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Striatal hand deformities in Parkinson's disease - hand surgical perspectives

Brogren, Elisabeth LU ; Dahlin, Lars LU orcid ; Franzén, Erika and Lindholm, Beata LU (2022) In Movement Disorders Clinical Practice 9(8). p.1047-1054
Abstract
Background
The knowledge about striatal hand deformities (SHD) in Parkinson’s disease (PD), has recently increased but need more attention due to their early impact on dexterity. The focus of clinical studies has been on the staging of SHD severity and neurological features. However, a hand surgical perspective has not been considered.
Objectives
Our purpose was to examine SHD in patients with PD using hand surgical assessment
methods and the recommended staging of SHD.
Methods
In this observational study, a specialist in neurological physiotherapy examined 100 consecutive PD patients and identified 35 with suspected SHD, who were then
examined by two hand surgeons. Their hands were clinically evaluated for... (More)
Background
The knowledge about striatal hand deformities (SHD) in Parkinson’s disease (PD), has recently increased but need more attention due to their early impact on dexterity. The focus of clinical studies has been on the staging of SHD severity and neurological features. However, a hand surgical perspective has not been considered.
Objectives
Our purpose was to examine SHD in patients with PD using hand surgical assessment
methods and the recommended staging of SHD.
Methods
In this observational study, a specialist in neurological physiotherapy examined 100 consecutive PD patients and identified 35 with suspected SHD, who were then
examined by two hand surgeons. Their hands were clinically evaluated for severity of SHD, according to a previous proposed staging, focusing on metacarpophalangeal (MCP) joint flexion, presence of intrinsic and extrinsic tightness, as well as other hand deformities.
Results
Three kinds of deformities were identified among 35 included patients: surgical
diagnoses unrelated to PD (n=5), SHD (n=23), and PD related hand deformities with increased extrinsic tightness (n=10); three of these 10 patients had also contralateral SHD, thus are included in SHD group. In addition to previously described MCP joint flexion, swan neck deformity and z-thumb deformity, we found in most hands finger “clefting”, abduction of the little finger and/or an increased intrinsic tightness, indicating pathology of intrinsic muscles of the hand involved in SHD.
Conclusions
SHD diagnosed with a modified staging method, including features of intrinsic and
extrinsic hand deformities, should be considered in PD to implement early and more accurate treatment (Less)
Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Movement Disorders Clinical Practice
volume
9
issue
8
pages
1047 - 1054
publisher
John Wiley & Sons Inc.
external identifiers
  • scopus:85136899060
  • pmid:36339303
ISSN
2330-1619
DOI
10.1002/mdc3.13531
language
English
LU publication?
yes
id
e7810e05-6b0e-4d1f-8686-1ec0907f5aee
date added to LUP
2022-08-21 11:45:53
date last changed
2024-02-01 22:28:36
@article{e7810e05-6b0e-4d1f-8686-1ec0907f5aee,
  abstract     = {{Background<br/>The knowledge about striatal hand deformities (SHD) in Parkinson’s disease (PD), has recently increased but need more attention due to their early impact on dexterity. The focus of clinical studies has been on the staging of SHD severity and neurological features. However, a hand surgical perspective has not been considered.<br/>Objectives<br/>Our purpose was to examine SHD in patients with PD using hand surgical assessment<br/>methods and the recommended staging of SHD.<br/>Methods<br/>In this observational study, a specialist in neurological physiotherapy examined 100 consecutive PD patients and identified 35 with suspected SHD, who were then<br/>examined by two hand surgeons. Their hands were clinically evaluated for severity of SHD, according to a previous proposed staging, focusing on metacarpophalangeal (MCP) joint flexion, presence of intrinsic and extrinsic tightness, as well as other hand deformities.<br/>Results<br/>Three kinds of deformities were identified among 35 included patients: surgical<br/>diagnoses unrelated to PD (n=5), SHD (n=23), and PD related hand deformities with increased extrinsic tightness (n=10); three of these 10 patients had also contralateral SHD, thus are included in SHD group. In addition to previously described MCP joint flexion, swan neck deformity and z-thumb deformity, we found in most hands finger “clefting”, abduction of the little finger and/or an increased intrinsic tightness, indicating pathology of intrinsic muscles of the hand involved in SHD.<br/>Conclusions<br/>SHD diagnosed with a modified staging method, including features of intrinsic and<br/>extrinsic hand deformities, should be considered in PD to implement early and more accurate treatment}},
  author       = {{Brogren, Elisabeth and Dahlin, Lars and Franzén, Erika and Lindholm, Beata}},
  issn         = {{2330-1619}},
  language     = {{eng}},
  month        = {{07}},
  number       = {{8}},
  pages        = {{1047--1054}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Movement Disorders Clinical Practice}},
  title        = {{Striatal hand deformities in Parkinson's disease - hand surgical perspectives}},
  url          = {{http://dx.doi.org/10.1002/mdc3.13531}},
  doi          = {{10.1002/mdc3.13531}},
  volume       = {{9}},
  year         = {{2022}},
}