Altered hand proprioception following regional anesthesia as a cause of traumatic jersey finger: Report of two cases
| Autor: | Ghada Asmar, Marc-Olivier Falcone, R. Chassat |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Sling (implant) media_common.quotation_subject Efferent Sensory system 030230 surgery Syncope Jersey Finger 03 medical and health sciences Postoperative Complications 0302 clinical medicine Physical medicine and rehabilitation Anesthesia Conduction Tendon Injuries Perception Finger Injuries medicine Humans Orthopedics and Sports Medicine media_common 030222 orthopedics Proprioception business.industry Rehabilitation Motor control Middle Aged Phalanx medicine.disease Carpal Tunnel Syndrome Accidental Falls Female Surgery business |
| Zdroj: | Hand Surgery and Rehabilitation. 39:582-584 |
| ISSN: | 2468-1229 |
| DOI: | 10.1016/j.hansur.2020.08.007 |
| Popis: | The sense of body ownership is being increasingly studied by manipulating incoming signals from the periphery with local anesthetics. We sought to understand how altered proprioception induced by anesthesia triggered a traumatic jersey finger, immediately postoperatively, in two patients who underwent surgical carpal tunnel release. Multiple mechanisms contributed to these postoperative injuries associated with a fall. Hand anesthesia deprives the brain of important afferent sensory information and modifies hand size perception in the brain. Moreover, it blocks efferent motor signals that contribute to the perception of hand position with sensory afferent signals. When the patients fell, their movement control was inadequate, generating a strong contraction of the hand extrinsic flexor muscles, against forceful distal phalanx extension. Lastly, both patients had removed their numb operated hand from their arm sling. Disrupted sensory and motor paths modify self-attribution of the hand, and thus halt adequate efferent commands. Protecting the operated hand until full sensory and motor control is regained could have prevented such rare accidents from happening. Level of evidence: V. |
| Databáze: | OpenAIRE |
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