OWL: OCOSH Classification/Hand Disorders and Deformities/Acquired Hand Deformities

Arthritis - Rheumatoid arthritis Hand

Charles Eaton — 2002-01-31 00:15:38 GMT

Clinical and x-ray images of hands, fingers and thumbs affected by rheumatoid arthritis

Arthritis- Rheumatoid arthritis with DRUJ and radiocarpal involvement

Charles Eaton — 2002-01-31 00:15:38 GMT

Rheumatoid arthritis has many forms of presentation. This patient has bilateral severe radiocarpal and distal radioulnar joint involvement, with relative sparing of the metacarpophalangeal and interphalangeal joints.

Arthritis- Rheumatoid thumb IP fusion with a Herbert screw

Charles Eaton — 2002-01-31 00:15:38 GMT

There are many methods to fuse interphalangeal joints. In this case, a Herbert screw was used for arthrodesis fixation of an unstable thumb interphalangeal joint. This case also demonstrates the eponychial splitting approach to the joint.

Boutonniere Deformity eMedicine Orthopedics

Likes & Ghidella — 2008-03-31 00:15:38 GMT

Boutonni�re deformity (BD) can manifest acutely following trauma, but most BDs are found weeks following the injury or as the result of progressive arthritis. The proximal interphalangeal (PIP) joint of the finger is flexed, and the distal interphalangeal (DIP) joint is hyperextended (see Image 1). Treatment options depend partly on etiology of the deformity and are discussed in the sections to follow.
Synonyms and related keywords: BD, buttonhole deformity
Likes & Ghidella 2008

Boutonniere Deformity Orthopaedia

Not Available — 2009-07-07 00:15:38 GMT

Among the many osseous abnormalities that may be seen in Rheumatoid Arthritis, the boutonniere deformity is the culmination of multiple abnormalities in the hand. Specifically, the deformity arises from hyperextension of the distal interphalangeal joint, while the proximal interphalangeal joint is flexed.

Intrinsic Hand Deformities eMedicine Orthopedics

Danikas, Neumeister & Nolan — 2008-04-03 00:15:38 GMT

Account of anatomy, nerve supply and injuries to the hand resulting in instrinsic deformity.
Synonyms and related keywords: claw hand deformity, claw-hand deformity, clawhand deformity, contractures of the hand, extrinsic tightness, Froment sign, Froment's sign, hand contractures, hand therapy, intrinsic muscles of the hand, intrinsic tightness test, median nerve injury, median nerve paresis, radial nerve paresis, ulnar nerve injury, ulnar nerve paresis, boutonniere deformity, opponensplasty
Danikas, Neumeister & Nolan 2008

Intrinsic Plus Hand eMedicine Orthopedics

Gillespie & Wilhelmi — 2008-04-03 00:15:38 GMT

The intrinsic plus position is otherwise known as the safe position for hand splinting. The hand can be immobilized in this position for long periods of time without developing as much stiffness as would occur if the digits were positioned differently. In the intrinsic plus position, the metacarpophalangeal (MP) joints are flexed at 60-70�, the interphalangeal (IP) joints are fully extended, and the thumb is in the fist projection. The wrist is held in extension at 10� less than maximal.
Synonyms and related keywords: intrinsic plus position, safe position for hand splinting, hand immobilization, hand stiffness, intrinsic contractures, hand deformity, hand disability, intrinsic muscle contracture, intrinsic tightness test, intrinsic plus test
Jessica Gillespie, MD & Bradon J Wilhelmi, MD 2005

Mallet Finger eMedicine Orthopedics

Roy A Meals, MD — 2008-04-03 00:15:38 GMT

Loss of extensor tendon continuity at the distal interphalangeal joint (DIPJ) causes the joint to rest in an abnormally flexed position. This occurs with a laceration to the dorsum of the digit near the DIPJ. Mallet finger describes the condition in which the skin remains closed and the extensor tendon is either forcibly stretched or avulsed from the distal phalanx.
Synonyms and related keywords: baseball finger, dropped finger
Author: Roy A Meals, MD

Mallet Fracture eMedicine Sports

Michael E Robinson, MD — 2008-04-03 00:15:38 GMT

The term mallet finger has long been used to describe the deformity produced by disruption of the terminal extensor mechanism at the distal interphalangeal (DIP) joint.1, 2, 3 Mallet finger is the most common closed tendon injury that is seen in athletes; this injury is also common in nonathletes after "innocent" trauma. Mallet finger has also been referred to as drop, hammer, or baseball finger (although baseball accounts for only a small percentage of such injuries).
Synonyms and related keywords: baseball finger, drop finger, hammer finger, swan-neck deformity, mallet finger/deformity
Author: Michael E Robinson, MD 2007

