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Immediate Toe Transfer Following Index Finger Amputation for Extensive Giant Cell Tumor of the Tendon Sheath with Intraosseous Invasion.  [PDF]
Chun-Te Lu,Hung-Chi Chen,O. Koray Coskunfirat
Chang Gung Medical Journal , 2004,
Abstract: Giant cell tumor of the tendon sheath (GCTTS) is the second most common benigntumor of the hand. Although bony indentation from external compression by the GCTTS isfrequently seen on x-ray film, the intraosseous invasion is relatively rare and is a sign forhigh recurrence. We present a woman with extensive GCTTS located in the left index fingerat the level of distal interphalangeal joint. X-ray films revealed multiple osteolytic cysticcavities in the shaft of the middle phalanx. Amputation of the index finger at the base of themiddle phalanx was performed because of extensive bony involvement and concern aboutpossible recurrence from inadequate excision. Her left second toe was transferred to replacethe amputated index finger in the same session. Follow-up examination at 15 months postoperativerevealed good function and appearance of the reconstructed index.
Assessing Injection Techniques in the Treatment of Trigger Finger  [PDF]
John R Fowler, Lauren Ogrich, Perry Evangelista, Alyssa A Schaffer
Modern Plastic Surgery (MPS) , 2012, DOI: 10.4236/mps.2012.24020
Abstract: Background: Trigger finger is characterized by the inability to smoothly flex and extend the digit. Corticosteroids are an accepted non-surgical treatment option and can be delivered via two techniques. While the palmar approach is more commonly used, some have suggested that the mid-axial approach may be less painful for patients and yield higher intrasheath injection rates. The purpose of this study is to compare the accuracy of the palmar and midaxial approaches for delivery of corticosteroids into the flexor tendon sheath using radio-opaque dye in a cadaver model. Methods: A total of 50 injections were performed, 25 via midaxial technique and 25 via palmar technique. A one inch, 25-gauge needle was used to inject 1 mL of Isovue contrast dye into the flexor tendon sheath under live fluoroscopy. The fluoroscopic images were examined after injection to determine intrasheath versus extrasheath delivery of the dye, with visualization of contrast filling the sheath defining a successful injection. Results: The midaxial approach had a success rate of 52% compared to the conventional palmar approach success rate of 36%, p=0.5. The ring finger is the most common location of trigger finger and the rates of success were equal between groups for this digit (80%). Conclusions: Based on our findings, there is no statistical difference in the accuracy of intrasheath injection between the midaxial technique and palmar technique. The midaxial technique can be considered as an alternative to the palmar technique for trigger finger injection.
Giant Cell Tumour of Tendon Sheath in Thumb—A Case Report  [PDF]
Sankar Rao. P, Siddaram Patil, Sandeep Reddy
Open Journal of Orthopedics (OJO) , 2014, DOI: 10.4236/ojo.2014.44019
Abstract: Giant cell tumor of the tendon sheath is the second most common tumor of the hand often referred to as xanthoma. Histologically these tumors are composed of multinucleated giant cells, polyhedral histiocytes, fibrosis and hemosiderin deposits. Marginal excision of giant cell tumor of the tendon sheath is the treatment of choice. We present a case of xanthoma of flexor pollicis longus tendon presented as a single enlarging mass in volar aspect of left thumb. After clinical diagnosis, work-up is done with ultrasound, FNAC and excision biopsy.
Giant cell tumor of the flexor tendon sheath of the hand
Mazheruddin Ali Khan,Mohammed Mateen
Journal of Medical and Allied Sciences , 2012,
Abstract: Giant cell tumor of the tendon sheath (GCTTS) is a slowly progressing benign tumor arising from synovial cells of tendon sheaths. We report a case of GCTTS of the right ring finger in a forty year old female patient. Radiograph shows soft tissue globular swelling of the right ring finger with scalloping of the middle phalanx and irregular cortical outline with extrinsic soft tissue impression of the proximal phalanx due to pressure effect by the tumor. No evidence of soft tissue calcification is seen. Biopsy confirmed the diagnosis of Giant cell tumor of tendon sheath.
