Phalangeal Length Research Articles

A Study of Bone Transport Using a New Callus Bone Distractor

Background: This study was performed to evaluate the results of finger lengthening following traumatic amputation or congenitally short phalanges, metacarpal bones, ormetatarsal bones using a new callus distraction device. The device is simple, light, cheap, reliable, and easy to use. Methods: The study group consisted of 246 patients (108 females and 138 males) who had short bones in their hands or feet. The mean (± SD) age of the patients was 23 ± 8 years (4 - 37 years). In the study group, 68.2% of the patients had previously undergone traumatic amputation of fingers or toes. The mean follow-up time of the patients was 7 ± 1.5 years. Results: The mean metacarpal, phalangeal, and metatarsal length before surgery was 28 mm (19 - 35 mm). The mean lengthening after surgery was 18mm (13 - 29mm; more than 64% lengthening). Themean healing index ratio (HIR) was 3.88mm/d. No bone grafts were required after bone lengthening. Complications included pin tract infection in 5 (2%) cases, scar formation in the dorsum of the finger in 19 (7.7%) cases, neuronal damage in 3 (1.2%) cases, reversible joint stiffness in 23 (9.3%) cases, and bone malalignment pain in 29 (11.7%) cases. Conclusions: Callus distraction is an effective and reliable method for lengthening short phalangeal, metacarpal, and metatarsal bones. It also preserves periosteal tissue. Our distractor is reliable, cheap, lightweight, user friendly, and highly effective for callotasis

Effective Length Design of Humanoid Robot Fingers Using Biomimetic Optimization

In this study, we propose an effective design method for the phalangeal parameters and the total size of humanoid robot fingers based on a biomimetic optimization. For the optimization, an interphalangeal joint coordination parameter and the length constraints inherent in human fingers are considered from a biomimetic perspective. A reasonable grasp formulation is also taken into account from the viewpoint of power grasping, where the grasp space of a humanoid robot finger is importantly considered to determine the phalangeal length parameters. The usefulness of the devised biomimetic optimization method is shown through the design examples of various humanoid robot fingers. In fact, the optimization-based finger design method enables us to determine effectively the proper phalangeal size of humanoid robot fingers for human-like object handling tasks. In addition, we discuss its contribution to the structural configuration and coordinated motion of a humanoid robot finger, and address its practical availability in terms of effective finger design.

AP-2β is a transcriptional regulator for determination of digit length in tetrapods

The species-specific morphology of digits in the tetrapod limb, including the length and number of metacarpal, metatarsal, and phalangeal bones, suggests that a common developmental mechanism for digit formation is modified in a species-specific manner. Here, we examined the function of the AP-2β transcription factor in regulating digit length in the chicken autopod. Mutations in the gene encoding AP-2β are associated with Char syndrome, a human autosomal dominant disorder. Char syndrome patients exhibit autopod skeletal defects, including loss of phalanges and shortened fingers, suggestive of a function for AP-2β in normal digit development. The ectopic expression of two different dominant-negative forms of chick AP-2β, equivalent to mutant forms associated with human Char syndrome, in the developing chick hindlimb bud resulted in defective digit formation, including reductions in the number and length of phalanges and metatarsals. A detailed analysis of the AP-2β expression pattern in the limb bud indicated a correlation between the pattern/duration of AP-2β expression in the limb mesenchyme and digit length in three amniote species, the chicken, mouse and gecko. In addition, we found that AP-2β expression was downstream of Fgf signals from the apical ectodermal ridge, which is crucial in digit morphogenesis, and that excessive AP-2β function resulted in dysregulated digit length. Taken together, these results suggest that AP-2β functions as a novel transcriptional regulator for digit morphogenesis.

Localized acral hypertrophy.

