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Introduction
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
The lateral pinch is between the distal phalanx of the thumb and the lateral aspect of the index finger. It is quite a strong pinch compared to the above. It is of three types: Thumb-distal phalanx of index, thumb-middle phalanx and thumb-proximal phalanx depending upon the need (Figure 1.35).
Malignant tumors
Published in Archana Singal, Shekhar Neema, Piyush Kumar, Nail Disorders, 2019
Epithelioid hemangioendothelioma (EHEA) is a rare low-to-medium-grade angiosarcoma. One case in the nail apparatus appeared as a paronychia developing into a diffuse swelling of the big toe, which became bluish-red with an overcurved nail. The distal phalanx bone was lytic.99 Two more cases presented with violaceous nodules of the finger and toe tips, one with nail destruction and one thought to be due to prolonged exposure to vinyl chloride.100–103
The hand
Published in Ffion Davies, Colin E. Bruce, Kate Taylor-Robinson, Emergency Care of Minor Trauma in Children, 2017
Ffion Davies, Colin E. Bruce, Kate Taylor-Robinson
This is also an unusual injury. A true mallet finger is the rupture of the extensor tendon as it inserts onto the distal phalanx. This is fairly common in adults, and can occur in teenagers. In younger children, as in a UCL injury, it is more likely to be associated with an avulsion fracture of the physis and the actual tendon is intact. There is obvious droop of the distal phalanx when you look at it side-on.
Comparative outcomes between surgical treatment and orthosis splint for mallet finger: a systematic review and meta-analysis
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Chi Peng, Ren-Wen Huang, Shih-Heng Chen, Chung-Chen Hsu, Cheng-Hung Lin, Yu-Te Lin, Che-Hsiung Lee
Most authors recommended using the fracture fragment size (more than one-third of articular surface involvement) and subluxation of the distal phalanx as indications for surgery. In addition, an open fracture and chronic mallet finger injury have also been reported to be indications for surgical intervention [54]. Nevertheless, some studies have suggested conservative treatment for almost all types of mallet finger, even for bony mallet fingers with large fracture fragments and subluxation. Wehbe and Schneider concluded that splinting is safe and reliable for mallet finger, while surgical treatment is difficult and does not offer any advantage over conservative treatment [42]. Patient compliance is also a main issue when receiving splint treatment for about six to eight weeks. Some patients remove the orthosis or flex the DIP joint when changing the splint during the treatment period, which can cause loss of reduction and reduce the success rate. In addition, the patients’ occupation and nature of work should also be taken into consideration. Some authors have suggested that surgical intervention is appropriate for manual workers such as healthcare professionals and musicians who require fine hand skills and would have difficulty working while wearing the orthosis [55].
Surgical treatment of macrodactyly of the foot in children
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Lu Chen, Wei Huang, Wei Chen, Xiaofei Tian
If the affected toe was at least twice the length of the toe on the contralateral side, the distal phalanx was amputated; if it was less than twice this length, phalangeal shortening by wedge osteotomy or interphalangeal joint arthrodesis was performed. If both the width and height of the affected phalanges were increased, longitudinal osteotomy of the phalanx was carried out. Ray resection was performed in the following cases: (1) involvement of the metatarsal; (2) gross overgrowth of the forefoot; (3) accompanying syndactyly; (4) the order of the affected toes (more third and fourth rays were resected because the third and fourth toes were shorter than the first and second toes, anatomically); (5) the desire of the patients and parents (older patients had a stronger desire for ray resection). If the first metatarsal and phalanx were involved, osteotomy was preferred, rather than resection of the first ray, as the first toe contributes substantially to weight-bearing and normal gait. Soft tissue debulking was an integral part of the treatment and was performed in all cases.
Transosseous Sutures in Tendon-to-Bone Repairs: the Role of the Epitendinous Suture
Published in Journal of Investigative Surgery, 2022
Samuel M. Christen, Jörg G. Gruenert, Patrick S. Harenberg
For our experiment we chose porcine forelimbs because the anatomical dimensions and biomechanical properties of the tendons are similar to human flexor tendons [31, 32]. The feet of freshly butchered pigs were obtained from a local butcher’s shop. Based on preliminary data, a power analysis (SPSS Sample Power 3, IBM Inc., Armonk NY, USA) for 90% power was conducted which revealed a necessary number (n) of 5. To compensate for the eventuality of errors, a n of 10 was chosen. The specimens were randomly divided into three groups with n = 10 flexor tendons per group. The deep flexor tendons (two per foot) were dissected from the proximal amputation level to the tendon insertion in the distal phalanx of the claw. Afterwards, the distal phalanx was exarticulated and freed from surrounding skin and subcutaneous tissue. The sesamoid bone present at the dorsal aspect of the tendon near the insertion was removed. The tendon was then transected in a transverse plane at the base of the phalanx.