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Introduction: Foot‐related lameness is common in Standardbred and Thoroughbred racehorses. Magnetic resonance imaging (MRI) provides information on both the soft tissue and osseous structures of the distal extremity. The aim of this study was to determine whether abnormalities identified on distal limb MRI differed between these two racehorse populations. Materials and Methods: The records of Standardbred and Thoroughbred racehorse distal extremity MRI examinations conducted at Camden Equine Centre and Ballarat Veterinary Practice between 2013 and 2023 were retrieved. Horses were included if pain causing lameness had been localised to the foot using perineural or intra‐articular analgesia. MRI abnormalities of the structures within the distal extremity were recorded and comparisons made between the two groups. Results: There was a significant difference in the rate of occurrence of certain MRI abnormalities between the Thoroughbred and Standardbred racehorse populations, including distal phalangeal fractures, proximal phalangeal short tau inversion recovery (STIR) hyperintensity (distal aspect), the presence and severity of ungular cartilage ossification, abnormalities of the navicular bone distal border synovial invaginations/vascular channels and navicular bone distal border fragments. The presence of distal extremity STIR hyperintensity and fractures was significantly higher in Standardbred compared to Thoroughbred racehorses when these findings were grouped and considered in combination. Conclusion: There were many similarities in the distal extremity MRI abnormalities identified in lame Australian Standardbred and Thoroughbred racehorses. However, distal phalangeal fractures, ungular cartilage ossification and distal extremity STIR hyperintensity were identified in significantly more in Standardbred than Thoroughbred racehorses. [ABSTRACT FROM AUTHOR]

Objectives To assess the frequency of simultaneous distal interphalangeal (DIP) joint disease and adjacent nail psoriasis (finger unit) among patients with psoriatic arthritis (PsA) and compare the efficacy of the IL-17A antagonist ixekizumab (IXE) and the TNF-α inhibitor adalimumab (ADA). Methods This post hoc analysis evaluated the simultaneous occurrence of DIP joint involvement (tenderness and/or swelling) and adjacent nail psoriasis among patients with PsA from the SPIRIT-H2H (NCT03151551) trial comparing IXE to ADA. Among patients with simultaneous DIP joint involvement and adjacent nail psoriasis in ≥1 digit at baseline, treatment effects were assessed through week 52 for each affected finger unit; 'finger unit' defines the connected DIP joint and adjacent nail of an individual digit. Results A total of 354 patients had simultaneous DIP joint involvement and adjacent nail psoriasis in ≥1 finger unit at baseline. Among them, 1309 (IXE: 639; ADA: 670) finger units had baseline DIP joint tenderness and/or swelling and adjacent nail psoriasis. Proportions of affected finger units achieving complete resolution were significantly higher with IXE vs ADA as early as week 12 (38.8% vs 28.4%, P  < 0.0001) and at all post-baseline assessments through week 52 (64.9% vs 57.5%, P  = 0.0055). Conclusion In this study cohort, patients with DIP joint involvement almost always had adjacent nail psoriasis. Greater resolution of DIP joint tenderness, swelling and adjacent nail psoriasis was achieved at all time points over 52 weeks through targeting IL-17A with IXE than TNF-α with ADA, which is noteworthy given prior comparable musculoskeletal outcomes for both drug classes. [ABSTRACT FROM AUTHOR]

This paper presents statistical shape models of the four fingers of the hand, with an emphasis on anatomic analysis of the proximal and distal interphalangeal joints. A multi-body statistical shape modelling pipeline was implemented on an exemplar training dataset of computed tomography (CT) scans of 10 right hands (5F:5M, 27–37 years, free from disease or injury) imaged at 0.3 mm resolution, segmented, meshed and aligned. Model generated included pose neutralisation to remove joint angle variation during imaging. Repositioning was successful; no joint flexion variation was observed in the resulting model. The first principal component (PC) of morphological variation represented phalanx size in all fingers. Subsequent PCs showed variation in position along the palmar-dorsal axis, and bone breadth: length ratio. Finally, the models were interrogated to provide gross measures of bone lengths and joint spaces. These models have been published for open use to support wider community efforts in hand biomechanical analysis, providing bony anatomy descriptions whilst preserving the security of the underlying imaging data and privacy of the participants. The model describes a small, homogeneous population, and assumptions cannot be made about how it represents individuals outside the training dataset. However, it supplements anthropometric datasets with additional shape information, and may be useful for investigating factors such as joint morphology and design of hand-interfacing devices and products. The model has been shared as an open-source repository (https://github.com/abel-research/OpenHands), and we encourage the community to use and contribute to it. [ABSTRACT FROM AUTHOR]

PURPOSE OF THE STUDY Osteoarthritis (OA) of the joints of the hand is one of the most common musculoskeletal disorders in the elderly population. It is a complex, degenerative disease affecting all components of the joint. Surgical treatment is indicated when conservative therapy fails. The ultimate solution is arthrodesis of the distal interphalangeal (DIP) joint. Various methods of arthrodesis have been described, ranging from the use of K-wires or compression screw to different types of intra-articular (intramedullary) implants. The aim of this study is to evaluate the surgical outcomes of arthrodesis of the distal interphalangeal (DIP) joint of the fingers using intramedullary implants. MATERIAL AND METHODS Since 2011, arthrodesis of the distal interphalangeal joint using an intramedullary implant has been performed at our department 97 times in total, in 59 patients. 9 patients (15 cases of arthrodesis) were excluded from the study group due to their failure to complete the questionnaire, 1 female patient died. In the fi nal group, 82 cases of arthrodesis in 49 patients (47 women, 2 men) were evaluated. In 72% of cases, the surgery was performed on the dominant hand. The mean age at the time of surgery was 58 years (median 59 years). The patients were indicated for surgery after the failure of all conservative treatment options. In addition to radiographs, also the hand function and pain were assessed based on the preand postoperative DASH score questionnaires. RESULTS The surgical outcomes for all implants are satisfactory. In all 82 patients, the surgical wounds healed per primam. In one case, implant extraction was performed due to infection. Another complication was an unhealed fusion and formation of a non-union with minimum pathological mobility (the patient is satisfi ed with the outcome). In three patients, a fracture at the base of the distal phalanx was observed on postoperative radiographs, which fully healed within 3 months after surgery. The mean DASH score decreased from 41.95 preoperatively to 14.93 postoperatively. The mean time to healing of the arthrodesis observed on radiographs was 9.1 weeks. DISCUSSION Currently, there are many different types of arthrodesis of the distal interphalangeal joint of the hand. Each method has its pros and cons. Arthrodesis using an intramedullary implant has the advantages of the older methods while minimizing postoperative complications. Our results are comparable to those reported in the foreign literature. CONCLUSIONS Based on the evaluated outcomes, arthrodesis of the distal interphalangeal joint using an intramedullary implant can be considered valid. It defi nitely deserves to be included in the portfolio of surgical treatment of osteoarthritis of the DIP joints of the hand. According to our observation, the differences between various types of implants are minimal and their outcomes are comparable to those reported in foreign publications. The pain relief, restored fi nger function and fusion rate are comparable to, if not better than, those achieved by the older surgical methods. The advantage of this method is mainly easier implantation, fewer complications, and the possibility of implantation without the use of an X-ray image intensifi er, which ultimately reduces the cost of surgery. The main disadvantage is the higher purchase price of the implant. [ABSTRACT FROM AUTHOR]