A 35-year-old male presented with complaints of a progressive increase in the size of his right thumb. There was a significant increase in subcutaneous tissue, which was most prominent on the palmar aspect. He was experiencing difficulty in his day-to-day work due to restricted movement. There was no history of trauma, infection, or a family history suggestive of neurofibromatosis or any similar disease. He had undergone surgery two years prior for similar complaints in the index finger. Plain radiograph of the hand [Figure 1] was advised following this magnetic resonance imaging (MRI) of the right hand was performed to confirm the diagnosis and assess the disease status [Figure 2]. Figure 1 (a) Clinical photograph showing localized enlargement of thumb with postoperative changes in index finger. (b) X-ray imaging of the hand shows hypertrophy of soft tissue and bone with mushroom shaped terminal phalanx. Secondary degenerative changes are ... Figure 2 Magnetic resonance imaging of the fingers. (a) T1-weighted imaging shows proliferation of the fibro-fatty tissue of the thumb. (b and d) Proton Density fat saturated image confirms the fatty nature. (c) T2-weighted imaging shows osteophyte formation with ... A plain X-ray of the hand of another patient with similar complaints in the middle finger showed increased lengths of metacarpals and phalanges of the middle finger with prominent soft tissue and is shown in Figure 3. Figure 3 X-ray imaging of the hand of another patient shows hypertrophy of soft tissue and bone of middle finger with advanced degenerative changes in the involved digits.

Anatomy of the Flexor Digitorum Profundus Insertion

To describe the anatomical insertion of the flexor digitorum profundus (FDP) on the distal phalanx. The FDP insertion to the index, middle, ring, and little fingers were dissected in 10 fresh-frozen cadavers. The FDP tendon was dissected off the volar plate, which was elevated from proximal to distal, before the distal phalanx was disarticulated. The distal phalanx was then inked and the FDP was sharply dissected from bone. The insertion length, width, and distance of the insertion from the joint were measured and the insertion surface area and centroid of the FDP insertion were calculated. The average insertion length and width were 6.2 mm (range, 5.1-7.0 mm) and 7.9 mm (range, 6.9-8.4 mm), respectively. The average surface area of the distal phalanx occupied by the FDP tendon, for all fingers, was 20% (range, 15%-27%). The average distance from the most proximal insertion to the joint surface was 1.2 mm (range, 0.4-2.1 mm) and the calculated centroid of the FDP insertion from the distal interphalangeal joint was 3.6 mm (range, 2.5-5.1 mm) or approximately 20% of the distal phalangeal length. These findings may aid anatomical attachment of the FDP tendon in the treatment of zone I injuries. A better understanding of the anatomy of the FDP insertion may aid proper repair positioning in the treatment of zone I injuries.

Digit ratio and laterality indices: the Chuvashian study

The aim of the present study was to evaluate the association between digit ratio indices (representing the prenatal androgen and estrogen exposure) and different laterality indices, handedness (HDD), the dominant eye (DE), hand clasping (HCL) and arm folding (ARMF) in a large (N=1,586) Chuvashian population-based sample. HDD showed a significant association with the right phalangeal length ratio, the right and the left metacarpal ratio and the right ray ratio. Subjects with a right dominant hand had lower right phalangeal, right and left metacarpal and right ray ratios than those with a left dominant hand. This is the first study showing a significant association between the eye dominance and the left metacarpal and the left ray ratios. Subjects with a right DE had lower left metacarpal and left ray ratios than those with the left DE. HCL and ARMF showed no association with radiologically measured digit ratios.

Osteometric sex determination using proximal foot phalanges from a documented human skeletal collection.

Diagnosing sex is vital for developing biological profiles from human skeletal remains. For that purpose, osteometric evaluation of bone size has proven to be usually effective. The present study investigates the degree of sexual dimorphism in proximal foot phalanges from a documented human skeletal collection, known as the Athens collection. Furthermore, it utilizes the data for the development of sex-discriminant formulas in Greek population. The material used consists of 749 proximal foot phalanges (left and right), which belong to 174 adult individuals (91 males and 83 females) that lived during the 20(th) century. The degree of sexual dimorphism reached as high as 16.76 %, with the left side demonstrating higher sexual dimorphism. The 1(st) proximal foot phalanges are proven to be the most sexually dimorphic among the bones of the sample. The minimum sexual dimorphism observed was in the maximum lengths of phalanges, whereas the most sexually dimorphic measurement was the medio-lateral width at midshaft. The discriminant functions developed provide classification accuracies that ranged between 77.1 % and 90.9 % for left and between 72.2 % and 86.6 % for right proximal foot phalanges. The results of this study suggest that proximal foot phalanges are useful for sex determination in Greek population.

