Journal articles: 'Joints; Thumb'

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Tonogai, Ichiro, Yoshitaka Hamada, and Naohito Hibino. "EVALUATION OF THE FIRST METACARPAL PROXIMAL FACET INCLINATION AS A PROGNOSTIC PREDICTOR FOLLOWING ARTHROPLASTY FOR OSTEOARTHRITIS OF THE THUMB CARPOMETACARPAL JOINT." Hand Surgery 18, no. 01 (January 2013): 69–72. http://dx.doi.org/10.1142/s0218810413500135.

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We have retrospectively reviewed 17 thumbs in 16 patients with osteoarthritis of the thumb carpometacarpal joints, for which arthroplasty was performed using Kaarela's method. Postoperatively, three thumbs in two patients had poor outcomes; both patients had a sharp slope of the base of the first metacarpal. Serial radiographic measurements suggested that this sharp slope affected the adducted position of the first metacarpal, and led to the appearance of a metacarpophalangeal joint hyperextension deformity of the thumb. This radiological finding could be a prognostic predictor after surgery for osteoarthritis of the thumb carpometacarpal joint.

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Wang, Kun, Fangxin Ai, Pan Zhou, Zhiwei Liu, Zhenbing Chen, and Jianghai Chen. "Opening wedge phalangeal osteotomy for correction of Wassel type IV-D thumb duplication." Handchirurgie · Mikrochirurgie · Plastische Chirurgie 52, no. 02 (October 9, 2019): 147–50. http://dx.doi.org/10.1055/a-0893-6659.

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Abstract Background Thumb duplication is one of common anomalies of the hand. Among of Wassel type IV subtypes, type IV-D duplication with a zigzag deformity is most challenging for reconstructing. Several factors may affect the surgical outcomes. This study aimed to present an opening wedge osteotomy at proximal phalangeal neck for treating type IV-D duplication. Methods Data from 14 patients are presented in this study. Eight patients had duplication of the right thumb, and six left thumb. After removal of radial supernumerary thumb, a snug collateral ligament was repaired to correct angular deformity of metacarpophalangeal joint (MCP). Angular deformity of the interphalangeal (IP) joint was corrected by an opening wedge osteotomy at the proximal phalangeal neck. A wedge bone from ablated thumb was grafted to correct the malalignment. IP joint was further stabilized by plication of the ulnar capsule. The relocation of radial part of FPL to the center of distal phalangeal base by use of pull-out suture technique Results After surgery, the angulations of the IP joints and the MCP joints were improved. Bone union was observed in all patients. According to the Japanese Society for Surgery of the Hand evaluation form, twelve cases were rated good, 2 cases fair. Stability of IP and MCP joints was good in all cases. The active ROM of IP was less in residual thumb than in normal thumb. Small nails were observed in some patients. Conclusions Although the reconstructed thumbs were smaller than normal counterparts, they were aligned and with stable joints. The opening wedge osteotomy at proximal phalangeal neck could improve realignment of IP joint and prevent reoccurrence of deformity over time.

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JENKINS, M., H. B. BAMBERGER, L. BLACK, and R. NOWINSKI. "Thumb Joint Flexion." Journal of Hand Surgery 23, no. 6 (December 1998): 796–97. http://dx.doi.org/10.1016/s0266-7681(98)80100-9.

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The purpose of this study was to measure the amount of active flexion from a neutral position in normal thumb metacarpophalangeal and interphalangeal joints and compare the results with previously published reports. One hundred and nineteen subjects (238 thumbs) volunteered to have active flexion of the metacarpophalangeal (MP) and interphalangeal (IP) joints of the thumb measured with a computerized Greenleaf goniometer by a certified hand therapist. The mean MP flexion was 59° and IP flexion was 67°. The results of this study suggest that the accepted normal values of thumb flexion should be reconsidered, particularly as a guide for determining impairment.

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Minami, Akio, Norimasa Iwasaki, Keiji Kutsumi, Naoki Suenaga, and Kazunori Yasuda. "A LONG-TERM FOLLOW-UP OF SILICONE-RUBBER INTERPOSITION ARTHROPLASTY FOR OSTEOARTHRITIS OF THE THUMB CARPOMETACARPAL JOINT." Hand Surgery 10, no. 01 (July 2005): 77–82. http://dx.doi.org/10.1142/s0218810405002607.

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There are several surgical options for osteoarthritis (OA) of the thumb carpometacarpal (CMC) joint. This paper presents our long-term clinical and radiographic review of 12 thumbs in ten patients treated by partial trapezial excision and silicone-rubber interposition arthroplasty. The follow-up period averaged 15; three years with a ten-year minimum. Although the procedure provided early pain relief in most thumbs, all but two had mild to severe pain at follow-up. The average range of post-operative palmar abduction was 23°. The average post-operative grip strength was 9.5 kg. Both tip and key pinch between thumb and index finger averaged about 50% that of normal subjects. Dislocation of the implant occurred in two joints and breakages in five. Bony erosions around the implant, which we attributed silicone synovitis, were found in four thumbs. The indications for silicone-rubber interposition arthroplasty for OA of the thumb CMC joint should be severely restricted as these produced unsatisfactory long-term results.

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Sasaki, Shuichi. "The development of the Kitasato thumb splint as a conservative therapy treatment for patients with thumb carpometacarpal (CMC) arthropathy." Impact 2021, no. 8 (October 28, 2021): 64–66. http://dx.doi.org/10.21820/23987073.2021.8.64.

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Orthoses are devices that are applied externally to help in the rehabilitation of specific bones or joints. Dr Shuichi Sasaki, Department of Rehabilitation, Kitasato University Hospital, Japan, and his team is working to develop a new orthosis for repatriating thumb arthropathies called the Kitasato thumb splint. It is designed to improve usability of the thumb joint, especially in cases of thumb carpometacarpal (CMC) arthropathy, by taking into consideration the thumb CMC joint structure. It exerts force at the base of the CMC joint to move the thumb into the correct joint alignment, improving symptoms for patients. With the Kitasato thumb splint, Sasaki and the team are also eager to provide patients with an alternative to surgery as they believe that the use of more conservative measures with orthoses can prove effective and also prevent costly surgery. The Kitasato thumb splint is made of a low-temperature thermoplastic knit material and can be assembled in as little as 10 minutes, quickly and conveniently providing patients with additional support during painful daily tasks. In his work, Sasaki and the team are looking at orthoses used to treat thumb CMC osteoarthritis and analysing the pressure on CMC joints using quantitative analysis. So far, the Kitasato thumb splint has been found to help in pain reduction and improvements in the activities of daily living in patients with mild cases (Eaton Classifications I to II) of thumb CMC joints and to also provide some improvement in severe cases (Eaton Classifications III-IV).