Background/aim: Rheumatoid arthritis (RA) usually affects the wrist, metacarpophalangeal joint, and proximal interphalangeal joint of the hands. However, the distal interphalangeal (DIP) joints may also be involved in RA patients. In this study, we aimed to evaluate the frequency and associated factors of DIP joint erosion in patients with RA. Materials and methods: Medical records of patients with RA were reviewed retrospectively. Patients with major trauma affecting DIP joints, osteoarthritis, erosive osteoarthritis, psoriatic arthritis, systemic sclerosis, calcium pyrophosphate dihydrate disease, and gout were excluded. Anteroposterior hand X-rays were evaluated and patients were divided into groups according to autoantibody profile. Results: We reviewed 1213 patients with a mean age of 54.3 ± 12.5 years; 82.8% of them were female, and 95.4% had RA-type erosive changes. The DIP erosion rate was 12%. DIP involvement was generally unilateral and asymmetric, with the 3rd finger being the most commonly affected joint. Patients with DIP erosions had a significantly longer disease duration (p = 0.036). Older age was an independent predictive factor for DIP erosion (p = 0.001). Conclusion: In this large-sample study, we reported DIP joint involvement in patients with RA. Advanced age could have affected the results because hand erosions increase above 50 years in a healthy population. Our results may provide a different perspective on joint involvement in RA. [ABSTRACT FROM AUTHOR]

Background. Mucous cysts of hand represent tumor-like masses. This pathology is associated with a large number of diagnostic and treatment mistakes with inappropriate procedures and incomplete surgical interventions, which result in recurrences and complications. Aim of the study — to analyze diagnostics and treatment mistakes in patients with mucous cysts of fingers in order to improve the quality of medical care for patients with this pathology. Methods. The study enrolled 62 patients. Diagnostics included medical history analysis, clinical and X-ray examination, and ultrasonography. According to the patients’ history, they were divided into two groups: group 1 consisted of patients who had come to the clinic for the first time, group 2 — of patients who had referred to the clinic with recurrences of mucous cysts. All patients underwent surgical interventions with osteophyte excision of the phalanx and skin defect grafting after cyst excision. Treatment results were evaluated 2, 6, 12 months after the operation using X-ray data, VAS, QuickDash questionnaire, and measurements of the range of motion in the distal interphalangeal joint. Results. Initial referrals of group 2 patients (with disease recurrence) were analyzed in terms of the profile of specialists and the type of care provided. It was found that patients with recurrence had undergone procedures (cyst puncture, cauterization, removal of thin skin over the cyst) or surgeries without osteophyte excision of the phalanx and skin defect grafting after cyst excision. The use of a diagnostic algorithm at the referral stage made it possible to confirm the diagnosis and detect an osteophyte of the affected phalanx in all patients. Patients were followed up for a year. Conclusion. At the diagnostic stage, X-ray and ultrasonography are conclusive methods of examination. The only correct method of mucous cysts treatment is radical surgery including skin defect grafting with local tissues after cyst excision and osteophyte removal.

Objective K‐wire arthrodesis methods are commonly used during arthrodesis of the finger distal interphalangeal (DIP) or thumb interphalangeal (IP) joints. Here we propose an advantageous approach involving dual parallel intramedullary K‐wires with the K‐wire tips cut to bury underneath the skin. Methods From January 2017 to December 2021, 35 patients (43 joints) underwent finger DIP or thumb IP joint arthrodesis using this method. Radiographic outcomes were evaluated, while functional outcomes were assessed using the visual analogue scale (VAS) for pain and the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score. Patients with at least 1 year follow‐up were analyzed. The preoperative and postoperative functional results were analyzed using the paired t‐test. Results Arthrodesis union was achieved in 41/43 joints (95.3%). We treated 10 thumb IP joints and 33 finger DIP joints, for which the underlying cause was osteoarthritis and trauma in 37 and six digits, respectively. The average time of K‐wire removal was 8.9 (range, 7–10) weeks after surgery. Twenty‐four patients (27 joints; 22 women, two men) had at least 1 year follow‐up (mean 15.9; range, 12.5–40.8) months. For patients with bone healing, the VAS score improved from 6.6 (range, 5–8) to 0.6 (range, 0–1) (p

Dupuytren disease is a common benign fibromatosis of the palmar and finger fascia caused by pathological cord formation. As both the retrovascular and lateral cords are jointly responsible for the flexion contracture of the distal interphalangeal (DIP) joint, isolated DIP joint contracture caused by Dupuytren disease is rare. We present a 34-year-old right-hand-dominant male patient with a 6-month history of an isolated DIP joint flexion contracture in the right ring finger due to Dupuytren disease. Surgical fasciotomy of the retrovascular cord improved the contracture without adverse events. It is important to pay attention to the anatomical relationships between the pathological cord and neurovascular bundle to avoid neurovascular injury during fasciotomy in patients with Dupuytren disease, especially in isolated DIP joint contracture cases. Level of Evidence: Level V (Therapeutic) [ABSTRACT FROM AUTHOR]

Objective: K‐wire arthrodesis methods are commonly used during arthrodesis of the finger distal interphalangeal (DIP) or thumb interphalangeal (IP) joints. Here we propose an advantageous approach involving dual parallel intramedullary K‐wires with the K‐wire tips cut to bury underneath the skin. Methods: From January 2017 to December 2021, 35 patients (43 joints) underwent finger DIP or thumb IP joint arthrodesis using this method. Radiographic outcomes were evaluated, while functional outcomes were assessed using the visual analogue scale (VAS) for pain and the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score. Patients with at least 1 year follow‐up were analyzed. The preoperative and postoperative functional results were analyzed using the paired t‐test. Results: Arthrodesis union was achieved in 41/43 joints (95.3%). We treated 10 thumb IP joints and 33 finger DIP joints, for which the underlying cause was osteoarthritis and trauma in 37 and six digits, respectively. The average time of K‐wire removal was 8.9 (range, 7–10) weeks after surgery. Twenty‐four patients (27 joints; 22 women, two men) had at least 1 year follow‐up (mean 15.9; range, 12.5–40.8) months. For patients with bone healing, the VAS score improved from 6.6 (range, 5–8) to 0.6 (range, 0–1) (p < 0.001), and the QuickDASH score improved from 57.9 (range, 31.8–77.3) to 14.7 (range, 6.8–20.5) (p < 0.001) at final follow‐up. Both of the two failure cases were in the thumb. There were no other complications. Conclusions: This technique is simple and cost‐effective and achieves a good union rate. The advantages include the ability to choose variable K‐wire sizes according to the size of the medullary canal and the ease of postoperative care. [ABSTRACT FROM AUTHOR]

