• Archives of Plastic Surgery
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• v.48 no.6
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• pp.635-640
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• 2021

Background Injuries to the proximal interphalangeal (PIP) joint are common and complex. However, the treatment of osteochondral defects of the head of the proximal phalanx has rarely been described. Herein, we propose a new technique for the management of unicondylar defects of the proximal phalanx that can restore joint amplitudes and provide PIP stability. Methods In this cadaveric feasibility study, unicondylar defects were generated using striking wedges and chisels. First, a transverse tunnel measuring 2 mm in diameter passing through the head of the proximal phalanx was made. A second tunnel at the base of the middle phalanx with the same diameter was then created. The hemitendon of the flexor carpi radialis graft was passed through each of these tunnels. The proximal end of the graft was interposed in the area with a loss of bone substance. The ligamentoplasty was then tensed and fixed by two anchors on the proximal phalanx. Joint amplitudes and frontal stability were measured preoperatively and postoperatively. Results There was no significant change in the joint's range of motion: preoperatively, the mean mobility arcs were -2° to 113.80°, and they were -2° to 110° after the procedure (P=0.999). There was no significant difference in joint stability (P>0.05). Conclusions Ligamentoplasty with PIP interposition appears to be a possible solution for the management of unicondylar defects of the proximal phalanx. An evaluation of clinical results is planned in order to definitively confirm the validity of this procedure.

• Journal of Korean Foot and Ankle Society
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• v.17 no.3
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• pp.220-224
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• 2013

Purpose: When medial protrusion in the base of proximal phalanx is severe from removing metatarsal bunion during the hallux valgus surgery, it could lead to skin irritation and medial pain after the surgery. The purpose of this paper was to report our clinical and radiographic results with transarticular fixation of Akin osteotomy for the treatment of patients with hallux valgus after resection of the medial protrusion of base of the proximal phalanx. Materials and Methods: Our study is subject to 34 cases of 30 patients who went through proximal phalanx medial corticectomy among patients undergone both hallux valgus surgery and Akin osteotomy at our institution from March 2006 to March 2012. In all cases, we used absorbable suture material through the articular surface for Akin osteotomy after resection of the medial protrusion in proximal phalanx. Radiographs were reviewed to assess the union and displacement of osteotomy site at the time of postoperative 6 months. The clinical results were assessed by using AOFAS score and complication such as skin irritation and pain. Results: AOFAS score was improved from average 44 points(36-58), before operation and average 87 points(74-96), 12 months after operation. In two cases, partial union was suspected in radiological perspective, however, complete union on the osteotomy site was observed in all cases, 12 months after the operation. No patients was dissatisfied with pain, joint discomfort, skin irritation and inflammation from the knot. Conclusion: When medial protrusion in the base of proximal phalanx is severe from removing metatarsal bunion during the hallux valgus surgery, We have good results by transarticular fixation of Akin osteotomy using absorbable suture material.

• The Journal of the Korean bone and joint tumor society
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• v.2 no.1
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• pp.116-119
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• 1996

The solitary osteochondroma is a hamartoma of the skeleton which derives from an aberrant subperiosteal germ of the fertile cartilage. Osteochondromas, which are uncommon in the hand can occur at the distal end of the proximal and middle phalanx away from the epiphyseal plate region. We experienced a rare case of solitary osteochondroma arising from distal end of fifth proximal phalanx of hand, and limiting the active motion of proximal interphalangeal joint. The patient was treated by marginal excision and tumor showed characteristic microscopic findings of osteochondroma.

• Journal of Korean Foot and Ankle Society
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• v.17 no.1
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• pp.60-63
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• 2013

Small osteophytes are frequently encountered in the foot and ankle, and not to be confused with true osteochondromas, which are relatively uncommon in this region. Osteochondromas are the most common benign osseous neoplasm, occurs in the metaphysis of the long bone. It is rarely found in bones of the foot. Treatment of the osteochondroma is usually conservative, unless symptoms usually pain, are progressive rapid growth, and malignant transformation is suspected. We experienced a rare case of hallux rigidus with osteochondroma of the hallucal proximal phalanx which cause pain and corn of the plantar.

• Journal of Korean Foot and Ankle Society
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• v.16 no.1
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• pp.70-72
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• 2012

Stress fractures of the proximal phalanx of the great toe are rare. This fractures have been associated with halux valgus deformity in most reports. We performed open reduction and internal fixation with distal chevron osteotomy for the stress fracture of the proximal phalanx of the great toe in a basketball player with hallux valgus, and obtained successful bony union and rapid return to sports.

