EARLY AND MODERATE HAND INVOLVEMENT The joints of the hands and wrists are among the most frequent sites of involvement (see Plate 5-2). In the fingers, some or all of…

Rheumatoid arthritis and osteoarthritis (also called degenerative joint disease) are the most common forms of arthritis. Both of these chronic conditions are characterized by pain, stiffness, restricted joint motion, joint…

As the disease becomes more chronic, fibroblasts infiltrate the inflamed joint capsule, which becomes thickened and boggy. The pannus progresses, causing more destruction and joint deformity. The progressive inflammation causes…

Constriction bands are more likely to involve the distal part of the limb, especially the hand and foot. The central digits are usually affected; severe acrosyndactyly is rare in the…

Surgical reconstruction is indicated if it can improve function (and possibly yield cosmetic benefit) without subjecting the patient to many operations. Surgery should be undertaken as early as possible. The…

Surgical treatment is very challenging and may include total or partial amputation or reduction in size. If the deformity is unsightly, amputation may be indicated. Although surgical reduction of an…

Surgical treatment is usually performed to improve appearance. Early amputation is indicated when the polydactylous finger is a flail, poorly attached appendage. When the attachment of the extra digit is…

Shoulder Defects. Congenital elevation of the scapula (see Plate 4-28) and absence of the pectoral muscles are the two types of failure of differentiation in the shoulder. Skeletal involvement at…

In determining treatment for the cleft hand, existing function must be considered. The two opposing digital units are often stable, mobile, and quite functional, although not cosmetically attractive. If function…

Camptodactyly refers to congenital flexion contracture of the proximal interphalangeal joint of the finger (usually little finger), a condition that is often hereditary and can be bilateral. Although it usually…