Background: Osteoarthritis (OA) is a disabling disease that can affect 6% to 12% of the adult population and more than a third of people over 65 years of age. Purpose: To assess whether a group of people with hand ost...Background: Osteoarthritis (OA) is a disabling disease that can affect 6% to 12% of the adult population and more than a third of people over 65 years of age. Purpose: To assess whether a group of people with hand osteoarthritis (hOA) who received different types of treatment improved their function after two years of follow-up. Method: The entire sample (n = 97) underwent three follow-up assessments regarding anthropometric parameters of the upper limbs and ability to perform functional activities. Subsequently, the sample was divided into two groups for the intervention periods, called the First Period (n = 73) and the Second Period (n = 24);the First Period kept the same protocol with orientations, and the Second Period went to an intervention with orientation strength exercises and use of orthosis. Findings: In the separate analysis of the three questions of the DASH pain module, no differences were found between the assessment moments for groups of guidelines, treatment, or symptoms. Significant effects were observed for F(2, 162) = 3.5, p = 0.033, η2 = 0.04, and interaction for moments and intervention F(2, 162) = 4.3, p = 0.016, η2 = 0.05. Implications: It can be concluded that only guidance treatment does not benefit patients with hand osteoarthritis. In contrast, guidance, exercise, and orthosis treatment can significantly improve the disease.展开更多
Objective: To evaluate the prevalence of hand osteoarthritis (hOA) in a population with knee osteoarthritis (KOA) at baseline and one year following the administration of a multi-professional OA educational program co...Objective: To evaluate the prevalence of hand osteoarthritis (hOA) in a population with knee osteoarthritis (KOA) at baseline and one year following the administration of a multi-professional OA educational program correlating symptoms and changes in BMI with function questionnaires of the upper limbs and direct grip strength measurements. Design: Epidemiological study of the prevalence of hand OA in patients with knee osteoarthritis. The Stanford Health Assessment Questionnaire instruments (HAQ);Disabilities of the Arm, Shoulder and Hand* (DASH);grip strength;and finger pinch were utilized, and the upper limbs symptoms were verified at baseline and one year following the educational program. Results: The prevalence of hOA was 23.7% at baseline and 47.4% at one year (incidence of 31.8% per year). The HAQ indicated that patients who did not alter or increased their BMI experienced worsened global strength, whereas patients who reduced BMI improved global strength (p = 0.041). Patients with higher initial BMIs experienced less improvement in the HAQ (r = -0.148, p = 0.041). The DASH results improved, but the right and left tripod grip worsened in all patients, irrespective of BMI change (p < 0.05) or symptoms at baseline and reassessment (p < 0.05). Pinch strength (right and left tripod and left pulp-pulp) was higher in patients without symptoms at baseline (p = 0.048, p = 0.045 and 0.033, respectively). Conclusions: The prevalence of hand OA increased for patients with OA undergoing an educational program irrespective of improved upper function and regardless of BMI change. Patients who decreased their BMI improved their global strength.展开更多
Preaxial polydactyly is a common congenital anomaly of the hand presenting at birth.Surgical treatment is aimed at creating a functional thumb capable of normal grip and pinch strength with acceptable aesthetics.Each ...Preaxial polydactyly is a common congenital anomaly of the hand presenting at birth.Surgical treatment is aimed at creating a functional thumb capable of normal grip and pinch strength with acceptable aesthetics.Each case is unique and presents individual challenges to the hand surgeon.The aim of this review is to provide a synopsis of current knowledge and recommended surgical techniques for the duplicated thumb.展开更多
Objective： Interphalangeal joint con- tracture is a challenging complication of hand trauma, which reduces the functional capacity of the entire hand. In this study we evaluated the results of soft tissue distraction...Objective： Interphalangeal joint con- tracture is a challenging complication of hand trauma, which reduces the functional capacity of the entire hand. In this study we evaluated the results of soft tissue distraction with no collateral ligament transection or volar plate removal in comparison with traditional operation of contracture re- lease and partial ligament transection and volar plate removal. Methods： In this prospective study, a total of 40 pa- tients in two equal groups （A and B） were studied. Patients suffering from chronic flexion contracture of abrasive trau- matic nature were included. Group A were treated by soft tissue distraction using pentagonal frame technique and in Group B the contracture release was followed by finger splinting. Results： Analyzed data revealed a significant differ- ence between the two groups for range of motion in the proximal interphalangeal joints （P〈0.05）, while it was not meaningful in the distal interphalangeal joints （P〉0.05）. There was not a significant difference in the degrees of flexion contracture between groups （P〉0.05）. Regression analysis showed that using pentagonal frame technique significantly increased the mean improvement in range of motion of proxi- mal interphalangeal joints （P〈0.001）, while the higher the preoperative flexion contracture was observed in proximal interphalangeal joints, the lower improvement was achieved in range of motion of proximal interphalangeal joints after intervention （P〈0.001）. Conclusion： Soft tissue distraction using pentagonal frame technique with gradual and continuous collateral liga- ment and surrounding joint tissues distraction combined with skin Z-plasty significantly improves the range of mo- tion in patients with chronic traumatic flexion deformity of proximal and/or distal interphalangeal joints.展开更多