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Kodama, Akira, Hiroshi Kurumadani, Teruyasu Tanaka, Rikuo Shinomiya, Toru Sunagawa, and Nobuo Adachi. "Three-dimensional analysis of thumb motion recovery after carpal tunnel release." Journal of Hand Surgery (European Volume) 46, no. 7 (May 9, 2021): 743–48. http://dx.doi.org/10.1177/17531934211014700.

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This study quantified recovery of thumb motion in patients with carpal tunnel syndrome after carpal tunnel release using three-dimensional motion analysis with a retroreflective surface-based marker method. Eighteen hands from 14 patients who underwent carpal tunnel release for idiopathic carpal tunnel syndrome were included. The angular movements of the three joints of the thumb, the path length of the thumb tip and the area enclosed by the perimeter path of the thumb tip were measured during circumduction. The range of joint movement, including abduction/adduction of the trapeziometacarpal joint, and flexion/extension of the interphalangeal and metacarpophalangeal joints and the path length of the thumb tips, improved significantly 1 year after surgery. The quantification of thumb kinematics helps to better understand motor dysfunction in carpal tunnel syndrome, assess the severity of the condition and decide on treatment. Level of evidence: IV

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Jarque-Bou, Néstor J., Margarita Vergara, and Joaquín L. Sancho-Bru. "Estimation of the Abduction/Adduction Movement of the Metacarpophalangeal Joint of the Thumb." Applied Sciences 11, no. 7 (April 1, 2021): 3158. http://dx.doi.org/10.3390/app11073158.

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Thumb opposition is essential for grasping, and involves the flexion and abduction of the carpometacarpal and metacarpophalangeal joints of the thumb. The high number of degrees of freedom of the thumb in a fairly small space makes the in vivo recording of its kinematics a challenging task. For this reason, along with the very limited independence of the abduction movement of the metacarpophalangeal joint, many devices do not implement sensors to measure such movement, which may lead to important implications in terms of the accuracy of thumb models. The aims of this work are to examine the correlation between thumb joints and to obtain an equation that allows thumb metacarpophalangeal abduction/adduction movement to be estimated from the other joint motions of the thumb, during the commonest grasps used during activities of daily living and in free movement. The correlation analysis shows that metacarpophalangeal abduction/adduction movement can be expressed mainly from carpometacarpal joint movements. The model thus obtained presents a low estimation error (6.29°), with no significant differences between grasps. The results could benefit most fields that do not typically include this joint movement, such as virtual reality, teleoperation, 3D modeling, prostheses, and exoskeletons.

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Yonekura, Satoru, Hiroyoshi Hagiwara, Takahiro Nishimura, Hiroshi Amagai, Mayu Yamamura, Osamu Miyamoto, and Sueo Nakama. "Synovial Osteochondromatosis at the Carpometacarpal Joint of the Thumb." Case Reports in Orthopedics 2017 (2017): 1–3. http://dx.doi.org/10.1155/2017/3974342.

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Synovial osteochondromatosis (SOC) is a benign tumor characterized by synovial connective tissue metaplasia. SOC commonly affects major joints including the knee followed by the hip, elbow, and wrist. SOC cases in the hand are not reported as often as SOC of major joints. Particularly SOC of the carpometacarpal joint of the thumb is rare. We report on a 57-year-old female with primary SOC of the carpometacarpal joint of her left thumb. Surgical excision was performed and the patient had no symptoms with full range of motion of her left thumb. At 3 years of follow-up, there was no recurrence.

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Kurumadani, Hiroshi, Kazuya Kurauchi, Shota Date, Yosuke Ishii, and Toru Sunagawa. "Effect of the position of the interphalangeal joint on movements of the trapeziometacarpal joint during thumb opposition." Journal of Hand Surgery (European Volume) 47, no. 5 (January 8, 2022): 495–500. http://dx.doi.org/10.1177/17531934211065879.

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The Kapandji test is a simple method to score thumb opposition; however, the position of the interphalangeal joint of the thumb during this test has not been described. We aimed to quantitatively examine the effect of the thumb interphalangeal joint position on movements of the trapeziometacarpal joint during thumb opposition using the Kapandji test. The Kapandji test was carried out in 20 healthy participants during thumb interphalangeal joint extension and flexion. Movements of the joints and the activity of thenar muscles were recorded using motion capture and electromyography, respectively. We found that interphalangeal joint extension increased the trapeziometacarpal joint movement and thenar muscle activity compared with interphalangeal joint flexion, which contributed to thumb opposition at Kapandji Positions 0–6. These findings suggest the position of the thumb interphalangeal joint affects the trapeziometacarpal joint during thumb opposition, and assessment of thumb opposition using the Kapandji test is best done with the thumb interphalangeal joint in extension.

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Grinyagin, I. V., E. V. Biryukova, and M. A. Maier. "Kinematic and Dynamic Synergies of Human Precision-Grip Movements." Journal of Neurophysiology 94, no. 4 (October 2005): 2284–94. http://dx.doi.org/10.1152/jn.01310.2004.

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We analyzed the adaptability of human thumb and index finger movement kinematics and dynamics to variations of precision grip aperture and movement velocity. Six subjects performed precision grip opening and closing movements under different conditions of movement velocity and movement aperture (thumb and index finger tip-to-tip distance). Angular motion of the thumb and index finger joints was recorded with a CyberGlove and a three-dimensional biomechanical model was used for solving the inverse dynamics problem during precision grip movements, i.e., for calculating joint torques from experimentally obtained angular variations. The time-varying joint angles and joint torques were analyzed by principal-component analysis to quantify the contributions of individual joints in kinematic and dynamic synergies. At the level of movement kinematics, we found subject-specific angular contributions. However, the adaptation to large aperture, achieved by an increase of the relative contribution of the proximal joints, was subject-invariant. At the level of movement dynamics, the adaptation of thumb-index finger movements to task constraints was similar among all subjects and required the linear scaling of joint torques, the synchronization of joint torques under high velocity conditions, and a flexible redistribution of joint torques between the proximal joint of the thumb and that of the index finger. This work represents one of the first attempts at calculating the joint torques during human precision-grip movements and indicates that the dynamic synergies seem to be remarkably simple compared with the synergies found for movement kinematics.

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BORETTO, J., V. ALFIE, A. DONNDORFF, G. GALLUCCI, and P. DE CARLI. "A Prospective Clinical Study of the A1 Pulley in Trigger Thumbs." Journal of Hand Surgery (European Volume) 33, no. 3 (June 2008): 260–65. http://dx.doi.org/10.1177/1753193408087070.

