DIP Joint Research Articles

High-frequency ultrasonography for the detection of subclinical arthritis in chronic plaque psoriasis patients - A cross-sectional study.

Background Psoriatic arthritis (PsA) is seen in almost 30-40% cases of psoriasis. Psoriasis precedes the onset of PsA in 85% of cases. Delay in the diagnosis of PsA may lead to poor functional outcomes and morbidity. Screening psoriasis patients with high-frequency ultrasound helps to diagnose arthritis at an early stage leading to prompt intervention and possible reduction in the morbidity associated with the disease. Objectives To determine the role of high frequency ultrasonography (USG) in the detection of subclinical PsA. Methods A cross-sectional study was conducted in a dermatology and radiology department of Armed Forces Medical College, Pune between July 2021 and December 2022. Patients of chronic plaque psoriasis with no clinical evidence of arthritis were assessed using high-frequency USG. Various parameters such as bony erosions, synovial thickening, tendon thickening, tendon hypo-echogenicity, calcifications and power doppler signals were assessed. Results A total of 117 patients were included in the study. The distal interphalangeal joint (DIP) and Achilles tendon were the most commonly affected sites. Synovial thickening in DIP was observed in 67 (57%) patients and Achilles tendon thickening was observed in 39 (33%) patients. Limitations of the study The cross-sectional nature of the study is the major limitation. A longitudinal study will be required to understand the clinical relevance of ultrasonographic changes in these patients. Another limitation of the study is the lack of age and gender-matched controls. Future research should include such controls to ensure more accurate results. Conclusion Subclinical arthritis is common in patients with chronic plaque psoriasis. High-frequency ultrasound is a useful tool for detecting subclinical synovitis and enthesitis in asymptomatic patients. The DIP joint and Achilles tendon ultrasound can be used for screening for early detection of PsA.

Effectiveness comparison of open reduction and hook plate fixation versus closed indirect reduction and dorsal extension blocking Kirschner wire fixation for bony mallet finger

To compare the effectiveness of open reduction and hook plate fixation versus closed indirect reduction and dorsal extension blocking Kirschner wire fixation for bony mallet fingers. The clinical data of 68 patients with bony mallet finger who admitted between May 2019 and June 2022 were retrospectively analyzed. Among them, 33 cases were in the open group (treated with open reduction and hook plate fixation) and 35 cases were in the closed group (treated with closed indirect reduction and dorsal extension blocking Kirschner wire fixation). There was no significant difference between the two groups in terms of gender, age, the affected side, the affected finger, cause of injury, time from injury to operation, and Wehbé-Schneider classification ( P>0.05). The operation time, intraoperative fluoroscopy frequency, fracture healing time, time of returning to work, and postoperative complications were recorded and compared between the two groups. At 12 months after operation, visual analogue scale (VAS) score was used to assess the pain of the injured finger, active flexion range of motion and extension deficit of the distal interphalangeal joint (DIP) were measured by goniometer, and the effectiveness was assessed by Crawford criteria. All patients in the two groups were followed up 12-26 months, with an average of 15 months. There was no significant difference in the follow-up time between the closed group and the open group ( P>0.05). The operation time in the closed group was shorter than that in the open group, and the intraoperative fluoroscopy times, the fracture healing time, and the time of returning to work in the closed group were more than those in the open group, and the differences were significant ( P<0.05). In the closed group, there were 5 cases of pinning tract infection and 3 cases of small area pressure ulcer skin necrosis on the dorsal side of the finger, which were cured after intensive nursing and dressing change. Local nail depression deformity occurred in 7 cases in the open group, and the deformity disappeared after removal of plate. The incisions of the other patients healed uneventfully without complications such as infection, skin necrosis, exposure of the internal fixation, or nail deformity. There was no significant difference in the incidence of skin necrosis between the two groups ( P>0.05), but the differences in the incidence of infection and nail deformity between the two groups were significant ( P<0.05). There was no significant difference in VAS score, DIP active flexion range of motion, DIP extension deficiency, or Crawford criteria evaluation between the two groups at 12 months after operation ( P>0.05). At last follow-up, there was no DIP osteoarthritis and joint degeneration in both groups. Open reduction and hook plate fixation versus closed indirect reduction and dorsal extension blocking Kirschner wire fixation have their own advantages and disadvantages, but both of them have good results in the treatment of bony mallet fingers. Open reduction and hook plate fixation is recommended for young patients with bony mallet fingers who are eager to return to work.

