Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 9.839
Filtrar
1.
BMJ Case Rep ; 17(7)2024 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-38991569

RESUMO

Linburg-Comstock syndrome is an acquired symptomatic restrictive thumb index finger flexor tenosynovitis involving a hypertrophic tenosynovium between flexor pollicis longus and flexor digitorum profundus. Patients may report synkinetic movement of the thumb and index finger, pain and swelling. We present the case of a woman in her 80s who presented with painless Linburg-Comstock syndrome after a trapeziectomy 4 months earlier for trapeziometacarpal arthritis. A literature review of PubMed-indexed case reports found that Linburg-Comstock syndrome has never been described in a post-trapeziectomy patient. This unusual presentation that arose as a side effect of hand surgery remains unreported in the literature. We present this unique complication as the first such case in the world. This case report is a valuable addition to the existing knowledge on the complications of trapeziectomy surgery.


Assuntos
Complicações Pós-Operatórias , Trapézio , Humanos , Feminino , Trapézio/cirurgia , Idoso de 80 Anos ou mais , Complicações Pós-Operatórias/cirurgia , Complicações Pós-Operatórias/etiologia , Síndrome , Tenossinovite/cirurgia , Tenossinovite/etiologia , Polegar/anormalidades , Polegar/cirurgia
2.
Acta Chir Orthop Traumatol Cech ; 91(3): 175-181, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38963897

RESUMO

PURPOSE OF THE STUDY: The purpose of this study was to assess the patient experience of trapeziectomy under WALANT for trapeziometacarpal joint (TMJ) osteoarthritis (OA) in a prospective study with 2-year follow-up. MATERIAL AND METHODS: The study included 23 patients with TMJ OA undergoing trapeziectomy with WALANT. All patients were seen by a hand therapist preoperatively and at 3, 12, and 24 months postoperatively. At each visit, VAS pain scores, thumb range of motion, grip strength, and Disabilities of the Arm, Shoulder and Hand (DASH) score were assessed. The Picker Patient Experience (PPE-15) questionnaire was administered within 2 weeks of surgery. RESULTS: All 23 patients completed the PPE-15 questionnaire. Their mean age was 64 years. The 21 patients who remained at the 24-month follow-up all said they would choose the same anaesthesia method again. At this follow-up, VAS pain scores, thumb range of motion, key pinch grip and DASH scores had improved significantly, while thumb opposition and hand grip strength remained largely unchanged. The majority of patients felt well informed before and during the procedure, and all patients rated pain relief as good or satisfactory. Nearly 40% of patients reported receiving inadequate information about the postoperative medications. DISCUSSION: Patients have a positive attitude to trapeziectomy with WALANT, and seem to prefer WALANT over other methods of anaesthesia. Trapeziectomy with WALANT for TMJ OA is a safe procedure and appears to give a functional outcome similar to trapeziectomy under general anaesthesia. CONCLUSIONS: Trapeziectomy with WALANT for TMJ OA is safe, preferred by patients and has similar clinical outcome as trapeziectomy in general anesthesia. KEY WORDS: trapeziectomy, osteoarthritis, WALANT.


Assuntos
Anestesia Local , Osteoartrite , Amplitude de Movimento Articular , Trapézio , Humanos , Osteoartrite/cirurgia , Osteoartrite/fisiopatologia , Pessoa de Meia-Idade , Trapézio/cirurgia , Feminino , Masculino , Anestesia Local/métodos , Estudos Prospectivos , Seguimentos , Articulações Carpometacarpais/cirurgia , Articulações Carpometacarpais/fisiopatologia , Força da Mão , Idoso , Medição da Dor , Satisfação do Paciente , Resultado do Tratamento , Inquéritos e Questionários , Polegar/cirurgia , Polegar/fisiopatologia , Ossos Metacarpais/cirurgia
4.
Med Sci Monit ; 30: e943686, 2024 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-38944680

