A Prospective Review of Open Central Slip Laceration Repair and Rehabilitation

2002 ◽  
Vol 27 (6) ◽  
pp. 530-534 ◽  
Author(s):  
A. L. PRATT ◽  
N. BURR ◽  
A. O. GROBBELAAR
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Slip Zone ◽  
Good Recovery ◽  
Distal Interphalangeal Joint ◽  
Central Slip ◽  
Distal Interphalangeal ◽  
Joint Flexion

A prospective review was carried out to evaluate the outcome of surgically repaired open central slip (zone III) injuries which were treated with 3 weeks of proximal interphalangeal joint immobilization within a cylinder splint and then with 3 weeks of controlled mobilization within a Capener coil splint. Thirty-one fingers in 27 patients were assessed by the same independent therapist. All fingers achieved an excellent or good recovery with a mean proximal interphalangeal joint flexion of 94° (range 70–110°) and a mean distal interphalangeal joint flexion of 57° (range 30–81°). Extension deficits of the proximal interphalangeal joint were noted in five fingers (mean 6°, range 3–15°). The results show that a combination of immobilization and controlled mobilization is an effective rehabilitation regime for surgically repaired open central slip injuries.

Diagnosis of Closed Central Slip Injuries

1996 ◽  
Vol 21 (5) ◽  
pp. 614-616 ◽  
Author(s):  
J. RUBIN ◽  
D. J. BOZENTKA ◽  
F. W. BORA
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Non Invasive ◽  
Testing Resistance ◽  
Fresh Frozen ◽  
Central Slip ◽  
Distal Interphalangeal ◽  
Joint Flexion ◽  
Joint Rigidity

Four non-invasive tests for central slip integrity were analysed using 20 fresh frozen cadaver fingers. A pre-boutonnière deformity was simulated by dividing the central slip. A passively correctable boutonnière was simulated by dividing the central slip, triangular ligament and oblique fibres of the extensor expansion. The test described by Boyes, which evaluates distal interphalangeal joint flexion, was found not to be reliable for the diagnosis of either injury. The test described by Elson, which evaluates distal interphalangeal joint rigidity while actively extending the flexed proximal interphalangeal joint, was the only manoeuvre which was able to discern central slip integrity in both simulated injuries. The central slip tenodesis test and testing resistance of active proximal interphalangeal joint extension should be performed with the proximal interphalangeal joint in flexion to weaken the effectiveness of the lateral bands.

Volar plating versus external fixation for unstable dorsal fracture-dislocations of the proximal interphalangeal joint

2021 ◽  
pp. 175319342110593
Author(s):  
Atsuhiko Murayama ◽  
Kentaro Watanabe ◽  
Hideyuki Ota ◽  
Shigeru Kurimoto ◽  
Hitoshi Hirata
Keyword(s):  
External Fixation ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Volar Plating ◽  
Distal Interphalangeal Joint ◽  
Active Flexion ◽  
Plate Group ◽  
Fracture Dislocations ◽  
Distal Interphalangeal

We retrospectively compared the results of volar plating and dynamic external fixation for acute unstable dorsal fracture-dislocations of the proximal interphalangeal joint with a depressed fragment. We treated 31 patients (31 fingers), 12 with volar buttress plating and 19 with dynamic external fixation. Follow-up averaged 35 and 40 months in the two groups, with a minimal 6-month follow-up. Average active flexion of the proximal interphalangeal joint was 95° after plate fixation and 87° after external fixation, with an active extension lag of –6° and –9°, respectively. Active flexion at the distal interphalangeal joint averaged 67° in the plate group and 58° in the external fixation group, with active extension lags of 0° and –5°, respectively. We conclude that both methods can obtain a good range of motion at the proximal interphalangeal joint. A limitation of the extension of the distal interphalangeal joint occurred with dynamic external fixation but not with volar buttress plating. Level of evidence: IV

Postburn Nailfold Retraction: A Reconstructive Technique

1986 ◽  
Vol 11 (3) ◽  
pp. 385-387
Author(s):  
R. C. K. NGIM ◽  
K. SOIN
Keyword(s):  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Transposition Flap ◽  
Left Thumb ◽  
Nail Deformity ◽  
Distal Interphalangeal ◽  
Joint Flexion ◽  
Reconstructive Technique

Postburn nailfold retraction often results in nail deformity and loss of distal interphalangeal joint flexion. A technique of reconstruction of the nailfold using a proximally based transposition flap is described in a patient with postburn nailfold retraction of the left thumb, index and middle fingers.

Resistive testing in a patient with suspected zone I flexor tendon injury

Hand Therapy ◽  
2009 ◽  
Vol 14 (3) ◽  
pp. 83-85
Author(s):  
Gangatharam Sudhagar ◽  
Monique Leblanc
Keyword(s):  
Occupational Therapy ◽  
Flexor Tendon ◽  
Tendon Injury ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Hand Surgeon ◽  
Flexor Tendon Injury ◽  
Distal Interphalangeal

Lacerations are the major cause of flexor tendon injury in zone I and they are most commonly missed due to incomplete examinations. We report a case of lacerated flexor tendon injury in Zone I closed without explorations and which was referred to occupational therapy with the diagnosis of stiff hand. The patient received therapy for his stiff hand following which he could flex the distal interphalangeal joint (DIP) on blocking the proximal interphalangeal joint but failed to flex his DIP joint on making a composite fist. With resistive testing the patient failed to initiate resistance on flexion. The patient was referred back to the hand surgeon and subsquently diagnosed with a flexor tendon injury.

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.

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