Purpose: To assess the efficacy and safety of intra-arterial injection of imipenem/cilastatin sodium (IPM/CS) via a needle placed into the radial artery or ulnar artery (RA/UA) for distal interphalangeal and proximal interphalangeal joint osteoarthritis (DIP/PIP-OA). Materials and Methods: This is a retrospective single-arm cohort study. Ninety-two patients [92% women, mean (SD) age 55(8.3) years] with a primary DIP/PIP-OA meet the American College of Rheumatology criteria for hand osteoarthritis with pain ≥ 4 on the 0–10 numeric rating scale (NRS) were enrolled. All procedures were performed by injecting IPM/CS through a 24-gauge needle percutaneously inserted into the RA/UA. Two procedures were planned; the second procedure was scheduled 1–2 months after the first. NRS, Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, Patient Global Impression of Change (PGIC) scale, and procedure-related adverse events were evaluated. Results: Technical success, defined as injection of IPM/CS into the RA/UA, was achieved in all patients. Clinical success, defined as a reduction of 2 points or more in the NRS at 12 months, was 77% (95% confidence interval 68–85%). The NRS improved from the baseline to 3, 6, and 12 months (7.8 ± 1.6 vs. 3.8 ± 2.6, 3.9 ± 2.7, and 4.0 ± 2.8, respectively, all p < 0.001). The QuickDASH score improved from the baseline to 12 months (27 ± 15 vs. 19 ± 17, p < 0.001) respectively. No major adverse events were observed. Conclusions: Intra-arterial injection of IPM/CS is a feasible treatment option for DIP/PIP-OA. [ABSTRACT FROM AUTHOR]

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Abstract Background The digital artery-based V–Y advancement flap is a widely used flap for soft tissue coverage in the treatment of flexion contracture of the proximal interphalangeal (PIP) joint. A standard method for the flap design and a mathematical method to predict the advance distance have not been well established. In this study, we proposed a simplified method for the design of V–Y advancement flaps based on digital arteries and used a geometric model to predict the advance distance for the flexion contracture correction surgery. Methods According to the general concept of hand flap design and law of cosine, we proposed three principles in the design of the digital artery-based V–Y advancement flap that should be followed. Since 2021 to 2022, finger geometric data of 120 fingers (index, middle, ring, and small fingers) from 30 healthy participants were collected and analysed to evaluate the necessary advance distance and flap tip angle for PIP flexion contracture correction of different fingers by our flap design method. Results The middle finger needed a significantly longer advance distance compared to other fingers in the same degree flexion contracture correction. The ring finger had the largest length-to width ratio and smallest flap tip angle among the four fingers in the V–Y flap design. No vertical scar crossed the flexion creases and flap tip angle

Background: Symptomatic distal interphalangeal (DIP) joint arthritis is frequently treated by arthrodesis, though DIP arthroplasty has been reported as a treatment option since 1977. This study reviews the current evidence on DIP joint arthroplasty for the treatment of arthritis refractory to non-operative management. Methods: A systematic search of PubMed, MEDLINE and Embase databases was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of bias was assessed using the ROBINS-I tool. Results: The search yielded 55 records, of which six studies were included in the narrative review. All the included studies were of level IV evidence (case series or cohort studies). DIP arthroplasty was effective in relieving pain and reducing subsequent dysfunction. The average total arc of motion was 30°–40° but with an extension lag of 10°–15°. The overall complication rate was 15% with a re-operation rate of 8%. Joint instability (incidence of 2.5%) and infection (incidence of 2.1%) were the most common complications, while implant fracture was seen in 1% of cases. Joints that failed after DIP arthroplasty were salvaged by DIP arthrodesis. Conclusions: DIP arthroplasty is an effective treatment for painful arthritis but with a complication rate of 15%. Its main advantage over arthrodesis is the preservation of DIP motion. However, due to the limited high-quality evidence available, its use should be limited to circumstances where there is a desire or vocational need to maintain motion at the DIP joint. Level of Evidence: Level V (Therapeutic) [ABSTRACT FROM AUTHOR]

Introduction: The prime requisites of a good digital arthrodesis are a painless and stable union in a proper position. Arthrodesis of the distal interphalangeal joint of the fingers is not without potential complications including nonunion, malunion, and deep tissue infections. The Shark Screw® is a human, cortical bone allograft for osteosynthesis and an alternative to metal or bioabsorbable devices in orthopedics and trauma surgery. The primary hypothesis is that the fusion and complication rate, using the Shark Screw®, is at least similar to those reported in the literature, using metal or bioabsorbable screws. Material and methods: This retrospective cohort study analyzes the fusion and complication rate and the patient satisfaction of distal interphalangeal joint arthrodesis of 27 fingers with the human allogeneic cortical bone screw. Complications, Disabilities of Arm, Shoulder, and Hand Questionnaire (Quick-DASH) score and Michigan Hand Outcomes Questionnaire (MHQ) score, grip and pinch strength and fusion angle were investigated. Results: The mean follow-up was 23 months. At 6 weeks after surgery, fusion was obtained for all fingers. There was no surgical complication that required revision surgery. An average fusion angle of 13.6° ± 10.7° was measured. VAS pain score decreased significantly from 6.9 before surgery to 0.14 after surgery. The Quick-DASH score decreased from 10.7 to 7.8. The MHQ score improved in all sub-scores. Conclusion: The complication rates, using the Shark Screw® for DIP joint arthrodesis, are lower compared to the results reported in the literature for other surgical techniques. Complications related to the human allograft cortical bone screw itself were not observed. The bone screw is completely remodeled into the host bone and further hardware removal is not necessary. Level of evidence: IV. [ABSTRACT FROM AUTHOR]