RESUMO

BACKGROUND Congenital hypoplasia of the thumb type IV, also known as floating thumb, is a condition in which 2 small phalanges are attached to the hand with a thin skin bridge. Surgical management options for this condition vary from amputation to flap reconstruction. MATERIAL AND METHODS This retrospective study analyzed 11 infants with congenital hypoplasia of the thumb type IV who underwent surgical reconstruction using a modified vascularized polydactylous hallux flap. The study included 6 male and 5 female infants, aged 6 to 24 months. Functional evaluations and radiographic studies were conducted postoperatively. RESULTS All 11 patients underwent the complete surgical protocol. Successful vascular and nerve anastomoses were performed during the initial procedure, ensuring sufficient blood supply and neural connectivity to the transferred toes. The second operation showed promising outcomes, including improvements in thumb opposition, grasp strength, and overall function. Postoperative assessments demonstrated satisfactory radiographic alignment and no major complications during the follow-up period. CONCLUSIONS The modified vascularized polydactylous hallux flap reconstruction is a viable surgical option for managing congenital hypoplasia of the thumb type IV in infants. This technique effectively restores thumb opposition, grasp strength, and overall hand function, with satisfactory radiographic alignment and minimal complications. The study findings support the efficacy and safety of this surgical approach in addressing this rare congenital anomaly.


Assuntos
Procedimentos de Cirurgia Plástica , Retalhos Cirúrgicos , Polegar , Humanos , Polegar/anormalidades , Polegar/cirurgia , Polegar/diagnóstico por imagem , Masculino , Feminino , Estudos Retrospectivos , Lactente , Procedimentos de Cirurgia Plástica/métodos , Resultado do Tratamento , Pré-Escolar , Radiografia/métodos , Força da Mão/fisiologia , Deformidades da Mão/cirurgia , Deformidades Congênitas da Mão/cirurgia , Deformidades Congênitas da Mão/diagnóstico por imagem
5.
Handchir Mikrochir Plast Chir ; 56(3): 201-211, 2024 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-38861975

RESUMO

The introduction of the new generation of thumb carpometacarpal (CMC I) joint implants for the treatment of CMC I osteoarthritis has significantly broadened the scope of hand surgery in recent years. However, the technical demands of the procedure and the many details that need to be considered require appropriate training and a learning curve. To share experiences with the Touch CMC I prosthesis, we held the first German-speaking CMC I joint prosthetics user meeting in Zurich. After some basic introductory lectures on biomechanics and the principles of prosthetic fitting of the CMC I joint, the various challenges associated with CMC I joint prosthetics were discussed in interactive expert panels. Subsequently, cases were discussed in small groups under expert guidance and the respective conclusions were discussed in plenary. The main results of this symposium are summarised in this manuscript.


Assuntos
Articulações Carpometacarpais , Prótese Articular , Osteoartrite , Desenho de Prótese , Polegar , Articulações Carpometacarpais/cirurgia , Humanos , Polegar/cirurgia , Osteoartrite/cirurgia , Ajuste de Prótese , Fenômenos Biomecânicos , Masculino
6.
Handchir Mikrochir Plast Chir ; 56(3): 192-200, 2024 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-38861974

RESUMO

Base-of-thumb osteoarthritis is the most frequent osteoarthritis of the hand requiring surgical treatment, although conservative treatment options should be exhausted before surgery. If the wear process progresses with continuing pain-related loss of thumb function, thus leading to a loss of function of the whole hand, surgical treatment is indicated. In 1947, Gervis published results after trapeziectomy and heralded the development of a multitude of different surgical procedures. The long time needed for rehabilitation is a major problem of trapeziectomy with or without tendon interposition and/or suspension. After the implementation of the first CMC I prosthesis by De la Caffiniere 50 years ago, a rapid development took place, leading to the current modular bipolar implants. Especially in the German-speaking world, there is still some scepticism regarding these prostheses, which is why this review aims to illuminate both surgical procedures with a special focus placed on the aspects of indication.


