Simultaneous double dislocation of the interphalangeal joint in one finger

Isolated traumatic dislocation of the distal and proximal interphalangeal .joints of fingers is a common occurrence. However, simultaneous double dislocation of the interphalangeal ,joints in one finger is rare. Here we report one case of simultaneous dorsal dislocation of both interphalangeal .joints in the little finger with a review of the literature.

Distraction ligamentotaxis for complex proximal interphalangeal joint fracture dislocations:a clinical study and themodified pins rubber band traction system revisited

Background:The purpose of this study is to present our experience with the modified pins and rubber band traction system, discuss problems encountered, and make recommendations to optimize outcomes. Methods:Data was collected prospectively from November 2013 to March 2017 at a tertiary referral hospital in Melbourne, Australia. Patients with closed complex proximal interphalangeal joint fracture dislocations that were considered unsuitable for other surgical options were included in the study. Patients underwent dynamic skeletal distraction using the modified (Deshmukh) pins rubber band traction system. Outcomes were measured using the Nominal Rating Scale for pain;Disabilities of the Arm, Shoulder, and Hand (DASH) score;active and passive range of motion;patient rating scale;and complications. Results:Twenty patients underwent the procedure, and 19 were included in analyses. At the final follow-up assessment, an average of 62° and 77° was achieved for proximal interphalangeal joint active and passive range of motion, respectively. Pain levels were low (median score of 0 at rest and 1 ranging, out of 10). Four patients suffered minor pin site infections. Conclusion:Distraction ligamentotaxis is a useful part of the armamentarium, especially in the absence of more suitable procedures. It is important to select appropriate patients, educate, and ensure adherence to postoperative therapy. Employing the Deshmukh frame modification streamlines the theatre processes, and removal of wires at approximately 4 weeks minimizes risk of pin site infection.

Septic arthritis of the hand:Current issues of etiology,pathogenesis,diagnosis,treatment

Septic arthritis of the hand is a serious disease that often results in dysfunction of the joint or even the need to perform amputation of the finger.They rank second in the frequency of occurrence after lesions of the knee joint.Many points concerning the etiology,the timing of the development of cartilage destruction and the development of osteomyelitis,approaches to surgical treatment,the duration of antibiotic therapy,and the start of rehabilitation measures remain the subject of numerous discussions.Based on a search in the PubMed,Web of Science and Google Scholar databases down to 1990-2021,publications on septic arthritis of the hand were found and analyzed.The following inclusion criteria were used in our review:(1) Septic arthritis of the hand;(2) Published in a peer review journal;(3) Written in English;and(4) Full text version available.Studies were excluded if they met any of the following criteria:(1) Letters;(2) Articles published in abstract form only;and(3) Cadaveric studies.Septic arthritis of the hand was characterized by the most frequent damage to the joints of the index and middle fingers(> 50% of cases).Up to 90% of cases,the infection enters the joint as a result of penetrating trauma,animal bites,etc.Staphylococcus aureus became the most frequently isolated microorganism(30%-55%),and its polyantibiotic-resistant form Methicillin-resistant Staphylococcus aureus was found,according to various sources,from 0% to 73% among all isolated Staphylococcus aureus.In arthritis,Pasteurella multocida(6%-11%) is often isolated as a result of animal bites.Articular cartilage destruction in the experiment developed within 24-48 h after infection.In clinical studies,the development of osteomyelitis was noted when treatment was delayed by more than 10 d.X-ray data during the first two weeks were uninformative.Priority of surgical treatment of septic arthritis.Drainage and surgical treatment,and with the development of osteomyelitis,the implementation of arthrodesis.Antibacterial therapy for 2-4 wk and early start of rehabilitation measures.Timely surgical treatment in combination with antibiotic therapy and rehabilitation makes it possible to obtain a positive result in the treatment of septic arthritis of the hand.

An Isolated Case of Brachyphalangism of the Basal Finger Bones of the Little Finger with Symptoms of Tenosynovitis: A Case Report

Brachydactyly is a general term that refers to disproportionately short fingers and toes and forms a part of the group of limb malformations characterized by bone dysostosis. Brachydactyly usually occurs either as an isolated malformation or as a part of a complex malformation syndrome. Brachydactyly is classified as types A, B, C, D, or E;brachymetatarsus IV;Sugarman brachydactyly;or Kirner deformity. Various types of isolated brachydactyly are rare, except for types A3 and D. We describe a 15-year-old girl with isolated brachyphalangism of the basal finger bones of the little finger with symptoms of tenosynovitis. Tenosynovitis might be caused by growth deviation between the flexor digitorum superficialis and the flexor digitorum profundus. The patient responded very well to surgical treatment.

The Pathognomic Radiologic Features of Gout in the Fingers and Review of the Literature, Including the Latest Drug Therapy

Gout is one of the most common inflammatory arthritides that predominantly affects the first metatarsophalangeal joint. The underlying inflammatory process is elicited by the deposition of monosodium urate (MSU) crystals in the affected joint that are termed tophi and which may in the course of chronic gout progress into subcutaneous depositions of tophi. In this case report, we present a patient (PID: 6925981) who was seen in our outpatient department with a first episode of tophaceous gout in the finger, an infrequently seen condition that mostly affects older men with long-term gout. We discuss the case in view of the current literature on diagnosis and treatment of tophaceous gout.

Anatomical and clinical study of a new mallet fracture classification method

Background:Mallet fracture is avulsion of the terminal extensor tendon from the base of the distal phalangeal bone with a fragment.This study was performed to evaluate the anatomical characteristics of mallet fractures,invest电ate a new mallet fracture classification system using anatomical and imaging methods,and discuss the treatment schemes for different types of mallet fracture.Methods:Sixty-four fresh cadaveric fingers were divided into four groups,and models of different types of mallet fracture with distal interphalangeal joint instability were established by dissecting 25%,50%,75%,and 100% of the bilateral collateral ligaments.The the stability of the distal interphalangeal joint was them observed.The lateral radiographs of mallet fractures in 168 patients were analyzed and classified according to the involvement of the joint surface in the fracture,the thickness of fracture,the untreated time after injury,and the complication of distal interphalangeal joint palmar subluxation.Forty-seven patients were surgically treated by reconstruction of extensor tendon insertion,the Ishiguro method,or single Kirschner wire fixation.Results:The established mallet fracture model showed that the distal interphalangeal joint was stable when the bilateral collateral effect of mallet fractures on was then observed.The lateral radiographs of mallet ligaments were cut off by 25%(t=-0.415,P=0.684)and significantly unstable when this range was≥50%(50% transection:t=-6.363,P<0.001;75% transection:t=-17.036,P<0.001;100%transection:t=-30.977,P<0.001,respectively).The mallet fractures were divided into Types Ⅰ,Ⅱ,and Ⅲ(fracture involving<20%,20%-50%,and>50% of the joint surface,respectively).Type Ⅱ was further divided into Tpes Ⅱa and Ⅱb according to whether the course of injury was<or≥2 weeks,respectively.The mean post-operative flexion of the distal interphalangeal joint was 63.4°±7.9°,and the mean extension lag was 6.7°±4.6°.Conclusions:The lateral collateral ligament is the main factor that maintains the stability of the distal interphalangeal joint.Type Ⅱ was further divided into Types Ⅱa and Ⅱb according to whether the course Classification that combines the involvement of the joint surface in the fracture,the thickness of the fracture,and the untreated time after injury is reasonable and will help to choose an appropriate operational method.