In treatment of mallet finger fractures (MFFs), the aim is to minimize residual extension lag, reduce subluxation, and restore congruency of the distal interphalangeal (DIP) joint. Failure to do so may increase the risk of secondary osteoarthritis (OA). However, long-term follow-up studies focusing on OA of the DIP joint after an MFF are scarce. The purpose of this study was to assess OA, functional outcomes, and patient-reported outcome measures (PROMs) after an MFF. A cohort study was performed with 52 patients who sustained an MFF at a mean of 12.1 years (range, 9.9–15.5 years) previously and who were treated nonsurgically. A healthy contralateral DIP joint was used as the control. Outcomes were radiographic OA, using the Kellgren and Lawrence and Osteoarthritis Research Society International classifications, range of motion, pinch strength, and PROMs (Patient-Rated Wrist Hand Evaluation, Quick Disabilities of the Arm, Shoulder, and Hand, Michigan Hand Outcome Questionnaire, 12-item Short Form Health Survey). Radiographic OA was correlated with PROMs and functional outcomes. At follow-up, there was an increase in OA in 41% to 44% of the MFFs. Of all the MFFs, 23% to 25% showed a higher degree of OA than the healthy control DIP joint. Range of motion (mean difference ranging from −6° to −14°) and Michigan Hand Outcome Questionnaire score (median difference, −1.3) were decreased after MFFs but not to a clinically relevant extent. Radiographic OA was weakly to moderately correlated with functional outcomes and PROMs. Radiological OA after an MFF is similar to the natural degenerative process in the DIP joint and is accompanied by a decrease in range of motion of the DIP joint, which does not clinically affect PROMs. Therapeutic IV. [ABSTRACT FROM AUTHOR]

Dissection of arthritic cadaveric digits revealed an expanded extensor tendon footprint involving the dorsal osteophyte on the terminal phalanx. Osteophyte attachments can be safely released up to the width of a number 15 scalpel blade without risking the integrity of the extensor tendon. [ABSTRACT FROM AUTHOR]

The plantar or dorsal approach has been previously reported for the replantation or revascularization of a completely or incompletely amputated lesser toe. However, no reports exist describing an alternative approach for the replantation or revascularization of an amputated lesser toe, either complete or incomplete. We encountered a rare case of revascularization of an incompletely amputated second toe using a mid‐lateral approach. The purpose of this case report was to describe the mid‐lateral approach, which is novel in its nature for the replantation or revascularization of a completely or incompletely amputated lesser toe. A 43‐year‐old male was involved in a motor vehicle accident and had incomplete crush amputation of a second toe at the base of the nail, along with open dislocation of the distal interphalangeal (DIP) joint in the third toe. We performed artery‐only revascularization of the second toe using a mid‐lateral approach, with the patient in the supine position with his hip in flexion and external rotation. The postoperative course was uneventful, and the second toe was deemed viable. The Japanese Society for Surgery of the Foot (JSSF) standard rating system of the lesser toe was rated 90 and the Self‐Administered Foot Evaluation Questionnaire (SAFE‐Q) scored 100 in all the mentioned categories. The mid‐lateral approach could be an option for the replantation or revascularization of an amputated lesser toe distal to the proximal interphalangeal (PIP) joint. [ABSTRACT FROM AUTHOR]

Swan neck deformity is characterized by hyperextension of the proximal interphalangeal joint and limited extension of the distal interphalangeal joint, showing the shape of a swan's neck. The deformity can occur either acutely or chronically. A common acute cause of this deformity is trauma, and a common chronic cause is a secondary deformity due to rheumatoid arthritis. The treatment of swan neck deformity tends to depend on the knowledge and experience of the physician because the number of cases that hand surgeons can experience is limited, and there are no clear guidelines on treatment options. This review introduces the known causes of swan neck deformity and its treatment options. For swan neck deformity, the cause of the deformity, the elapsed time, the stage of the deformity, the biomechanical relationship between adjacent joints, and the functional limitations and needs of the patients must be considered when determining the treatment method. Based on these considerations, an appropriate choice should be made between nonsurgical and surgical treatment. The patients should receive a full explanation before treatment that an optimal outcome is not always guaranteed. The treatment process requires full understanding and cooperation from the patient. [ABSTRACT FROM AUTHOR]

Determination of measurements of cartilage thickness on dGEMRIC, T2 maps and histology of pre-determined sites in normal and naturally occurring osteoarthritic Warmblood cadaver distal interphalangeal joints (DIPJs), correlation of histological and MRI measurements, and testing of the effect of cartilage health and cartilage position within the joint on the cartilage thickness (histological and MRI measurements). From 12 Warmblood DIPJ cadavers cartilage thickness was obtained from dGEMRIC images after intra-articular gadolinium administration (T1postGd) and from T2maps using a 3 tesla magnet at predetermined sites in the DIPJ. Corresponding cartilage sites underwent histologic evaluation to determine cartilage health and cartilage thickness was measured by 2 observers. Interobserver agreement was calculated using intraclass correlation coefficients. Mean T1postGd and T2map cartilage thickness was correlated with histological cartilage thickness. Mixed generalised linear models were created to evaluate the effects of cartilage site, articular surface, and cartilage health on cartilage thickness. 122 cartilage specimens were analysed. T1postGd (r=0.42–0.43; P<0.001) and T2map (r=0.34–0.35; P<0.001) cartilage thickness correlated positively with histological cartilage thickness. T1postGd cartilage thickness significantly decreased as osteoarthritis progressed. There were topical variations in cartilage thickness. Whereby articular cartilage was thinnest situated in the dorsal DIPJ zone (T1PostGd, T2map and histology), on the condyles (T2map) and on the distal aspect of the middle phalanx (histology). In conclusion T1PostGd and T2map are reliable to evaluate the thickness of normal and osteoarthritic equine articular cartilage, whereby T1PostGd is superior. Topographical variations of DIPJ cartilage thickness should be appreciated by clinicians to avoid misinterpretation of cartilage thinning secondary to cartilage disease. Volume averaging should be appreciated as a complicating factor, especially in the joint periphery. [ABSTRACT FROM AUTHOR]

BackgroundCalcific tendonitis rarely occurs in the fingers, and it is easily misdiagnosed. Herein we describe the case of a patient with multiple calcific lesions within the flexor digitorum superficialis and the extensor digitorum tendons of the distal interphalangeal joints of the right index finger, and the surgical treatment of those lesions.Case presentationThe patient was a 66-year-old man who reported pain and swelling in his right index finger for one year. He was diagnosed with chronic calcific tendonitis based on his symptoms and radiology images. He was successfully treated surgically, and histopathological examination confirmed the diagnosis. After one month, the patient had healed well, and there was no recurrence.ConclusionsThis is the first report of a patient suffering from chronic calcific tendonitis in a finger who failed conservative treatment and was successfully treated with surgery. The outcome demonstrates that surgical debridement can yield a good outcome in patients with chronic calcific tendonitis.