Assuntos
Articulações Carpometacarpais , Prótese Articular , Osteoartrite , Desenho de Prótese , Polegar , Trapézio , Osteoartrite/cirurgia , Humanos , Trapézio/cirurgia , Polegar/cirurgia , Articulações Carpometacarpais/cirurgia , Complicações Pós-Operatórias/cirurgia , Complicações Pós-Operatórias/etiologia
7.
Handchir Mikrochir Plast Chir ; 56(3): 212-218, 2024 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-38861976

RESUMO

BACKGROUND: The increasing use of thumb carpometacarpal joint prostheses for advanced CMC 1 (carpometacarpal) joint arthritis reflects the success of the latest prosthesis generations, which has been achieved through their improved functional outcomes and lower complication rates. Precise alignment of the prosthesis cup parallel to the proximal joint surface of the trapezium is essential for stability and the prevention of dislocation. This is a challenging surgical step, particularly for surgeons new to this technique. Despite adequate positioning of the guidewire, misplacements of the cup may occur, necessitating intraoperative revision. MATERIAL AND METHODS: This study examined the deviations in cup and guidewire positioning in thumb carpometacarpal joint prosthesis implantations by inexperienced and experienced surgeons through radiological analysis of 65 prostheses. RESULTS: Both inexperienced and experienced surgeons achieved precise guidewire positioning with mean deviations of<2.2°. Inexperienced surgeons showed significantly larger cup deviations in the dorsopalmar and lateral view (7.6±6.1° and 7.3±5.9°) compared with experienced surgeons (3.6±2.7° and 3.6±2.5°; p=0.012, p=0.017). The deviation of the cup position exhibited by inexperienced surgeons tends to be in the direction opposite to the initial guidewire position (p<0.0038). CONCLUSION: The results highlight the current challenges in cup positioning depending on a surgeon's level of experience, questioning the reliability of the current guidewire placement.


Assuntos
Articulações Carpometacarpais , Polegar , Articulações Carpometacarpais/cirurgia , Humanos , Polegar/cirurgia , Masculino , Feminino , Prótese Articular , Fios Ortopédicos , Competência Clínica , Pessoa de Meia-Idade , Idoso , Desenho de Prótese , Complicações Pós-Operatórias/prevenção & controle , Complicações Pós-Operatórias/etiologia , Reoperação , Osteoartrite/cirurgia
8.
Ital J Pediatr ; 50(1): 121, 2024 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-38915054

RESUMO

BACKGROUND: Townes-Brocks syndrome (TBS) is a rare genetic disorder characterized by imperforate anus, dysplastic ears, thumb malformations, and other abnormalities. Previous studies have revealed that mutations in the SALL1 gene can disrupt normal development, resulting in the characteristic features of Townes-Brocks syndrome. Spalt-like transcription factors (SALLs) are highly conserved proteins that play important roles in various cellular processes, including embryonic development, cell differentiation, and cell survival. Over 400 different variants or mutations have been reported in the SALL1 gene in individuals with TBS. Most of these variants lead to the formation of premature termination codons (PTCs), also known as nonsense mutations. The majority of these PTCs occur in a specific region of the SALL1 gene called the "hotspot region", which is particularly susceptible to mutation. METHODS: In this study, we conducted whole-exome sequencing on a three-generation Chinese family with anorectal malformations. RESULTS: We identified a novel heterozygous mutation (chr16:51175376:c.757 C > T p.Gln253*) in the SALL1 gene. Molecular analysis revealed a heterozygous C to T transition at nucleotide position 757 in exon 2 of the SALL1 (NM_002968) gene. This mutation is predicted to result in the substitution of the Gln253 codon with a premature stop codon (p.Gln253*). The glutamine-rich domain forms a long alpha helix, enabling the mutant protein to interact with the wild-type SALL1 protein. This interaction may result in steric hindrance effects on the wild-type SALL1 protein. CONCLUSIONS: Our findings have expanded the mutation database of the SALL1 gene, which is significant for genetic counseling and clinical surveillance in the affected family. Furthermore, our study enhances the understanding of Townes-Brocks syndrome and has the potential to improve its diagnosis and treatment.


