Acute calcific tendinitis of the shoulder is a well-known condition, but it is rare in the hand or finger. It is often misdiagnosed when it occurs outside the shoulder. We report an unusual case of acute calcific tend...Acute calcific tendinitis of the shoulder is a well-known condition, but it is rare in the hand or finger. It is often misdiagnosed when it occurs outside the shoulder. We report an unusual case of acute calcific tendinitis of the flexor digitorum superficialis insertion of the 4th finger in a young female martial art athlete after minor trauma history, and discuss with a review of the literature.展开更多
BACKGROUND The extensor indicis proprius(EIP)tendon is a frequently used donor for a variety of tendon transfers,most commonly for reconstruction of the extensor pollicis longus(EPL).EIP is known to have frequent anat...BACKGROUND The extensor indicis proprius(EIP)tendon is a frequently used donor for a variety of tendon transfers,most commonly for reconstruction of the extensor pollicis longus(EPL).EIP is known to have frequent anatomic variants including split tendons and variations in tendon arrangement.AIM To characterize the anatomy of the EIP at the level of the extensor retinaculum,where tendon harvest is often performed,and share our preferred technique for EIP to EPL transfer.METHODS Twenty-nine fresh-frozen cadaveric forearms without history of forearm or hand injury or surgery were dissected.Tendon circumference and relationship of the EIP and extensor digitorum communis to the index(EDCI)at the metacarpophalangeal(MCP)joint and the distal extensor retinaculum were recorded.Distance from the distal extensor retinaculum to the EIP myotendinous junction was measured.RESULTS EIP was ulnar to the EDCI in 96.5%of specimens(28/29)at the distal edge of the extensor retinaculum.In the remaining specimen,EIP was volar to EDCI.Tendon circumference at the distal extensor retinaculum averaged(9.3 mm±1.7 mm)for EDCI and 11.1 mm(±2.7 mm)for EIP(P=0.0010).The tendon circumference at the index MCP joint averaged 11.0 mm(±1.7 mm)for EDCI and 10.6 mm(±2.1 mm)for EIP(P=0.33).EIP had a greater circumference in 76%(22/29)of specimens at the distal extensor retinaculum whereas EIP had a greater circumference in only 31%(9/29)of specimens at the MCP joint.CONCLUSION The EIP tendon is frequently ulnar to and greater in circumference than the EDCI at the distal extensor retinaculum,which can be taken into consideration for tendon transfers involving EIP.展开更多
In the present paper, the authors treated 26 cases of tenovaginitis of flexor di gitorum with acupunctomy (needle-knife technique). After 1～3 treatments , 2 0 cases were cured, 5 experienced improvement and one faile...In the present paper, the authors treated 26 cases of tenovaginitis of flexor di gitorum with acupunctomy (needle-knife technique). After 1～3 treatments , 2 0 cases were cured, 5 experienced improvement and one failed, the total cure ra te was 76.92%, improvement rate 96.15%, and the failure rate 0.04%.展开更多
Background： Single-fiber electromyography （SFEMG） abnormality in the extensor digitorum communis （EDC） was reported in ocular myasthenia gravis （OMG）, which indicated subclinical involvement beyond extraocular ...Background： Single-fiber electromyography （SFEMG） abnormality in the extensor digitorum communis （EDC） was reported in ocular myasthenia gravis （OMG）, which indicated subclinical involvement beyond extraocular muscles in OMG patients. The relationship between the abnormal findings of SFEMG in EDC and the probability for OMG to develop generalized myasthenia gravis （GMG） is unknown, This retrospective study aimed to determine the predictive value of abnormality of SFEMG in EDC of OMG patients. Methods： One-hundred and two OMG patients underwent standard clinical diagnosis process and SFEMG test in EDC muscle when diagnosed and were clinically followed up for 5 years. The SFEMG data were compared between different clinical groups according to thymus status, onset age, and different outcome of OMG developing. Chances of progressing to GMG were compared between two different groups according to SFEMG and repetitive nerve stimulation （RNS） results, acetylcholine receptor antibody （AchRAb） titer, thymus status, and onset age. Results： Abnormal SFEMG results were observed in 84 （82.4%） patients. The mean jitter, percentage of jitter 〉55 Its （%）, and blocking were higher in OMG patients than in healthy volunteers. There were no statistical differences in jitter analysis between thymoma group and non-thymoma group （P = 0.65）, or between the later OMG group and the later GMG group （P = 0.31）, including mean jitter, percentage of jitter 〉55 Its （%）, and blocking. Elderly group （〉45 years old） had a higher mean jitter than younger group （t = 2.235, P = 0.028）. Total 55 OMG developed GMG, including 47 in abnormal SFEMG group while 8 in normal SFEMG group. There was no statistical difference in the conversion rates between the two groups （x^2 = 0.790, P = 0.140）. RNS abnormality, AchRab titer, or onset age had no correlation with OMG prognosis （P = 0.150, 0.070, 0.120, respectively） while thymoma did （x^2 = 0.510, P = 0.020）. Conclusion： SFEMG test in the EDC showed high abnormality in OMG, suggesting subclinical involvement other than extraocular muscles. Nevertheless, the abnormal jitter analysis did not predict the prognosis of OMG according to clinical follow-up.展开更多
文摘Acute calcific tendinitis of the shoulder is a well-known condition, but it is rare in the hand or finger. It is often misdiagnosed when it occurs outside the shoulder. We report an unusual case of acute calcific tendinitis of the flexor digitorum superficialis insertion of the 4th finger in a young female martial art athlete after minor trauma history, and discuss with a review of the literature.