Background: The digital artery-based V–Y advancement flap is a widely used flap for soft tissue coverage in the treatment of flexion contracture of the proximal interphalangeal (PIP) joint. A standard method for the flap design and a mathematical method to predict the advance distance have not been well established. In this study, we proposed a simplified method for the design of V–Y advancement flaps based on digital arteries and used a geometric model to predict the advance distance for the flexion contracture correction surgery. Methods: According to the general concept of hand flap design and law of cosine, we proposed three principles in the design of the digital artery-based V–Y advancement flap that should be followed. Since 2021 to 2022, finger geometric data of 120 fingers (index, middle, ring, and small fingers) from 30 healthy participants were collected and analysed to evaluate the necessary advance distance and flap tip angle for PIP flexion contracture correction of different fingers by our flap design method. Results: The middle finger needed a significantly longer advance distance compared to other fingers in the same degree flexion contracture correction. The ring finger had the largest length-to width ratio and smallest flap tip angle among the four fingers in the V–Y flap design. No vertical scar crossed the flexion creases and flap tip angle < 20° was found in the tentative V–Y flap design for the 120 fingers. Conclusions: Our flap design method provides a proper advance distance and flap length-to-width ratio without common skin complications in the flap design for PIP flexion contracture of index, middle, ring and small fingers. This geometric model provides a mathematical basis for prediction of advance distance and flap tip angle in the design of a digital artery-based V–Y advancement flap. [ABSTRACT FROM AUTHOR]

Aim: Psoriatic Arthritis (PsA) is a chronic progressive inflammatory disease that affects 10-30% of patients with psoriasis (PsO). The term "PsA sine psoriasis" is used to describe "patients diagnosed with PsA without skin manifestations". In this study, it was aimed to define the demographic and clinical features of "PsA" "sine psoriasis" according to CASPAR criteria. Patients and Methods: Twenty-nine patients diagnosed with PsA sine psoriasis according to CASPAR criteria between 2016-2022 were included in the study. Patients with rheumatic diseases and any skin involvement were excluded from the study. Results: All twenty-nine patients included in the study were diagnosed with PsA according to the CASPAR criteria. 16 of the patients were female. The mean (±SD) age of the patients was 45±11 years. The mean (±SD) PsA duration of the patients was 6.2±3.0 years. A history of psoriasis in the first-degree relatives of patients with PsA was 54.1%; A history of psoriasis in second-degree relatives was found in 45.9%. 39.4% patients had polyarticular, 35.7% had oligoarticular, 24.9% had axial involvement. DIP involvement was present in 19 (65.5%) of all patients. Nail findings were present in 88.9% of the patients. Besides, enthesitis was detected in 17 (58.6%) and dactylitis was in 18 (62%) of patients. Conclusion: Patients with clinical symptoms and findings suggestive of PsA and a family history of psoriasis can be classified as PsA sine psoriasis. Patients with dactylitis and DIP arthritis, familial psoriasis may represent a subgroup of PsA. [ABSTRACT FROM AUTHOR]

Osteoarthritis of the equine distal interphalangeal joint is a common cause of lameness. MicroRNAs from biofluids are promising biomarkers and therapeutic candidates. Synovial fluid samples from horses with mild and severe equine distal interphalangeal joint osteoarthritis were submitted for small RNA sequencing. The results demonstrated that miR-92a was downregulated in equine synovial fluid from horses with severe osteoarthritis and there was a significant increase in COMP, COL1A2, RUNX2 and SOX9 following miR-92a mimic treatment of equine chondrocytes in monolayer culture. This is the first equine study to evaluate the role of miR-92a in osteoarthritic chondrocytes in vitro. [ABSTRACT FROM AUTHOR]

Introduction: Volar dermatofibroma over the distal interphalangeal (DIP) joint is extremely rare compared with more common tumors of the hand, such as giant cell tumors of the tendon sheath and ganglion cysts. Clinical image report: A 37-year-old male with no underlying disease presented with an abnormal mass over the DIP joint of the volar site of the third digit of the left hand for 5 months. With histopathological analysis by excisional biopsy, the patient was diagnosed with dermatofibroma. Conclusion: The current gold standard for a definite diagnosis is identifying the histopathological analysis by tissue biopsy.

Primary synovial chondromatosis is a rare, benign proliferative disease of the joint synovium, tenosynovium, or bursal lining, in which cartilage metaplasia leads to the development of multiple intra-articular and periarticular loose osteocartilaginous bodies. This disease usually involves larger joints (knee, hip, elbow, and shoulder), but it has also rarely been reported in the hand. Patients with this disease complain of pain, swelling, nodules, and decreased range of motion of the affected joint. Due to its nonspecific symptoms and low prevalence, this disease often goes misdiagnosed, leading to delays in patient treatment. In the literature to date, there are only a few reports of primary synovial chondromatosis. In this case report, we present a patient with a rare case of primary synovial chondromatosis localized to right small finger distal interphalangeal joint. [ABSTRACT FROM AUTHOR]

Distal interphalangeal joint arthrodesis is a frequent surgical operation performed to treat severe arthritis. Nevertheless, the angle selected when fusing the joint is arbitrarily chosen without any quantified data concerning its mechanical effects, thus preventing the optimal choice for the patient. In the current study, we realized an experiment and developed a numerical model to investigate the effect of fusion angle on the biomechanics of adjacent non-operated joints. Six participants performed a pinch grip task while arthrodesis was simulated with a metal splint. Kinematic and force data were recorded during this task and used in a biomechanical model to estimate contact pressures in adjacent joints. The biomechanical model involved combining a multibody system and a finite element method. Results showed that the angle of any distal interphalangeal joint arthrodesis influences index finger kinematics and maximal grip force in several participants. For one participant, in the arthrodesis simulation, we observed an increase of 1.9 MPa in the proximal interphalangeal joint contact pressure. Our results provide quantified information about the biomechanical consequences of this surgical operation and its potential long-term effects. [ABSTRACT FROM AUTHOR]