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A prospective study was performed in 19 patients with trigger thumbs to define the anatomy of the A1 pulley of the thumb in this condition and to evaluate biomechanical parameters of the thumb after complete division of the A1 pulley. Pre- and postoperatively, flexion of the interphalangeal and metacarpophalangeal joints, key pinch strength and tip pinch strength were measured and compared with these measurements on the contralateral thumb. We identified three types of A1 pulley. The clinical data showed that there is no deficit with respect to motion and strength of the thumb after completely sectioning any of the three types of A1 pulley.

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Lee, C. H., H. Y. Park, J. O. Yoon, and K. W. Lee. "Correction of Wassel type IV thumb duplication with zigzag deformity: results of a new method of flexor pollicis longus tendon relocation." Journal of Hand Surgery (European Volume) 38, no. 3 (September 27, 2012): 272–80. http://dx.doi.org/10.1177/1753193412460809.

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The purpose of this study is to present a treatment algorithm and a method of flexor pollicis longus tendon relocation for Wassel type IV thumb duplication with zigzag deformity. Forty-two thumbs in 42 patients were included in this study and the mean follow-up was 4 years. In addition to excision of the extra digit, tendon relocation and metacarpal and/or proximal phalangeal osteotomy were carried out, based on the degree of angulation at the metacarpophalangeal and interphalangeal joints. Tendon relocation was achieved using our pull-out suture technique. The results were assessed using an evaluation form for thumb polydactyly provided by the Japanese Society for Surgery of the Hand. At the time of latest clinical contact, eight cases were rated good, 31 cases fair, and three cases poor. It is useful to decide surgical procedures according to the degree of angulation of the metacarpophalangeal and interphalangeal joints and flexor pollicis longus tendon relocation is important to prevent malalignment at the interphalangeal joint.

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Wood, V. E., and M. Skie. "An Unusual Complication of the Thumb Following Abductor Digiti Minimi Opponensplasty." Hand Surgery 02, no. 02 (December 1997): 183–89. http://dx.doi.org/10.1142/s0218810497000331.

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An unusual complication of thumb abduction at the metacarpophalangeal joint following an abductor digiti minimi opponensplasty in a hypoplastic thumb is presented in two cases. It is difficult to create a strong ulnar collateral ligament in these children with unstable thumb joints. In some children, the abductor digiti minimi transfer may be too strong for the function it is intended to provide. Reconstruction of the ulnar collateral ligament may not be strong enough to prevent overpull and secondary deformity. Fusion of the thumb metacarpophalangeal joint or chondrodesis may ultimately be required.

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ISLAM, S., H. WATANABE, and S. FUJITA. "Contrast Arthrography in Thumb Polydactyly with Variable Morphological Patterns." Journal of Hand Surgery 17, no. 2 (April 1992): 178–84. http://dx.doi.org/10.1016/0266-7681(92)90084-f.

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Contrast arthrography was performed in 20 patients with duplicated thumbs where the interphalangeal, metacarpophalangeal, and carpometacarpal joints were involved. Three groups were apparent, those with no joint alteration, those with joint involvement and separate articular impressions, and those with abnormal duplex joints.

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Shimawaki, Satoshi, Yoshiaki Nakamura, Masataka Nakabayashi, and Hideharu Sugimoto. "Flexion Angles of Finger Joints in Two-Finger Tip Pinching Using 3D Bone Models Constructed from X-Ray Computed Tomography (CT) Images." Applied Bionics and Biomechanics 2020 (September 10, 2020): 1–6. http://dx.doi.org/10.1155/2020/8883866.

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The motion analysis of two-finger tip pinching using the thumb and index finger provides crucial data for designing the motion mechanism of electric prosthetic hands. The purpose of this study is to determine the joints that have high mobility during two-finger tip pinching by measuring the flexion angle of each joint. Ten Japanese men with normal hand were selected. CT images were obtained while the hands adopted the following four postures: a basic posture not pinching a cylinder, and three postures pinching wooden cylinders with different diameters (2, 10, and 30 mm). Three-dimensional bone models of the thumb and index finger were created using the CT images and used to measure the flexion angles of the joints. The flexion angles of the proximal interphalangeal and metacarpophalangeal joints of the index finger significantly decreased as the diameter of the cylinder increased. However, even when the diameter of the cylinder changed, the flexion angle of the distal interphalangeal joint of the index finger, and the flexion and rotation angles of all of the thumb joints did not change. When pinching objects of different sizes with a two-finger tip pinch, the posture of the thumb is fixed, and only the posture of the index finger changes. When designing the two-finger tip pinch motion for an electric prosthetic hand, it is sufficient to drive the joints of the index finger only.

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Huffman, Rebel, and Ghazi M. Rayan. "THUMB METACARPOPHALANGEAL ARTHRODESIS WITH LOCAL BONE GRAFTING." Hand Surgery 16, no. 01 (January 2011): 55–61. http://dx.doi.org/10.1142/s0218810411005072.

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A restrospective study identified 47 thumb MP joints in 41 patients who underwent arthrodeses using cup and cone osteotomy secured with Kirschner-wire fixation and augmented with local bone graft from the thumb metacarpal. Union rate was 96% averaging 6.8 weeks. Two patients had nonunion; 6.3 year follow-up of 15 thumbs showed improvement of or no pain. MHQ scores were 56.5 in the operative hand and 66.7 in the contralateral hand. Thumb MP arthrodesis augmented with local bone graft negates the morbidity of obtaining distant graft. It is a safe and effective technique that provides excellent pain relief with an acceptable union rate.

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Sakai, Naotaka, and Satoshi Shimawaki. "Motion Analysis of Thumb in Cellular Phone Use." Applied Bionics and Biomechanics 7, no. 2 (2010): 119–22. http://dx.doi.org/10.1155/2010/318641.

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The thumb motion of 10 normal subjects during cellular phone use was measured using a reflective marker detection system to compare the maximum, minimum and range of flexion angles of the interphalangeal (IP), metacarpophalangeal (MP) and carpometacarpal (CM) joints. Two micro-reflective markers 3 mm in diameter were each placed on the dorsal surface of the distal phalanx, basal phalanx and metacarpal bone of the thumb. Three markers were placed on the dorsal hand in order to define the dorsal hand plane. Each subject pushed the 12 keys of a folding cellular phone with an 85-mm-long and 40-mm-wide keypad, sequentially from ‘1’ to ‘#’, and the pushing motion was recorded by six infrared video cameras for 12 seconds, using the VICON 612 system. The mean maximum flexion angle of the MP joint was significantly (p< .05) larger than the CM joint, and the mean minimum flexion angle of the CM joint was significantly (p< .01) smaller than the IP and MP joints. The mean range of motion of the IP joint was significantly (p< .05) larger than the MP and the CM joints. In a comparison of different key-pushing motions, only the CM joint was significantly (p< .05) larger in its range of motion. In conclusion, thumb motion on pushing the keys of the cellular phone was produced mainly by the MP and the CM joints. In addition, the ability to reach keys in different areas of the cellular phone keypad is regulated by changing the flexion angle of the CM joint.

