We present evidence of kinematic and functional improvements of the trigger digit after sonographically assisted percutaneous release using quantitative motion analyses and functional assessments, respectively. Twenty-two patients with idiopathic trigger digits, who received the surgery, were recruited. A motion tracking system was used to measure the assigned kinematics parameters at the presurgical visit and at 1, 4, and 12 weeks after surgery. The hand strength and functional outcome were also obtained using dynamometer and selfreport questionnaire assessments. The hand strength, maximal workspace, and joint range of motion of the involved digit were significantly smaller than that of the intact finger on the contralateral hand before surgery. The triggering phenomenon of the involved digit was significantly higher than that of the corresponding finger in the intact hand using a subscribed angular acceleration factor. The repeated measures showed that the workspace, joint range of motion, hand strength, and triggering effect of the involved hand significantly improved in follow-up examinations after the surgical intervention. Painful movement or insufficient tendon excursion of the trigger digit can cause loss of movement and strength, thus interfering with functional performance. After the disappearance of the pain and triggering by sonographically assisted percutaneous release, improvements in kinematics and function were objectively quantified in this study. Keywords: trigger digits; kinematics; sonographically assisted percutaneous release; motion analysis A change in anatomical structure can alter movement into improper or malaligned patterns. The trigger digit is a common example that symptomatically shows a catching or snapping phenomenon owing to a mismatched anatomical relationship between the flexor tendon and A1 pulley.1-5 The severity of the disease is usually graded based on the levels of these triggering effects and the location of tenderness. In prior studies, researchers usually used simple physical examinations, such as clinical observations of range of motion (ROM) or movement abnormality and pain rating and selfreported satisfaction questionnaires to evaluate conditions before and after treatment.1,6-14 With these methods, clinicians can easily and conveniently assess treatment outcomes; however, little research has focused on objectively assessing the efficacy of surgical release based on quantifiable measures. To describe hand movements thoroughly, uses of three-dimensional and dynamic goniometric measures to represent thumb and finger ROM based on computer-aided motion analysis techniques were recently reported.15-18 These methods provide objective spatial and temporal assessment rather than the static indication using conventional goniometric measurements. To date, however, limited reports exist on the objective description of the trigger digit movement.Recent years have seen increased research into percutaneous release methods for treating triggering problems of digits. A son...

No abstract

While researchers have suggested that joint mobility would probably be affected by age and gender, research findings often present discrepancies. Little research has been performed on the factors which effect mobility of the trapeziometacarpal (TMC) joint. The purpose of this study was to address the effects of age and gender on the ranges of motion of the normal TMC joint. Eighty normal subjects divided into four age groups participated in this study. The TMC joint motions were recorded using an electromagnetic tracking system. In order to achieve a maximal range of TMC joint motion which was defined as the maximal workspace, each subject was asked to perform actively maximal circumduction, flexion-extension, and abduction-adduction of the TMC joint. Numerical and statistical methods were used to compute the TMC workspace and to detect significant differences. A workspace-to-length ratio was determined as an index to examine the effects of the age and gender on the joint mobility. The results demonstrated that age and gender had significant influences on the TMC workspace among the groups studied. The understanding of TMC joint mobility under different age and gender conditions is achieved through this study. The findings can be used to report clinical measures in the determination of the extent of impairment of osteoarthritis as well as the outcomes between pre- and post-surgical (or non-surgical) interventions.

No abstract

No abstract