Gooseneck deformity

from Wikipedia, the free encyclopedia

In medicine, gooseneck deformity is the misalignment of a long finger when the middle joint is overstretched and the end joint is fixed in a flexed position. The basic joint is usually also in a flexion malposition. The term also describes the flexion deformity of a toe joint (claw position - usually 2nd toe).

finger

Gooseneck ring to correct the deformity

The cause of this type of misalignment is a defect in the palmar tendon plate, i.e. primarily the finger flexor tendons in the area of ​​the middle joint. The gooseneck deformity is a typical hand change in chronic polyarthritis , but can also result from an accident-related tear of the palmar tendon plate at the middle joint .

Therapy consists of reconstruction of the flexor tendon apparatus at the middle joint , possibly with tenodesis (repositioning with fixation) and, in the case of rheumatic causes, with arthrolysis or passive mobilization of the middle joint . Arthrodesis can also be performed for fixed deformities or lateral instability . Follow-up treatment after reconstruction is usually carried out with partial immobilization for up to four weeks in a 20–30 ° flexion position of the middle joint, which allows flexion but prevents extension.

toe

The main cause here is the mechanical stress, especially when the second toe is longer than the big toe. Therapeutically, it is important to eliminate the misalignment and its cause. To do this, it may be necessary to resect the distal part of the middle phalanx and fix it accordingly. This not only corrects the misalignment, but also shortens the toe (eliminating the cause).

Individual evidence

  1. ↑ a b A. Imhoff et al: foot surgery. Thieme Verlag, 2004, ISBN 3-13-123851-8 , p. 114, (online at: books.google.de )
  2. ^ HJ Hettenkofer: Rheumatology . Thieme-Verlag, 1998, p. 56.
  3. ↑ G. Souza-Offtermatt: Intensive Surgery Course . Urban & Fischer-Verlag, 2004, ISBN 3-437-43490-X , p. 566, (online at: books.google.de )
  4. ↑ J. Krämer et al.: Orthopädie. Springer, 2004, ISBN 3-540-21970-6 , p. 113, (online at: books.google.de )
  5. ↑ Lexicon entry: Tenodese
  6. ^ R. Hoffmann: Hand surgery . Current medicine checklists. Thieme-Verlag, 1997, p. 420.