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Congenital Ulnar Drift in a Surgeon.

McKee D, Eliasson S, Griswold J - Case Rep Orthop (2015)

Bottom Line: Windblown hand is a term used in many instances to describe ulnar deviations of the fingers with or without other malformations.While the most common cause of ulnar deviation of the fingers is rheumatoid arthritis, it can also be caused by other conditions such as windblown hand or Jaccoud's arthropathy.We present a case of a surgeon who has had noticeable ulnar deviation of the digits at the level of the metacarpophalangeal joint since his early 20s.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Texas Tech University, 3601 4th Street, Mail Stop 9436, Lubbock, TX 79430-9436, USA.

ABSTRACT
Windblown hand is a term used in many instances to describe ulnar deviations of the fingers with or without other malformations. In 1994 Wood reviewed all of the descriptions of cases of windblown hand and pointed out how many variants of congenital ulnar drift there are, suggesting that the many variations seen may all belong to a larger type of arthrogryposis. While the most common cause of ulnar deviation of the fingers is rheumatoid arthritis, it can also be caused by other conditions such as windblown hand or Jaccoud's arthropathy. While most hand surgeons are familiar with presentations of congenital ulnar drift, few of them are knowledgeable about Jaccoud's arthropathy as this is usually discussed within medical communities such as Rheumatology. We present a case of a surgeon who has had noticeable ulnar deviation of the digits at the level of the metacarpophalangeal joint since his early 20s. We propose that the current case is a demonstration of a type of windblown hand that has some hereditary component but is not immediately obvious at birth and presents physically more like Jaccoud's arthropathy than traditional windblown hand.

No MeSH data available.


Related in: MedlinePlus

Left windblown hand.
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fig3: Left windblown hand.

Mentions: The patient had no history of rheumatoid arthritis, rheumatic fever, or SLE. ESR was 1, uric acid was 6.0, C-reactive protein was 0.0, rheumatoid factor was <10, and he was negative for anti-nuclear antibody suggesting no rheumatoid arthritis or SLE. It was felt to be unlikely seronegative rheumatoid arthritis given his family history and the lack of other symptoms compatible with this disease process. The deformity was not present at birth and he had no other deformities as a child. The pain was isolated to the MP and CMC joints of his hands. Radiographs of his hands were done as seen in Figures 3 and 4. The radiographs confirmed osteoarthritic changes of the left hand and wrist, worsening at the second MCP joint, the third MCP joint, and the scaphotrapezial joint. Spurs were present at the second metacarpal head as well as at the trapezium. The radiographs also confirmed osteoarthritic changes in the right hand with severe joint space narrowing at the scaphotrapezial and first CMC joint, along with minor joint space narrowing in the second and third MCP joints.


Congenital Ulnar Drift in a Surgeon.

McKee D, Eliasson S, Griswold J - Case Rep Orthop (2015)

Left windblown hand.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4488582&req=5

fig3: Left windblown hand.
Mentions: The patient had no history of rheumatoid arthritis, rheumatic fever, or SLE. ESR was 1, uric acid was 6.0, C-reactive protein was 0.0, rheumatoid factor was <10, and he was negative for anti-nuclear antibody suggesting no rheumatoid arthritis or SLE. It was felt to be unlikely seronegative rheumatoid arthritis given his family history and the lack of other symptoms compatible with this disease process. The deformity was not present at birth and he had no other deformities as a child. The pain was isolated to the MP and CMC joints of his hands. Radiographs of his hands were done as seen in Figures 3 and 4. The radiographs confirmed osteoarthritic changes of the left hand and wrist, worsening at the second MCP joint, the third MCP joint, and the scaphotrapezial joint. Spurs were present at the second metacarpal head as well as at the trapezium. The radiographs also confirmed osteoarthritic changes in the right hand with severe joint space narrowing at the scaphotrapezial and first CMC joint, along with minor joint space narrowing in the second and third MCP joints.

Bottom Line: Windblown hand is a term used in many instances to describe ulnar deviations of the fingers with or without other malformations.While the most common cause of ulnar deviation of the fingers is rheumatoid arthritis, it can also be caused by other conditions such as windblown hand or Jaccoud's arthropathy.We present a case of a surgeon who has had noticeable ulnar deviation of the digits at the level of the metacarpophalangeal joint since his early 20s.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Texas Tech University, 3601 4th Street, Mail Stop 9436, Lubbock, TX 79430-9436, USA.

ABSTRACT
Windblown hand is a term used in many instances to describe ulnar deviations of the fingers with or without other malformations. In 1994 Wood reviewed all of the descriptions of cases of windblown hand and pointed out how many variants of congenital ulnar drift there are, suggesting that the many variations seen may all belong to a larger type of arthrogryposis. While the most common cause of ulnar deviation of the fingers is rheumatoid arthritis, it can also be caused by other conditions such as windblown hand or Jaccoud's arthropathy. While most hand surgeons are familiar with presentations of congenital ulnar drift, few of them are knowledgeable about Jaccoud's arthropathy as this is usually discussed within medical communities such as Rheumatology. We present a case of a surgeon who has had noticeable ulnar deviation of the digits at the level of the metacarpophalangeal joint since his early 20s. We propose that the current case is a demonstration of a type of windblown hand that has some hereditary component but is not immediately obvious at birth and presents physically more like Jaccoud's arthropathy than traditional windblown hand.

No MeSH data available.


Related in: MedlinePlus