RESUMO
The critical step in dynamic claw-finger correction procedures is adjustment of tension on the tendon slips which are being sutured at the new insertion sites to correct finger-clawing. Several methods to balance and adjust the tension have been described ever since these procedures have been in use. Ultimately it is the experience of the operating surgeon that helps to decide as to the tension that is to be kept on each slip so that maximum deformity correction is obtained without compromising the functional capabilities of the hand. An attempt has been made to describe this "experience" in words so that the surgeons who perform these corrective surgical procedures for the first time have some criteria to guide them.
Assuntos
Dedos/cirurgia , Deformidades Adquiridas da Mão/cirurgia , Tendões/cirurgia , Dedos/fisiopatologia , Deformidades Adquiridas da Mão/fisiopatologia , Humanos , Tendões/fisiopatologiaRESUMO
A retrospective study was carried out to compare the effectiveness of different muscles as motors in modified lasso procedures for correction of finger clawing in leprosy. It was observed that palmaris longus and extensor carpi radialis longus were more suitable than the flexor digitorum superficialis. In some patients, removal of superficialis is associated with complications which could not be predicted before surgery. Extensor carpi radialis longus has advantages over palmaris longus in selected cases.
Assuntos
Masculino , Feminino , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Articulações/anatomia & histologia , Articulações/anormalidades , Articulações/fisiologia , Articulações/lesões , Atividade Motora/fisiologia , Tendões/anatomia & histologia , Tendões/anormalidades , Tendões/cirurgia , Tendões/fisiopatologia , Tendões/inervaçãoRESUMO
A study of 221 claw fingers of fifty-one leprosy patients with ulnar or combined ulnar and median-nerve paralysis showed that the severity of the deformity was determined mostly by the completeness of paralysis of intrinsci muscles, and to a lesser extent by the duration of paralysis. There was no predilection for severe deformity in any one finger. Recurrent dislocation of the extensor tendon from the knuckle of the metacarpophalangeal joint was observed mostly in fingers that were completely deprived of all intrinsic muscles. No satisfactory explanation could be found for this. Flexing the wrist facilitated opening of the claw finger, but the effect was more evident at the metacarphophalangeal joint than at the proximal interphalangeal joint.