EXTENSOR TENDON INJURIES AT THE DISTAL INTERPHALANGEAL JOINT

Hand Clinics ◽  
1995 ◽  
Vol 11 (3) ◽  
pp. 373-386 ◽  
Author(s):  
Mark A. Brzezienski ◽  
Lawrence H. Schneider
Keyword(s):  
Extensor Tendon ◽  
Tendon Injuries ◽  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Distal Interphalangeal ◽  
Extensor Tendon Injuries

scholarly journals Effect of Methotrexate in the Treatment of Distal Interphalangeal Joint Extensor Tendon Enthesopathy in Patients with Nail Psoriasis

2018 ◽  
Vol 7 (12) ◽  
pp. 546 ◽  
Author(s):  
Magdalena Krajewska-Włodarczyk ◽  
Agnieszka Owczarczyk-Saczonek ◽  
Waldemar Placek ◽  
Maja Wojtkiewicz ◽  
Joanna Wojtkiewicz
Keyword(s):  
Nail Plate ◽  
Extensor Tendon ◽  
Interphalangeal Joint ◽  
Response To Treatment ◽  
Distal Interphalangeal Joint ◽  
Nail Psoriasis ◽  
The Matrix ◽  
Tendon Thickness ◽  
Distal Interphalangeal ◽  
Methotrexate Treatment

To assess the effect of methotrexate on the development of distal interphalangeal joint extensor tendon enthesopathy in psoriasis, thirty-two people aged 34 to 57 years with nail psoriasis and distal interphalangeal joint extensor tendon enthesopathy (19 patients with Ps (psoriasis) and 13 with PsA (psoriatic arthritis) were started on methotrexate at 15 to 25 mg/week and the treatment was continued for 6 months). A total of 319 nails were examined. After six months of treatment, the thicknesses of the nail plate, nail bed and nail matrix were found to decrease in both groups of patients. Methotrexate treatment resulted in a decrease in the joint extensor tendon thickness only in patients with Ps (0.94 ± 0.05 vs. 0.96 ± 0.04, p < 0.001), where the tendon thickness after treatment correlated with the matrix thickness (r = 0.337, p = 0.018) and with the bed thickness (r = 0.299, p = 0.039). Methotrexate treatment resulted in a decrease in the extensor tendon thickness only in patients with Ps but not in PsA. The findings of this study may suggest the effectiveness of systemic treatment of nail psoriasis in patients without arthritis and the use of US nail examinations in Ps and PsA patients in morphological change assessment and response to treatment.

scholarly journals Broken Kirschner Wire in Distal Interphalangeal Joint Fixation: A Case Report

2021 ◽  
Vol 26 (3) ◽  
pp. 171-173
Author(s):  
Kyung Jin Lee ◽  
Jung Hyun Park ◽  
Sung Hoon Koh ◽  
Dong Chul Lee ◽  
Si Young Roh ◽  
...  
Keyword(s):  
Kirschner Wire ◽  
Extensor Tendon ◽  
Interphalangeal Joint ◽  
Middle Phalanx ◽  
Distal Interphalangeal Joint ◽  
Protective Measures ◽  
X Ray ◽  
Distal Interphalangeal ◽  
Continued Use

Kirschner wire (K-wire) has been widely used for treatment of fracture for its cost-effectiveness and reliability. This case presents the K-wire breakage in distal interphalangeal joint (DIPJ) fixation. A 55-year-old male patient was injured by a knife and showed rupture of extensor tendon at 1/2 of middle phalanx. A 0.9-mm K-wire was implemented for DIPJ extension, and tenorrhaphy was done. After 6 weeks, we detected breakage of K-wire in the follow-up X-ray. The broken K-wire in the distal phalanx was removed. We removed the remaining K-wire through an incision on volar side of middle phalanx under C-arm after 2 weeks for the patient’s personal reasons. Breakage during postoperative K-wire maintenance is exceedingly rare. This patient is presumed to have ruptured because he continued using his finger. Therefore, while K-wire is present, continued use of finger without protection may cause breakage, so protective measures such as splint are required.