Objectives To assess the clinical outcomes of using a bipedicle advancement flap to cover the skin defects after digital mucous cyst (DMC) excision. Methods Data for 15 patients (18 fingers) with DMC, admitted to the Department of Orthopaedics and Surgery of the Affiliated Zhongshan Hospital of Dalian University from January 2016 to January 2018, were analyzed retrospectively. This study included 4 men and 11 women, with a mean age of 64 ± 7.8 years (range, 47–77 years). A total of 5 cases involved the thumb, 4 involved the index finger, 5 involved ithe middle finger, and 4 involved the ring finger. Among a total of 18 digital mucous cysts, 7 cases were in the left hand and 11 were in the right hand. Approximately 77.8% of cases had osteophytes. The cysts ranged in size from 0.5–1.0 cm to 0.7–1.2 cm. All patients underwent cyst and osteophyte excision and a bipedicle advancement flap to cover the resultant defect. The same surgical procedure was applied to all patients. Postoperative flap survival, healing, and infection were evaluated. The preoperative and postoperative ranges of motion (ROM) of the distal interphalangeal (DIP) and thumb interphalangeal joints (TIPJ) were recorded. Postoperative patient satisfaction was assessed by the visual analog scale (VAS, 0–10) during follow‐up visits. The Shapiro–Wilk test was used to determine whether the data for the difference between the preoperative and postoperative ROM of the DIP/TIPJ were normally distributed or not. The homogeneity of variance was expressed as mean ± standard deviation. A paired t‐test was used to compare the preoperative and postoperative ROM of the DIP/TIPJ. Results The patients were followed up for 20 ± 6.0 months (range, 12–36 months). All the flaps survived after surgery, and the incisions healed well. The sutures were removed 2 weeks postoperatively. No infections occurred and there was no cyst recurrence at follow up. After systemic physical therapy and functional exercises, the ROM of all the fingers was restored to the preoperative ROM by 1 month after surgery. The scores for patient satisfaction with surgery by means of the VAS were 8.5 ± 1.0 points, 2.8 ± 1.4 points, 2.0 ± 1.6 points, 1.5 ± 1.2 points, and 1.1 ± 1.3 points preoperatively, and 1, 3, 6, and 12 months postoperatively, respectively. The data for the difference between preoperative and postoperative VAS scores were normally distributed. There were significant differences between the preoperative and postoperative VAS scores. The preoperative DIP/TIPJ ROM was 71.7° ± 14.0°, and the postoperative ROM at 1, 3, 6, and 12 months were 69.3° ± 15.3°, 70.4° ± 12.7°, 71.5° ± 15.6°, and 71.8° ± 15.6°, respectively. The data for the difference between preoperative and postoperative ROM of the DIP/TIPJ were normally distributed. No difference was found between the preoperative and postoperative ROM. Conclusion The bipedicle advancement flap provides a simple and effective technique for covering skin defects following DMC excision.

Summary: Four horses presenting for lameness were diagnosed with unilateral osteochondral fragmentation (OCF) of the palmarolateral/plantarolateral aspect of the distal phalanx within the distal interphalangeal joint (DIPJ). Histological evaluation of one case supported a diagnosis of osteochondritis dissecans (OCD), with patient age and history from two cases suggesting a traumatic origin. Lesion appearance on conventional radiography, computed tomography (CT), nuclear scintigraphy and magnetic resonance imaging (MRI) are described. Fragmentation was best identified on dorsal 65° proximal‐palmaro/plantarodistal oblique (D65°PrPDiO/D65°PrPlDiO) and dorsal 65° proximal‐palmaro/plantarodistal lateral oblique (D65°Pr45°L‐PDiMO/D65°Pr45°L‐PlDiMO) radiographic projections of the foot, but articular pathology appeared more severe on cross‐sectional imaging modalities. In all cases, lameness was refractory to conservative management. Arthroscopic evaluation of the DIPJ was performed in three horses, although the lesion was inaccessible in two. In one horse, access to the lesion was possible due to increased joint laxity, presumably due to concurrent soft tissue injury. One horse was euthanased after failed conservative management, one was pasture sound following palmar digital neurectomy 12 months after initial presentation, one returned to racing and one was lost to follow‐up. Osteochondral fragmentation at this location has not previously been described, treatment options are limited and the prognosis appears to be poor. [ABSTRACT FROM AUTHOR]

BackgroundMucous cyst of the distal interphalangeal joint (DMC) or interphalangeal connection of the thumb is common in middle-aged and elderly people, and it often occurs in the fingers of people with osteoarthritis (OA). Although there are many conservative treatments, DMC is usually treated by surgery. The common complications of surgical treatment are recurrence of DMC and skin necrosis. This article introduces the method and clinical effect of osteophyte excision and joint debridement in the treatment of DMC of the distal interphalangeal (DIP) joint.MethodsIn total, 19 cases of affected fingers made an 'S' incision in the DIP joint under local anesthesia to remove the osteophyte of the DIP joint, clean the dorsal joint capsule, wash the joint, and retain only the bilateral collateral ligament and extensor tendon device. It is suspected that the injured finger of the extensor tendon should be protected by external fixation.ResultsOut of 15 patients, 1 patient presented with partial skin necrosis that healed after dressing changes while the other patients recovered well. The visual analog scale (VAS) scores of all affected fingers after surgery were lower than those before the surgery (VAS score: 4.93 ± 0.88 vs. 4.07 ± 1.03, p < 0.05). The range of motion (ROM) of the affected finger decreased in one patient, and the post-operative activity of the other fingers increased in varying degrees (ROM: 67.60 ± 5.40 vs. 71.27 ± 7.06, p > 0.05).ConclusionsUsing osteophyte excision and joint debridement to treat DMC can avoid skin necrosis caused by cyst removal and can avoid the recurrence of DMC to the greatest extent, so it is a safe and effective way of treatment.

Aims: Postoperative tendon adhesions contribute to functional disability and reconstructive failure. In this study, we present the long-term outcomes of a prospective study in which acellular dermal matrix (ADM) was used to prevent postoperative adhesion after tendon injury. Methods: The study was conducted between March 2014 and February 2017. Patients, aged 19–65 years, with an acute single flexor tendon injury in zones 1 or 2, distal to the palmar digital crease were candidates for the study. Patients were allocated to either an ADM treatment group or a control group without ADM treatment. Results: A total of 37 patients were enrolled in the study: 21 patients in the ADM group and 16 patients in the control group. At six months after surgery, the range of motion in the proximal interphalangeal joint was 81.0±5.1 degrees in the ADM group and 75.8±6.9 degrees in the control group. The range of motion in the distal interphalangeal joint was 79.9±7.1 in the ADM group and 71.2±5.7 degrees in the control group, with significant difference (p=0.03 and p<0.05, respectively). In addition, the total active motion was higher in the ADM group than in the control group. The patients' scores on the Patient Satisfaction Questionnaire were also significantly different, with higher satisfaction scores in the ADM group (p=0.02). The minimal follow-up period was six months. Conclusion: The use of ADM after tendon repair has the potential to significantly improve the outcome of tendon surgery in terms of range of motion. Declaration of interest: None of the authors has any financial interest in the products, devices, or drugs mentioned in this article. [ABSTRACT FROM AUTHOR]