Trigger finger presenting secondary to leiomyoma: a case report
Ziad Harb, Quamar Bismil, David M Ricketts
Journal of Medical Case Reports , 2009, DOI: 10.1186/1752-1947-3-7284
Abstract: A 39-year-old Caucasian man presented with a fairly typical presentation of trigger finger. During surgical treatment, the lesion was excised and sent for histology, which showed tissue consistent with a leiomyoma. The patient made an uneventful recovery.Trigger finger is a common condition that is usually easily diagnosed and managed. However, it is important to appreciate that uncommon conditions, such as leiomyoma, can present with what is sometimes considered trivial disease, and one should always consider the differential diagnoses even when faced with relatively benign conditions.Trigger finger is a common condition, first described by Notta in 1850, characterised by painful clicking and locking of a digit. The underlying cause is a failure of normal tendon gliding in the A1 pulley region of the tendon sheath. This is usually associated with a proliferation of chondrocytes (stenosing tensosynovitis). We present a case of trigger finger secondary to a leiomyoma; a previously unreported condition.A 39-year-old, right-handed Caucasian male office worker presented with a three-month history of painful locking and clicking of his right ring finger. There was no history of trauma and he was otherwise fit and well. On examination, he had a tender mass on the volar aspect of the metacarpophalangeal joint as he actively flexed and extended the ring finger, and there was a small, palpable lump overlying the fourth metacarpophalangeal joint.A diagnosis of trigger finger was made; however, the palpable lump was significantly larger than usually found with a Notta's nodule. An X-ray of the right hand was unremarkable and an ultrasound scan revealed an elliptical soft tissue mass associated with the flexor tendons and A1 pulley.At surgical exploration under general anaesthesia, a circumscribed soft tissue mass, 1.5 cm in diameter, was found infiltrating the A1 pulley and flexor digitorum superficialis (FDS) (Figure 1). The lesion was excised en masse, protecting the neurova
Surgery for ganglia of the flexor tendon sheath
Vilhjalmur Finsen,?yvind Ha?berg,Grethe Elisabeth Borchgrevink
Orthopedic Reviews , 2013, DOI: 10.4081/or.2013.e6
Abstract: There are very few reports in the literature on the results of surgery for ganglia of the flexor tendon sheaths of the digits. We reviewed 24 patients operated for flexor tendon sheath ganglia 8 (3-11) years previously. Two operations were for recurrences and one of these recurred again. There was one permanent digital nerve injury and one patient complained of cold sensibility. VAS (0=best; 100=worst) for mean general complaints from the hand was remembered as 51 before surgery and was 5 at review. Mean pain at review was reported as VAS 4 and general satisfaction with the operation as VAS 3. All stated that they would have consented to surgery if they had known the outcome in advance. We conclude that the results of surgery are good, although complications do occur.
Palmar Nerve Sheath Myxoma: A Case Report
Amany Fathaddin,Rehab Fatani
Oman Medical Journal , 2012,
Abstract: Nerve sheath myxoma is a rare benign tumor of the peripheral nerves. It typically presents as a painless, firm, and slow growing nodule with a predilection for extremities mostly fingers and knees. Microscopically, it has characteristic multilobules of spindle cells in an abundant myxoid stroma. The cells are strongly positive for S-100 protein. However, this rare tumor is usually misdiagnosed as other more common benign neuronal tumors. This report describes a rare case of nerve sheath myxoma involving the palmar surface of a 23-year-old female. Clinically, it was diagnosed as a fibroma. It was excised and the final diagnosis was made after histopathological and comprehensive immunohistochemical examination of the specimen. The clinicopathological features of this rare tumor and its important differential diagnoses are discussed along with a brief review of the literature.
An unusual case of cycticercosis of the tendon sheath of the tendoachilles.  [PDF]
Sharat Agarwal,Paragjyoti Gogoi
Electronic Physician , 2010,
Abstract: Cysticercosis is an infection by the larval stage (cystcercus cellulosae) of the cestode, Taenia Solium (pork tape worm), especially in those individuals who live in the endemic areas. After gaining entry into the body, the larvae become encysted and may lie in subcutaneous tissue, striated muscle, the vitreous humor, or other tissues. We report an unusual case of cysticercosis of the the tendon sheath of the tendoachilles that presented as a swelling of the tendoachilles. Upon Fine Needle Aspiration and Cytology (FNAC) that were conducted preoperatively, the possibility of villonodular synovitis was identified. However, the cysticercosis diagnosis was confirmed later after an excisional biopsy was performed. We could find no reports in the literature concerning an occurrence of cysticercosis in the tendon sheath of tendoachilles.
Fibroma of tendon sheath located within the ankle joint capsule
Riccardo Ciatti,Pier Paolo Mariani
Journal of Orthopaedics and Traumatology , 2009, DOI: 10.1007/s10195-009-0058-2
Abstract: We report a very rare case of fibroma of the tendon sheath arising from the anteromedial ankle joint capsule, with no apparent connection to any tendon in the area, found in a 58-year-old patient complaining of progressive local swelling. This uncommon tumor has its usual localization in tendon sheaths, is extremely rare in joint capsules, and has never been described in this location previously. MRI showed nonuniform low signal intensity in T1- and T2-weighted images and high intensity in STIR images. The mass was completely excised by open surgery. Histopathological analysis later confirmed the diagnosis of a fibroma of the tendon sheath.
Dorso-palmar triangular finger flap-A new advancement flap for cover of finger amputations-A preliminary report  [cached]
Mishra Satyanarayan
Indian Journal of Plastic Surgery , 2001,
Abstract: A triangular V-Y type advancement flap on the finger has been designed, which advances skin from over the whole circumference of the finger, which includes both palmar and dorsal skin. The flap is sensate too. It is indicated for finger and thumb amputations proximal to the body of the nail. Six flaps were raised with five successes and one partial necrosis. This is a preliminary report on a new flap.
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