文摘BACKGROUND The extensor indicis proprius(EIP)tendon is a frequently used donor for a variety of tendon transfers,most commonly for reconstruction of the extensor pollicis longus(EPL).EIP is known to have frequent anatomic variants including split tendons and variations in tendon arrangement.AIM To characterize the anatomy of the EIP at the level of the extensor retinaculum,where tendon harvest is often performed,and share our preferred technique for EIP to EPL transfer.METHODS Twenty-nine fresh-frozen cadaveric forearms without history of forearm or hand injury or surgery were dissected.Tendon circumference and relationship of the EIP and extensor digitorum communis to the index(EDCI)at the metacarpophalangeal(MCP)joint and the distal extensor retinaculum were recorded.Distance from the distal extensor retinaculum to the EIP myotendinous junction was measured.RESULTS EIP was ulnar to the EDCI in 96.5%of specimens(28/29)at the distal edge of the extensor retinaculum.In the remaining specimen,EIP was volar to EDCI.Tendon circumference at the distal extensor retinaculum averaged(9.3 mm±1.7 mm)for EDCI and 11.1 mm(±2.7 mm)for EIP(P=0.0010).The tendon circumference at the index MCP joint averaged 11.0 mm(±1.7 mm)for EDCI and 10.6 mm(±2.1 mm)for EIP(P=0.33).EIP had a greater circumference in 76%(22/29)of specimens at the distal extensor retinaculum whereas EIP had a greater circumference in only 31%(9/29)of specimens at the MCP joint.CONCLUSION The EIP tendon is frequently ulnar to and greater in circumference than the EDCI at the distal extensor retinaculum,which can be taken into consideration for tendon transfers involving EIP.
文摘In the present paper, the authors treated 26 cases of tenovaginitis of flexor di gitorum with acupunctomy (needle-knife technique). After 1～3 treatments , 2 0 cases were cured, 5 experienced improvement and one failed, the total cure ra te was 76.92%, improvement rate 96.15%, and the failure rate 0.04%.
文摘Background： Single-fiber electromyography （SFEMG） abnormality in the extensor digitorum communis （EDC） was reported in ocular myasthenia gravis （OMG）, which indicated subclinical involvement beyond extraocular muscles in OMG patients. The relationship between the abnormal findings of SFEMG in EDC and the probability for OMG to develop generalized myasthenia gravis （GMG） is unknown, This retrospective study aimed to determine the predictive value of abnormality of SFEMG in EDC of OMG patients. Methods： One-hundred and two OMG patients underwent standard clinical diagnosis process and SFEMG test in EDC muscle when diagnosed and were clinically followed up for 5 years. The SFEMG data were compared between different clinical groups according to thymus status, onset age, and different outcome of OMG developing. Chances of progressing to GMG were compared between two different groups according to SFEMG and repetitive nerve stimulation （RNS） results, acetylcholine receptor antibody （AchRAb） titer, thymus status, and onset age. Results： Abnormal SFEMG results were observed in 84 （82.4%） patients. The mean jitter, percentage of jitter 〉55 Its （%）, and blocking were higher in OMG patients than in healthy volunteers. There were no statistical differences in jitter analysis between thymoma group and non-thymoma group （P = 0.65）, or between the later OMG group and the later GMG group （P = 0.31）, including mean jitter, percentage of jitter 〉55 Its （%）, and blocking. Elderly group （〉45 years old） had a higher mean jitter than younger group （t = 2.235, P = 0.028）. Total 55 OMG developed GMG, including 47 in abnormal SFEMG group while 8 in normal SFEMG group. There was no statistical difference in the conversion rates between the two groups （x^2 = 0.790, P = 0.140）. RNS abnormality, AchRab titer, or onset age had no correlation with OMG prognosis （P = 0.150, 0.070, 0.120, respectively） while thymoma did （x^2 = 0.510, P = 0.020）. Conclusion： SFEMG test in the EDC showed high abnormality in OMG, suggesting subclinical involvement other than extraocular muscles. Nevertheless, the abnormal jitter analysis did not predict the prognosis of OMG according to clinical follow-up.