English

CONTEXT: Stature or body height is one of the most important and useful anthropometric parameter that determine the physical identity of an individual. The study was done to estimate stature from the hand and length of phalanges. Study design: descriptive cross sectional study. Place of Study: department of Anatomy, Dr.S.N. Medical College, Jodhpur MATERIAL: One hundred males and one hundred females with the age of 18to 25yrs of, Dr.S.N. Medical College, Jodhpur. METHOD: Measurement of stature using standiometer and hand length and phalangeal length of right hand with a slide caliper respectively. RESULT: The present study showed significant correlation between the stature and hand lengths and phalangeal length.provide multiplication factors for stature with other parameters.

The Obłazowa 1 early modern human pollical phalanx and Late Pleistocene distal thumb proportions

The human distal thumb phalanx from the earlier Upper Paleolithic of Obłazowa Cave, southern Poland, exhibits features of its palmar surface that align it morphologically principally with early modern humans. These aspects include the configurations of the proximal palmar fossa, the flexor pollicis longus tendon insertion, the proximal margin of the palmar apical tuft, and especially its low ulnar deviation angle. If it is assumed that it possessed the pollical phalangeal length proportions of an early modern human, it would exhibit modest base and tuft breadths. However, given Late Pleistocene archaic-modern contrasts in relative pollical phalanx lengths, the isolated nature of the phalanx prevents secure assessment of its radioulnar interphalangeal articular and apical tuft hypertrophy. Similar constraints apply to the assessment of other Pleistocene Homo pollical phalanges.

Sexual Dimorphism of Proximal Hand Phalanges

AbstractResearch on sexual dimorphism in proximal hand phalanges contributes to the assessment of the biological profile of an individual from human skeletal remains. Furthermore, it provides fundamental information for studying the origins of manual dexterity. The anatomy of proximal hand phalanges has been widely described, and the occurrence of sexual dimorphism has been reported in studies concentrating on sex determination. However, there is limited research focusing on the level of sexual dimorphism. Therefore, the aim of this study is to examine the degree of sexual dimorphism in proximal hand phalanges. A total of 661 bones from 160 adult individuals (86 men and 74 women) of the Athens collection were studied. Seven measurements were taken involving the maximum length and diaphyseal and epiphyseal widths. Descriptive statistics,t‐values and percentages of sexual dimorphism were estimated. The results of this study indicate that, in almost all dimensions measured, men have larger proximal hand phalanges than women. Proximal hand phalanges present a high degree of sexual dimorphism (reached 24.78%). The phalanges of the left side demonstrate a higher degree of sexual dimorphism. The proximal phalanges of the thumb proved to be the most sexually dimorphic bones in the material. The minimum sexual dimorphism observed was in the maximum lengths of phalanges, whereas the most sexually dimorphic measurement is the medio‐lateral width at midshaft. Copyright © 2013 John Wiley & Sons, Ltd.

Fractional Fowler Tenotomy for Chronic Mallet Finger: A Cadaveric Biomechanical Study