Assuntos
Anormalidades Múltiplas , Anus Imperfurado , Linhagem , Fatores de Transcrição , Humanos , Fatores de Transcrição/genética , Anormalidades Múltiplas/genética , Anus Imperfurado/genética , Feminino , Masculino , China , Mutação , Doenças Raras/genética , Malformações Anorretais/genética , Povo Asiático/genética , População do Leste Asiático , Perda Auditiva Neurossensorial , Polegar/anormalidades
9.
Acta Orthop ; 95: 325-332, 2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38887076

RESUMO

BACKGROUND AND PURPOSE: Thumb carpometacarpal (CMC) joint osteoarthritis (OA) is increasingly treated with total joint arthroplasty (TJA). We aimed to perform a systematic review and meta-analysis of the benefits and harms of the TJA for thumb CMC OA compared with other treatment strategies. PATIENTS AND METHODS: We performed a systematic search on MEDLINE and CENTRAL databases on August 2, 2023. We included randomized controlled trials investigating the effect of TJA in people with thumb CMC joint OA regardless of the stage or etiology of the disease or comparator. The outcomes were pooled with a random effect meta-analysis. RESULTS: We identified 4 studies randomizing 420 participants to TJA or trapeziectomy. At 3 months, TJA's benefits for pain may exceed the clinically important difference. However, after 1-year follow-up TJA does not improve pain compared with trapeziectomy (mean difference 0.53 points on a 0 to 10 scale; 95% confidence interval [CI] 0.26-0.81). Furthermore, it provides a transient benefit in hand function at 3 months (measured with Disabilities of Arm, Shoulder, and Hand questionnaire, scale 0-100, lower is better) compared with trapeziectomy with or without ligament reconstruction tendon interposition. The benefit in function diminished to a clinically unimportant level at 1-year follow-up (4.4 points better; CI 0.42-8.4). CONCLUSION: Transient benefit in hand function for TJA implies that it could be a preferable option over trapeziectomy for people who consider fast postoperative recovery important. However, current evidence fails to inform us if TJA carries long-term higher risks of revisions compared with trapeziectomy.


Assuntos
Articulações Carpometacarpais , Osteoartrite , Ensaios Clínicos Controlados Aleatórios como Assunto , Polegar , Humanos , Articulações Carpometacarpais/cirurgia , Articulações Carpometacarpais/fisiopatologia , Osteoartrite/cirurgia , Polegar/cirurgia , Polegar/fisiopatologia , Artroplastia de Substituição/métodos , Artroplastia de Substituição/efeitos adversos , Trapézio/cirurgia
10.
Anat Sci Int ; 99(3): 326-330, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38733476

RESUMO

The extensor digitorum profundus complex underwent degeneration of the ulnar segments during primate adaptation and evolution. This process resulted in the preservation of only the extensor pollicis longus and extensor indicis in some apes, including humans. Consequently, anatomical variations within the digitorum profundus complex in modern humans have been well-documented, with detailed reports on their frequency and patterns in previous studies. Here, we report an unusual arrangement involving two anomalies in the extensor digitorum profundus complex, identified in a 66-year-old Japanese male cadaver. In this cadaver, two accessory muscles differentiated from both the extensor pollicis longus and extensor indicis. Notably, the latter muscle featured a tendon bifurcating towards both the thumb and index fingers, referred to as the extensor pollicis et indicis communis. Under the extensor retinaculum, the tendon of the accessory extensor pollicis longus passed through an independent compartment, whereas that of the extensor pollicis et indicis communis traversed a compartment shared by the extensor indicis and the extensor digitorum communis. Both muscles were innervated by the posterior interosseous nerve. Previous studies have reported that the accessory slip of the extensor pollicis longus and extensor pollicis et indicis communis appear at frequencies of 0.6% and 0.4-1.4%, respectively. However, to the best of our knowledge, a configuration in which both appear simultaneously has not been reported. The data from this case could provide essential insights into the variations in the extensor digitorum profundus complex in humans and non-human primates.