Aims: Few reports have focused on the distal interphalangeal (DIP) joint in patients with rheumatoid arthritis (RA). The purposes of this study were to evaluate the frequency of bone erosion of the DIP joint, and to determine the factors associated with its deformity. Methods: This study reviewed 204 patients with RA in whom radiographs of hands were obtained. According to the presence/absence of bone erosion of the DIP joint, patients were divided into two groups (DIP-positive and DIP-negative groups). Additionally, wrist, metacarpal phalangeal (MP), thumb interphalangeal (IP), and proximal interphalangeal (PIP) joints were evaluated. Clinical variables such as age, sex, body mass index, disease duration, disease activity (DAS28-CRP), and drug use were investigated. Results: Regarding the radiological findings of the DIP joint, 32 patients (15.7%) were allocated to the DIP--positive group and 172 patients (84.3%) to the DIP--negative group. The mean age, disease duration, DAS28-CRP, and the rate of corticosteroids usage were significantly higher in the DIP-positive than in the DIPnegative group (p = 0.0031, 0.0062, 0.0342, and 0.0011, respectively). Radiologically, concomitant bone erosions of the wrist, MP, thumb IP, and PIP joints were significantly more common in the DIP-positive than in the DIPnegative group (p < 0.01 for all four joints). Multivariate analysis demonstrated that advanced age, long disease duration, and the presence of radiological bone erosion of the PIP joint were independently associated with bone erosion of the DIP joint (p = 0.0480, 0.0307, and 0.0021, respectively). Accordingly, in patients with DIP erosions, mean DAS28-CRP was significantly higher in patients with <5 years (n = 10) than in those with ≥5 years of disease duration (n = 22, p = 0.0088). Conclusions: Bone erosion can be observed at the DIP joint in patients with RA, and these cases frequently shows bone erosions of other finger joints, such as PIP joint. In addition, bone erosion can be observed soon after the onset of RA caused by uncontrolled disease activity in some patients with RA. [ABSTRACT FROM AUTHOR]

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Objectives PsA prevalence among skin psoriasis is ∼30%. Nail psoriasis, especially onycholysis, is present in >70% of PsA and the risk of developing PsA is more than doubled in patients with nail involvement. We hypothesized that onycholysis may be associated with early bone erosions of the DIP joint without harbouring PsA symptoms. Methods We compared tendon thickness, assessed by US, and bone erosions, assessed by high-resolution peripheral quantitative CT, of the DIP joint in patients with psoriatic onycholysis without PsA (ONY) with those in patients with cutaneous psoriasis only (PSO). We used patients with PsA as reference (PsA group), and healthy age-matched controls (CTRL). Differences between groups were assessed by analysis of variance tests followed by post hoc analysis using the Scheffe method. Results Mean (s.e.m.) age of the 87 participants (61% males) was 45.2 (1.3) years. The mean extensor tendon thickness was significantly larger in ONY than in PSO patients. In the PsA group, 68% of patients exhibited erosions of three different shapes: V-, Omega- and U-shape. Association with erosions was greater in the ONY group than in the PSO group (frequency: 57 vs 14%; P  < 0.001; mean number of erosions: 1.10 (0.35) vs 0.03 (0.03); P  < 0.001). Conclusion Onycholysis was associated with significant enthesopathy and bone erosions in our cohort. These data support the pathogenic role of enthesopathy in PsA. Onycholysis may be considered as a surrogate marker of severity in psoriasis. Trial registration ClinicalTrails.gov, https://clinicaltrials.gov , NCT02813720 [ABSTRACT FROM AUTHOR]

In baseball players, a high degree of functional recovery is required for the treatment of fractures in the distal interphalangeal (DIP) joint, especially on the throwing side. While dynamic external fixation is a useful treatment option to restore the joint function, existing external fixators are too large for use on DIP joints. Three cases of DIP joint intra-articular comminuted fractures in baseball players treated using the new dynamic external finger fixator which we developed are reported. The external fixator was kept attached for four weeks. The patients returned to play baseball 7–8 weeks after surgery. The total arc of the DIP joint was 90–100% of the contralateral side. Follow-up radiographs demonstrated that joint congruity had been reacquired. This technique was adaptive in the treatment of comminuted intra-articular fractures of the DIP joint and resulted in a near-normal range of joint motion and remodeling of the joint surface. [ABSTRACT FROM AUTHOR]

Objectives: To assess the clinical outcomes of using a bipedicle advancement flap to cover the skin defects after digital mucous cyst (DMC) excision. Methods: Data for 15 patients (18 fingers) with DMC, admitted to the Department of Orthopaedics and Surgery of the Affiliated Zhongshan Hospital of Dalian University from January 2016 to January 2018, were analyzed retrospectively. This study included 4 men and 11 women, with a mean age of 64 ± 7.8 years (range, 47–77 years). A total of 5 cases involved the thumb, 4 involved the index finger, 5 involved ithe middle finger, and 4 involved the ring finger. Among a total of 18 digital mucous cysts, 7 cases were in the left hand and 11 were in the right hand. Approximately 77.8% of cases had osteophytes. The cysts ranged in size from 0.5–1.0 cm to 0.7–1.2 cm. All patients underwent cyst and osteophyte excision and a bipedicle advancement flap to cover the resultant defect. The same surgical procedure was applied to all patients. Postoperative flap survival, healing, and infection were evaluated. The preoperative and postoperative ranges of motion (ROM) of the distal interphalangeal (DIP) and thumb interphalangeal joints (TIPJ) were recorded. Postoperative patient satisfaction was assessed by the visual analog scale (VAS, 0–10) during follow‐up visits. The Shapiro–Wilk test was used to determine whether the data for the difference between the preoperative and postoperative ROM of the DIP/TIPJ were normally distributed or not. The homogeneity of variance was expressed as mean ± standard deviation. A paired t‐test was used to compare the preoperative and postoperative ROM of the DIP/TIPJ. Results: The patients were followed up for 20 ± 6.0 months (range, 12–36 months). All the flaps survived after surgery, and the incisions healed well. The sutures were removed 2 weeks postoperatively. No infections occurred and there was no cyst recurrence at follow up. After systemic physical therapy and functional exercises, the ROM of all the fingers was restored to the preoperative ROM by 1 month after surgery. The scores for patient satisfaction with surgery by means of the VAS were 8.5 ± 1.0 points, 2.8 ± 1.4 points, 2.0 ± 1.6 points, 1.5 ± 1.2 points, and 1.1 ± 1.3 points preoperatively, and 1, 3, 6, and 12 months postoperatively, respectively. The data for the difference between preoperative and postoperative VAS scores were normally distributed. There were significant differences between the preoperative and postoperative VAS scores. The preoperative DIP/TIPJ ROM was 71.7° ± 14.0°, and the postoperative ROM at 1, 3, 6, and 12 months were 69.3° ± 15.3°, 70.4° ± 12.7°, 71.5° ± 15.6°, and 71.8° ± 15.6°, respectively. The data for the difference between preoperative and postoperative ROM of the DIP/TIPJ were normally distributed. No difference was found between the preoperative and postoperative ROM. Conclusion: The bipedicle advancement flap provides a simple and effective technique for covering skin defects following DMC excision. [ABSTRACT FROM AUTHOR]

