A demonstration of validity of 3-D video motion analysis method for measuring finger flexion and extension.

This study demonstrates the validity of using 3-D video motion analysis to measure hand motion. Several researchers have devised ingenious methods to study normal and abnormal hand movements. Although very helpful, these earlier studies are static representations of a dynamic phenomenon. Despite the many studies of hand motion using scientifically impeccable techniques, little is known about digital motion, and there are still few researchers investigating dynamic three-dimensional motion of the hand. Results from a three-camera video motion analysis system were compared to those from the "gold standard", 2-D lateral view fluoroscopy. We used these two methods to record hand motion simultaneously during unrestricted flexion and extension of the index finger of the dominant hand in 6 neurologically normal, healthy volunteers. After collection and post-processing, the waveforms of the PIP, DIP and MCP joint angles were compared using the adjusted coefficient of multiple determination (R2(a), or CMD). The mean CMD values for the MCP, PIP and DIP joint angle waveforms were 0.96, 0.98 and 0.94, respectively, suggesting a close similarity between motion of comparable joints analyzed by the 2-D and 3-D methods. This shows that the method of 3-D motion analysis is capable of accurately quantifying digital joint motion. It is anticipated that 3-D motion analysis, in addition to being used as a research tool, will also have clinical applications such as surgical planning in neuromuscular disorders and the documentation of abnormal motion in many other pathological hand conditions.

Reconstruction of the dorsal ligament of the triangular fibrocartilage complex.

The distal radio-ulnar ligaments (DRUL) are key components of the triangular fibrocartilage complex (TFCC). The dorsal DRUL tightens during pronation of the forearm and helps to stabilize this motion. 12 women and three men at our clinic have been treated for DRUJ instability secondary to dorsal DRUL rupture or attenuation. Their chief complaint was pain. The dorsal DRUL was reconstructed using a tendon graft, the ends of which were anchored in the bone of the radius and ulna. This technique has been shown to correct dynamic DRUJ instability in carefully selected patients, decreasing or eliminating pain and restoring normal function.

Functional anatomy of the hand.

The emphasis of this review is on anatomy as related to function of the hand. We have described all aspects of functional anatomy from the skin to the skeletal framework. This article provides a concise overview of the hand and intricacies.

Nonunion of fractures of the scaphoid tuberosity.

Fracture of the tuberosity of the scaphoid is common and usually heals without incident because of the good blood supply. We report four cases of nonunion of this fracture. Three of them were symptomatic and two required operative treatment.

The burned hand.

Like other work-related injuries, the performance and documentation of a thorough history and physical examination will allow optimal care of the burned worker by accepted management methods. Through understanding of the physical properties of electricity and improving understanding of the pathophysiology of the electric injury, state-of-the-art surgical reconstruction can be appropriately applied. The diversity of chemical compounds at the work place and the wide variety of early measures advocated for treatment requires prevention of chemical burns and careful on-site documentation of chemicals and availability of first aid measures.

Excision of the pisiform in piso-triquetral osteoarthritis.

12 patients with pain in the piso-triquetral region are described. 11 had radiological evidence of osteoarthritis of the piso-triquetral joint, which was confirmed in the nine cases treated by excision of the pisiform. Seven of these had complete relief of symptoms. The clinical findings are constant and relief of pain by conservative treatment is usually only temporary. Ulnar nerve symptoms were present in four patients and these were also relieved by surgery. Excision of the pisiform is a useful operation for this condition, which often remains undiagnosed due to incomplete clinical and radiological evaluation. Full return to normal function is the rule if the problem is not associated with other wrist pathology.

Hand injuries in cricketers.

55 patients with 64 injuries of the hand sustained while playing cricket were reviewed, 46 clinically. Most of the injuries were during fielding. The peripheral digits were most frequently involved and joint injuries predominated. Though the majority of the patients had a satisfactory functional outcome, some admitted to occasional pain and persistence of swelling and/or minor deformity. The most serious injuries were eleven fractures of the base of the middle phalanx with dislocation of the P.I.P. joint.