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Mutilating hand injuries are a challenge to both the hand surgeon and the patient. The surgeon must make decisions ranging from the initial debridement to which fingers and joints will be preserved and the appropriate use of the parts to be removed. Late reconstruction constitutes the second part of this difficult task. The difficulty attributed to the characteristics of each lesion, the large number of treatment possibilities, and the different levels of complexity must be adapted to the personal needs and motivation of each patient. This case report describes a late hand reconstruction with index and middle finger loss, using metacarpophalangeal joint transplantation of the index finger to gain the proximal interphalangeal function of the middle finger.

Optical tomographic imaging (OTI) was reported to be a novel technique for the early diagnosis and disease activity assessment of rheumatoid arthritis (RA). This study aimed to evaluate the clinical utility of OTI for the detection of hand synovitis of RA patients. Manu-scan was used to perform imaging targeting the proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joints in 12 RA patients and three controls. The enrolled RA patients also underwent magnetic resonance imaging (MRI) and bone scintigraphy (BS) to provide reference images. Of the 181 joints feasible for OTI analysis, 140 joints (111 in RA patients and 29 in controls, 77.3%) in which the difference of the OTI indices in the two measurements was within 20% were evaluated. The OTI indices in RA joints were significantly lower than those in control joints (p < 0.001). Overall, the OTI indices in RA joints decreased as the synovitis grades on MRI or BS increased. Moreover, OTI was able to discriminate between RA and control joints (AUC = 0.815, 95% CI 0.739–0.891), even if RA joints were normal on physical examination (AUC = 0.714, 95% CI 0.594–0.834). OTI was in good agreement (kappa = 0.60) with MRI for evaluating synovitis in RA patients and showed positive results in 11.4% of clinically asymptomatic joints. OTI in this study showed the potential to be a supplementary imaging modality for the quantification of synovial inflammation in PIP and MCP joints of RA patients. Further large-scale trials are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Objective It has been shown that nail involvement in psoriasis is associated with systemic enthesopathy. Our objective was to evaluate the association of nail involvement and enthesopathy at distal interphalangeal joint (DIP) level in psoriasis (PsO) and psoriatic arthritis (PsA) patients. Methods Consecutive patients (54 PsO and 56 PsA) seen at the outpatients clinic in this cross-sectional study were included. All patients underwent both clinical and ultrasound (US) assessment on the same day. Results US revealed enthesopathy in at least 1 DIP joint in 9 patients with PsO (17%, 95% CI: 8–29%) and in 18 patients with PsA (32%, 95% CI: 20–46%). US extensor tendon enthesopathy was detected in a higher proportion of fingers with clinical nail involvement compared with fingers without clinical nail involvement, both in PsO and PsA patients (61.2% vs 16.8%, p < 0.0001 and 60.1% vs 22%, p < 0.0001, respectively). Among patients with PsO, 20% (95% CI: 7–41%) and 14% (95% CI: 4–32%) of those with and without clinical nail involvement showed enthesopathy on US examination, respectively ( p = 0.54). Among PsA patients, the prevalence of enthesopathy was 30% (95% CI: 15–49%) for patients with clinical nail involvement and 35% (95% CI: 17–56%) for those without nail involvement ( p = 0.71). Conclusion Nail disease was associated with DIP US enthesopathy. There was a significant increased prevalence of extensor tendon enthesopathy in fingers with involved nails both in PsO and PsA, although no association was found between nail involvement and extensor tendon enthesopathy at patients’ level. These features might support the nail-entheseal pathogenesis theory at DIP level. [ABSTRACT FROM AUTHOR]

We have already formulated the human three-joint arm’s optimal control model with its hand-joint’s feedback mechanism and have clarified that the model is effective in reproducing human unconstrained reaching movements including the experimental fact that the hand-joint angle hardly changes over the entire movement. For validating the proposed model, this paper applies it to reproducing human constrained reaching movements in which the hand has to take a specified posture at the final point as in the case of holding a cup’s handle with fingertips. The following results were obtained: (1) the proposed model was able to move its hand joint despite the existence of the feedback mechanism preventing the hand-joint angle from changing; (2) the proposed model succeeded at reproducing the measured hand trajectories and the measured angular transition characteristics for the hand joint in most of the constrained reaching movements. These results suggest that the proposed model has the ability to simulate human reaching movements regardless of whether they are unconstrained or constrained, i.e., it can be a general and plausible model for the human three-joint arm's control mechanism. Moreover, it is computationally considered that the hand-joint’s angular transition characteristic depends on the average of the resultant torque around the hand joint over the entire movement.