Extensor Tendon Injuries at the Proximal Interphalangeal Joint

Hand Clinics ◽  
1988 ◽  
Vol 4 (1) ◽  
pp. 25-37
Author(s):  
John A. Froehlich ◽  
Edward Akelman ◽  
James H. Herndon
Keyword(s):  
Extensor Tendon ◽  
Proximal Interphalangeal Joint ◽  
Tendon Injuries ◽  
Interphalangeal Joint ◽  
Extensor Tendon Injuries

Outcome of primary tendon grafts for open Zone 3 extensor tendon injuries

2020 ◽  
Vol 45 (10) ◽  
pp. 1045-1050
Author(s):  
Jeff Ecker ◽  
Courtney Andrijich ◽  
Karolina Pavleski ◽  
Nicole Badur ◽  
Bruno E. Crepaldi
Keyword(s):  
Extensor Tendon ◽  
Tendon Graft ◽  
Proximal Interphalangeal Joint ◽  
Tendon Injuries ◽  
Interphalangeal Joint ◽  
Level Of Evidence ◽  
Wound Excision ◽  
Poor Outcomes ◽  
Open Injuries ◽  
Extensor Tendon Injuries

Open injuries of the extensor mechanism in Zone 3 (dorsum of the proximal interphalangeal joint) have poor outcomes. We retrospectively analysed the outcomes of treating 19 Zone 3 extensor tendon injuries in 17 patients. The treatment comprised wound excision and debridement, primary tendon graft to reconstruct the damaged/missing extensor tendon, skeletal fixation when required, local flaps to vascularize the zone of injury and immediate short arc motion therapy. Using the criteria defined by Geldmacher et al., the outcome was predicted to be poor in nine, satisfactory in seven and good in three cases. In this study the outcomes were excellent in 10, good in six and satisfactory in three cases. Mean range of motion was 75° (range 25°–115°) at the proximal interphalangeal joint. We conclude that using the protocol described there should no longer be the perception of a dismal outcome for these complex Zone 3 extensor tendon injuries. Level of evidence: IV

Osteophyte excision without cyst excision for a mucous cyst of the finger

2013 ◽  
Vol 39 (3) ◽  
pp. 258-261 ◽  
Author(s):  
H.-J. Lee ◽  
P.-T. Kim ◽  
I.-H. Jeon ◽  
H.-S. Kyung ◽  
I.-H. Ra ◽  
...  
Keyword(s):  
Medical Records ◽  
Lateral Collateral Ligament ◽  
Extensor Tendon ◽  
Skin Incision ◽  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Cyst Excision ◽  
Post Operative Pain ◽  
Distal Interphalangeal ◽  
Mucous Cyst

Osteophyte excision is a mainstay of treatment for mucous cyst combined with Heberden’s node in a distal interphalangeal joint or in an interphalangeal joint of the thumb. The aim of this study was to evaluate the results of osteophyte excision without cyst excision for the treatment of a mucous cyst combined with Heberden’s node. The medical records of 37 patients (42 cases) with a mucous cyst with Heberden’s node were retrospectively reviewed. Thirty-eight of 40 cases with available pre-operative simple radiographs showed evidence of joint arthrosis. A T-shaped skin incision of the joint capsule between the extensor tendon and lateral collateral ligament was used. Osteophyte excision without cyst excision was performed. All cysts, except one, regressed without recurrence or a skin complication after osteophyte excision, but eight cases showed post-operative pain and loss of range of motion. Osteophyte excision without cyst excision may be a good treatment choice for mucous cyst of the finger.