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WEE, J. T. K., D. CHANDRA, and K. SATKU. "Simultaneous Dislocations of the Interphalangeal and Carpometacarpal Joints of the Thumb: A Case Report." Journal of Hand Surgery 13, no. 2 (April 1988): 224–26. http://dx.doi.org/10.1016/0266-7681_88_90146-5.

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A case of simultaneous dislocations of the interphalangeal and carpometacarpal joints of the thumb after a fall is described. We believe this is a unique situation not reported before in the literature. The results of operative intervention of the open IP joint and closed CMC joint dislocations resulted in a stable pain-free thumb with a good range of motion.

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Bernstein, Derek T., Patrick C. McCulloch, Leland A. Winston, and Shari R. Liberman. "Early Return to Play With Thumb Spica Gauntlet Casting for Ulnar Collateral Ligament Injuries Complicated by Adjacent Joint Dislocations in Collegiate Football Linemen." HAND 15, no. 1 (July 17, 2018): 92–96. http://dx.doi.org/10.1177/1558944718788644.

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Background: Treatment of thumb ulnar collateral ligament (UCL) ruptures in elite athletes aims to restore thumb stability while minimizing lost playing time. Thus, surgical repair with early protected return to play in a thumb spica cast has been advocated. The purpose of this study was to document adjacent joint dislocations after primary surgical repair sustained during protected return to play with thumb spica casting in elite-level football players. Methods: Three Division I collegiate starting linemen sustaining adjacent joint dislocations in thumb spica casts following acute surgical repair of ipsilateral thumb UCL ruptures were retrospectively reviewed. Demographic data were recorded as well as the timeline for injury, treatment, and subsequent return to sport. Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores were obtained at final follow-up. Results: The mean time from thumb UCL injury to surgical repair was 8.7 days, and the mean return to sport was 13.3 days from surgery. There were 4 simple dislocations including 3 proximal interphalangeal (PIP) joints and 1 elbow. Each PIP dislocation was close reduced and treated with buddy straps with immediate return to play. The elbow dislocation was close reduced and splinted with return to play 22 days after injury. The mean QuickDASH score was 2.3 at 12 month follow-up. Conclusions: This report highlights that while thumb spica casting protects the surgically repaired thumb UCL and allows for earlier return to play, it risks placing additional stress upon adjacent joints and therefore adjacent injury. Appropriate counseling of the risks and benefits of this treatment strategy is essential.

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Zaidenberg, Ezequiel E., Dante Palumbo, Ezequiel Martinez, Martin Pastrana, Efrain Farias Cisneros, and Carlos R. Zaidenberg. "Innervation of the interphalangeal joint of the thumb: anatomical study." Journal of Hand Surgery (European Volume) 43, no. 6 (April 18, 2018): 631–34. http://dx.doi.org/10.1177/1753193418771311.

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We dissected 30 cadaveric thumb interphalangeal joints to delineate the sensory nerve anatomy of its capsule. Four articular branches supplying the interphalangeal joint capsule of the thumb were found in all specimens. Ulnar and radial proper digital nerves provide one palmar capsular nerve branch on their respective sides. Of the two dorsal branches of the radial nerve at the dorsum of the thumb, we observed that each nerve provided one branch to the interphalangeal dorsal capsule. Our findings demonstrate a consistent pattern of innervation and may provide the anatomical basis to the treating surgeon for an effective and safe denervation of the interphalangeal joint of the thumb.

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FAHMY, N. R. M., N. KEHOE, J. G. WARNER, and N. COURTMAN. "The “S” Quattro Turbo in the Management of Neglected Dorsal Interphalangeal Dislocations." Journal of Hand Surgery 23, no. 2 (April 1998): 248–51. http://dx.doi.org/10.1016/s0266-7681(98)80187-3.

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We have used the “S” Quattro Turbo to treat four neglected dorsal interphalangeal joint dislocations. At an average follow up period of 45 months, there was a mean increase in the range of movement of the PIP joints by 74° and of the IP joint of the thumb or DIP joints by 45°. We recommend this technique for treating dorsal dislocations of the interphalangeal joints of more than 3 weeks duration.

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Cole, K. J., and J. H. Abbs. "Coordination of three-joint digit movements for rapid finger-thumb grasp." Journal of Neurophysiology 55, no. 6 (June 1, 1986): 1407–23. http://dx.doi.org/10.1152/jn.1986.55.6.1407.

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Human thumb and index finger kinematics were examined for multiple repetitions of a simple grasp task as a means to evaluate motor planning and execution of these important hand movements. Subjects generated a rapid (approximately 90-ms duration) pinch movement of the index finger and thumb from an open-hand position. Approximately 400 repetitions were obtained from four naive subjects. The two-dimensional trajectory of the fingertip and the angular positions of the metacarpophalangeal (MP) and proximal interphalangeal (PIP) joints of the index finger were recorded along with the angular position of the thumb interphalangeal joint (TH). Individual joint angular positions were transduced using planar electrogoniometers of an exoskeletal linkage design. Except for consistent single-peaked joint angle and digit trajectory velocity profiles, most kinematic features of the grasp varied considerably across trials, including fingertip spatial position at contact, specific finger paths, finger and thumb path distances, finger and thumb peak tangential velocities, and 5) individual joint rotation magnitudes and peak velocities. However, this kinematic variability was not random. Variable TH angular positioning was paralleled by complementary two-dimensional variations in the finger path. These fingertip adjustments were accomplished by actively controlled, reciprocal angular positioning of the MP and PIP joints. Specifically, with natural reductions in thumb flexion, MP flexion was greater while PIP flexion was reduced and vice versa. These adjustments acted to minimize variations in the point contact of the finger on the thumb and yielded a robust and seemingly natural preference for finger-thumb contact at the more distal surfaces of the digits. The kinematic variability was not due to the finger and thumb movements being controlled independently of digit contact. The variable appositional movements of the finger and thumb and the associated contact force were generated as a single action. This was indicated by an absence of kinematic or force adjustments after contact, smooth digit trajectories with a single peak in their tangential velocities, and finger-thumb contact that consistently occurred well after peak velocity. Likewise, because the variability in the kinematics of the grasp was systematic, it apparently was not due simply to sloppiness or noise in motor execution.(ABSTRACT TRUNCATED AT 400 WORDS)

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NYLÉN, S., A. JOHNSON, and A.-M. ROSENQUIST. "Trapeziectomy and Ligament Reconstruction for Osteoarthrosis of the Base of the Thumb." Journal of Hand Surgery 18, no. 5 (October 1993): 616–19. http://dx.doi.org/10.1016/0266-7681(93)90017-a.

