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At least 19 recordsLinked to original sources

Arthroscopy of the wrist and finger joints.

Ninety arthroscopies of the wrist and finger joints in 34 clinical cases and two amputated arms were carried out with the number 24 arthroscope. Eighty-four wrist and finger joints of four cadavers and two amputated arms were also dissected for macroscopic observation. Most portions of the interior structures of the wrist and finger joints can be observed by the dorsal approaches. Color photography and punch biopsy are also possible. Some arthroscopic photographs taken with the number 24 arthroscope are illustrated. From these experiences it is concluded that the number 24 arthroscope is a useful diagnostic tool in arthroscopy of the small joints, even though there are still many problems.

Adult

Metacarpophalangeal joint implants. I. Roentgenographic study on the silastic finger joint implant, swanson design.

A roentgenographic study was carried out on 104 Silastic Finger Joint Implants, Swanson design. Sixty-two of the implants were examined in the anterio-posterior-projection (AP) from 4 months to 5 1/2 years postoperatively, a total of 116 examinations. Forty-two implants were examined in the AP-projection and in the lateral projection by tomography in maximum active extension and flexion from 9 days to 42 months postoperatively, a total of 110 examinations. Stem fractures were found in 11/104 implants: two of these preceded by a laceration of the implant surface visualized by tomography. Fragmentation of the midsection was found in 14/104 implants. Cortical erosion was seen radially in the phalanx and the metacarpal bone in some joints showing ulnar deviation, predominantly MCP joints II and III. On the tomograms a cortical erosion dorsally in the metacarpal bone could be demonstrated. Particularly around the distal stem was found an intramedullary bone lamella, varying in distance from the stem as well as in density and regularity. Bone resorption was found at the site where the midsection bore on the metacarpal bone and the proximal phalanx, resulting in a migration of the implant in a proximal and/or distal direction. The migration of the implant was evaluated on the tomograms with maximum active extension and classified into 4 Grades. Concomitant with the migration in the proximal direction a bony spur developed volarly at the resected end of the metacarpal bone, also seen in the AP-projection. The degree of maximum joint flexion was measured on the tomograms by drawing a line along the dorsal contour of each bone. In some cases flexion was found to decrease as a consequence of implant migration in the distal direction or the development of a bony spur. In several cases the range of flexion was maintained by gliding of the stems, particularly the distal one.

Arthritis, Rheumatoid

Position sense at the proximal interphalangeal joint is distorted in patients with rheumatoid arthritis of finger joints.

The results of this investigation demonstrate, using a position matching paradigm, that the ability of subjects to detect changes in the position of the proximal interphalangeal joint is impaired in patients with rheumatoid arthritis affecting this joint. In this group there is a systematic flexion bias in position judgements compared to an age- and sex-matched control group. This bias becomes progressively more pronounced at more extended positions. These results suggest that chronic inflammatory joint disease significantly alters proprioceptive sensations at finger joints and this may be due to the loss or distortion of afferent feedback from mechanoreceptors innervating the affected joint.

Adult

Finger joint swelling: correlation with age, gender, and manual labor.

A soft tissue immersion radiography technique was used to study changes in 4,648 finger joints of 166 patients free from signs of inflammatory joint disease. An age-specific correlation was found for joint swelling, joint space narrowing, joint margin spurs, and intraarticular loose bodies. The distal interphalangeal joints were more commonly swollen in women, and the proximal interphalangeal and metacarpophalangeal joints more commonly swollen in manual laborers. Both correlations are highly significant (P less than 0.001). The second and third digits showed a definite predilection for joint swelling. Swelling of finger joints is closely correlated with age and degenerative disease, and its occurrence in older patients is associated with degenerative changes. In manual laborers it should not be interpreted as evidence for inflammatory joint disease.

Adult

[Results of alloarthroplasty in finger joints damaged through injury].

Follow-up examination is reported of 24 patients with post-traumatic arthritis treated by 29 finger joint implants. The average follow-up time was 35 months. It could be shown that implant arthroplasty in painful, unstable finger joints stiffened in an unfavourable position represents a quite reasonable method of treatment. Necessary essentials, however, are sufficient function of the tendons, skin areas without twoo extensive cicatrical changes, precise operative procedure and adequate postoperative treatment.

Arthroplasty

Silicone lymphadenopathy and synovitis. Complications of silicone elastomer finger joint prostheses.

We report two complications of silicone elastomer finger joint prostheses. In one patient, the prostheses broke, with silicone particles present in synovium ("detritic synovitis"). In another patient, silicone particles were found in an axillary lymph node five years after insertion of prostheses in the ipsilateral hand (prostheses were intact at the time). Microscopically, silicone particles in synovium and lymph node were identical to particles abraded from a new prosthesis.

