Seventy three Camitz-Littler operations combining carpal tunnel release and palmaris longus oppenens transfer provided 90.7% good long term results. A technical modification can provide pronation.
Twenty-eight vascularized toe-joint transfers performed on 25 patients were reviewed. A number of different techniques were used: proximal interphalangeal joint or metacarpophalangeal joint reconstruction, one-stage double joint transfer, and interphalangeal thumb or trapezometacarpal joint replacement. Using these types of vascularized joint transfer allows one-stage composite transfer (including skin, bone, and extensor tendon) and provides rapid bone healing, potential growth in the young, good long-term cartilage preservation, normal lateral stability in pinch, and limited but useful range of motion (mainly at the proximal interphalangeal level).
Tenolysis of the flexor tendons was performed in 78 fingers (72 patients) by the same surgeon. Two technical modifications were introduced: reconstruction of a robust pulley; and initial immobilization with the tendon in a proximally migrated position, permitting later breakdown of early adhesions by gentle extension either by the surgeon or using an extension spring. After a mean follow-up of 21.5 months, the total active movement was improved from 135 degrees (pre-operative) to 203 degrees (post-operative) in 84% of fingers and from 65 degrees to 115 degrees in 78% of thumbs. This corresponds to a reduction in impairment of 10.1% for the thumb and 21.6% for the fingers. There was no improvement in four digits and nine cases were made worse, averaging a loss of range of 25.4 degrees. Among these were two cases of skin breakdown and two cases of tendon rupture (2.5%), one combined with skin necrosis.
Most attempts to measure forces developed by the human hand have been implemented by placing force sensors on the object of interaction. Other researchers have placed sensors just on the subject's fingertips. In this paper, a system is described that measures forces over the entire hand using thin-film sensors and associated electronics. This system was developed by the authors and is able to obtain force readings from up to 60 thin-film sensors at rates of up to 400 samples/s per sensor. The sensors can be placed anywhere on the palm and/or fingers of the hand. The sensor readings, together with a video stream containing information about hand posture, are logged into a portable computer using a multiplexer, analogue-to-digital converter and software developed for the purpose. The system has been successfully used to measure forces involved in a range of everyday tasks such as driving a vehicle, lifting saucepans and hitting a golf ball. In the latter case, results are compared with those from an instrumented golf club. Future applications include the assessment of hand strength following disease, trauma or surgery, and to enable quantitative ergonomic investigations.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.