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100 thumbs with primary osteoarthrosis of the joints of the trapezium were treated by trapeziectomy and a FCR sling arthroplasty to reconstruct a first intermetacarpal ligament by the method described by Burton and Pellegrini (1986). Pain at rest remained in five. Some pain at or after exertion persisted in 46, and 49 became completely pain-free. 88 were satisfied with the procedure and there was a significant increase in pinch strength and in the ability to perform activities of daily life. It has become our preferred procedure for treating osteoarthrosis of the basal joint of the thumb.

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Panajotovic, Ljubomir, Jefta Kozarski, and Vladislav Ribnikar. "Surgical management of hand deformities in hereditary dystrophic epidermolysis bullosa." Vojnosanitetski pregled 60, no. 1 (2003): 11–17. http://dx.doi.org/10.2298/vsp0301011p.

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In the period 1996-2001 in the Clinic for Plastic Surgery and Burns of the Military Medical Academy, 18 patients. 12 male and 6 female, with hereditary dystrophic epidermolysis bullosa (HDEB) and hand deformities were surgically treated, to achieve the complete separation of fingers, correction of the thumb adduction contracture and flexion or extension contracture of finger joints. The period of wound healing on flat surfaces after surgery, and the period between two operations was estimated. The most common deformity was the flexion contractures of metacarpophalangeal (MP) joints (45%) and one or both interphalangeal (IP) joints (types A1, A2). In 20% of the hands MP joint was streched with the flexion contracture in distal interphalangeal (DIP) or both IP joints (types B1, B2). In 35% of hands MP joint was in hyperextension with folded proximal interphalangeal (PIP) or both IP joints (C1 i C2). The adduction deformity of the thumb type 1, without the possibility of abduction, was present in 15%, type 2, when the thumb was placed above the palm in 60% and type 3, when the thumb was fused in the palm in 25%. Pseudosyndactyly of the first degree (till PIP joint) was found in 30% of hands, the second degree (till DIP joint) in 25%, and the third degree (the whole finger length) in 45% of hands. Fingers were completely separated and stretched surgically. The period of spontaneous healing was 15 days on the average. EBDC represents great medical and social problem that requires multidisciplinary approach of physicians of various specialties (surgeons, dermatologists, pediatrists, geneticists, nutritionists physiatrists, ophtalmologists, dentists, ENT, as well as specially trained persons and families). The efficient specific systemic therapy aiming to increase the skin resistence to mechanical trauma does not exist yet, and should be developed in the field of gene therapy. The surgical correction of hand deformities, acrylate glove use in the longer post operative period combined with physiotherapy, the active use of hands, the protection of injuries and skin care are the measures which prolong the period between the recurrence of contractures.

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NAASAN, A., and R. E. PAGE. "Duplication of the Thumb." Journal of Hand Surgery 19, no. 3 (June 1994): 355–60. http://dx.doi.org/10.1016/0266-7681(94)90089-2.

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Thumb duplication is a common congenital abnormality accounting for 6.6% of all hand deformities. The object of the primary surgery is to achieve a thumb with aligned joint surfaces and epiphyses perpendicular to the long axis, central flexor and extensor tendons, and adequate collateral ligaments. Experienced surgeons with an understanding of the abnormal anatomy and knowledge of the numerous refinements in technique cannot guarantee a flawless result. Of 43 cases treated in this Unit during the period 1970–1989 49% were noted to have secondary deformities. Angulation at the IP and/or MP joints were the most commonly observed problems. Unsatisfactory results were seen with a greater frequency following correction of the more complex deformities.

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SWANSON, ALFRED B., and GENEVIEVE DE GROOT SWANSON. "Arthroplasty of the Thumb Basal Joints." Clinical Orthopaedics and Related Research &NA;, no. 195 (May 1985): 151???160. http://dx.doi.org/10.1097/00003086-198505000-00014.

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27

Li, Zong-Ming, and Jie Tang. "Coordination of thumb joints during opposition." Journal of Biomechanics 40, no. 3 (January 2007): 502–10. http://dx.doi.org/10.1016/j.jbiomech.2006.02.019.

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SWANSON, ALFRED B., and Genevieve de Groot Swanson. "Reconstruction of the Thumb Basal Joints." Clinical Orthopaedics and Related Research &NA;, no. 220 (July 1987): 68???85. http://dx.doi.org/10.1097/00003086-198707000-00010.

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WU, W. C., T. C. WONG, and T. H. YIP. "Chronic Finger Joint Instability Reconstructed With Bone–Ligament–Bone Graft from the Iliac Crest." Journal of Hand Surgery 29, no. 5 (October 2004): 494–501. http://dx.doi.org/10.1016/j.jhsb.2004.03.014.

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Five patients with chronic instability of digital joints presented with instability and functional disability. Two patients had ulnar collateral ligament damage of the thumb metacarpophalangeal joint and another had chronic multidirectional instability due to radial collateral ligament, dorsal capsule and palmar plate laxity of the metacarpophalangeal joint of the thumb. The fourth patient had a lax radial collateral ligament and palmar plate of the proximal interphalangeal joint of the little finger and the fifth had chronic laxity of the ulnar collateral ligament of the interphalangeal joint of the thumb. All were reconstructed with bone–ligament–bone graft harvested from the iliac crest. The graft was fixed with screws and joint stability was achieved intra-operatively in all patients. All patients achieved a stable joint with improved functional performance at final followup.

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LIM, G. J. S., A. YAM, S. C. TAY, F. C. YONG, and L. C. TEOH. "A Split-EPB Tendon Sling for Chronic Post-Traumatic Palmar Instability of the Thumb Metacarpophalangeal Joint." Journal of Hand Surgery (European Volume) 34, no. 3 (May 20, 2009): 358–62. http://dx.doi.org/10.1177/1753193408097320.

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Kessler’s extensor pollicis brevis (EPB) palmar tendon sling is a simple and reliable reconstruction for symptomatic palmar instability of the thumb metacarpophalangeal (MP) joint. However, we encountered subluxation of the extensor pollicis longus tendon and extension lag at the MP joint when the entire tendon was used. We modified the technique, splitting the tendon to preserve its function as an MP joint extensor. Six thumb MP joints with anteroposterior instability secondary to hyperextension injury were reconstructed using the split-EPB technique. At an average of 22 months postoperatively, all patients had stable and pain-free MP joints. Pinch strength improved an average of 5.6 kg. MP joint flexion was decreased an average of 17.5° and two patients had flexion contractures of 5° and 20°, respectively. Extensor pollicis longus subluxation and MP extension lag did not occur, and there were no recurrences.