Assuntos
Cadáver , Músculo Esquelético , Tendões , Humanos , Masculino , Idoso , Músculo Esquelético/anormalidades , Músculo Esquelético/anatomia & histologia , Tendões/anormalidades , Tendões/anatomia & histologia , Dedos/anormalidades , Dedos/anatomia & histologia , Variação Anatômica , Polegar/anormalidades
11.
Genes Chromosomes Cancer ; 63(5): e23241, 2024 05.
Artigo em Inglês | MEDLINE | ID: mdl-38738966

RESUMO

Osteoblastomas (OBs) are benign neoplasms constituting approximately 1% of primary bone tumors with a predilection for the spine and sacrum. We describe an OB of the proximal phalanx of the left thumb in a 38-year-old female. MRI of left hand demonstrated a 29-mm mildly expansile enhancing lesion involving the entire proximal phalanx of the first digit. Histology displayed a bone-forming tumor consisting of trabeculae of remodeled woven bone framed by plump osteoblasts in a vascularized background. Next-generation sequencing analysis identified a PRSS44::ALK fusion gene.


Assuntos
Neoplasias Ósseas , Osteoblastoma , Polegar , Humanos , Feminino , Adulto , Polegar/patologia , Polegar/anormalidades , Osteoblastoma/genética , Osteoblastoma/patologia , Neoplasias Ósseas/genética , Neoplasias Ósseas/patologia , Proteínas de Fusão Oncogênica/genética
12.
J Pediatr Health Care ; 38(3): e1-e4, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38697700

RESUMO

We describe the case of a 6-year-old female who presented with tender nodules and fixed flexion of her thumbs, diagnosed as bilateral pediatric trigger thumb. Though present since infancy, her condition was not diagnosed in prior clinical visits. Pediatric trigger digit is a clinical diagnosis, often missed if the digit's range of motion is not assessed routinely. Given the duration, pain, and severity of her condition, conservative management was deferred, and she was referred for surgery. An approach to clinical management is discussed. Ultimately, further study is required to develop structured management guidelines for pediatric trigger digit.


Assuntos
Diagnóstico Tardio , Dedo em Gatilho , Humanos , Feminino , Dedo em Gatilho/diagnóstico , Criança , Amplitude de Movimento Articular , Polegar/fisiopatologia
13.
J Biomech ; 168: 112129, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38703515

RESUMO

The thumb carpometacarpal (CMC) joint facilitates multidirectional motion of the thumb and affords prehensile power and precision. Traditional methods of quantifying thumb CMC kinematics have been largely limited to range-of-motion (ROM) measurements in 4 orthogonal primary directions (flexion, extension, abduction, adduction) due to difficulties in capturing multidirectional thumb motion. However, important functional motions (e.g., opposition) consist of combinations of these primary directions, as well as coupled rotations (internal and external rotation) and translations. Our goal was to present a method of quantifying the multidirectional in vitro biomechanics of the thumb CMC joint in 6 degrees-of-freedom. A robotic musculoskeletal simulation system was used to manipulate CMC joints of 10 healthy specimens according to specimen-specific joint coordinate systems calculated from computed tomography bone models. To determine ROM and stiffness (K), the first metacarpal (MC1) was rotated with respect to the trapezium (TPM) to a terminal torque of 1 Nm in the four primary directions and in 20 combinations of these primary directions. ROM and K were also determined in internal and external rotation. We found multidirectional ROM was greatest and K least in directions oblique to the primary directions. We also found external rotation coupling with adduction-flexion and abduction-extension and internal rotation coupling with abduction-flexion and adduction-extension. Additionally, the translation of the proximal MC1 was predominantly radial during adduction and predominantly ulnar during abduction. The findings of this study aid in understanding thumb CMC joint mechanics and contextualize pathological changes for future treatment improvement.