Offsetting Hand and Upper Limb Problems in Cerebral Palsy

Abram E. Kirschenbaum, MD — 2009-08-07 00:15:38 GMT

Upper extremity involvement in cerebral palsy interferes with optimal use of the hands. Contractures of the elbows, for example, may interfere with the ability to position the hands in space. Mild to moderate wrist contractures may interfere with grasp and release and limit use of the affected hand as an assisting hand. Severe wrist contractures may interfere with dressing as a stiff flexed wrist is hard to get through a shirt or coat sleeve.

Reconstruction- Digital Extensor Tenolysis

Charles Eaton — 2002-01-31 00:15:38 GMT

Stiffness of the fingers is a common problem following either closed or open injury. The moving parts of fingers are often glued together by scar tissue following injury, and if movement can not be recovered through therapy and time, and if all other conditions are favorable (wound maturation, patient motivation, available therapy, absence of infection or mechanical impediment, etc. ), tenolysis may be helpful. A practical guideline is that the expected final active range of motion will be halfway between the preoperative active and passive ranges of motion. These cases illustrate extensor tenolysis at the proximal and distal interphalangeal joints after open injury.

Rheumatoid Hand eMedicine Plastics

Neumeister, Nguyen & Wilhelmi — 2008-04-03 00:15:38 GMT

Rheumatoid arthritis (RA) is a systemic disease that affects synovial tissue. The disease affects approximately 1% of the population, has a female predominance (female-to-male ratio of 2.5:1), and shows increased incidence with age.1 The clinical course of the disease is variable and ranges from mild, self-limited arthritis to a progressive multisystem disease.
The surgical treatments for RA include synovectomy, tenosynovectomy, tendon realignment, reconstructive surgery or arthroplasty, and arthrodesis. The main goals for surgical treatment of RA are alleviation of pain, improvement of function, retardation of the progression of the disease, and improvement of appearance.
Synonyms and related keywords: rheumatoid arthritis, RA, arthritis, rheumatism, synovial hypertrophy, matrix metalloproteinase, MMP, tumor necrosis factor-alpha, TNF-alpha, TNF-a, interleukin-1, IL-1, synovectomy, tenosynovectomy, tendon realignment, reconstruction surgery, arthroplasty, arthrodesis, tenosynovitis, paratenon, synovium, metacarpophalangeal joint, MP joint, MCP joint, rheumatoid nodule, trigger finger, finger triggering, tendon rupture, swan neck deformity, swan-neck deformity, boutonniere deformity, skier's thumb, gamekeeper's thumb, skiers thumb, gamekeepers thumb, hand deformity, synovial proliferation, synovial inflammation, carpal tunnel release, Vaughn-Jackson lesion, caput ulna syndrome
Neumeister, Nguyen & Wilhelmi 2008

Swan Neck Deformity eMedicine Orthopedics

Sandoval — 2008-04-03 00:15:38 GMT

Structural deformities of the digits of the hand are common in patients with rheumatoid arthritis (RA). A swan-neck deformity, typically defined as proximal interphalangeal (PIP) joint hyperextension with concurrent distal interphalangeal (DIP) joint flexion, occurs in approximately 50% of patients with RA. However, swan-neck deformity is not unique to RA, because it may also be congenital or traumatic in nature. Multiple surgical procedures are available for the correction of this digital abnormality. The deformity of the finger or fingers must be staged accurately to use the most appropriate surgical technique. The staging of the deformed finger is based on the condition of the articular cartilage�which is determined by radiography�and on the flexibility of the PIP joint.
Synonyms and related keywords: volar plate synovitis, synovitis of capsule, collateral ligament synovitis, finger deformity, arthritis, rheumatoid arthritis, hand deformity, finger deformity, rheumatoid factor, rheumatoid hand, RA, tenosynovitis, swan neck deformity, boutonniere deformity Author: Roberto Sandoval, MD 2007

Transformation- Boutonniere deformity

Charles Eaton — 2002-01-31 00:15:38 GMT

Clinical images of Boutonniere Deformity

Transformation- Swan neck finger deformity

Charles Eaton — 2002-01-31 00:15:38 GMT

Clinical and x-ray images of fingers with swan neck deformity