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Oka, Yoshinori, Hiroki Harayama, and Masayoshi Ikeda. "Reconstructive Procedure to Repair Chronic Injuries to the Collateral Ligament of Metacarpophalangeal Joints of the Hand." Hand Surgery 08, no. 01 (July 2003): 81–85. http://dx.doi.org/10.1142/s021881040300156x.

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We have devised a reconstructive procedure to repair chronic injuries to the collateral ligament of metacarpophalangeal (MCP) joints. It comprises palmaris longus tendon grafting into a bone tunnel and suturing onto the base of the residual ligament without involving fixation of the tendon graft stump. Thirteen patients were treated for injured MCP joints: thumb/ulnar, ten cases; thumb/radial, two; and middle finger/radial, one. All patients had pain and instability of average 41° in the affected MCP joints. The patients were followed at an average period of five years and nine months. Pain and joint instability disappeared in all patients. The mean MCP joint range of motion (ROM) was 1° on extension and 58° on flexion. The tip pinch strength averaged 4.8 kg. The gratifying results obtained using this method are attributed to the fact that optimal tension of the ligament and satisfactory ROM can be achieved during the course of rehabilitation.

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Braga Silva, J., F. Faloppa, W. Albertoni, A. Gazzalle, and G. L. da Cunha. "Adipofascial turnover flap for the coverage of the dorsum of the thumb: an anatomic study and clinical application." Journal of Hand Surgery (European Volume) 38, no. 4 (February 22, 2012): 371–77. http://dx.doi.org/10.1177/1753193412439168.

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The purpose of this report is to show how our anatomical findings have influenced the design of the dorsal homodigital adipofascial turnover arterial flap to the thumb. Thirty-six thumbs from 18 fresh cadavers were dissected at the Fèr à Moulin Laboratoire (Paris, France) between January 1998 and March 1999. All branches of the proper digital artery (PDA) were identified. During the clinical study, from 2002 to 2008, 12 patients with dorsal thumb skin defects were treated with adipofascial turnover flaps. The dorsal branches of the PDA typically emerge at the level of the metacarpophalangeal and interphalangeal joints, 10 mm apart from the joint line. Based on the anatomical study, the flap could be designed predictably and reliably. The main advantages of dorsal adipofascial turnover flaps include their simplicity; the possibility of a one stage procedure; avoiding the use of tissue from elsewhere on the limb/body; minimal donor-site deformity; and avoidance of damage to the volar digital arteries.

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LEE, Sanglim, and Suk Ha JEON. "Locking of the Metacarpophalangeal Joint of the Thumb Caused by Entrapment of the Radial Sesamoid Bone." Journal of Hand Surgery (Asian-Pacific Volume) 27, no. 03 (June 2022): 580–85. http://dx.doi.org/10.1142/s2424835522720274.

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Locking of metacarpophalangeal (MCP) joints of the thumb may be a consequence of dorsal subluxation from hyperextension injury. The joint is locked in mild hyperextension and cannot flex actively or passively. We report four patients with locked MCP joint of the thumb due to radial sesamoid entrapment after hyperextension or forced flexion injury. All patients had a prominent radial condyle of the metacarpal bone. Three patients had a deformity of the longitudinal groove on which the sesamoid was overlaid. The radial sesamoid was entrapped proximal to the radial condyle which could result in limited extension and hinged flexion of the joint. Excision of the radial sesamoid could release the locked joint. The radial sesamoid should be assessed if the motion of the thumb MCP joint is limited after flexion or extension injury. Level of Evidence: Level V (Therapeutic)

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CHAKRABARTI, A. J., A. H. N. ROBINSON, and P. GALLAGHER. "De La Caffinière Thumb Carpometacarpal Replacements." Journal of Hand Surgery 22, no. 6 (December 1997): 695–98. http://dx.doi.org/10.1016/s0266-7681(97)80427-5.

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The results of 93 de la Caffinière thumb joint replacements in 71 patients were reviewed between 6 and 16 years. The survival rate was 89% at 16 years. Eleven thumb joints had failed requiring revision. The commonest reason for failure was aseptic loosening of the trapezial component. The failure rate was higher in men of working age than any other group, which possibly reflects the increased demands on the prosthesis of these patients. We support the use of this implant for degenerative osteoarthritis, but caution against its use in men under 65 years.

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Wan, Shao Song, Jian Cao, Qun Song Zhu, and Cong Yan. "Research on Image Vectorization Based on Dual-Thumb Pneumatic Flexible Robot Hand." Advanced Materials Research 989-994 (July 2014): 3181–84. http://dx.doi.org/10.4028/www.scientific.net/amr.989-994.3181.

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Because the traditional linear vectorization methods have some shortcomings including processing data slowly, being sensitive to noises and being easy to be distorted. Fuzzy rules and its inference mechanism are the assurance of achieving feature fusion. This paper has a design and analysis on the dual thumb pneumatic flexible robot hand base on the active flexible bending joints we have developed. The flexible joint is composed of four elongation artificial muscles with parallel arrangement. The robot hand has five multi-actuated fingers each with three flexible joints. To improve the flexibility and stability of grasp, the other four fingers are orthogonal and symmetrical except the middle finger, which forms the dual thumb oriented grasp model. Furthermore, we study on the position and posture of fingers applying the parameterized homogeneous transformation to the large deformation and nonlinear problems of flexible joint.

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36

Harris, Patrick G., and John F. Mosher. "Injury to the Collateral Ligaments of the Metacarpophalangeal Joints of the Fingers." Canadian Journal of Plastic Surgery 2, no. 3 (September 1994): 125–29. http://dx.doi.org/10.1177/229255039400200304.

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PG Harris, JF Mosher. Injury to the collateral ligaments of the metacarpophalangeal joints of the fingers. Can J Plast Surg 1994;2(3): 125-129. Injury to the collateral ligaments of metacarpophalangeal (mcp) joints of the fingers has not been given much attention in the literature compared with the more frequently encountered lesion involving the thumb (‘game keeper's’ or ‘skier's’ thumb). Nevertheless, such lesions can result in significant disability if not appropriately treated. To prevent this, awareness of the pathology is required. Pain and lateral instability at the mcp joints may be the only signs. The anatomical lesions vary in sites. Instability to laterally directed stress in full mcp flexion is diagnostic. Most lesions heal with corrective immobilization with the mcp joint at 40° or 45° and ‘buddy taping’ of the fingers. Surgery, through a dorsal approach, is required in cases of rotated or significantly displaced bony attachment and in chronic instability.

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Barmakian, Joseph T. "ANATOMY OF THE JOINTS OF THE THUMB." Hand Clinics 8, no. 4 (November 1992): 683–91. http://dx.doi.org/10.1016/s0749-0712(21)00735-6.

