics: Bone Wires; Finger Injuries; Hand Deformities, Acquired; Humans; Tendon Injuries; Tendons
PubMed: 34738569
DOI: 10.23750/abm.v92i5.11731 -
Hand (New York, N.Y.) Dec 2016Poland anomaly is a sporadic, phenotypically variable congenital condition usually characterized by unilateral pectoral muscle agenesis and ipsilateral hand deformity.... (Review)
Review
Poland anomaly is a sporadic, phenotypically variable congenital condition usually characterized by unilateral pectoral muscle agenesis and ipsilateral hand deformity. A comprehensive review of the medical literature on Poland anomaly was performed using a Medline search. Poland anomaly is a sporadic, phenotypically variable congenital condition usually characterized by unilateral, simple syndactyly with ipsilateral limb hypoplasia and pectoralis muscle agenesis. Operative management of syndactyly in Poland anomaly is determined by the severity of hand involvement and the resulting anatomical dysfunction. Syndactyly reconstruction is recommended in all but the mildest cases because most patients with Poland anomaly have notable brachydactyly, and digital separation can improve functional length. Improved understanding the etiology and presentation of Poland anomaly can improve clinician recognition and management of this rare congenital condition.
Topics: Brachydactyly; Hand Deformities, Congenital; Humans; Pectoralis Muscles; Phenotype; Poland Syndrome; Syndactyly
PubMed: 28149203
DOI: 10.1177/1558944716647355 -
The Pan African Medical Journal 2021
Topics: Abnormalities, Multiple; Child, Preschool; Ectromelia; Foot Deformities, Congenital; Hand Deformities, Congenital; Humans; Male; Nose
PubMed: 34887989
DOI: 10.11604/pamj.2021.40.115.28167 -
The Yale Journal of Biology and Medicine 1977Congenital absence or traumatic amputation of the thumb is a major disability profoundly disturbing the function of the hand, as the thumb represents an estimated 50% of...
Congenital absence or traumatic amputation of the thumb is a major disability profoundly disturbing the function of the hand, as the thumb represents an estimated 50% of total hand function. The methods for thumb reconstruction utilizing the index finger were developed some twenty years ago, and progress has been made in the last several years with emphasis on intrinsic muscle reconstruction as emphasized by Buck-Gramcko. The method, technique and anatomy of index pollicization is discussed, and representative cases presented for congenital absence of the thumb and for traumatic amputation of the thumb.
Topics: Adult; Hand; Hand Deformities, Acquired; Humans; Infant; Orthopedics; Thumb
PubMed: 899040
DOI: No ID Found -
Orphanet Journal of Rare Diseases Jun 2008Brachydactyly ("short digits") is a general term that refers to disproportionately short fingers and toes, and forms part of the group of limb malformations... (Review)
Review
Brachydactyly ("short digits") is a general term that refers to disproportionately short fingers and toes, and forms part of the group of limb malformations characterized by bone dysostosis. The various types of isolated brachydactyly are rare, except for types A3 and D. Brachydactyly can occur either as an isolated malformation or as a part of a complex malformation syndrome. To date, many different forms of brachydactyly have been identified. Some forms also result in short stature. In isolated brachydactyly, subtle changes elsewhere may be present. Brachydactyly may also be accompanied by other hand malformations, such as syndactyly, polydactyly, reduction defects, or symphalangism. For the majority of isolated brachydactylies and some syndromic forms of brachydactyly, the causative gene defect has been identified. In isolated brachydactyly, the inheritance is mostly autosomal dominant with variable expressivity and penetrtance. Diagnosis is clinical, anthropometric and radiological. Prenatal diagnosis is usually not indicated for isolated forms of brachydactyly, but may be appropriate in syndromic forms. Molecular studies of chorionic villus samples at 11 weeks of gestation and by amniocentesis after the 14th week of gestation can provide antenatal diagnosis if the causative mutation in the family is known. The nature of genetic counseling depends both on the pattern of inheritance of the type of brachydactyly present in the family and on the presence or absence of accompanying symptoms. There is no specific management or treatment that is applicable to all forms of brachydactyly. Plastic surgery is only indicated if the brachydactyly affects hand function or for cosmetic reasons, but is typically not needed. Physical therapy and ergotherapy may ameliorate hand function. Prognosis for the brachydactylies is strongly dependent on the nature of the brachydactyly, and may vary from excellent to severely influencing hand function. If brachydactyly forms part of a syndromic entity, prognosis often depends on the nature of the associated anomalies.