Assuntos
Articulações Carpometacarpais , Amplitude de Movimento Articular , Polegar , Humanos , Articulações Carpometacarpais/fisiologia , Polegar/fisiologia , Amplitude de Movimento Articular/fisiologia , Fenômenos Biomecânicos , Masculino , Feminino , Rotação , Modelos Biológicos , Idoso , Pessoa de Meia-Idade
14.
J Hand Surg Asian Pac Vol ; 29(3): 184-190, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38726488

RESUMO

Background: Untreated or insufficiently treated collateral ligament injuries of the thumb metacarpophalangeal (MP) joint can lead to instability or even osteoarthritis. Arthrodesis is one of the treatment options available for the treatment of the sequelae of collateral ligament injuries. The objective of our study was to evaluate the radiological, clinical and functional outcomes of MP joint arthrodesis performed for sequelae of collateral ligament injuries. Methods: We conducted a retrospective, single-centre study and reviewed the files of patients who had a thumb MP joint arthrodesis following a collateral ligament injury between 2011 and 2019. We collected patient's demographic data and the results of the radiological and clinical examinations. Results: Eighteen patients were included in the study. The average age was of 53.6 years and the time between injury to arthrodesis averaged 7 years. Four patients (22%) had nonunion. In the remaining 14 patients with solid union at an average of 72 months follow-up, the visual analogue pain score at rest was 0.14, the thumb opposition was 82%, grip strength 85%, tip pinch 92% and key pinch 79% of the contralateral side. Conclusions: The clinical and functional results of patients with a successful arthrodesis are satisfactory with restoration of good grip and pinch strength. Despite a lack of thumb MP joint flexion, stability allowed force transmission and may be preferred for manual workers. Level of Evidence: Level IV (Therapeutic).


Assuntos
Artrodese , Ligamentos Colaterais , Articulação Metacarpofalângica , Polegar , Humanos , Articulação Metacarpofalângica/cirurgia , Articulação Metacarpofalângica/lesões , Artrodese/métodos , Masculino , Pessoa de Meia-Idade , Feminino , Estudos Retrospectivos , Polegar/cirurgia , Polegar/lesões , Ligamentos Colaterais/cirurgia , Ligamentos Colaterais/lesões , Adulto , Seguimentos , Idoso , Força da Mão/fisiologia , Resultado do Tratamento
15.
J Hand Surg Asian Pac Vol ; 29(3): 191-199, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38726498

RESUMO

Background: Thumb carpometacarpal joint (CMC) osteoarthritis is the most symptomatic hand arthritis but the long-term healthcare burden for managing this condition is unknown. We sought to compare total healthcare cost and utilisation for operative and nonoperative treatments of thumb CMC arthritis. Methods: We conducted a retrospective longitudinal analysis using a large nationwide insurance claims database. A total of 18,705 patients underwent CMC arthroplasty (trapeziectomy with or without ligament reconstruction tendon interposition) or steroid injections between 1 October 2015 and 31 December 2018. Primary outcomes, healthcare utilisation and costs were measured from 1 year pre-intervention to 3 years post-intervention. Generalised linear mixed effect models adjusted for potentially confounding factors such as the Elixhauser comorbidity score with propensity score matching were applied to evaluate the association between the primary outcomes and treatment type. Results: A total of 13,646 patients underwent treatment through steroid injections, and 5,059 patients underwent CMC arthroplasty. At 1 year preoperatively, the surgery group required $635 more healthcare costs (95% CI [594.28, 675.27]; p < 0.001) and consumed 42% more healthcare utilisation (95% CI [1.38, 1.46]; p < 0.0001) than the steroid injection group. At 3 years postoperatively, the surgery group required $846 less healthcare costs (95% CI [-883.07, -808.51], p < 0.0001) and had 51% less utilisation (95% CI [0.49, 0.53]; p < 0.0001) annually. Cumulatively over 3 years, the surgical group on average was $4,204 costlier than its counterpart secondary to surgical costs. Conclusions: CMC arthritis treatment incurs high healthcare cost and utilisation independent of other medical comorbidities. At 3 years postoperatively, the annual healthcare cost and utilisation for surgical patients were less than those for patients who underwent conservative management, but this difference was insufficient to offset the initial surgical cost. Level of Evidence: Level III (Therapeutic).