The Fowler tenotomy, adjusting the balance of the extensor mechanism by central slip and lateral band detachment, is a common surgical technique for chronic mallet finger. The purpose of this study was to determine how much tendon to detach from the middle phalanx by measuring the extensor lag of the distal interphalangeal (DIP) joint following the procedure and to quantify how often a boutonniere deformity occurred as a consequence of the procedure. Sixteen fingers were obtained from 8 fresh-frozen cadaver hands. We made mallet finger deformity models by terminal tendon elongation. We detached the central slip and lateral band from the middle phalanx by one-third, one-half, and two-thirds of the phalangeal length and measured extensor lag of the DIP and proximal interphalangeal joints before and after this procedure. In these models, the average extensor lag of the DIP joint was 44° (range, 40° to 50°). After central slip and lateral band detachment over one-third of the phalangeal length, the average residual extensor lag of the DIP joint was 19° (range, 0° to 40°). With one-half detachment, the average lag was 13° (range, 0° to 35°), and with two-thirds detachment, the average lag was 6° (range, 0° to 15°). Extensor lag at the proximal interphalangeal joint occurred in 4 fingers, with an average lag of 8° (range, 5° to 15°). In the Fowler tenotomy models, detachment of the central slip and lateral band from the middle phalanx reduced extensor lag of the DIP joint. Detachment of up to two-thirds of the phalangeal length was effective in this model and did not cause any boutonniere deformity. Controlled clinical application of our cadaveric results might yield improved active motion for chronic mallet extensor lag.

American Journal of Medical Genetics Part A: Volume 158A, Number 9, September 2012

AbstractCOVER FIGUREHand X‐ray showing hyperphalangism of the third and fourth fi ngers associated with brachymetacarpy, abnormal shape and length of middle phalanges of the fi ngers and carpal fusion between the hamate and capitate bones in a child with a Catel‐Manzke‐like phenotype and a IMPAD1 mutation. See article by Nizon et al. in this issue.

Sex determination by the length of metacarpals and phalanges: X-ray study on Egyptian population

Measurements of hand bones length have been shown to be sexually dimorphic in many nationalities. The aim of this study is to assess the accuracy of sex determination from the length of all metacarpals and phalanges of right and left hands using X-ray radiographs and to develop a discriminant formula that can be used in the Egyptians. One hundred Egyptians are included in the study (50 adult males and 50 adult females) in the period from December 2009 to January 2011 with mean age 31.60 ± 9.44. Each is subjected to X-ray radiographs on both hands. The results reveal that males have significantly greater mean values than females for all metacarpals and phalanges of both hands and the Egyptian population has greater measurements in comparison to the other ones (e.g. Turkish and European Americans). In addition there is no significant difference between the right and the left hands in either males or females. The correct classification reached an accuracy of 88%–94% by using both hands, while that for right hand only is 88% and 88%–90% for the left hand only. Regarding the accuracy of each bone, the present results revealed that 1st DP & PP and 3rd and 4th MC in the right and left hands are the best bones that can be used in correct sex determination. It is concluded that the length of metacarpals and phalanges (especially the 1st DP & PP and 3rd and 4th MC) could be used for sex determination. The right hand could be used as the left hand in determination of sex. Also the X-ray radiographs are good non invasive and simple tool in the determination of sex from the hand bones. Furthermore the regression equation for both hands and each hand separately is specific to Egyptian population and should be used after validation of the results in other ones.

The thumb of Miocene apes: New insights from Castell de Barberà (Catalonia, Spain)

Primate hands display a major selective compromise between locomotion and manipulation. The thumb may or may not participate in locomotion, but it plays a central role in most manipulative activities. Understanding whether or not the last common ancestor of humans and Pan displayed extant-ape-like hand proportions (i.e., relatively long fingers and a short thumb) can be clarified by the analysis of Miocene ape hand remains. Here we describe new pollical remains-a complete proximal phalanx and a partial distal phalanx-from the middle/late Miocene site of Castell de Barberà (ca., 11.2-10.5 Ma, Vallès-Penedès Basin), and provide morphometric and qualitative comparisons with other available Miocene specimens as well as extant catarrhines (including humans). Our results show that all available Miocene taxa (Proconsul, Nacholapithecus, Afropithecus, Sivapithecus, Hispanopithecus, Oreopithecus, and the hominoid from Castell de Barberà) share a similar phalangeal thumb morphology: the phalanges are relatively long, and the proximal phalanges have a high degree of curvature, marked insertions for the flexor muscles, a palmarly bent trochlea and a low basal height. All these features suggest that these Miocene apes used their thumb with an emphasis on flexion, most of them to powerfully assist the fingers during above-branch, grasping arboreal locomotion. Moreover, in terms of relative proximal phalangeal length, the thumb of Miocene taxa is intermediate between the long-thumbed humans and the short-thumbed extant apes. Together with previous evidence, this suggests that a moderate-length hand with relatively long thumb-involved in locomotion-is the original hand morphotype for the Hominidae.

