Management of complications of periarticular fractures of the distal interphalangeal, proximal interphalangeal, metacarpophalangeal, and
carpometacarpal joints. Hand Clin 2015; 31: 179-92.
Caroli, "Divergent dislocation of the fourth and fifth
carpometacarpal joints," The Journal of Hand Surgery, vol.
FDS is responsible for flexion of multiple joints crossed by its tendons, that is, wrist joints, intercarpal joints,
carpometacarpal joints, metacarpophalangeal joints, and the proximal interphalangeal joints [1].
The presence of hand OA was determined by using ACR criteria for hand OA, which included pain, aching, or stiffness in the hand and any three of the following conditions: (1) hard tissue enlargement of two or more of the following joints: 2nd and 3rd distal interphalangeal, the 2nd and 3rd proximal interphalangeal, and the 1st
carpometacarpal joints of both hands; (2) hard tissue enlargement of 2 or more distal interphalangeal joints; (3) less than three swollen metacarpophalangeal joints; (4) deformity of 2 or more joints listed in (1) [17].
Stability in the finger's
carpometacarpal joints is provided by a system of four ligaments.
The bilateral 2[sup]nd–5[sup]th distal and proximal interphalangeal, thumb interphalangeal, and 1[sup]st–5[sup]th metacarpophalangeal and
carpometacarpal joints were graded according to the Kellgren-Lawrence grading scale.[sup][19] Symptomatic HOA was defined as at least one joint with existing radiographic HOA (Kellgren-Lawrence grade ≥2) and pain/aching/stiffness in the same joint(s).
The carpal joint consists of the three chief joints; the antebrachiocarpal joint, intercarpal and
carpometacarpal joints between all carpal bones (Budras et al, 2012; Getty, 1975; Konig et al, 2007).
(a) Swollen or tender joint (excluding distal interphalangeal joints, first
carpometacarpal joints, first metatarsophalangeal joints); may be confirmed by imaging evidence of synovitis.
Figure 3 X-ray AP views both hands (a) showing short metacarpals with cone shaped (v shaped) epiphyses at
carpometacarpal joints (black arrows).
Distal interphalangeal joints, first
carpometacarpal joints, and first metatarsophalangeal joints were excluded from assessment.
The MR demonstrated extensive contrast in the mid-carpal joint and
carpometacarpal joints (Figure 1).
The range of extension of the shoulder, elbow, and
carpometacarpal joints was initially reduced but improved with daily passive range of motion therapy over the next week.