Progressive failure and quantitative stability analysis of rock slope with cross-type discrete fracture network using spring-based smoothed particle hydrodynamics method

The propagation and coalescence of discontinuous cross-type joints are often the primary drivers of rock slope failures. Due to the inherent randomness of these joints, identifying suitable methods to accurately characterize progressive failure and quantitatively assess the stability of slopes with cross-type joints is particularly challenging. To address this, a Discrete Fracture Network-Spring Based-Smoothed Particle Hydrodynamics (DFN-SB-SPH) method is proposed, which considers cross-type DFN generation, rock matrix heterogeneity, cracking, block contact, and deposition within a unified SPH framework. In this approach, damage and contact of blocks are achieved by introducing a fracture sign to enhance the kernel function and applying Newton's law to the damaged particles to realize the point to point contact. A uniaxial compression test on rock samples with double fissures is carried out to verify the accuracy of the proposed method. The influence of joint density, geometric parameters (i.e., trace length, dominate dip angle) of cross joints, and rock mass heterogeneity on the failure characteristics of RSCD are investigated. The results revealed that the DFN-SB-SPH model possesses robust capabilities for crack tracking, mass movement, and contact slipping along fracture surfaces. Moreover, DFN generation, heterogeneous characterization, shear and tensile fractures within a single SPH framework without mesh distortion are realized. Five typical failure modes calculated by DFN-SB-SPH are primarily determined by the combination of joint dip angles and trace lengths. Furthermore, the dip angle, trace length, joint density, and rock mass heterogeneity significantly alter the stability of RSCD with sensitivity coefficients for factor safety of 27.7 %, 44.6 %, 72.9 % and 35.0 %, respectively. Higher dominant dip angles (above 60°) lead to significantly longer run-out distances for RSCD compared to lower angles (below 30°) once instability occurs. The sudden rise in major principal stress at the slope's top and toe, along with the shift of tensile stress concentration towards the middle, predicts the stages of crack propagation and sliding in slope failure.

Detection and Grading of Radiographic Hand Osteoarthritis Using an Automated Machine Learning Platform.

Automated machine learning (autoML) platforms allow health care professionals to play an active role in the development of machine learning (ML) algorithms according to scientific or clinical needs. The aim of this study was to develop and evaluate such a model for automated detection and grading of distal hand osteoarthritis (OA). A total of 13,690 hand radiographs from 2,863 patients within the Swiss Cohort of Quality Management (SCQM) and an external control data set of 346 non-SCQM patients were collected and scored for distal interphalangeal OA (DIP-OA) using the modified Kellgren/Lawrence (K/L) score. Giotto (Learn to Forecast [L2F]) was used as an autoML platform for training two convolutional neural networks for DIP joint extraction and subsequent classification according to the K/L scores. A total of 48,892 DIP joints were extracted and then used to train the classification model. Heatmaps were generated independently of the platform. User experience of a web application as a provisional user interface was investigated by rheumatologists and radiologists. The sensitivity and specificity of this model for detecting DIP-OA were 79% and 86%, respectively. The accuracy for grading the correct K/L score was 75%, with a κ score of 0.76. The accuracy per DIP-OA class differed, with 86% for no OA (defined as K/L scores 0 and 1), 71% for a K/L score of 2, 46% for a K/L score of 3, and 67% for a K/L score of 4. Similar values were obtained in an independent external test set. Qualitative and quantitative user experience testing of the web application revealed a moderate to high demand for automated DIP-OA scoring among rheumatologists. Conversely, radiologists expressed a low demand, except for the use of heatmaps. AutoML platforms are an opportunity to develop clinical end-to-end ML algorithms. Here, automated radiographic DIP-OA detection is both feasible and usable, whereas grading among individual K/L scores (eg, for clinical trials) remains challenging.