Development of a hand exoskeleton system for index finger rehabilitation

In order to overcome the drawbacks of traditional rehabilitation method, the robot-aided rehabilitation has been widely investigated for the recent years. And the hand rehabilitation robot, as one of the hot research fields, remains many challenging issues to be investigated. This paper presents a new hand exoskeleton system with some novel characteristics. Firstly, both active and passive rehabilitative motions are realized. Secondly, the device is elaborately designed and brings advantages in many aspects. For example, joint motion is accomplished by a parallelogram mechanism and high level motion control is therefore made very simple without the need of complicated kinematics. The adjustable joint limit design ensures that the actual joint angles don’t exceed the joint range of motion (ROM) and thus the patient safety is guaranteed. This design can fit to the different patients with different joint ROM as well as to the dynamically changing ROM for individual patient. The device can also accommodate to some extent variety of hand sizes. Thirdly, the proposed control strategy simultaneously realizes the position control and force control with the motor driver which only works in force control mode. Meanwhile, the system resistance compensation is preliminary realized and the resisting force is effectively reduced. Some experiments were conducted to verify the proposed system. Experimentally collected data show that the achieved ROM is close to that of a healthy hand and the range of phalange length (ROPL) covers the size of a typical hand, satisfying the size need of regular hand rehabilitation. In order to evaluate the performance when it works as a haptic device in active mode, the equivalent moment of inertia (MOI) of the device was calculated. The results prove that the device has low inertia which is critical in order to obtain good backdrivability. The experiments also show that in the active mode the virtual interactive force is successfully feedback to the finger and the resistance is reduced by one-third; for the passive control mode, the desired trajectory is realized satisfactorily.

Morphological diversity of wing structure in Rhinolophoid bats (Chiroptera, Rhinolophoidea)

The results of studies on the morphological diversity of wing structure in horseshoe bats (Rhinol� ophoidea) are considered in relation to ecological differentiation within the superfamily. Various skeletal ele� ments of the wing are shown to form several groups of mutually correlated characters. The main groups com� prise the characters that account for the size of the wing and play a role in the formation of its outer contours. The distribution of characters shows that they describe different aspects of variation and can provide a fairly complete picture of the morphological and ecological structure of the superfamily. The results obtained by means of multidimensional scaling and clustering methods primarily reflect ecological types of bats and only then characterize their taxonomic relationships. Analysis of variation in structural features of the wing within the superfamily Rhinolophoidea shows that the same wing form in different families may be accounted for by different ratios of digit elements, primarily the lengths of distal and proximal phalanges of digits III and IV.

The correspondence between proximal phalanx morphology and locomotion: Implications for inferring the locomotor behavior of fossil catarrhines

Phalanges are considered to be highly informative in the reconstruction of extinct primate locomotor behavior since these skeletal elements directly interact with the substrate during locomotion. Variation in shaft curvature and relative phalangeal length has been linked to differences in the degree of suspension and overall arboreal locomotor activities. Building on previous work, this study investigated these two skeletal characters in a comparative context to analyze function, while taking evolutionary relationships into account. This study examined the correspondence between proportions of suspension and overall substrate usage observed in 17 extant taxa and included angle of curvature and relative phalangeal length. Predictive models based on these traits are reported. Published proportions of different locomotor behaviors were regressed against each phalangeal measurement and a size proxy. The relationship between each behavior and skeletal trait was investigated using ordinary least-squares, phylogenetic generalized least-squares (pGLS), and two pGLS transformation methods to determine the model of best-fit. Phalangeal curvature and relative length had significant positive relationships with both suspension and overall arboreal locomotion. Cross-validation analyses demonstrated that relative length and curvature provide accurate predictions of relative suspensory behavior and substrate usage in a range of extant species when used together in predictive models. These regression equations provide a refined method to assess the amount of suspensory and overall arboreal locomotion characterizing species in the catarrhine fossil record.