• Archives of Plastic Surgery
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• v.33 no.4
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• pp.480-484
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• 2006

Purpose: A lot of surgical techniques were tried to correct extension lag of distal interphalangeal joint. Spiral oblique retinacular ligament reconstruction is the one of correction techniques. Methods: From January 2004 to January 2005, a total of 13 extension lag of distal interphalangeal joint corrections were performed using spiral oblique retinacular ligament reconstruction for 11 patients. After dorsal incision exposing from base of distal phalanx to proximal phalanx, the new ligament(half of lateral band or graft tendon) lies distally at the dorsum of the distal phalanx and passes volarly and proximally along the side of the middle phalanx and anterior and obliquely across the front of the proximal interphalangeal joint to the opposite side of the digit at the proximal phalanx. Results: 5 of 6 mallet finger deformities and 7 swan neck deformities were corrected, which were both extension lag of distal interphalangeal joint and hyperextension of proximal interphalangeal joint. Conclusion: As a result, spiral oblique retinacular ligament reconstruction is an effective and recommendable method for correction of mallet finger deformity and swan neck deformity.

• Journal of Korean Foot and Ankle Society
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• v.25 no.4
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• pp.195-198
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• 2021

Nora et al. first reported a bizarre parostealosteochondromatous proliferation (BPOP) as a small size bone malformation mainly in the foot and hand in April 1983 that was called Nora's lesion or Nora's disease. Nora's disease is known for its low incidence and is characterized as a benign lesion, without a malignancy or metastasis with different histological, radiological, and clinical features from other common lesions. Several cases of Nora's disease on the hand, foot, and long bone have been reported in Korea. This paper reports a case of BPOP of the proximal phalanx of the great toe.

• Journal of Korean Foot and Ankle Society
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• v.12 no.2
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• pp.220-223
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• 2008

Osteochondroma is the most common benign bone tumor which commonly occurs in the metaphysis of the long bones such as proximal humerus, tibia, and distal femur. It is rarely found in bones of the foot. Although they are benign lesions, when they occur in the foot, they are typically identified earlier than other regions because of the low proliferation of subcutaneous tissue in the region and may cause symptoms. We experienced a rare case of osteochondroma in a 60-year-old male which cause pain and swelling of the fourth toe.

• The Journal of the Korean bone and joint tumor society
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• v.7 no.4
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• pp.151-156
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• 2001

The reported incidence of osteosarcoma of the foot varies between 0.2-2% of all osteosarcoma. Low grade osteosarcoma of the long bone represents only 1.9% of all osteosarcoma. A 38-year-old female had suffered painful mass in the proximal phalanx of the second toe for 1 year. Radiographic finding showed enlarged osteloytic mass which had penetrated thin cortex of the second toe and apparent increased uptake in bone scan was seen. Mass resection with autogenous bone graft using rib was performed. Histologically, the tumor was compatible with "low grade osteosarcoma". Second stage wide resection was performed. Because low grade osteosarcoma located in the proximal phalanx of the second toe is very rare, we report this unusual case with review of literature.

• The Journal of Korea Robotics Society
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• v.11 no.4
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• pp.193-204
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• 2016

This paper presents an anthropomorphic finger prosthesis for amputees whose proximal phalanx is mutilated. The finger prosthesis to be proposed is able to make the amputees to perform the natural motion such as flexion/extension as well as self-adaptive grasping motion as if normal human finger does. The mechanism of finger prosthesis with three degrees-of-freedom (DOFs) consists of two five-bar and one four-bar linkages. Two passive components composed of torsional spring and mechanical stopper and only one active joint are employed in order to realize an underactuation. Each passive component is installed into the five-bar linkage. In order to activate the finger prosthesis, it is required for the user to flex and extend the remaining proximal phalanx on the metacarpophalangeal (MCP) joint, not an electric motor. Thus the finger prosthesis conducts not only the natural motion according to his/her intention but also the grasping motion through the deformation of springs by the object for human finger-like behavior. In order to reveal the operation principle of the proposed mechanism, kinematic analysis is performed for the linkage design. Finally both simulations and experiments are conducted in order to reveal the design feasibility of the proposed finger mechanism.