Arthritis, Rheumatoid

[A new intraosseous finger-joint prosthesis].

The faults of interposition-arthroplasty of the finger-joints were shown and intraosseous implantation and intraosseous endoprothesis are presented with initial results. Sources of failure and their treatment are explained and postoperative details and postoperative treatment outlined.

Arthroplasty

[Synoviorthesis of finger joints using erbium-169. Parameters influencing the clinical results at middle-term].

Synoviorthesis of the finger joint with erbium-169 is a beneficial therapeutic procedure which produces reduction of articular pain and swelling in 2/3 of cases. The effect is lasting and shows only slight regression during the first 24 months. However, if the rheumatoid disease is very active, or if the articular lesions are primarily erosive, the results are poorer. No correlation was found between therapeutic results and the radiological findings prior to 169E treatment. Erbium-169 reduces inflammation and leads to progressive articular fibrosis. Any chronic synovitis of interdigital joints resistant to appropriate conventional anti-inflammatory treatment may benefit from radio-synoviorthesis with erbium-169. Erbium-169 synoviorthesis is is technically easy to perform and free of side effects. It is a palliative measure which the authors consider a valuable complement to the classical treatment of rheumatoid arthritis.

Aged

Implants designed for finger joints. A roentgenorgraphic study and a study of implant wear and tear.

Two types of flexible finger implants (one intramedullary movable, the Silastic Finger Joint Implant, Swanson design, and the other presumable intramedullary fixed, the Niebauer T-M Cutter Metacarpophalangeal Joint Prosthesis) were subjected to animal trials. Forty-four Swanson implants and 33 Niebauer implants were implanted in the knee joint of rabbits. Roentgenographic examinations were carried out immediately after surgery and then at monthly intervals. The joint was examined in the lateral projection in a flexed and in an extended position to obtain better information about the behaviour of the implant. The Swanson implant was assessed as being intramedullary movable. The Niebauer implant was found to bend within other parts than just the thin central part of the midsection as it is supposed to do. Intramedullary bone formation was seen along the distal stem of the Swanson implant. It developed in a very typical manner considered to be related to the motion of the stem. A similar phenomenon was seen along the distal stem of some of the Niebauer implants and was considered a sign of insufficient fixation of the stem. Cortical erosion and periosteal callus formation were found in the femur at the site at which the proximal stem of the Swanson implant was in direct contact with the bone. The implants were examined at autopsy both in situ and after removal. The Swanson implants showed consistently a wearing of the surface and a permanent deformation. Isolated cracks were seen in 8/44 implants, while fractures, either isolated or in combination with cracks and/or fragmentation, were seen in 22/44 implants. It was not possible to evaluate deformation of the Niebauer implants. Slight wearing was seen in 4/32 implants. Cracks, fragmentations and fractures were seen either isolated (except for the fragmentations) or in different combinations with no specific pattern in 25/32 implants. The combination of inelastic dacron fibres and elastic silicone rubber in one functional unit as in the Niebauer implant was considered the main cause of the damage.

Animals

[2 Kirschner wires as simplified external fixation devices in finger joint arthrosis].

A new technique for arthrodesis of the PIP joint is described; after resection of the joint two percutaneous Kirschner wires of diameter 1.2-1.3 mm are placed transversely through the two phalanges. The wires are twisted together on each side of the finger to produce a compression effect on the bone surface. Additional external immobilisation is used for five days only, but the wires are left in place for six weeks. The method has been used without complication in ten patients. The average length of time off work was seven and a half weeks. In the author's view the advantages of this method lie in its technical simplicity and in the free movement of other finger joints.

Arthrodesis

Compression arthrodesis of finger joints.

Compression arthrodesis is useful for treatment of finger and thumb joints in arthrosis, scleroderma, hypermobile joints, paralytic deformities, and rheumatoid arthritis. A dorsal incision exposes the joint. Its surfaces are prepared in a ball-and-socket arrangement using a high-speed burr. A longitudinal pin 1.1 mm in diameter is passed distally and then retrograde to determine the angle of fusion and to prevent migration of bone ends as the longitudinal compression is applied. Transverse pins 1.5 mm in diameter are put in one-third of the distance from the joint. A Charnley clamp, as modified by Micks and Hager, is applied and tightened. At 6 weeks, the arthrodesis is checked for solidity and, if stable, X-rays are examined for new bone. When solid, the joints should be protected by external splinting for an additional 2 weeks to be sure that the fusion is complete. Compression arthrodesis was obtained in 49 of 54 joints. Solid fusion was usually attained within 6 weeks, without loss of mobility of other joints.

Adolescent