文摘Background: Osteoarthritis (OA) is a disabling disease that can affect 6% to 12% of the adult population and more than a third of people over 65 years of age. Purpose: To assess whether a group of people with hand osteoarthritis (hOA) who received different types of treatment improved their function after two years of follow-up. Method: The entire sample (n = 97) underwent three follow-up assessments regarding anthropometric parameters of the upper limbs and ability to perform functional activities. Subsequently, the sample was divided into two groups for the intervention periods, called the First Period (n = 73) and the Second Period (n = 24);the First Period kept the same protocol with orientations, and the Second Period went to an intervention with orientation strength exercises and use of orthosis. Findings: In the separate analysis of the three questions of the DASH pain module, no differences were found between the assessment moments for groups of guidelines, treatment, or symptoms. Significant effects were observed for F(2, 162) = 3.5, p = 0.033, η2 = 0.04, and interaction for moments and intervention F(2, 162) = 4.3, p = 0.016, η2 = 0.05. Implications: It can be concluded that only guidance treatment does not benefit patients with hand osteoarthritis. In contrast, guidance, exercise, and orthosis treatment can significantly improve the disease.
文摘Objective: To evaluate the prevalence of hand osteoarthritis (hOA) in a population with knee osteoarthritis (KOA) at baseline and one year following the administration of a multi-professional OA educational program correlating symptoms and changes in BMI with function questionnaires of the upper limbs and direct grip strength measurements. Design: Epidemiological study of the prevalence of hand OA in patients with knee osteoarthritis. The Stanford Health Assessment Questionnaire instruments (HAQ);Disabilities of the Arm, Shoulder and Hand* (DASH);grip strength;and finger pinch were utilized, and the upper limbs symptoms were verified at baseline and one year following the educational program. Results: The prevalence of hOA was 23.7% at baseline and 47.4% at one year (incidence of 31.8% per year). The HAQ indicated that patients who did not alter or increased their BMI experienced worsened global strength, whereas patients who reduced BMI improved global strength (p = 0.041). Patients with higher initial BMIs experienced less improvement in the HAQ (r = -0.148, p = 0.041). The DASH results improved, but the right and left tripod grip worsened in all patients, irrespective of BMI change (p < 0.05) or symptoms at baseline and reassessment (p < 0.05). Pinch strength (right and left tripod and left pulp-pulp) was higher in patients without symptoms at baseline (p = 0.048, p = 0.045 and 0.033, respectively). Conclusions: The prevalence of hand OA increased for patients with OA undergoing an educational program irrespective of improved upper function and regardless of BMI change. Patients who decreased their BMI improved their global strength.
文摘Preaxial polydactyly is a common congenital anomaly of the hand presenting at birth.Surgical treatment is aimed at creating a functional thumb capable of normal grip and pinch strength with acceptable aesthetics.Each case is unique and presents individual challenges to the hand surgeon.The aim of this review is to provide a synopsis of current knowledge and recommended surgical techniques for the duplicated thumb.
文摘Objective： Interphalangeal joint con- tracture is a challenging complication of hand trauma, which reduces the functional capacity of the entire hand. In this study we evaluated the results of soft tissue distraction with no collateral ligament transection or volar plate removal in comparison with traditional operation of contracture re- lease and partial ligament transection and volar plate removal. Methods： In this prospective study, a total of 40 pa- tients in two equal groups （A and B） were studied. Patients suffering from chronic flexion contracture of abrasive trau- matic nature were included. Group A were treated by soft tissue distraction using pentagonal frame technique and in Group B the contracture release was followed by finger splinting. Results： Analyzed data revealed a significant differ- ence between the two groups for range of motion in the proximal interphalangeal joints （P〈0.05）, while it was not meaningful in the distal interphalangeal joints （P〉0.05）. There was not a significant difference in the degrees of flexion contracture between groups （P〉0.05）. Regression analysis showed that using pentagonal frame technique significantly increased the mean improvement in range of motion of proxi- mal interphalangeal joints （P〈0.001）, while the higher the preoperative flexion contracture was observed in proximal interphalangeal joints, the lower improvement was achieved in range of motion of proximal interphalangeal joints after intervention （P〈0.001）. Conclusion： Soft tissue distraction using pentagonal frame technique with gradual and continuous collateral liga- ment and surrounding joint tissues distraction combined with skin Z-plasty significantly improves the range of mo- tion in patients with chronic traumatic flexion deformity of proximal and/or distal interphalangeal joints.
