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Results for “Hand Deformities, Congenital”

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At least 19 recordsLinked to original sources
PubMed2002

[Psychological approach to congenital hand deformities. Congenital deformities, the desire to know].

The psychological approach to congenital malformation is determined by the stares of the others and the individual's needs. The relationship of the body of the person afflicted with a congenital malformation is a question of aesthetic suffering and not of functional use. Caught up in a network of a priori and anxiety-based projections, it is difficult for patients, children, adolescents or adults, to express themselves and make themselves heard. This multi-faced issue poses a basic problem for a society, which penalizes physical deformity. Beyond the medical techniques, the subject's ethic has to be considered.

Adolescent↗
PubMed2006

Outcome analysis, including patient and parental satisfaction, regarding nonvascularized free toe phalanx transfer in congenital hand deformities.

The therapy for congenital hand malformations, especially in symbrachydactyly and constriction ring syndromes, is challenging. Between 1975 and 1995, 20 children with congenital hand deformities underwent reconstruction by 56 nonvascularized free toe phalanx transfers. The average age at initial surgery was 4.8 (range, 0.5 to 22) years. Retrospectively, the children were examined after an average of 3.5 (range, 1.5 to 17.6) years for function of the hand, transplanted phalanx growth, assessment for the epiphyseal plate, and assessment for psychologic performance with their parents. Donor-site morbidity was determined according to measured growth deficit, observing the child's gait, and toe function. In the younger patients (up to 1.5 years), the grafts were well tolerated and showed good growth and only few resorptions. In the age group from 1.5 to 4 years, the grafts showed no growth. In the age group older than 4 years, the grafts were mostly resorbed. The clinical reexamination revealed in most cases only passive motion in the joints, but the function of the hand was improved, with only few problems of the donor site. Most patients and their parents reported a positive effect of the phalanx transfer.

Adolescent↗
PubMed1994

Digital lengthening in congenital hand deformities.

12 hands with congenital short finger in 11 patients were treated with various types of metacarpal bone lengthening. These included three patients with brachydactyly, seven with transverse deficiency, and one with constriction ring syndrome. All cases involved metacarpal lengthening and surgery was performed 16 times in 15 digits. Single-stage lengthening was performed in seven cases, on-top plasty in three cases, and distraction lengthening in six cases. The length gained ranged from 2 to 10 mm in single-stage lengthening, 3 to 17 mm in on-top plasty, and 12 to 30 mm in distraction lengthening. Delayed union and malunion occurred in single-stage lengthening or on-top plasty. After metacarpal lengthening, pinch function was improved in seven out of eight patients with either transverse deficiency or constriction band syndrome, and aesthetic improvement was achieved in three patients with brachydactyly.

Adolescent↗
PubMed1986

Single stage lengthening by intercalary bone graft in patients with congenital hand deformities.

The experience with single-stage lengthening by intercalary bone graft in four patients with congenital hand deformities is presented. In all seven lengthenings the gap was bridged by a toe phalanx bone graft. The elongation of the ray ranged from 5-14 mm. Examination of patients followed from one to five years after the treatment showed a good appearance of the lengthened ray. One bone graft assimilation resulted in a pseudoarthrosis and another had osteopenia that resolved spontaneously. All others healed uneventfully. The quality of the skin sensitivity, vascular status and tendon balance is preserved after the lengthening.

Bone Lengthening↗
PubMed1989

First web-space reconstruction by Caroli's technique in congenital hand deformities with severe thumb ray adduction.

A personal technique is described for reconstruction of the first web-space in congenital hand deformities with severe adduction of the thumb. The technique is based on the use of two local rotation flaps, one designed on the thenar area and the other on the radial half of the back of the hand. Seven patients were treated with such a technique and followed up for an average of 32 months. Excellent results were obtained in five cases.

Child↗
PubMed2001

A congenital hand deformity: Dupuytren's disease.

A 10-month-old child presented with a lack of extension at the distal interphalangeal joint. Despite the absence of trauma, a provisional diagnosis of mallet finger led to treatment using a short dorsal splint. Four months later the flexion had increased and included the proximal interphalangeal joint. Palpation revealed a palmar cord on the lateral aspect of the finger. Surgery disclosed a typical Dupuytren cord and the histology supported this diagnosis. There was no known family history of the disease. There was no sign of recurrence 27 months after surgery in this case of Dupuytren's disease that was present at birth.

Dupuytren Contracture↗
PubMed1985

Segmental digital transposition in congenital hand deformities.

A review of the current management of congenital digital hypoplasia in the hand has been presented. Techniques for augmenting the size and length of hypoplastic digits have included flap and graft techniques and segmental digital transposition techniques; they now include digital distraction lengthening techniques and free vascularized digital transposition techniques. Since all of these methods are still in use, the relationship between them has been described and some of the lesser known segmental digital transposition techniques have been discussed in greater detail.

Fingers↗
PubMed2000

[Value of a new first web space reconstruction in congenital hand deformities. A study of 54 patients].

INTRODUCTION: Only a few studies are available in the literature on the specific problem of the congenital contracture or absence of the first web in hand deformities, and first web reconstruction. MATERIAL AND METHODS: Sixty-seven first web plasties in 54 patients were retrospectively analyzed: they included 44 cases of classical plasties, i.e., Z-plasty (21 cases); dorsal flap plasty of the index (19 cases), thumb (1 case), or the hand (10 cases), and 16 cases of' pseudo-kite flap. RESULTS: The results were difficult to assess, as the syndromes were dissimilar and the deformities were not comparable (e.g., Apert syndrome versus Poland syndrome). However, it was found that the 'pseudo-kite' technique which was applicable to certain cases resulted in a web extension of 3.2 cm without any deepening. DISCUSSION: No method of classical assessment can be used to comprehensively evaluate the results of first web reconstruction due to the wide variability in clinical characteristics, the lack of patient cooperation in this young age group, the possible MPJ articular thumb instability, and growth factors. Although 4-flap Z-plasty is an adequate technique for non-severe first web deformities, the 'pseudo-kite' flap approach is useful in more severe cases. In 13 cases, a peroperative measurement before and following plasty was made, and a significant increase (205%) in planimetric and stereotactic gain compared to pre-plasty findings was noted. CONCLUSION: It does not seem logical to have a particular preference for a certain approach when considering first web reconstruction in congenital malformations. Each technique has its advantages and disadvantages, depending on patient age, the type of malformation, the state of the thumb, the extent of the first web deformity and the possible presence of scar tissue.

Acrocephalosyndactylia↗
PubMed2003

Non-vascularized free toe phalanx transfers in congenital hand deformities--the Great Ormond Street experience.

Many options of varying complexity are available for the management of congenital short digits resulting from aphalangia in symbrachydactyly and constriction ring syndrome. We have used non-vascularized free toe phalanx transfers for these children when a vascularized toe transfer has been contraindicated. We describe our technique and experience with 22 children who underwent a total of 64 transfers of the proximal (35) or middle (29) toe phalanges (average 3 per child). The mean age at initial surgery was 15 months, and the mean follow-up was 5 years. Duration of time until epiphyseal closure could not be determined accurately, but total digital elongation averaged 6mm. Complications of this technique include joint instability, premature epiphyseal closure and, in one patient, infection and graft loss. Donor site deformity was determined according to measured growth deficit and toe function. This technique is a simple option for digital elongation and, if performed in the appropriate age group in short fingered and monodactylous subtypes of symbrachydactyly, has the potential to allow growth and function with minimal donor site deficit.

Bone Resorption↗