Calculation method and evaluation of surrounding rock pressure of vertical shaft

The surrounding rock pressure of vertical shafts is one of the basic parameters of shaft lining design. Investigating its calculation methods and applicable scopes has great engineering significance. The paper classifies and compares the calculation methods, discusses the application scopes of various calculation methods, and proposes that the axisymmetric layered method is highly consistent with the field monitoring data for the calculation of surrounding rock pressure of vertical shafts in bedrock sections on the basis of practical engineering examples. On the basis of Terzaghi theory, the calculation formula of surrounding rock pressure of vertical shaft in inclined rock strata with single group joints is derived. The formula can reflect the influence of rock strata dip angle and joints.

An Investigation On The Effect Of Smartphone Use On Morphological And Radiological Changes Of The Fifth Finger

Background: The purpose of this study is to describe the macroscopic and radiological changes on the fifth finger related to mobile phone use and to evaluate the effect of size and weight of the device and the average time spent using the smartphone on these morphological alterations. Methods: One-hundred and one patient were included in the study. Age, weight, height, education, mobile phone data and digital photographs used in this cross-sectional study were obtained from interviews with the participants in an outpatient orthopedics clinic setting. Digital photographs of the dorsal aspects of both hands were taken with an iPhone X ® (dual 12-megapixel wide camera). The DIP joint angle of the fifth finger was measured on computer software (Image J® version 1.46, National Institute of Health, Bethesda, MD) separately for digital photographs and AP hand X-rays. Results: The proportion of smartphone usage time over 4 hours was significantly higher in patients with complaints than patients without complaints (p&amp;lt;0.05). The mean time of smartphone use over 4 hours was significantly higher in patients with shape discrepancy than in patients without shape discrepancy (p&amp;lt;0.05). Conclusion: Smartphone use of more than 4 hours per day, regardless of size and weight, can cause deformity of the fifth finger, which may disturb the patient even if it does not cause radiologically changes.

Immediate effects of a novel hand rehabilitation board on fine motor skills in children with cerebral palsy: A pilot study.

In children with cerebral palsy (CP), fine motor skills limit forearm supination and active extension of the elbow, wrist, or fingers. Therapeutic interventions focusing on improving the ranges at these joints while facilitating active movements are the key to augmenting fine motor skills. This pilot study examines if children with CP (with UE involvement) exposed to the Novel Hand Rehabilitation (NHR) Board will demonstrate 1) changes in spasticity and passive ROM of forearm and wrist/finger muscles, and 2) improvement in fine motor abilities. The forearm and wrist/fingers of children with spastic CP (N = 15; M = 7, F = 8) aged 49-72 months (65.33±6.355 months) were positioned on the NHR board till their tolerance limit or a minimum duration of 30 minutes. The outcome measures, i.e., spasticity (Modified Ashworth Scale), passive range of motion (PROM) of wrist and fingers, and fine motor skills (PDMS-2 - Fine motor scale), were recorded. The spasticity of forearm pronators (0.001) and wrist flexors (0.008) reduced significantly, but not in wrist extensors. Post-intervention improvements in wrist extension (p = 0.005) and ulnar deviation ROM (p = 0.007) were significant. In thumb, changes were non-significant for the CMC flexion, but extension (0.003) and abduction (0.001) as well as MCP extension (0.004) were significant. The post-intervention MCP extension ROM for the 2nd (0.001), 3rd (0.007), and 4th fingers (0.014) were also substantial, but not for PIP and DIP joints. The post-intervention percentage change in the Grasping and Visual-motor integration subtests of PDMS-2 was 11.03% (p = 0.002) and 5.09% (p = 0.001) respectively. The immediate effects on fine motor skills in children with CP after the NHR board application were positive and encouraging. Hence, the NHR board can be recommended as an intervention to improve the fine motor abilities of children with CP.

