ABSTRACT
The senior author has performed the Swanson implant arthroplasty for arthritis of the basal joint of the thumb for the past 12 years. Fifty-two patients with a total of 64 arthroplasties of the thumb were reviewed, with follow-up periods of 12-156 months (average, 4.4 years). The majority (80%) of the arthroplasties were performed for osteoarthritis; 11% were performed for rheumatoid arthritis, 6% for traumatic arthritis, and 3% for mixed connective tissue disease. Subjective and objective hand functional measurements and radiographic examinations were performed in the majority of patients (77%). The overall results were good both subjectively and objectively. Although degenerative changes involving the implant occurred with increasing frequency as the follow-up period increased, these changes were not symptomatic in the majority of cases.
Subject(s)
Arthritis/surgery , Arthroplasty/methods , Carpal Bones , Prostheses and Implants , Adult , Aged , Carpal Bones/diagnostic imaging , Female , Follow-Up Studies , Humans , Male , Middle Aged , Postoperative Complications , Radiography , Retrospective Studies , Silicones , Thumb/diagnostic imagingABSTRACT
Osteoarthritis should initially be treated conservatively with the use of oral medication, intra-articular steroid injections, hand therapy, and splinting. The reduction of pain and the resultant increase in function to the patient are the ultimate goals of this treatment.
Subject(s)
Hand , Osteoarthritis/therapy , Wrist Joint , Activities of Daily Living , Betamethasone/therapeutic use , Exercise Therapy , Humans , Injections, Intra-Articular , Osteoarthritis/rehabilitation , Physical Therapy Modalities , Splints , Triamcinolone Acetonide/analogs & derivatives , Triamcinolone Acetonide/therapeutic useABSTRACT
Sporothrix schenckii is a fungus known to cause infection of skin in the subcutaneous tissues. In this case tenosynovitis was caused by sporotrichosis resulting in rupture of the extensor tendon. Excision of the involved tenosynovium and repair of the tendons were done. Five months of oral medication with ketoconazole, 400 mg daily, led to resolution of the synovial disease and regression of a 1 cm pulmonary nodule found on a routine chest x ray film.
Subject(s)
Fingers , Sporotrichosis/pathology , Tenosynovitis/etiology , Aged , Diagnosis, Differential , Humans , Male , Rupture, Spontaneous , Sporotrichosis/diagnosis , Sporotrichosis/therapy , Tendons/pathology , Tenosynovitis/pathology , Tenosynovitis/therapySubject(s)
Leg Injuries/surgery , Microsurgery/methods , Surgical Flaps , Adult , Child, Preschool , Female , Humans , Male , Middle Aged , Wound HealingABSTRACT
A patient with nonunion of the capitate presented for treatment with a painful, snapping wrist. Grafting was successful in obtaining union of the fracture and relief of symptoms.
Subject(s)
Carpal Bones/injuries , Fractures, Ununited/surgery , Adult , Bone Transplantation , Humans , MaleSubject(s)
Amputation, Traumatic/surgery , Finger Injuries/surgery , Replantation , Thumb/injuries , Adult , Child, Preschool , Female , Humans , Male , Wound HealingABSTRACT
Anterior dislocation of the proximal interphalangeal joint is a complex injury involving specific pathomechanics. Progression of this injury to a chronic stage is associated with considerable morbidity in the form of pain, instability, and loss of motion in the involved joint. Surgical reconstruction is complicated and results of delayed intervention are compromised. Two cases of anteriorly dislocated interphalangeal joints, unrecognized as such early and allowed to progress to a chronic stage, presented to us as boutonniere deformities. Descriptions of clinical presentation, surgical findings, and treatment results in these cases attest to the disabling potential of this injury. Emphasis is therefore placed on early recognition of the anteriorly dislocated proximal interphalangeal joint so that appropriate treatment can be initiated and progression to a chronic stage prevented.
Subject(s)
Finger Injuries/pathology , Finger Joint , Joint Dislocations/pathology , Adult , Child , Female , Finger Injuries/surgery , Finger Joint/diagnostic imaging , Finger Joint/surgery , Humans , Joint Dislocations/surgery , Male , RadiographyABSTRACT
During a period from April, 1972 to May, 1983, 339 Swanson silastic implants were implanted in eighty-two hands of fifty-five patients. A follow-up study was performed to evaluate the long-term function of these implants. Our follow-up study indicates that metacarpophalangeal joint arthroplasty can relieve pain, correct deformity, improve appearance and improve hand function by providing functional motion and stability. Few long-term problems were noted and the functional benefits gained by surgery decreased little with time. Patient satisfaction was high.