Morphology and posthatching ontogeny of the autopodial skeleton of Bolitoglossa nicefori (Caudata: Plethodontidae)

Webbed foot morphology is a highly homoplastic character in species of Bolitoglossa and has been assumed to be pedomorphic. This study examines the morphology and posthatching ontogeny of the autopodial skeleton of Bolitoglossa nicefori and compares the descriptive and morphometric results with other species of the genus. We show that the autopodial morphology of B. nicefori coincides with the generalized pattern of the genus; webbed foot morphology is produced by pedomorphosis that affect the phalange length of the digits, resulting in a synchronized growth of digits (length and ossification rates) and the fleshy web. Although the webbed foot morphology of B. nicefori might be explained by the pervasive pedomorphic developmental trend observed in the genus, the large degree of variation encountered in the morphology of the distal phalanges indicates that the pedomorphic processes acting in this species are neither a simple truncation of the autopodial developmental program during early posthatching development nor a global process acting over the whole body plan. Instead, this morphological pattern is probably a result of the modular nature of limb development.

Biomechanical Analysis of Digital Movement in Injured Hand as Method for Functional Diagnosis

New method for functional diagnostics of motion activity of fingers based on registration of digital movements and their biomechanical analysis is suggested. Kinematical and dynamical parameters of digital movement accounted by biomechanical model adequately reflect the patterns of motion disorders and give the objective numerical evaluation. The method includes: a) registration of digital movement in both intact and injured hands using electromagnetic system of MiniBirds type; b) calculation of individual biomechanical parameters of fingers - length of phalanges, position and alignment; c) calculation of kinematic parameters of movement - time-base of joint angles, angular velocities and accelerations, range of motion of separate joints, degree of coordination of changes in various joints angles (kinematic synergy); d) evalua-tion of dynamic parameters of motion - time-base of total muscular forces moment in joints (dynamic synergy); e) evaluation of functional state based on analysis of kinematic and dynamic parameters of motion before, during and after treatment.

Implications for the Anatomy of the Flexor Hallucis Brevis Insertion

Excessive hallux proximal phalangeal base removal during first MTP resection arthroplasty, implant arthroplasty, or amputation can compromise the flexor hallucis brevis (FHB) insertion leading to first MTP joint plantarflexion weakness, cock-up toe deformity, and altered forefoot loading. The insertional anatomy of the FHB tendon was measured in 30 fresh frozen cadaver specimens. The FHB was then cyclically loaded and bone sequentially removed from the proximal phalangeal base until specimen failure occurred. The mean length of the lateral and medial FHB insertions measured 9.0 +/- 0.6 mm and 8.0 +/- 0.5 mm, respectively (p < 0.0001). The mean width of the lateral and medial FHB insertions measured 7.1 +/- 1.0 mm and 8.8 +/- 1.4 mm, respectively (p < 0.0001). FHB insertion length as a percentage of total proximal phalangeal length was 26% +/- 3% medially and 30% +/- 3% laterally. Twenty-two specimens failed at the FHB insertion site after an average of 7.8 +/- 1.0 mm or 24% +/- 3% of the total length of the proximal phalanx had been resected from the base. Six millimeters of bone or 20% of the proximal phalangeal length could be safely removed from the hallux proximal phalangeal base without compromising the integrity of the FHB insertion to a physiologic load. Retaining 10 mm of the hallux proximal phalangeal base during amputation would preserve the medial FHB insertion and sacrifice none to less than 0.4 mm of the lateral insertion in our specimens. This study demonstrates how much hallux proximal phalangeal base can be resected during first MTP arthroplasty or needs to be retained during amputation to preserve FHB function.