The outcomes of zone 1 flexor tendon injuries treated using micro bone suture anchors

2013 ◽  
Vol 38 (9) ◽  
pp. 973-978 ◽  
Author(s):  
S. Huq ◽  
S. George ◽  
D. E. Boyce
Keyword(s):  
Range Of Motion ◽  
Flexor Tendon ◽  
Proximal Interphalangeal Joint ◽  
Tendon Injuries ◽  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Flexor Tendon Injuries ◽  
Distal Interphalangeal ◽  
Bone Anchors ◽  
The Mean

This article evaluates the outcome of 42 consecutive zone 1 flexor tendon injuries treated by using micro bone anchors during the period 2003–2008. Patients were rehabilitated using the modified Belfast Regime. The range of motion at the distal interphalangeal joint was assessed using Moiemen’s classification. A total of 56% of patients achieved excellent or good results for range of motion at the distal interphalangeal joint and 23% had a poor outcome. The mean distal interphalangeal joint and proximal interphalangeal joint range of motion were 48° and 96°, respectively. A total of 94% of patients returned back to work by 12 weeks. One patient sustained a tendon rupture and one developed osteomyelitis. The mean QuickDASH score was 13.5 and 81% of patients were satisfied with their outcomes. This is the largest clinical study on the use of bone anchors for zone 1 tendon injuries. Our study demonstrated a low rate of complications and outcomes that compare favourably with other published techniques.

Extensor Tendon Rehabilitation a Prospective Trial Comparing Three Rehabilitation Regimes

2005 ◽  
Vol 30 (2) ◽  
pp. 175-179 ◽  
Author(s):  
N. W. BULSTRODE ◽  
N. BURR ◽  
A. L. PRATT ◽  
A. O. GROBBELAAR
Keyword(s):  
Prospective Trial ◽  
Extensor Tendon ◽  
Metacarpophalangeal Joint ◽  
Tendon Injuries ◽  
Interphalangeal Joint ◽  
Hand Therapy ◽  
Active Motion ◽  
Joint Mobilization ◽  
Total Active Motion ◽  
Extensor Tendon Injuries

Forty-two patients with 46 complete extensor tendon injuries were prospectively allocated to one of three rehabilitation regimes: static splintage; interphalangeal joint mobilization with metacarpophalangeal joint immobilization or; the “Norwich” regime. All 42 patients were operated on by one surgeon and assessed by one hand therapist. At 4 weeks the total active motion in the static splintage group was significantly reduced but by 12 weeks there was no difference between the regimes. There was no difference in total active motion between the repaired and uninjured hand at 12 weeks, with all patients achieving good or excellent results. However, grip strength at 12 weeks was significantly reduced compared to the uninjured hand after static splintage. There was no difference in hand therapy input between the regimes.

K-Wire Fixation for Extraarticular Transverse/Short Oblique Fractures of the Shaft of the Middle Phalanx Associated with Extensor Tendon Injury

2008 ◽  
Vol 33 (5) ◽  
pp. 561-565 ◽  
Author(s):  
M. M. AL-QATTAN
Keyword(s):  
Extensor Tendon ◽  
Tendon Injury ◽  
Interphalangeal Joint ◽  
Middle Phalanx ◽  
Distal Interphalangeal Joint ◽  
Active Motion ◽  
Total Active Motion ◽  
Distal Interphalangeal ◽  
A Prospective Study

In a prospective study, 22 cases of extraarticular transverse/short oblique fractures of the shaft of the middle phalanx associated with extensor tendon injury had fixation of the fracture as well as immobilisation of the distal interphalangeal joint using a K-wire. Mobilisation of the proximal interphalangeal and metacarpophalangeal joints was started immediately after surgery. The wires were removed after 6 weeks. No post-operative complications were noted. At final follow-up (mean = 15 weeks, range = 12–24 weeks), 18 of 22 patients obtained excellent and good total active motion (TAM) scores. Stiffness was confined to the distal interphalangeal joint, and hence when the results were re-analysed for motion at that joint only, only 11 patients had excellent and good outcomes.

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