Anatomically-Inspired Robotic Finger with SMA Tendon Actuation for Enhanced Biomimetic Functionality.

This research introduces an advanced robotic finger designed for future generalist robots, closely mimicking the natural structure of the human finger. The incorporation of rarely discussed anatomical structures, including tendon sheath, ligaments, and palmar plates, combined with the usage of anatomically proven 3D models of the finger, give rise to the highly accurate replication of human-like soft mechanical fingers. Benefiting from the accurate anatomy of muscle insertions with the utilization of Shape Memory Alloy (SMA) wires' muscle-like actuation properties, the bonding in-between the flexor tendons and extensor tendons allows for the realization of the central and lateral band of the finger anatomy. Evaluated using the computer vision method, the proposed robotic finger demonstrates a range of motion (ROM) equivalent to 113%, 87% and 88% of the human dynamic ROM for the DIP, PIP and MCP joints, respectively. The proposed finger possesses a soft nature when relaxed and becomes firm when activated, pioneering a new approach in biomimetic robot design and offering a unique contribution to the future of generalist humanoid robots.

Midterm Outcomes of Closed Extension Block Pinning for Mallet Fractures

Objectives Mallet fractures constitute approximately 30% of mallet finger injuries and their treatment remains controversial. This study aimed to assess the functional and radiological outcomes of mallet fractures treated with closed extension-block pinning. Methods A retrospective review was conducted on patients who underwent closed extension-block pinning for mallet fractures between December 2013 and May 2023. Twenty-one patients (76% male) included in the study were analyzed. Clinical and radiological assessments were performed to evaluate bone healing, joint function, pain, and daily functional limitations via QDASH, VAS, Crawford criteria. Results The mean age was 36 ± 13 years, with a follow-up duration averaging 53,1 ± 40 months. Mallet finger predominantly occurred due to sports injuries and falls (15 patients, 71,5%). Overall, bone union was achieved in 19 (90,5%) cases. The mean flexion of the DIP joint post-surgery was 67,1 ± 10,9 degrees, with three cases (14,2%) exhibiting extension lag and a mean extension limitation of 6,1 ± 10,3 degrees. Overall, patients reported high satisfaction with finger movements after surgery, with significantly lower postoperative pain and functional impairment scores, particularly among males (p&lt;0,05). According to the Crawford evaluation criteria, 6 patients were classified as excellent, 11 patients as good, 2 patients as fair, and 2 patients as poor outcomes. One instance of postoperative complication noted a pin tract infection. Conclusion The closed extension-block pinning technique for mallet fractures offers minimally invasive, easy-to-learn application, fast procedure times, and safe outcomes in short to medium term, but complications such as nonunion may increase in delayed cases

Optimizing the blast fragmentation quality of discontinuous rock mass: Case study of Jebel Bouzegza Open-Cast Mine, North Algeria

Purpose. The research aims to investigate the impact of discontinuity characteristics, including dip direction, dip and joint spacing, on the size distribution of blasted fragments in mines and quarries. The accuracy of blasting results is essential for efficient operations, and understanding these factors can enhance blast fragmentation outcomes. Methods. We conducted our research at the Jebel Bouzegza C01 aggregate quarry, analyzing eight blast benches. To determine fragment sizes, we employed image processing tools to calculate P50, P80, and Pmax sizes. Additionally, we used the Kuz Ram model to predict the average size (X50) and the percentage of oversize fragments (Pmax). The determination coefficient (R²) is calculated for both methods to assess their correlations with dip direction. Findings. Our analysis revealed significant findings related to the impact of discontinuity characteristics on fragment size distribution. The dip direction exhibits the strongest correlation of Pmax size when using Split Desktop and X50, as well as Pmax% with the Kuz Ram model. Joint spacing also plays a role in influencing blast fragmentation outcomes, although its effect depends on the infill materials. Originality. This research contributes to the understanding of factors affecting blast fragmentation outcomes. The research focuses on dip direction, dip and joint spacing characteristics, and adds to existing knowledge in this field. Practical implications. The findings of this research have practical implications for mines and quarries, offering valuable guidance for site investigations and optimization of blasting practices. By assessing properties such as dip direction and joint spacing, blasting operations can be enhanced to achieve more efficient and accurate results.

