No abstract available.
Finger Injuries* ; Fingers*

Fractures and dislocation of the hand is a body injury involving complex structures and multiple functions, which frequently occur as they represent 10%-30% of all fractures. Such fractures and dislocation of the hand should be treated in the context of stability and flexibility; and tailored treatment is required in order to achieve the most optimal functional performance in each patient since deformation may occur if not treated, stiffness may occur with unnecessarily excessive treatment, and both deformation and stiffness may occur coincidently with inappropriate treatment. Stable injuries can be fixed with splintage whereas surgery is actively considered for unstable injuries. In addition, surgeons should keep in mind that as the surgical intervention is done aggressively, aggressive rehabilitation must be followed in correspondence with the surgical intervention. Successful outcome requires effort to prevent any potential complication including nerve hypersensitivity and infection. Finally, it is also important that the patient to know that swelling, stiffness, and pain may last for a long period of time until the recovery of fractures and dislocation of the hand.
Dislocations* ; Finger Injuries ; Hand* ; Humans ; Hypersensitivity ; Pliability ; Rehabilitation

The degloving injuries of the digits and palm remain a persistent challenge. We used an antero- lateral thigh flap to treat an 18-year-old, right-handed male worker with degloving injuries of the index, middle and ring fingers. The flap was designated to wrap the entire circumference of three fingers sustaining degloving injury and to form mitten-hand. The total lengths of the distal phalanxes of three fingers were retained almost complete. The donor defect was covered with split-thickness skin graft. Three months after the first operation, roentgenograms revealed terminal phalanxex resorption in three injured fingers, and the surgical syndactyly between the middle and ring finger was separated at the same time. One month later, the syndactyly between the index and middle fingers was also separated. Good coverage of the soft tissue defects with good function and appearance was achieved. Therefore, we considered that the length of the degloved finger could be preserved using free flap.
Adolescent ; Finger Injuries ; surgery ; Humans ; Male ; Surgical Flaps

Adolescent ; Adult ; Aged ; External Fixators ; Female ; Finger Injuries ; surgery ; Finger Phalanges ; injuries ; Fracture Fixation ; methods ; Humans ; Male ; Middle Aged

The proximal phalangeal base is the most commonly fractured hand bone in children. Such fractures are rarely reported to be irreducible as a consequence of flexor tendon entrapment. A 12-year-old male sustained a malunited base fracture of the proximal phalanx of the small finger on the right hand and was unable to flex the finger. 6 weeks ago he was treated with closed reduction and percutaneous K-wire fixation, at another hospital. In a subsequent operation, it was found that the flexor tendon was entrapped at the fracture site. Flexor tenolysis and realignment of the fracture and internal fixation with K-wires were performed. The patient could perform his work without discomfort in his hand and a normal range of motion was possible in the small finger 12 months after the operation.
Child ; Epiphyses ; Finger Injuries ; Fingers ; Fractures, Malunited ; Hand ; Humans ; Male ; Reference Values ; Tendon Entrapment ; Tendons ; Trigger Finger Disorder

Annular pulley injury of fingers is usually observed in rock climbers who support their entire body weight with flexed fingers during climbing. But these lesions can also follow trivial trauma, such as lifting heavy objects with the fingertips, or during sports and recreational activities. The A2 and A4 pulleys are most usually involved and reported most frequently. However, traumatic A1 pulley rupture has not been reported yet, to the best of our knowledge. Kendo is a very vigorous martial art with frequent physical contact. Therefore, we reported two cases of repetitive microtraumatic left fourth finger A1 pulley rupture in Kendo players with results from physical examination and imaging studies, such as ultrasonography and magnetic resonance imaging, together with related literature.
Athletic Injuries ; Body Weight ; Finger Injuries ; Fingers* ; Lifting ; Magnetic Resonance Imaging ; Physical Examination ; Rupture* ; Sports ; Ultrasonography

A twenty-year-old male visited our clinic with wrist and long finger metacarpophalangeal (MP) joint pain. Dynamic ultrasonography revealed sagittal band (SB) ulnar subluxation and extensor carpi ulnaris (ECU) volar subluxation. Magnetic resonance imaging showed longitudinal splitting and dislocation of the volar half slip of the ECU tendon. The redundant radial SB was augmented and ECU sheath was advanced to the periosteum using suture anchors. He was able to perform his previous activities at the last follow-up. We encountered a case of "simulateous" ECU dislocation with extensor tendon subluxation of the long finger at the MP joint. Therefore, we report this case with a review of the relevant literature.
Finger Injuries/*diagnosis/*surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Tendon Injuries/*diagnosis/*surgery ; Ultrasonography ; Young Adult

BACKGROUND: Fingertip injuries involving subtotal or total loss of the digital pulp are common types of hand injuries and require reconstruction that is able to provide stable padding and sensory recovery. There are various techniques used for reconstruction of fingertip injuries, but the most effective method is functionally and aesthetically controversial. Despite some disadvantages, cross-finger pulp flap is a relatively simple procedure without significant complications or requiring special techniques. METHODS: This study included 90 patients with fingertip defects who underwent cross-finger pulp flap between September 1998 and March 2010. In 69 cases, neurorrhaphy was performed between the pulp branch from the proper digital nerve and the recipient's sensory nerve for good sensibility of the injured fingertip. In order to evaluate the outcome of our surgical method, we observed two-point discrimination in the early (3 months) and late (12 to 40 months) postoperative periods. RESULTS: Most of the cases had cosmetically and functionally acceptable outcomes. The average defect size was 1.7x1.5 cm. Sensory return began 3 months after flap application. The two-point discrimination was measured at 4.6 mm (range, 3 to 6 mm) in our method and 7.2 mm (range, 4 to 9 mm) in non-innervated cross-finger pulp flaps. CONCLUSIONS: The innervated cross-finger pulp flap is a safe and reliable procedure for lateral oblique, volar oblique, and transverse fingertip amputations. Our procedure is simple to perform under local anesthesia, and is able to provide both mechanical stability and sensory recovery. We recommend this method for reconstruction of fingertip injuries.
Amputation ; Anesthesia, Local ; Discrimination (Psychology) ; Finger Injuries ; Hand Injuries ; Humans ; Microsurgery ; Nerve Transfer ; Subcutaneous Tissue

OBJECTIVETo investigate the efficacy of buried purse-string suture in the treatment of mallet finger deformities.

METHODSFrom February 2009 to February 2010, 12 patients with closed non-fracture mallet fingers were treated by buried purse-string suture. The rupture tendons were sutured by purse-string suture with an atraumatic needle, and the knots were buried under subcutaneous tissue. External fixator was used at the extension position of the finger every night within three weeks after operation.

RESULTSAll patients were followed up for 6-12 months, mean 7 months. According to the Patel's evaluation criteria, 2 cases (17%) obtained excellent results, 7 good (58%), 2 fair (17%) and 1 poor (8%). The overall rate of the cases with excellent and good outcomes was 75%.

CONCLUSIONBuried purse-string suture is an easy and effective way to treat mallet finger deformities, with no serious postoperative complications or no need for reoperation.

Adolescent ; Adult ; Female ; Finger Injuries ; surgery ; Humans ; Male ; Middle Aged ; Suture Techniques ; Tendon Injuries ; surgery