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38

Berger, Aaron J., and Roy A. Meals. "Management of Osteoarthrosis of the Thumb Joints." Journal of Hand Surgery 40, no. 4 (April 2015): 843–50. http://dx.doi.org/10.1016/j.jhsa.2014.11.026.

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39

Carroll, John J., William D. McClain, and Julia A. V. Nuelle. "Treatment of a Subacute Locked Thumb Metacarpophalangeal Joint with Sesamoid Entrapment." Case Reports in Orthopedics 2019 (March 24, 2019): 1–5. http://dx.doi.org/10.1155/2019/2136540.

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Introduction. Locked thumb metacarpophalangeal (MCP) joints due to entrapped radial sesamoids are rare injuries that commonly require open reduction, especially when the injury is delayed in presentation. Case Presentation. We present a case of a 24-year-old female with a subacute thumb MCP joint subluxation due to an incarcerated radial sesamoid. She underwent successful closed reduction but had persistent pain and difficulty gripping large objects necessitating eventual open volar plate repair despite therapy. She was able to achieve full motion, with little pain and disability, after undergoing delayed volar plate repair. Discussion. Delayed volar plate repair may be considered for those patients who fail to improve with conservative management and occupational therapy after a successful closed reduction for thumb MCP joint subluxation due to an incarcerated radial sesamoid.

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Duerinckx, Joris, and Frederik Verstreken. "Total joint replacement for osteoarthritis of the carpometacarpal joint of the thumb: why and how?" EFORT Open Reviews 7, no. 6 (June 1, 2022): 349–55. http://dx.doi.org/10.1530/eor-22-0027.

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Total joint replacement has certain advantages over other surgical treatment methods for osteoarthritis of the thumb carpometacarpal joint, including restoration of thumb length and alignment, good cosmetical result, fast recovery of hand function and prevention of iatrogenic complications at neighbouring joints. Disadvantages include the technical difficulty to perform this surgery and a possible higher complication rate. A meticulous surgical technique is mandatory. Combined with a cementless and modular ball-in-socket implant with a metal-on-polyethylene friction couple, a 10-year survival rate higher than 90% can be expected. Revision surgery is possible with implant exchange or conversion to trapeziectomy.

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Toros, Tulgar, Yusuf Gurbuz, Beray Kelesoglu, Kemal Ozaksar, and Tahir Sadık Sugun. "Reconstruction of extensive pulp defects of the thumb with a radial-based pedicled flap from the index finger." Journal of Hand Surgery (European Volume) 43, no. 10 (June 5, 2018): 1036–43. http://dx.doi.org/10.1177/1753193418778447.

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This article defines a sensate, pedicled heterodigital flap from the proximal radial side of the index finger for reconstructing large soft tissue defects of the thumb. The pedicle consists of the radial digital artery of the index finger. Dorsal sensory branch of proper digital nerve and one of the terminal sensory branches of radial nerve are included in the flap for sensation. The results of 17 consecutive patients at 24 months revealed mean static two-point discrimination of 7 mm at the reconstruction site and 10 patients were able to feel 4 mm at the reconstructed thumb. The mean range of motion of metacarpophalangeal and interphalangeal joints of operated thumbs reached 94% and 66%, the mean grip span reached 96% compared with the uninjured side. The presented flap provided a simple yet favourable alternative for reconstruction of the thumb tip, with thick and durable tissue requiring minimum dissection and donor side morbidity. Level of evidence: IV

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Plana, Natalie M., Valeriy Shubinets, Michael G. Tecce, Ines C. Lin, and Benjamin Chang. "Pollicization of Biphalangeal Index Finger for Type IV Thumb Hypoplasia: A Case Report Describing Preoperative Planning, Intraoperative Decision-Making, and Technical Modifications." HAND 13, no. 6 (July 11, 2018): NP20—NP26. http://dx.doi.org/10.1177/1558944718783472.

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Background: Index finger (IF) pollicization is the standard treatment for severe congenital thumb hypoplasia. The procedure requires a supple and anatomically normal IF. No guidelines exist for IF pollicization in patients who have concomitantly underdeveloped IF, specifically when the digit has only 2 phalanges and 1 interphalangeal joint. Methods: We present a case of a 20-month-old boy with congenital type IV thumb hypoplasia who also had biphalangeal IF. We proposed an IF pollicization operation that required significant modifications to the traditional procedure. Results: Preoperative planning and intraoperative execution are described. The modifications to the traditional procedure included: (1) removal of proximal third of IF metacarpal; (2) creation of a de novo thumb carpometacarpal (CMC) joint by fibrous union whereby the IF CMC joint cartilaginous components are maintained and the remaining distal IF metacarpal is translocated down and secured to this cartilage (in contrast to the traditional use of IF metacarpophalangeal joint as a de novo thumb CMC joint); (3) preservation of IF joints at their “natural” position and function; (4) maintenance of intrinsic muscles at their original distal insertion sites; and (5) important adjustments to skin incision. Conclusions: Pollicization of biphalangeal IF can be executed in a safe and efficient manner. Early recovery has shown promising signs. Long-term results, including the de novo thumb CMC joint function, remain to be evaluated.

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HOFER, S. O. P., and P. H. ROBINSON. "Palmar Capsulodesis for Treatment of Symptomatic Hyperextensibility of the Metacarpophalangeal Joints." Journal of Hand Surgery 24, no. 4 (August 1999): 468–70. http://dx.doi.org/10.1054/jhsb.1999.0157.

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A modification of the technique of palmar capsulodesis described by Filler et al. (1976) for the treatment of hyperextensibility in the metacarpophalangeal joint of the thumb was used in the metacarpophalangeal joints of the fingers. Seven of eight patients regained normal range of motion without pain.

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Towles, Joseph D., Derek G. Kamper, and William Z. Rymer. "Lack of Hypertonia in Thumb Muscles After Stroke." Journal of Neurophysiology 104, no. 4 (October 2010): 2139–46. http://dx.doi.org/10.1152/jn.00423.2009.

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Despite the importance of the thumb to hand function, little is known about the origins of thumb impairment poststroke. Accordingly, the primary purpose of this study was to assess whether thumb flexors have heightened stretch reflexes (SRs) following stroke-induced hand impairment. The secondary purpose was to compare SR characteristics of thumb flexors in relation to those of finger flexors since it is unclear whether SR properties of both muscle groups are similarly affected poststroke. Stretch reflexes in thumb and finger flexors were assessed at rest on the paretic side in each of 12 individuals with chronic, severe, stroke-induced hand impairment and in the dominant thumb in each of eight control subjects also at rest. Muscle activity and passive joint flexion torques were measured during imposed slow (SS) and fast stretches (FS) of the flexors that span the metacarpophalangeal joints. Putative spasticity was then quantified in terms of the peak difference between FS and SS joint torques and electromyographic changes. For both the hemiparetic and control groups, the mean normalized peak torque differences (PTDs) measured in thumb flexors were statistically indistinguishable ( P = 0.57). In both groups, flexor muscles were primarily unresponsive to rapid stretching. For 10 of 12 hemiparetic subjects, PTDs in thumb flexors were less than those in finger flexors ( P = 0.03). Paretic finger flexor muscle reflex activity was consistently elicited during rapid stretching. These results may reflect an important difference between thumb and finger flexors relating to properties of the involved muscle afferents and spinal motoneurons.