Distribution of nerve endings in human thumb interphalangeal joint.

This study aims to quantitatively analyze the distribution of encapsulated nerve endings in the human thumb interphalangeal (IP) joint capsule. There are three types of nerve endings. Type-I nerve endings (Ruffini-like ending) sense pressure changes, Type II (Pacini-like ending) nerve endings contribute to the kinesthetic sense, and Type III (Golgi-like ending) nerve ending provides proprioceptive information. We dissected five right thumbs IP joints from freshly frozen cadavers (5 men). The mean age of the cadavers at the time of death was 63.4 years (55-73). Sections were stained with the hematoxylin-eosin and antiprotein gene product 9.5 (PGP9.5) to identify encapsulated nerve endings. Transverse sections were cut and divided into volar, dorsal, and then into two equal parts, proximal and distal. The density of encapsulated nerve endings compared to volar versus dorsal and proximal versus distal regions was examined. This study showed that type 1 nerve endings were more common in the distal parts of the IP joint (p < 0.05). Also, type 3 nerve endings were observed in the thumb IP joint. There was no difference between regions in type II and type III nerve endings. The current study demonstrates that the distribution of encapsulated nerve endings in the IP joint is different from the PIP and DIP joints. Moreover, further studies are required to understand the thumb's physiology.

Gripping performance of soft grippers with fingerprint-like surface texture for objects with slippery surfaces

Soft robots face challenges when gripping and manipulating objects in lubricated environments, and one of the key issues in medical lubrication conditions in particular. In this study, soft actuators with independent pneumatic driven DIP and PIP joints are designed and prepared based on the anatomy of human fingers. The soft actuators are used to mimic the tip pinch action of the index finger and thumb, achieving dexterous grasping postures adapted to daily life, primarily for fine operation tasks. The bending capability, thrusting force, and fatigue life of the soft actuators are tested. Furthermore, by mimicking the three common fingerprint patterns (i.e., whorls, loops, and arches), three macroscopic surface textures were designed and prepared on the surface of silicone rubber materials. Tribological properties of the surface textures are studied under medical lubrication conditions with hyaluronic acid solution as lubricant. Based on this, tip pinch gripping experiments are conducted on standard shape objects, common medical devices, and biological materials with surface mucus layer. The results showed that the surface of the soft actuators can fit well with the surface of the gripped objects, thereby achieving a larger contact area and enabling the gripping of standard items and common medical devices. Moreover, for biological materials with mucous layer of significant differences in physiological function, the weight that can be gripped is significantly higher than that of the gripper without surface texture.

P17 A bend in the road: a patient with rheumatoid arthritis developing multicentric reticulohistiocytosis

P17 A bend in the road: a patient with rheumatoid arthritis developing multicentric reticulohistiocytosis