Background: The French Association of Foot Surgery (AFCP) recently proposed a morphological classification of lesser toe deformities, describing the position of each joint (metatarsophalangeal or MTP, proximal interphalangeal or PIP and distal interphalangeal or DIP) in relation to their anatomic position in the sagittal plane. A study was designed to test its reliability for assessment of sagittal plane deformities of the second toe.Methods: In this retrospective study 55 toes (55 feet, 50 patients) were evaluated. Eleven foot and ankle surgeons assessed independently standardized photographs of each case acquired in a blinded fashion. Assessment was repeated three times, each 15 days apart. Intra- (Intraclass Correlation Coefficient or ICC) and inter-observer reliability (Fleiss' Kappa coefficient) were calculated for each joint.Results: Intra- and inter-observer reliability were moderate for the MTP joint (ICC range, 0.54-0.61) (Kappa range, 0.53-0.61) and substantial for the PIP (ICC range, 0.60-0.71) (Kappa range, 0.68-0.75) and DIP joints (ICC range, 0.69-0.78) (Kappa range, 0.74-0.78). Mean assessment time±standard deviation was 35±10s per case.Conclusions: The AFCP classification proved itself reliable in the assessment of sagittal plane defomities of the second toe among eleven foot and ankle surgeons. It is based only on a visual description of the deformity, and does not provide informations on either the clinical reducibility of the deformity and the radiographic joint status.Level Of Evidence: Level IV, retrospective cohort study. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate patient satisfaction after distal interphalangeal joint silicone arthroplasty and compare this outcome to that achieved with screw arthrodesis. On average 4.4 years after surgery, range of motion of the distal interphalangeal joint, pain on a numeric rating scale, satisfaction, and hand appearance of 48 patients (78 treated fingers) were assessed. For arthroplasty patients, mean distal interphalangeal joint motion was 28° with an extension deficit of 17°. Pain was low for arthroplasty and arthrodesis patients with scores of 0.2 and 0.6 out of a total of 10 points, respectively. The patients in both groups were satisfied with their outcomes, but arthroplasty patients were less satisfied with the appearance. Twenty-one per cent of the arthroplasties and 15% of the arthrodeses underwent reoperation. We suggest the motion-preserving distal interphalangeal arthroplasty as an alternative to distal interphalangeal arthrodesis for patients with higher functional demands and whose joints are stable preoperatively. In patients attaching importance to hand aesthetics and for unstable joints, distal interphalangeal joint arthrodesis is preferable. Level of evidence: III [ABSTRACT FROM AUTHOR]

Background: The ADS memory staple is the first intramedullary shape device in use for distal interphalangeal joint arthrodesis. Methods: A retrospective analysis of 17 consecutive patients undergoing single digit DIPJ arthrodesis using the memory staple between October 2013 and February 2018 by 2 consultant plastic surgeons at 2 London teaching hospitals was performed. Functional and patient-reported outcomes as well as complications were measured. Results: Thirteen female (76%) and 4 male (24%) patients with a median age of 59 years (29–82 years) met our inclusion criteria, which included osteoarthritis (n = 4), traumatic arthritis (n = 8), rheumatoid arthritis (n = 4) and psoriatic arthritis (1). Thirteen DIPJs and 4 thumb IPJs were fused. Average follow-up time was 32.6 months (7.2–60 months). Four patients were retired, 2 unemployed and 11 actively working. Sixteen patients (94%) achieved bony union within 6 weeks of surgery and had a painless, functional hand. Device displacement occurred in 1 patient requiring removal and arthrodesis with K-wires. Two patients developed a wound infection requiring antibiotics, 1 developed a hypertrophic scar, and 1 healed with a mildly rotated DIPJ. There were no instances of skin necrosis, cold intolerance, paraesthesia or osteomyelitis. All patients were satisfied with their final outcome despite the one displacement. Conclusions: Within our small case series, we demonstrated a high union rate without many of the complications associated with other arthrodesis techniques. We present a rapid, reliable and cost-effective method of DIPJ arthrodesis using a novel new technique with high rates of patient satisfaction. Level of evidence: Level 4, therapeutic study [ABSTRACT FROM AUTHOR]

Summary: Collateral ligament (CL) desmopathy of the distal interphalangeal joint (DIPJ) is a known injury that is not uncommonly diagnosed in horses presenting for lameness isolated to the foot. Ultrasonography and radiography are often used as primary diagnostic tests with mixed success. Medical records of horses undergoing magnetic resonance imaging (MRI) of the foot between November 2007 and October 2015 were reviewed. Horses were included only if the MRI followed an examination that localised a component of the lameness to the foot, and the MRI study indicated that CL desmopathy of the DIPJ was the most important finding. Thirty‐four limbs from 28 horses were included and 48 CL desmopathies were identified. Of the 48; 27 were distal to the coronary band, 15 were proximal to the coronary band, five lesions involved the entire ligament, and one CL had proximal and distal focal lesions. Twenty‐four of the 28 horses were able to return to work. There was no significant association between severity or lesion location and time to return to work. This study confirms that a high proportion of CL lesions of the DIPJ are located distal to the coronary band and require MRI for an accurate diagnosis that would otherwise be missed by ultrasound examination alone. [ABSTRACT FROM AUTHOR]

Summary: This case series describes the analgesic effect of 2% ammonium chloride (2% AC) in horses with chronic foot pain. Ten horses with foot pain related to chronic laminitis (n = 1), bruised sole (n = 1), distal interphalangeal joint (DIPJ; n = 1), podotrochlear apparatus (PA; n = 4) and PA associated with DIPJ (PA + DIPJ; n = 3) received perineural injections with 3 mL of 2% AC on the palmar digital nerves. A Five horses with pain related to PA + DIPJ (n = 3), PA (n = 1) and DIPJ (n = 1) were treated with saline as control. The analgesic effect was evaluated as lameness improvement (LI) rate (%) using a body‐mounted inertial sensor system, and was assessed at 5, 12, 19, 35, 47 and 62 days after treatment. Horses treated with 2% AC demonstrated a mean LI rate above 50% from Day 12 (63% ± 26) to Day 62 (65% ± 26). Control horses has a overall LI of 28% (± 23%) and a LI above 50% was evidenced in horses with PA + DIPJ (n = 2) and PA pain (n = 1) at different times. Horses with PA pain presented higher LI rates (72% ± 23) than that presented by horses with PA + DIPJ (51% ± 9) or DIPJ (51% ± 19). Horses with severe radiographic lesions of the navicular bone and DIPJ had the lowest LI rates after treatment. The 2% AC is a useful treatment to be included in the clinical management of chronic foot pain involving the podotrochlear apparatus with mild radiographic lesions. [ABSTRACT FROM AUTHOR]