The Hip: Preservation, Replacement and Revision

Intrinsic Tightness and the Intrinsic Plus Hand



- See:
    - Intrinsic Muscles:

- Discussion:
    - results from intrisic stiffness (contracture);
    - specific causes:
           - truama:
               - posttraumatic intrinsic contractures may occur after severe injuries to hand that have resulted in considerable 
                      edema or hematoma;
           - ischemia
           - rheumatoid arthritis
           - Still's disease
           - mycobacterium leprae
           - CNS lesions
           - Parkinson's disease
           - cerebral palsy

- Exam:
    - Bunnel test:
    - early intrinsic extensor tightness of the PIP joint;
           - stiffness, tightness of fingers on grasp;
           - full flexion possible when MCP fully flexed;

- Treatment:
    - corrected with therapy, or if that fails, sometimes by intrinsic release/transfer (Little - distal) or (Zancolli - proximal);
    - late deformity:
            - distal intrinsiic releae of those oblique fibers contributing to lateral bands, preserving more proximal transverse contribution 
                   of interosseous aponeurotic expansion



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Friday, August 19, 2011 11:49 am