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Severing of the central slip by lacerations or a dislocation of the middle phalanx towards the bottom of the finger causes the tendon to tear off the bone [1] A secondary cause of boutonnière deformity is rheumatoid arthritis causing chronic inflammation that eventually results in tendon damage.
To perform the test, a patient is asked to hold an object, usually a flat object such as a piece of paper, between the thumb and index finger (pinch grip). The examiner then attempts to pull the object out of the subject's hands. [2] A normal individual will be able to maintain a hold on the object without difficulty.
This flexion deformity of the proximal interphalangeal joint is due to interruption of the central slip of the extensor tendon such that the lateral slips separate and the head of the proximal phalanx pops through the gap like a finger through a button hole (thus the name, from French boutonnière "button hole"). The distal joint is ...
Radial side of the proximal phalanx of the index finger: 2 Radial side of the middle phalanx of the index finger: 3 Tip of the index finger: 4 Tip of the middle finger: 5 Tip of the ring finger: 6 Tip of the little finger: 7 Distal interphalangeal joint crease of the little finger: 8 Proximal interphalangeal joint crease of the little finger: 9
The relative length of the digit varies during motion of the IP joints. The length of the palmar aspect decreases during flexion while the dorsal aspect increases by about 24 mm. The useful range of motion of the PIP joint is 30–70°, increasing from the index finger to the little finger.
Ectrodactyly, split hand, or cleft hand [1] (from Ancient Greek ἔκτρωμα (ektroma) 'miscarriage' and δάκτυλος (daktylos) 'finger') [2] involves the deficiency or absence of one or more central digits of the hand or foot and is also known as split hand/split foot malformation (SHFM). [3]
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The classification of central polydactyly is based on the extent of duplication and involves the following three types: Type I is a central duplication, not attached to the adjacent finger by osseous or ligamentous attachments; it frequently does not include bones, joints, cartilage, or tendons.