middle+phalanx

A 54-year-old patient presented with progressive pain for one month in the second finger of the right hand with an emphasis on the proximal interphalangeal (PIP) joint. Subsequent magnetic resonance imaging (MRI) showed a diffuse intraosseous lesion at the base of the middle phalanx with destruction of the cortical bone and extraosseous soft tissue. An expansively growing chondromatous bone tumor, e.g., a chondrosarcoma, was suspected. After incisional biopsy, the pathologic findings finally revealed, surprisingly, a metastasis of a poorly differentiated non-small cell adenocarcinoma of the lung...

Injuries of the hand's flexor tendons carry a poor prognosis, mainly if they are in zone II (also called 'the critical zone' or 'no man's land'). The superficial tendon in this zone ends by bifurcating and attaching to the sides of the middle phalanx, exposing the deep tendon that attaches to the distal phalanx. Thus, trauma to this zone may result in a complete cut to the deep tendon while the superficial one remains intact. The lacerated tendon, in turn, would be retracted proximally to the palm making it difficult to be found during wound exploration...

While children undergo skeletal maturation, it is difficult to distinguish between normal variants and abnormalities of the epiphysis and acrophysis on radiological images. Abnormalities in the epiphysis and acrophysis of the toe phalanx have not been reported yet. Here, we describe a series of abnormalities in the epiphysis and acrophysis of the fourth and fifth toe phalanges, including an investigation of their pathogenesis. We evaluated patients suspected of having bone tumors at a local orthopedic clinic because of abnormal findings of the toe phalanx between the distal and middle phalanx on plain radiographs...

BACKGROUND: The digital artery-based V-Y advancement flap is a widely used flap for soft tissue coverage in the treatment of flexion contracture of the proximal interphalangeal (PIP) joint. A standard method for the flap design and a mathematical method to predict the advance distance have not been well established. In this study, we proposed a simplified method for the design of V-Y advancement flaps based on digital arteries and used a geometric model to predict the advance distance for the flexion contracture correction surgery...

BACKGROUND: There are very few studies comparing patients with and without repair after digital nerve injury. It is still controversial whether digital nerve repair is necessary. AIMS: The aim of this study was to evaluate the long-term clinical outcomes of patients with unilateral isolated digital nerve injury who underwent surgical repair and those who did not. METHODS: Seventy-four patients with unilateral digital nerve injury were included in the study...

INTRODUCTION: Fracture configuration is often more complex than is radiographically appreciable. The objective of this study is to describe the influence of pre-operative computed tomography (CT) for surgical planning in a variety of fracture types. This has not been described in previous studies. MATERIALS AND METHODS: All cases with pre-operative radiographs, admitted for CT and surgical repair of a suspected limb fracture from January 2010-December 2020 were reviewed...

PURPOSE: Proximal interphalangeal joint (PIPJ) fracture dislocations are complex injuries that can result in persistent pain, stiffness, and angulation. Hemihamate arthroplasty (HHA) can be used to reconstruct the base of the middle phalanx in cases of unstable PIPJ fracture dislocations. Despite previous case series describing good outcomes with HHA, it has not gained widespread use. The purpose of this study is to describe our straightforward, reproducible technique and to demonstrate the benefit in motion after the procedure in chronic unstable PIPJ fracture dislocations...

Systemic sclerosis (SSc)-related digital ischaemia is a major cause of morbidity, resulting from a combination of microvascular and digital artery disease. Photoacoustic imaging offers a newly available, non-invasive method of imaging digital artery structure and oxygenation. The aim of this study was to establish whether photoacoustic imaging could detect and measure vasculopathy in digital arteries, including the level of oxygenation, in patients with SSc and healthy controls. 22 patients with SSc and 32 healthy controls (HC) underwent photoacoustic imaging of the fingers...

OBJECTIVE: The objective of this study was to evaluate epidemiological and anatomical characteristics of children with congenital thumb duplication (CTD). METHODS: We retrospectively reviewed 2108 children with CTD. Data regarding sex, age at the surgery, laterality, uni- or bilateral involvement, and dominant side were retrieved from the medical charts. Plain radiographs were used to classify all CTD according to Wassel-Flatt, Rotterdam and Chung classification systems and to evaluate the patho-anatomy of the duplication as well as the presence of associated anomaly...

PURPOSE: To investigate the volar anatomy of the middle phalanges of the hand; in particular, to define the presence and depth of a volar midline longitudinal groove. METHODS: Measurements were performed at 5 equidistant points along the shafts of 60 skeletonized middle phalanges from 15 cadaveric hands. The thickness at the midline of each phalanx was subtracted from the maximal dorsovolar thickness to indicate the presence or absence of a groove at each point...