Assuntos
Artroplastia , Articulações Carpometacarpais , Custos de Cuidados de Saúde , Osteoartrite , Polegar , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Retrospectivos , Osteoartrite/cirurgia , Osteoartrite/economia , Articulações Carpometacarpais/cirurgia , Custos de Cuidados de Saúde/estatística & dados numéricos , Polegar/cirurgia , Artroplastia/economia , Artroplastia/estatística & dados numéricos , Idoso , Estudos Longitudinais , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Injeções Intra-Articulares/economia , Adulto
16.
Sci Robot ; 9(90): eadk5183, 2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38809995

RESUMO

The advancement of motor augmentation and the broader domain of human-machine interaction rely on a seamless integration with users' physical and cognitive capabilities. These considerations may markedly fluctuate among individuals on the basis of their age, form, and abilities. There is a need to develop a standard for considering these diversity needs and preferences to guide technological development, and large-scale testing can provide us with evidence for such considerations. Public engagement events provide an important opportunity to build a bidirectional discourse with potential users for the codevelopment of inclusive and accessible technologies. We exhibited the Third Thumb, a hand augmentation device, at a public engagement event and tested participants from the general public, who are often not involved in such early technological development of wearable robotic technology. We focused on wearability (fit and control), ability to successfully operate the device, and ability levels across diversity factors relevant for physical technologies (gender, handedness, and age). Our inclusive design was successful in 99.3% of our diverse sample of 596 individuals tested (age range from 3 to 96 years). Ninety-eight percent of participants were further able to successfully manipulate objects using the extra thumb during the first minute of use, with no significant influences of gender, handedness, or affinity for hobbies involving the hands. Performance was generally poorer among younger children (aged ≤11 years). Although older and younger adults performed the task comparably, we identified age costs with the older adults. Our findings offer tangible demonstration of the initial usability of the Third Thumb for a broad demographic.


Assuntos
Mãos , Robótica , Humanos , Feminino , Masculino , Adulto , Idoso , Adolescente , Pessoa de Meia-Idade , Adulto Jovem , Criança , Mãos/fisiologia , Idoso de 80 Anos ou mais , Pré-Escolar , Robótica/instrumentação , Desenho de Equipamento , Sistemas Homem-Máquina , Dispositivos Eletrônicos Vestíveis , Polegar
18.
Acta Ortop Mex ; 38(2): 119-122, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38782479

RESUMO

INTRODUCTION: metacarpophalangeal dislocations of the thumb are not very frequent injuries, it is necessary to know the anatomy of the region to know possible causes of interposition that prevent a closed reduction of this pathology. CASE PRESENTATION: we present the case of a 75-year-old woman with a post-traumatic metacarpophalangeal dislocation of the thumb that required open reduction and surgical repair. In this procedure, we performed reduction of the dislocation, mobilization of the interposed structures, repair of the capsule and reinsertion of the ulnar collateral ligament. The early mobilization protocol helped to obtain very good results. CONCLUSION: it is imperative to consider possible associated injuries during the acute phase to achieve optimal short, medium, and long-term outcomes for our patients. A comprehensive and proactive approach to diagnosis and treatment is vital in effectively addressing this pathology and minimizing its potential sequelae.


