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Dupuytren's Contracture/Palmar Fibromatosis
Published in Charles Theisler, Adjuvant Medical Care, 2023
Dupuytren’s contracture causes bundles of connective tissue fibers (palmer and digital fascia) on the palm side of the hand to thicken and harden. As the cords tighten over time, they become shorter, typically resulting in one or two fingers (most often the fourth and fifth digits of both hands) being pulled into a permanently bent position at the metacarpal-phalangeal junction, resulting in hand deformity. The disorder is essentially painless but results in abnormal appearance and loss of function.
Introduction
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
The hand and wrist have 27 bones. The thumb has the shortest metacarpal articulating with the proximal phalanx to perform various vital functions (Figure 1.8). It has two phalanges and one metacarpal articulating with the trapezium. The trapezium is angled out in front of the carpal plane. The angle made by the first metacarpal to the second is about 45°, and this is the reason for more delicate movements of thumb in the given circumstances (Figure 1.9). The index, middle, ring and little fingers have an unequal length with one metacarpal and three phalanges each (Table 1.2).
Other Complications of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Signs and symptoms of carpal tunnel syndrome include hand and wrist pain, tingling, numbness, along the path of the median nerve. Sometimes, the entire hand is affected. The patient often wakes up at night with aching or burning pain, numbness, and tingling. Shaking the hand back and forth can relieve the pain and restore normal sensation. Later in the disease course, there may be thenar atrophy, and weakness of thumb opposition and abduction. Dupuytren contracture begins with tender palm nodules usually near the pinky or ring finger that gradually become painless. A superficial cord then forms, contracting the metacarpophalangeal joints and interphalangeal joints, resulting in arching of the hand. There may be fibrous thickening of the dorsum of the proximal interphalangeal joints. With diabetes, there can also be locked trigger fingers, systemic sclerosis, chronic reflex sympathetic dystrophy, and an ulnar claw hand.
Clinical effects of resurfacing fingertip amputations in long fingers using homodigital dorsal neurofascial broaden pedicle island flaps
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Zhongqing Ji, Rongjun Nie, Shiyan Li, Chuancheng Liu, Bin Wei, Chunyong Zhu
After rigorous screening, follow-up was available for 17 patients (14 males and 3 females, mean age: 44.7 ± 12.9 years) and 18 long fingers. The mean follow-up was 16.6 ± 4.0 months (range: 12–25 months). 13 fingers were on the left hand (72.2%) and 5 on the right hand (27.8%). The operations involved 6 index fingers (33.3%), 6 middle fingers (33.3%), 4 ring fingers (22.3%), and 2 little fingers (11.1%). The average size of fingertip defects was 1.11 × 1.13 cm (range: 0.6 × 1.0–2.0 × 1.8 cm). The mean flap size was 1.32 × 1.32 cm (range: 0.8 × 1.2–2.3 × 2.0 cm). Mean nutrient stripe length was 4.18 ± 0.34 cm (range: 3.4 − 4.6 cm). Mean broaden pedicle length was 0.44 ± 0.08 cm (range: 0.3 − 0.5 cm). Mean operating time was 123 ± 32 min (range: 90–185 min). The main etiology for fingertip wounds was crush amputations (55.6%) and clear-cut injuries (44.4%) (Tables 1 and 2). All flaps survived. One flap showed partial necrosis and two cases showed tension blister but healed with wound care. No wound infections were observed.
Clinical features and management of animal bites in an emergency department: a single-center experience
Published in Postgraduate Medicine, 2023
Orkun Aydin, Elif Tugce Aydin Goker, Zeynep Aybuke Arslan, Halil Mustafa Sert, Ozlem Teksam
After sixty-two patients were excluded as they had missing data, a total of 419 patients were included. 240 (57.2%) of the patients were male, and the median age was nine years (IQR 5–14). When patients were classified into age groups using a standard classification [14], most patients were seen in the 12–18 age group (40.3%). Regarding the seasonal distribution, most patients were seen during summer (Table 2). 51.5% of the patients (n = 216) had contacted dogs, and 47.4% had contacted cats (n = 199). In most cases, the contacted animal was a stray animal (74.7%). Most of the contacted animals were either not vaccinated, or their vaccination status was unknown (93.3%). Most cases were located at one site (91.6%). As expected, extremity injuries were observed the most (80.9%). Hand injuries were the most common among extremity injuries. Head and neck injuries were the second most common (17.6%). Twenty-two patients presented with a genital or buttock injury.
Epidemiology of professional bare-knuckle fighting injuries
Published in The Physician and Sportsmedicine, 2022
Don Muzzi, Anna M. Blaeser, John Neidecker, Guillem Gonzalez-Lomas
We found the overall incidence rate of injury to be 43.62% in our study. Lacerations and fractures represented the majority of injuries sustained by bare knuckle boxers, accounting for 79.7% and 13.8% of the total recorded injuries, respectively. Hand fractures specifically represented 6.5% of the injuries sustained. In comparison, Karpman et al. [4] identified an overall injury rate of 49.8% for boxers of Edmonton, Canada, while a rate of 59.5% was found for MMA competitors in the same geographic region. In contrast to our study, these authors classified contusions as injuries. Another study, by Zazryn et al. [5], tracked injuries sustained by 545 boxers in Australia over an 8.5-year period. An overall injury rate of 23.6% was reported. Lacerations represented 64% of injuries – although these almost never occurred on the hands. Fractures of the hand represented only 4.7% of all injuries. Finally, Loosemoore et al. [6] reported on injuries sustained by boxers in Great Britain over a 5-year period of time in both training and competition. The hand and wrist were found to be the most commonly injured, accounting for 33% of injuries. In contrast to our findings, hand fractures amongst these boxers represented only 3.4% of all injuries documented and hand lacerations were effectively non-existent. The majority of reported hand injuries were sprains or ligamentous injuries.