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Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness
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Etiology, Evaluation, and Management Options for the Stiff Digit
Louis W Catalano1, O Alton Barron, Steven Z Glickel
1From the Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY.
The Journal of the American Academy of Orthopaedic Surgeons
|November 27, 2018
Summary
Stiff fingers, often from hand trauma or surgery, impact function and quality of life. Treatment involves conservative measures or surgery, with outcomes depending on contracture severity and patient adherence to therapy.
Area of Science:
- Orthopedics
- Hand Surgery
- Rehabilitation Medicine
Background:
- Digital stiffness and contractures significantly impair hand function and patient quality of life.
- Etiologies include trauma, surgery, and intrinsic/extrinsic tendon and joint pathology.
- Understanding digital anatomy and biomechanics is vital for diagnosis and treatment planning.
Purpose of the Study:
- To review the causes, evaluation, and management of stiff digits.
- To outline conservative and surgical treatment options for finger stiffness.
- To discuss factors influencing treatment outcomes.
Main Methods:
- Literature review of digital stiffness and contractures.
- Analysis of anatomical structures and their role in finger motion.
- Overview of non-operative and operative management strategies.
Main Results:
- Conservative treatment (hand therapy, splinting, casting) is the initial approach.
- Surgery (joint release, tenolysis, external fixation) is reserved for severe or refractory cases.
- Treatment success is contingent on the specific joint, contracture severity, and patient compliance.
Conclusions:
- Effective management of stiff digits requires a comprehensive understanding of underlying pathologies.
- A stepwise approach, prioritizing conservative care, is generally recommended.
- Patient engagement in therapy is a critical determinant of functional recovery.
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