Topics: Child, Preschool; Fingers; Foot; Foot Deformities, Congenital; Hand; Hand Deformities, Congenital; Humans; Infant; Pedigree; Radiography; Toes
PubMed: 18554391
DOI: 10.1186/1750-1172-3-15 -
Plastic and Reconstructive Surgery Jul 2016Congenital hand differences induce social, psychological, and functional challenges for children. However, little is known about how children perceive their outcomes... (Review)
Review
BACKGROUND
Congenital hand differences induce social, psychological, and functional challenges for children. However, little is known about how children perceive their outcomes after reconstructive or what concerns children have.
METHODS
A total of 33 children (aged 6 to 17 years) who were treated for congenital hand differences, and their parents, participated in qualitative, semistructured interviews regarding the child's hand function and appearance. Discussion focused on the influence of congenital hand differences on the child's daily activities, school, and participation in sports and music. The interviews were open format to allow for spontaneous emergence of relevant themes followed by guided questioning. The interviews were transcribed verbatim and analyzed using qualitative coding, iterative comparisons, and frequency analysis to reveal perceptions of children and parents.
RESULTS
In this sample, 73 percent of children and parents reported difficulty with hand function. Children experienced difficulties with personal care (58 percent), school activities (30 percent), and household tasks (27 percent). Children were bothered by hand appearance (48 percent), pain (30 percent), and weakness (24 percent). Complex anomalies were associated with greater disability and limitation in sports and music.
CONCLUSIONS
Children with congenital hand differences are concerned with the aesthetics of their hands and limitations in their ability to perform activities. Children were often discouraged by activities that their peers accomplished easily, but with increasing age demonstrated adaptive behaviors to accommodate in their "own way," suggesting the uniqueness of their limitations. Patients may benefit from early hand therapy guided toward areas of concern to enhance functional adaptation.
Topics: Adaptation, Psychological; Adult; Child; Hand; Hand Deformities, Congenital; Humans; Microsurgery; Parents; Quality Indicators, Health Care; Plastic Surgery Procedures
PubMed: 27348688
DOI: 10.1097/PRS.0000000000002286 -
Ugeskrift For Laeger Mar 2017Rheumatoid arthritis results in characteristic deformities of the hand. Medical treatment has undergone a remarkable development. However, not all patients achieve... (Review)
Review
Rheumatoid arthritis results in characteristic deformities of the hand. Medical treatment has undergone a remarkable development. However, not all patients achieve remission or tolerate the treatment. Patients who suffer from deformities and persistent synovitis may be candidates for hand surgery, for which the main goals are pain relief and improved function. Surgical interventions can be divided into prophylactic and therapeutic procedures. The treatment strategy is individual and depends on close collaboration between rheumatologists, hand surgeons and patients.
Topics: Arthritis, Rheumatoid; Arthrodesis; Arthroplasty; Hand Deformities, Acquired; Humans; Tenosynovitis; Wrist Joint
PubMed: 28330532
DOI: No ID Found -
The Pan African Medical Journal 2021
Topics: Animals; Hand Deformities; Humans; Limb Deformities, Congenital; Nephropidae
PubMed: 34804347
DOI: 10.11604/pamj.2021.40.80.26009 -
Clinical Genetics Jan 2019Split-hand/foot malformation (SHFM) is caused by mutations in TP63, DLX5, DLX6, FGF8, FGFR1, WNT10B, and BHLHA9. The clinical features of SHFM caused by mutations of... (Review)
Review
Split-hand/foot malformation (SHFM) is caused by mutations in TP63, DLX5, DLX6, FGF8, FGFR1, WNT10B, and BHLHA9. The clinical features of SHFM caused by mutations of these genes are not distinguishable. This implies that in normal situations these SHFM-associated genes share an underlying regulatory pathway that is involved in the development of the central parts of the hands and feet. The mutations in SHFM-related genes lead to dysregulation of Fgf8 in the central portion of the apical ectodermal ridge (AER) and subsequently lead to misexpression of a number of downstream target genes, failure of stratification of the AER, and thus SHFM. Syndactyly of the remaining digits is most likely the effects of dysregulation of Fgf-Bmp-Msx signaling on apoptotic cell death. Loss of digit identity in SHFM is hypothesized to be the effects of misexpression of HOX genes, abnormal SHH gradient, or the loss of balance between GLI3A and GLI3R. Disruption of canonical and non-canonical Wnt signaling is involved in the pathogenesis of SHFM. Whatever the causative genes of SHFM are, the mutations seem to lead to dysregulation of Fgf8 in AER cells of the central parts of the hands and feet and disruption of Wnt-Bmp-Fgf signaling pathways in AER.
Topics: Bone Morphogenetic Proteins; Fibroblast Growth Factor 8; Foot Deformities, Congenital; Gene Expression Regulation; Hand Deformities, Congenital; Homeodomain Proteins; Humans; Limb Deformities, Congenital; Mutation; Syndactyly; Wnt Signaling Pathway
PubMed: 30101460
DOI: 10.1111/cge.13434 -
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