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Morizaki, Yutaka, and Toshiki Miura. "UNUSUAL PATTERN OF DISLOCATION OF THE TRAPEZIOMETACARPAL JOINT WITH AVULSION FRACTURE OF THE TRAPEZIUM: CASE REPORT." Hand Surgery 14, no. 02n03 (January 2009): 149–52. http://dx.doi.org/10.1142/s0218810409004414.

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Dislocation of the trapeziometacarpal joint is a rare injury. We report an unusual pattern of dorsal dislocation of the trapeziometacarpal joint with an avulsion fracture of the dorsoradial tubercle of the trapezium. Simultaneous ligament rupture with an avulsion fracture of the thumb metacarpophalangeal joint was associated. The trapeziometacarpal joint was reduced and disrupted ligaments with avulsed fragments of both joints were surgically repaired.

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Yan, Yadong, Chang Cheng, Mingjun Guan, Jianan Zhang, and Yu Wang. "The Influence of the Abduction Joints of Four Fingers to Grasp: Experimental and Simulated Verification." Applied Sciences 11, no. 24 (December 15, 2021): 11960. http://dx.doi.org/10.3390/app112411960.

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The thumb is the most important finger of the human hand and has a great influence on grasp manipulations. However, the extent to which joints other than the thumb joints affect the grasp, and thus, which joints should be included in a prosthetic hand, remains an open issue. In this paper, we focus on the metacarpophalangeal joints of the four fingers, except the thumb, which can generate flexion/extension and abduction/adduction motions. The contribution of these joints to grasping was evaluated in four aspects: grasp size, grasp force, grasp quality and grasp success rate. Six subjects participated in experiments with respect to the maximum grasp size and grasp force. The results show that possessing abduction mobility of the metacarpophalangeal joints can increase the grasp size by 4.67 ± 1.93 mm and the grasp force by 5.27 ± 4.25 N. Then, the grasping quality and success rate were tested in a simulation platform and using a robotic hand, respectively. The results show that grasp quality was promoted by 76.7% in the simulated environment with abduction mobility compared to without abduction mobility, whereas the grasp success rate was promoted by 68.3%. We believe that the results of this work can benefit the understanding of hand function and prosthetic hand design.

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Ghelani, Nilesh B., Sankit Shah, Sunmathi B. P., and Samir Patel. "Delayed presentation of extensor pollicis longus tendon injury treated using extensor indicis proprius tendon transfer." International Surgery Journal 6, no. 11 (October 24, 2019): 4138. http://dx.doi.org/10.18203/2349-2902.isj20195140.

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Spontaneous closed rupture of EPL tendon are frequently associated with rheumatoid arthritis, Colles fracture, sports related injury. In cases of delayed presentation direct tendon repair is not feasible and a tendon transfer is usually recommended. In this study we evaluated the results of extensor indicis proprius (EIP) to extensor pollicis longus (EPL) transfers for EPL ruptures. Four patients, (two male and two females); mean age 32 years (range 20 to 45 years) with EPL tendon rupture underwent EIP to EPL tendon transfer. The mean duration from rupture to surgery was 4.5 weeks (range 4 to 6 weeks). Range of motion of the metacarpophalangeal (MCP), interphalangeal joints (IP) of the thumb and index finger of the operated side was compared with the normal side. The results were scored using geldmacher scheme, for the thumb four functions were scored, the radial abduction angle, the elevation deficit, the opposition distance and flexion extension deficit of MP and IP joints. The mean follow-up period was 5 months. All the four patients were able extend the thumb at MCP joint and oppose the thumb to the MCP of little finger after mean follow up of 5 months. Based on the questionnaire, the results of tendon transfer scored by three (75%) patients was excellent and by one (25%) patient was good. Independent extension of the index finger of operated hand was possible in all 4 patients. The procedure of EIP to EPL tendon transfer provides excellent result for extension of thumb. It is a safe procedure.

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TONKIN, M. A., N. C. HATRICK, J. R. T. ECKERSLEY, and G. COUZENS. "Surgery for Cerebral Palsy Part 3: Classification and Operative Procedures for Thumb Deformity." Journal of Hand Surgery 26, no. 5 (October 2001): 465–70. http://dx.doi.org/10.1054/jhsb.2001.0601.

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Spastic thumb deformity is the result of imbalance between intrinsic and extrinsic forces acting across unstable joints. This paper presents a classification of spastic thumb deformity based on the accurate assessment of the deforming forces, outlines methods for their correction and reviews the results of our surgery. Thumb reconstruction procedures were performed in 32 patients with 33 spastic thumb deformities. All patients were assessed pre- and postoperatively using the same functional assessment system which was performed by the same team. The thumb was maintained out of the palm in 29 patients and lateral pinch was established in 26 patients.

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Gerbert, G., and Ha˚kan Ba˚stedt. "Centrically Loaded Bolt Joints." Journal of Mechanical Design 115, no. 4 (December 1, 1993): 701–5. http://dx.doi.org/10.1115/1.2919257.

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Externally loaded bolt joints of different design are investigated. The bolt load is substantially lower than that predicted by the mounting stiffnesses of bolt and abutment. A load application fraction n is introduced in VDI 2230 and some thumb rules are suggested. New fractions are determined which are much lower than the suggested ones. It appears that the application fraction n is almost independent of the location of the external load in practical design but it is influenced by the layout of the bolt joint.

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BEAUPERTHUY, G. D., and E. F. BURKE. "Alternative Method of Repairing Collateral Ligament Injuries at the Metacarpophalangeal Joints of the Thumb and Fingers." Journal of Hand Surgery 22, no. 6 (December 1997): 736–38. http://dx.doi.org/10.1016/s0266-7681(97)80436-6.

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Injuries to the joints of the thumb and fingers frequently cause complete or partial tears of the collateral ligaments, resulting in marked instability of the involved joint. Twelve patients with 12 unstable metacarpophalangeal joints were treated surgically with a Mitek® metal suture anchor. At the last postoperative follow-up (range 6 weeks-6 months) 11 of 12 patients had good to excellent results subjectively and had regained 75% of the strength of the uninjured side.

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Journal articles on the topic 'Joints; Thumb'

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