Giant cell tumour of the tendon sheath (GCTTS) is a rare benign soft tissue tumour with no known cause. It is more prevalent in the hand than in the ankle and foot. It appears as a non-painful, perceptible enlargement. Although pre-operative imaging and fine-needle aspiration cytology (FNAC) corroborate suspicion, histology following surgical resection is used to confirm the diagnosis. Due to its rarity, a case of giant cell tumour (GCT) of the extensor tendon sheath of the left ring finger is reported here...

Objectives: Ascertain the radiographic prevalence and variation in characteristics of juvenile osteochondral conditions (JOC) in the proximal interphalangeal joint (PIPJ) of Australian Thoroughbred racehorse yearlings. Establish whether there are any significant associations with public auction sale results and racing performance. Methods: Retrospective evaluation of 1,098 yearling repository radiograph sets. Comparison of sales results and whole career racing performance of the case group with two control groups: maternal siblings ( N = 397) and yearlings without PIP JOC ( N = 391)...

INTRODUCTION: Treatment of choice for posttraumatic arthritis in proximal interphalangeal (PIP) joints has remained a controversial subject. There is a lack of consensus regarding the optimal approach and treatment options for PIP joint arthritis. In this study, we report our experience in management of PIP joint arthritis using soft-tissue interpositional arthroplasty. CASE PRESENTATION: A 12-year-old female, right-handed, complains of stiffness on the left ring finger...

INTRODUCTION: Flexor tendon sheath infection may be due to trauma, laceration, or bites, commonly directly inoculating the sheath. Kanavel cardinal signs in flexor tendon sheath infection cases consist of symmetrical swelling of the entire digit, a digit with semi-flexed posture, exquisite tenderness along the course of the tendon sheath, and pain with attempted passive extension of the digit. Elevated levels of inflammation markers such as white blood cell count, erythrocyte sedimentation rate, and C-reactive protein are often found in such cases...

INTRODUCTION: Despite the substantial prevalence of skeletal Class II Division 1 malocclusion, only a few studies analyzed the maxillomandibular growth changes in these subjects with contrasting results. This study compared the longitudinal maxillomandibular growth changes in growing subjects with Class I and II skeletal relationships, specifically during the circumpubertal growth phase assessed by the modified third finger middle phalanx maturation (MPM) method. An attempt to uncover any maxillomandibular growth peak in subjects with Class II relationship has been followed...

BACKGROUND: Osteoporosis is a condition characterized by low bone mineral density, which typically leads to fractures and reduced quality of life. Currently, diagnostic devices used to assess this condition (e.g., dual-energy X-ray absorptiometry) are very costly, making it infeasible to meet the demand for testing in most countries. Therefore, we proposed a preclinical validation of a prototype called Osseus in an attempt to enhance osteoporosis screening tests and alleviate their costs...

In this study, we developed a modularized proximal interphalangeal (PIP) joint implant that closely resembles the anatomical bone articular surface and cavity contour based on computed tomography (CT) image reconstruction. Clouds of points of 48 groups reconstructed phalanx articular surfaces of CT images, including the index, middle, ring, and little fingers, were obtained and fitted to obtain the articular surface using iterative closest points algorithm. Elliptical-cone stems, including the length, the major and minor axis at the stem metaphyseal/diaphyseal side for the proximal and middle phalanxes, were designed...

BACKGROUND: Due to the functional coupling of adjacent finger joints and the quadriga effect, arthrodesis of the proximal interphalangeal joint (PIPJ) can be assumed to lead to a different grip pattern resulting in altered force distribution of the hand. PATIENTS AND METHOD: Ten patients with isolated arthrodesis of the PIPJ due to posttraumatic osteoarthritis (4×PIPJ II, 4×PIPJ III, 2×PIPJ IV) were assessed 59 (17-121) months postoperatively on average. The angle of arthrodesis was assessed by radiographs...

Fusion of the proximal interphalangeal joint (PIPJ) after failed arthroplasty may be challenging in view of bone loss at the ends of the proximal phalanx and the middle phalanx. This might require the use of a structural bone graft to fill the defect and avoid shortening of the digit. Although several methods have been described for primary PIPJ fusion, none of these methods addresses bone loss at this joint. We use a tricortical iliac crest bone graft fashioned to provide the required angulation at the fusion site...

BACKGROUND: The purpose of this study was to review the rate and type of infectious complications after surgical fixation of hand fractures managed under wide-awake local anesthesia with no tourniquet (WALANT) in minor procedure rooms outside the main operating room. METHODS: A two-surgeon retrospective chart review was performed of patients who received surgical fixation of hand fractures under WALANT in minor surgery from March of 2014 to March of 2019. RESULTS A TOTAL OF: patients, with distal phalanx ( n = 16), middle phalanx ( n = 7), proximal phalanx ( n = 11), or metacarpal ( n = 26) fractures, were included in the study...