INTRODUCCIÓN: las luxaciones metacarpofalángicas del pulgar no son lesiones muy frecuentes, es necesario conocer la anatomía de la región para conocer posibles causas de interposición que impidan una reducción cerrada de esta patología. PRESENTACIÓN DEL CASO: presentamos el caso de una mujer de 75 años con luxación metacarpofalángica postraumática del pulgar que requirió reducción abierta y reparación quirúrgica. En este procedimiento realizamos reducción de la luxación, movilización de las estructuras interpuestas, reparación de la cápsula y reinserción del ligamento colateral cubital. El protocolo de movilización temprana ayudó a obtener muy buenos resultados. CONCLUSIÓN: es imperativo considerar posibles lesiones asociadas durante la fase aguda para lograr resultados óptimos a corto, mediano y largo plazo para nuestros pacientes. Un enfoque integral y proactivo del diagnóstico y tratamiento es vital para abordar eficazmente esta patología y minimizar sus posibles secuelas.


Assuntos
Ligamento Colateral Ulnar , Luxações Articulares , Articulação Metacarpofalângica , Polegar , Humanos , Articulação Metacarpofalângica/lesões , Articulação Metacarpofalângica/cirurgia , Feminino , Luxações Articulares/cirurgia , Idoso , Polegar/lesões , Polegar/cirurgia , Ligamento Colateral Ulnar/lesões , Ligamento Colateral Ulnar/cirurgia
19.
PLoS One ; 19(5): e0302898, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38753715

RESUMO

Trapeziometacarpal osteoarthritis (TMC-OA) reduces the range of motion (ROM) of the thumb. However, the kinematic change achieved through surgical treatment remains unclear. Therefore, to quantify the kinematic change following TMC-OA surgery, we performed a three-dimensional motion analysis of the thumb using an optical motion capture system preoperatively and 1 year postoperatively in 23 patients with TMC-OA scheduled for arthrodesis (AD) or trapeziectomy with suspensionplasty (TS). Eighteen hands of nine healthy volunteers were also included as controls. Both procedures improved postoperative pain and Disability of the Arm, Shoulder and Hand scores, and AD increased pinch strength. The ROM of the base of the thumb was preserved in AD, which was thought to be due to the appearance of compensatory movements of adjacent joints even if the ROM of the TMC joint was lost. TS did not improve ROM. Quantifying thumb kinematic changes following TMC-OA surgery can improve our understanding of TMC-OA treatment and help select surgical procedures and postoperative assessment.


Assuntos
Artrodese , Osteoartrite , Amplitude de Movimento Articular , Polegar , Trapézio , Humanos , Osteoartrite/cirurgia , Osteoartrite/fisiopatologia , Feminino , Polegar/cirurgia , Polegar/fisiopatologia , Masculino , Pessoa de Meia-Idade , Artrodese/métodos , Idoso , Trapézio/cirurgia , Trapézio/fisiopatologia , Fenômenos Biomecânicos , Articulações Carpometacarpais/cirurgia , Articulações Carpometacarpais/fisiopatologia , Movimento , Adulto , Período Pós-Operatório
20.
JBJS Case Connect ; 14(2)2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38709910

RESUMO

CASE: Anterior interosseous nerve (AIN) palsy is an uncommon, though well-described, clinical entity. When isolated to the thumb, it can be confused with atraumatic rupture of the flexor pollicis longus (FPL) tendon. A 57-year-old man experienced atraumatic onset of difficulty flexing the distal interphalangeal thumb joint. Magnetic resonance imaging (MRI) demonstrated denervation edema of the FPL, suggesting atypical AIN palsy. Resolution of symptoms and MRI findings occurred concomitantly with nonoperative treatment. CONCLUSION: Atypical AIN palsy limited to the FPL is a rare clinical entity whose diagnosis can be supported with MRI. Here, we report a successful case of nonoperative management.


Assuntos
Imageamento por Ressonância Magnética , Humanos , Masculino , Pessoa de Meia-Idade , Polegar/inervação , Polegar/diagnóstico por imagem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA