Influence of joint injury on motor and functional recovery of finger replantation

Chiu, Hui‐Fen; Lee, Jing-Wei

doi:10.1002/micr.1920151205

Cited by 6 publications

(3 citation statements)

References 18 publications

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“…"-19 In the latter literature, some have compared the functional results of different injury level by gross data without statistical analand others used statistical comparison. 12,18,19 Comparisons based on gross data may produce bias because of small sample size; therefore statistical analysis is necessary for checking the validity of the difference. The statistics that have been applied in the aforementioned literature are all accomplished with univariate analysis.…”

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confidence: 99%

Multivariate analysis of factors influencing the functional recovery after finger replantation or revascularization

1995

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A multivariate statistical analysis was utilized to study the influence of the four preoperative (age, mechanism of injury, level of injury, and type of amputation) and one postoperative (rehabilitation) variables on the functional recovery of the replanted or revascularized finger. Statistically significant differences are summarized as follows. The young age group have a better functional recovery due to better sensory recovery than the old age group. The crush injury group have a better functional recovery, with better scores in motion and patient satisfaction, than the avulsion injury group. The middle phalangeal injury group have a better functional recovery, with better score in motion and sensation than the proximal phalangeal injury group. There is no statistically significant difference in functional recovery between the revascularized and replanted fingers, but there is a significantly better sensory recovery in the revascularized finger. The rehabilitation group has a better functional recovery, with better score in motion, subjective symptoms, and patient satisfaction, than the nonrehabilitation group.

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confidence: 99%

Multivariate analysis of factors influencing the functional recovery after finger replantation or revascularization

1995

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“…The major complications are joint stiffness and tendon adhesion, which may eventually lead to a useless digit because of prolonged immobilization. Making every effort to preserve a salvageable joint during replantation surgery improves functional recovery in the finger (Chiu and Lee, 1994). The pins and rubbers traction system, first described by Suzuki et al (1994), has been widely used in treating PIP fractures without impairment of circulation.…”

Section: Dear Sirmentioning

confidence: 99%

Revascularization and dynamic distraction for a complex finger injury

Hsueh¹,

Shieh

Chiu

2010

J Hand Surg Eur Vol

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discoid pyrocarbon implant for scaphotrapeziotrapezoid arthritis (Pequignot and Allieu, 2000).We report the use of the radio-capitate pyrocarbone implant (RCPi) for two patients presenting with combined mid-and radiocarpal osteoarthritis of the wrist with or without carpal collapse as an alternative to wrist fusion with a follow-up of 5 years. The surgery was done without denervation. The head of the capitate was sectioned with 1 mm of the hamate to insure a good surface for the prosthesis. This section has to take into account the slope of the implant and the length of the stem which must not extend beyond the capitate. The smallest implant was used. As there were no special instruments to fit the stem into the capitate, the position was checked on radiological imaging. An important shortcoming of the system is the lack of instruments to centre and ream. The elevated radiotriquetral ligament was sutured to the capsular attachments of the hamate. Proper implant placement was checked radiologically before and after closure in various wrist positions. A bulky dressing and a short-arm palmar splint were used. Passive assisted mobilization was started as soon as pain allowed. After radiological assessment at 4 weeks, unrestricted wrist motion was allowed. Two to five months of physiotherapy was needed. Two patients had this implant over 5 years ago.The first was an active, 65-year-old, female farmer, without a history of trauma, who presented with wrist pain at night which disturbed her sleep and she was unable to use her hand. The wrist was swollen, warm and painful when moved in any direction. She had 20 each of flexion and extension, and 80 each of painful pronation and supination. She had no measurable grip strength using the Jamar dynamometer set at the second position. The opposite wrist was normal and no further systemic joint pathology was noted. The patient refused a total wrist fusion and an RCPi implant was advocated but the patient was informed that no long-term results were available. She had her wrist replaced and at present she is still active on the farm, without pain, impairment, swelling or tenderness. Her wrist motion was limited to 40 each of flexion and extension but her grip strength was now equal to the opposite normal wrist and the quick DASH score was 9.5. The cyst within the radius resolved without any bony change around the stem on radiographs.The second patient, a 62-year-old nurse, had sustained a fall on the outstretched right dominant hand some months previously. She was unable to return to work and had a scapholunate rupture with radiocarpal and midcarpal arthritis. She accepted the RCPi implant well aware that a mishap would lead to a total wrist fusion. At final follow-up 6 years later she was still active, without any pain, swelling or limitation. Radiographs did not show radiolucency around the stem or axial deviation of the stem. Her grip strength was 20 kg (25 kg opposite hand), and flexion and extension of the wrist was 40 each, her forearm rotation was equal to the opposite sid...

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“…18 Loss of range of motion (ROM) in a single PIP joint can result in a significant reduction in overall hand function, 23 and preservation of PIP joint function following trauma to the hand has been demonstrated to significantly improve functional outcomes. 6 A better understanding of the PIP joint and soft tissues that provide support to the joint is essential to clinical management decisions in medical/surgical treatment and in rehabilitation.…”

Section: Proximity Of Collateral Ligament Origin To the Axis Of Rotatmentioning

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Proximity of Collateral Ligament Origin to the Axis of Rotation of the Proximal Interphalangeal Joint of the Finger

Loubert

Masterson

Schroeder³

et al. 2007

J Orthop Sports Phys Ther

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Normal function of the proximal interphalangeal (PIP) joints of the fingers is essential to hand function.18 Loss of range of motion (ROM) in a single PIP joint can result in a significant reduction in overall hand function, 23 and preservation of PIP joint function following trauma to the hand has been demonstrated to significantly improve functional outcomes.6 A better understanding of the PIP joint and soft tissues that provide support to the joint is essential to clinical management decisions in medical/surgical treatment and in rehabilitation.Among the components of the PIP joint considered critical to its function are the collateral ligaments. Insufficiency of the collateral ligaments can result in pain and instability of the PIP joints and overall diminished hand function. 1,10,16,19,21 Collateral ligaments help guide the PIP

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Influence of joint injury on motor and functional recovery of finger replantation

Cited by 6 publications

References 18 publications

Multivariate analysis of factors influencing the functional recovery after finger replantation or revascularization

Multivariate analysis of factors influencing the functional recovery after finger replantation or revascularization

Revascularization and dynamic distraction for a complex finger injury

Proximity of Collateral Ligament Origin to the Axis of Rotation of the Proximal Interphalangeal Joint of the Finger

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