123 Flexion Glove Modification to Isolate Proximal and Distal Interphalangeal Joint Range of Motion

Abstract Introduction Flexion gloves are a quick and easy way to provide a dynamic stretch to the digits for patients with limited composite flexion range of motion (ROM) or who are at risk for digit extension burn scar contractures. However, the flexion glove has been observed clinically to bias metacarpal phalangeal (MCP) joint flexion ROM when compared to the proximal and distal phalangeal (PIP and DIP) joints. The purpose of this case study is to demonstrate the use of a custom thermoplastic hand-based splint to block MCP joint motion in order to better isolate PIP and DIP joint ROM for a patient with primary PIP and DIP flexion ROM limitations. Methods A custom, thermoplastic, palmer hand-based splint was fabricated with an opening for the thumb and the splint extending to the proximal phalanxes stopping below the PIP joints in order to block MCP joint flexion ROM as seen in Figure 1b. Composite flexion passive ROM (PROM) measurements were taken for all MCP, PIP, and DIP joints of digits 2-4 with only the flexion glove donned and with the hand-based splint applied over the flexion glove as seen in Figure 1a and 1c. Results An increase in combined PIP and DIP joint PROM was found for all digits when the hand-based splint was donned over the flexion glove compared to the flexion glove only (see Table 1). These increases in combined PIP and DIP PROM included 35° for the index finger, 10° for the middle finger, 20° for the ring finger and 30° for the small finger, with an overall mean increase of 23.75° Conclusions This easy splinting technique combined with a flexion glove was effectively used to bias stretch of the PIP and DIP joints into flexion for a patient with adequate MCP flexion ROM and impaired PIP and DIP flexion ROM caused by burn scar contracture. Applicability of Research to Practice Using an off the shelf flexion glove and a basic hand-based splint, therapists can use this technique to easily adjust the angle of pull to maximize the benefit from a flexion glove to address specific joint limitations of the finger caused by burn scar contracture.

Dynamic Suzuki frame for the interphalangeal joint fracture: A case report

Proximal interphalangeal (PIP) joint injuries are one of the common injuries of hand. Most common in motor vehicle accidents and sports injury. Various treatment modalities are available to treat such fractures like buddy strapping with or without extension block splint, CRPP, ORIF with interfragmentary screws, Schenck dynamic traction, Hynes and Giddings device and many other modalities. This is one of the challenging fractures as there is high incidence of stiffness, loss of function and deformity leading to disability following the treatment. The pins and rubber traction frame (Suzuki frame) system is one of the novel technique to reduce the disability.Case: 66 years old male with history of motor vehicle accident, presented with comminuted intra-articular fracture of base of middle phalanx (PIP joint) extending distally to DIP joint of the fourth finger of left hand. We used Suzuki frame for the treatment of the fracture.Suzuki frame technique is a simple, minimally invasive, soft tissue sparing, cost effective, dynamic external fixation technique, can be done at minimal resource setting, which allows early ROM at PIP and DIP joint, enabling good bone and joint remodeling and good function of the finger, leading to disability free hand with minimal complication rate.

Mechanical Properties of Deep Variable Dip Joint Rock Mass in Reservoir Area under Wet and Dry Conditions

The mechanical property of deep complex jointed rock mass is a hot topic in rock mechanics. In order to grasp the deformation and damage rules of through-going variable dip joint rock masses, the triaxial compression test and joint surface morphology scan test were conducted on cylindrical specimens in dry and wet conditions under 0, 5, 10, and 20 MPa water pressure. Through these tests, the deterioration law of rock samples under different pore water pressure in dry and wet conditions was studied. The effect of pore water pressure on the strength of saturated jointed rock sample is nonlinear. The imposed pore water pressure can significantly increase the axial deformation of rock samples, and higher pore water pressure can facilitate the deformation deterioration of samples. When the pore pressure is high, the rock samples show the characteristics of sliding shear failure. Under different pore pressure, the compressive strength of dry jointed rock is significantly higher than that of saturated jointed rock, and the saturated rock is more susceptible to sliding in the joint plane than dry rock. Dry jointed rock samples have stronger deformation ability than saturated jointed rock samples. The change rate of the morphologic parameters and the distribution of the failure cracks indicate that the stress concentration is evident in the middle of the joint plane.

Structural Design and Analysis of an Adaptive Manipulator

In view of the fact that the existing special manipulator is difficult to meet the requirements, and the universal full-drive multi-finger dexterous manipulator has the shortcomings of complex control and relatively poor reliability, this paper designs a manipulator with simple structure, few driving components, strong adaptive ability, and flexible, stable and fast grasp of objects of different complex shapes. The adaptive manipulator underdrive finger adopts a bionic design, which is composed of a rotary wrist joint, condylar MP joint, intermediate PIP joint, and terminal DIP joint, mixed transmission with gear and tendon rope, with the interaction ability of outer rigidity and inner flexibility, which can realize adaptive envelope grasping and pinching.

