Proximal Phalanx Of Index Finger Research Articles

Tuberculous dactylitis (Spina ventosa) of proximal phalanx in a 10-year-old girl: A case report

Tubercular dactylitis, defined as Tubercular osteomyelitis of the short tubular bones of the hand and feet is an uncommon condition seen predominantly in children. The condition is characterised by cystic expansion of the bone due to filling up of the medullary canal with granulation tissue and pus and thinning of the overlying cortex, a condition radiologically termed as ‘spina ventosa’. We report a case of a 10-year-old girl who presented with a painful, slowly progressive swelling of two months’ duration in the index finger of right hand, without any associated history of trauma. The plain radiographs of the hand showed extensive destruction of the proximal phalanx of index finger with thinning of the overlying cortex. Magnetic Resonance Imaging (MRI) showed diffuse enlargement and focal cortical break in the proximal phalanx with thick organised fluid in the medullary canal with a small area of cortical breech. The finger was debrided and the digit stabilised by a K-wire which was removed at three weeks. Biopsy of the debrided material confirmed the clinical diagnosis of Tubercular osteomyelitis. The child was started on anti-tubercular drugs with aggressive mobilisation of the finger at three weeks. At one-year follow-up, the lesion had healed well with functional range of movements of the right index finger.

배드민턴 포핸드 헤어핀 동작 시 숙련 정도에 따른 손가락 압력 및 운동학적 변인 비교 분석

The purpose of this study was to compare and analyze the finger pressure and kinematic variables in the forehand hairpin net shot between skilled elite players and less skilled recreational players. Eight elite players(age: <TEX>$18.1{\pm}0.8yrs$</TEX>, height: <TEX>$176.8{\pm}1.5cm$</TEX>, weight: <TEX>$640.9{\pm}48.6N$</TEX>) with minimum of 6 years of experience and eight recreational players(age: <TEX>$27.9{\pm}1.6yrs$</TEX>, height: <TEX>$177.1{\pm}6.1cm$</TEX>, weight: <TEX>$820.5{\pm}62.8N$</TEX>) with less than one year experience were recruited in this study. For each trial being analyzed, four critical instants were identified from the video recordings: Right heel contact1 (E1), Right toe-off (E2), Right heel contact2 (E3), and Shuttlecock Impact (E4). Each hairpin net shot was broken into consecutive phases: E1~E2 (Right Landing Phase: RLP), E2~E3 (Sliding Step Phase: SSP), and E3~E4 (Impact Phase: IP). Temporal parameters, shuttlecock speed, linear and angular kinematics of body segments, and finger pressures were computed for this study. The results showed that The finger pressure of the ring finger and the middle finger for the skilled group during an impact had significantly greater than those of unskilled group. It is possible that all fingers were not used in the same manner when the racket was gripped in forehand hairpin. The result also suggested that the ring finger and the middle finger pushed the racket from top to bottom while having the mid-phalanx and proximal phalanx of index finger as an axis.

Comments on foucher′s flap

Foucher’s flap is one of the ideal flaps to cover traumatic defect of the pulp and dorsum of the thumb. Though ideally described for thumb defects with some shortening, it has been proved beyond doubt that it can also be requisitioned to resurface thumb defects without shortening. In the latter indication, it is necessary to harvest the flap up to the dorsum of the PIP joint. However, the distal 1/3 of such a first dorsal metacarpal artery (FDMA) flap becomes a random part of the axial artery flap and hence carries some risk of marginal necrosis. It is surmised that the survival of such a flap is ultimately determined by the relative length of index and thumb. Normally, the tip of the adducted thumb roughly reaches upto 70% of the length of the proximal phalanx of the index finger (32% of the index finger length beyond MP joint); [1,2] such thumbs being ideally suited for conventional FDMA flaps. Individuals with thumb length more than 70% of the proximal phalanx of index finger are the ones likely to need an extended FDMA flap i.e. wherein flap is harvested beyond the PIP joint. One more ambiguous parameter of this flap is the amount of blood supply which comes alongwith the superficial branch of radial nerve. We know that every superficial nerve is accompanied by an artery and vein of its own supplying the skin and integument. Being a neuro-sensory flap, it is an ideal flap for pulp of thumb which restores an acceptable level of sensation, however, it may not match Littler’s neuro-vascular island flap because of poorer cortical reorientation. Kulkarni et al. [3] need to be congratulated for describing one more indication for FDMA flap. Though small traumatic defects on the radial side of the palm are rare, when encountered, this flap is really handy when compared to the alternatives. These flaps are also used in reconstructive surgeries following post burn scar contracture release, [4] syndactyly release, and partial loss of reimplanted thumb. [5] Donor-defect following this flap usually needs split skin graft or full-thickness skin graft. These usually do not give rise to functional deficit. Cosmesis, however, will be a consideration. This can be avoided if one harvests only adipofascial flap to cover

指節に発生した骨膜性軟骨腫の１例

Periosteal chondroma is a rare, slow growing cartilaginous tumor arising on the surface of tubular bones. In this paper, we reported a case of periostealchondroma occurring at the proximal phalanx of the index finger representing the scalloping of the cortex and the curvature of the phalanx in the opposite direction of the tumor. The patient was a four-year-old boy. His mother noticed a mass in the right index finger when he was two years old and it slowly grew in size. On the first visit to our clinic, a hard subcutaneous mass was palpable at the ulnar aspect of the proximal phalanx of the right index finger. The tumor was immobile without adhesion to the skin and 25×18mm in size. On the radiogram, a semi-translucent mass was found adjacent to the cortex of the proximal phalanx. Scalloping and sclerosis of the cortex were seen. The proximal phalanx was also curved by 15 degrees in the opposite direction of the tumor. Resection of the tumor together with the overlying periosteum was performed. Pathological diagnosis was periosteal chondroma characterized by proliferation of cartilaginous cells with middle grade atypism and myxoid degeneration of the matrix. No recurrence was found after six months.