Automatic measuring of finger joint space width on hand radiograph using deep learning and conventional computer vision methods

Hand osteoarthritis (OA) severity can be assessed visually through radiographs using semi-quantitative grading systems. However, these grading systems are subjective and cannot distinguish minor differences. Joint space width (JSW) compensates for these disadvantages, as it quantifies the severity of OA by accurately measuring the distances between joint bones. Current methods used to assess JSW require users’ interaction to identify the joints and delineate the initial joint boundary, which is time-consuming. To automate this process and offer a robust measurement for JSW, we proposed two novel methods to measure JSW: (1) The segmentation-based (SEG) method, which uses traditional computer vision techniques to calculate JSW; (2) The regression-based (REG) method, which is a deep learning approach employing a modified VGG-19 network to predict JSW. On a dataset with 3591 hand radiographs, 10,845 DIP joints were cut as ROI and served as input to the SEG and REG methods. The bone masks of the ROI images generated by a U-Net model were sent as input in addition to the ROIs. The ground truth of JSW was labeled by a trained research assistant using a semi-automatic tool. Compared with the ground truth, the REG method achieved a correlation coefficient (r) of 0.88 and a mean square error (MSE) of 0.02 mm on the testing set; the SEG method achieved a correlation coefficient of 0.42 and an MSE of 0.15 mm. Results show the REG method has promising performance in JSW measurement and, in general, Deep Learning approaches can facilitate the automatic quantification of distance features in medical images.

Antibiotic Prophylaxis for Distal Interphalangeal Joint Arthrodesis.

A retrospective review of clean, elective DIP arthrodesis was conducted between September 2018 and September 2021. The subjects were aged 18 years and older and underwent elective DIP arthrodesis for the treatment of osteoarthritis or deformity of the DIP joint. All the procedures were performed using an intramedullary headless compression screw. The rates of postoperative infections and treatments required for infections were recorded and analyzed. Overall, 37 unique patients had at least one case of DIP arthrodesis that met the criteria for inclusion in our analysis. Twenty of the 37 patients did not receive antibiotic prophylaxis, and 17 of the 37 patients received antibiotic prophylaxis. Five of the 20 patients who did not receive antibiotics prophylactically developed infections, and none of the 17 patients who received antibiotics prophylactically developed an infection. Fisher exact test revealed a significant difference in the infection rates between the two groups (P < 0.05). There was no significant difference in infections with respect to smoking or diabetes status. Antibiotic prophylaxis should be administered for clean, elective DIP arthrodesis, using an intramedullary screw.

A solitary giant cell tumor of the tendon sheath of left third finger in a 23-year-old man: a case report

Giant cell tumor of the tendon sheath (GCTTS) is a common condition usually encountered in middle aged men, usually seen on the thumb, index, middle fingers. These benign tumors are known to reoccur. Re-occurrence can be attributed to poor surgical technique, excision of the tumor in toto is considered difficult given the close proximity of the digital nerves, blood vessels, tendons to the tumor. A magnifying loop is usually used in these cases to identify and resect the satellite lesions. In this case report, we are presenting a case of solitary GCTTS of the tendon sheath in a 23-year-old man with history of gradually progressive painless swelling over his left third finger. Musculo-skeletal ultrasound revealed a heterogeneously hypo-echoic well-defined lesion over the ventral aspect of the left third finger. Histopathology showed giant cell morphology. Patient underwent exploration, tumor excision in toto with primary suturing in our institute with an uneventful postoperative period. No loss of range of movements of the PIP, DIP joints was noted in the postoperative period. Good dissection with excision of the tumor in toto gives better outcomes.