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Hand and wrist anatomy

Robert W Irwin, Jeffrey Smith, S Barry Issenberg
The Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Physical Medicine and Rehabilitation (ABPMR) developed milestones for evaluation of resident physicians that include proper musculoskeletal ultrasound (MSUS) examination of major joints. To date, there have been no published data demonstrating acquisition and retention of these skills and correlation with the milestone evaluation. The investigators developed and implemented a curriculum in musculoskeletal ultrasound examination for Physical Medicine and Rehabilitation (PM&R) residents at a large academic medical center...
March 15, 2018: American Journal of Physical Medicine & Rehabilitation
Scott W Simpson, Bruce Latimer, C Owen Lovejoy
Among living mammals, only the African apes and some anteaters adopt knuckle-walking as their primary locomotor behavior. That Pan and Gorilla both knuckle-walk has been cited as evidence of their common ancestry and a primitive condition for a combined Homo, Pan, and Gorilla clade. Recent research on forelimb ontogeny and anatomy, in addition to recently described hominin fossils, indicate that knuckle-walking was independently acquired after divergence of the Pan and Gorilla lineages. Although the large-bodied, largely suspensory orangutan shares some aspects of the African ape bauplan, it does not regularly knuckle-walk when terrestrial...
March 2018: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
Georgi P Georgiev, R Shane Tubbs, Alexandar Iliev, Georgi Kotov, Boycho Landzhov
PURPOSE: The extensor indicis proprius (EIP) is a muscle of the forearm that originates from the posterior surface of the ulna and the adjacent interosseous membrane and attaches to the index finger. Many anatomical variations of this muscle have been reported in the literature. The extensor digitorum brevis manus (EDBM) is a variant muscle found on the back of the wrist and hand. These muscle variants should be considered in the context of clinical syndromes and reconstructive hand surgery...
January 30, 2018: Surgical and Radiologic Anatomy: SRA
Samir Kumta, Sudhir Warrier, Leena Jain, Rani Ummal, Manik Menezes, Shrirang Purohit
Introduction: Scaphoid fractures are not very common and frequently remain undiagnosed, presenting in non-union and persistent wrist pain. Options for scaphoid fracture treatment have been described over several decades, however, none with an optimal solution to achieve union along with good hand function. We describe here, the use of vascularised corticoperiosteal bone grafts from the medial femoral condyle (MFC) as a solution for the difficult problem of scaphoid fracture non-union...
May 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
Colin W Moore, Jacob Fanous, Charles L Rice
Surgical studies describe the palmaris longus (PL) as a synergist in thumb abduction, which may facilitate its use in restoring thumb function using opponensplasty. However, beyond morphological descriptions and isometric thenar abduction strength measures, the evidence supporting the PL as a thenar synergist in-vivo is limited. The purpose here was to determine whether the PL provides synergistic contributions to thenar musculature by: (1) recording PL muscle activity using indwelling electromyography (EMG) during thumb movements; and (2) quantifying changes in PL muscle architecture using ultrasonography...
November 27, 2017: Clinical Anatomy
M Gras, C Leclercq
Spasticity is a complex pathology, both in terms of assessment and treatment. This article focuses on the clinical examination (objective, capacity, performance and function), which is key for choosing a treatment and can be helped by botulinum toxin injections. The treatment involves physical therapy, occupational therapy, medications and surgery. Neurectomy has been used in the upper limb since 1912 and is one of the therapeutic options for spasticity. This treatment is usually reserved for nonfunctional hands...
December 2017: Hand Surgery and Rehabilitation
Harvey Chim
No abstract text is available yet for this article.
October 2017: Plastic and Reconstructive Surgery
Chad Hulsopple, Jesse Deluca, Christopher Jonas
Carpal bone fractures are common hand fractures that can be complicated by concomitant damage to surrounding structures, chronic comorbidities, or delays in diagnosis. This article provides an overview of wrist anatomy, an expedited review of the athlete's presenting condition, and a systematic approach to the evaluation of the wrist. Recommended treatment plans are based on a review of the literature and an evidence-based approach to imaging studies. It is imperative that sports medicine providers be aware of current literature for carpal bone fractures and collaborate with other medical subspecialties and the athlete to provide recommendations for a safe return to play...
September 2017: Current Sports Medicine Reports
Bernhard Gesslbauer, Laura A Hruby, Aidan D Roche, Dario Farina, Roland Blumer, Oskar C Aszmann
OBJECTIVE: Axons traveling within the brachial plexus are responsible for the dexterous control of human arm and hand movements. Despite comprehensive knowledge on the topographical anatomy of nerves innervating the human upper limbs, the definite quantity of sensory and motor axons within this neural network remains elusive. Our aim was to perform a quantitative analysis of the axonal components of human upper limb nerves based on highly specific molecular features from spinal cord level to the terminal nerves at wrist level...
September 2017: Annals of Neurology
E Carità, A Donadelli, L Cugola, P Perazzini
BACKGROUND/PURPOSE: Radial head replacement is frequently used in treatment of radial head fractures or sequela. Impossibility to restore a correct anatomy, acute elbow traumatic instability and failure of osteosynthesis hardware are the most common indications. The authors describe their case studies and results on the implantation of various radial head prostheses. MATERIALS: Between June 2005 and June 2016, 28 radial head prostheses were implanted in the same number of patients with an average follow-up of 49 months (6-104)...
December 2017: Musculoskeletal Surgery
C Lazerges
Soft tissue sarcoma of the forearm, wrist and hand are rare. Their benign appearance leads often to primary inadequate treatment. Due to the complex anatomy of the hand and forearm, they are challenging to treat. The two goals are to obtain wide resection of the primary tumor while preserving function. Limb-sparing surgery is now the cornerstone for the treatment of most sarcomas of the forearm, hand and wrist. To achieve optimal oncological and functional outcomes, the surgical excision should be associated with early reconstructive procedures and a multidisciplinary meeting to define the treatment strategy including adjuvant medical treatments...
September 2017: Hand Surgery and Rehabilitation
Pierre Kehr, Alain G Graftiaux
No abstract text is available yet for this article.
June 13, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Mabel Qi He Leow, Rebecca Qian Ru Lim, Shian Chao Tay
Clinical assessment of the hand is important for diagnosing underlying hand disorders. Using a case study approach, the clinical assessment for three disorders of the hands is presented: trigger finger (stenosing tenosynovitis), carpal tunnel syndrome, and ulnar-sided wrist injury (styloid impingement). We assess the annular one pulley and finger range of motion for patients with trigger finger. To diagnose for carpal tunnel syndrome, assessment for Tinel's sign, Phalen's sign, abductor pollicis brevis muscle bulk, two-point discrimination, and obtaining a nerve conduction study are performed...
May 2017: Orthopaedic Nursing
Hagay Orbach, Guy Rubin, Alejandro Wolovelsky, Micha Rinott, Uriel Giwnewer, Nimrod Rozen
Rock climbing, whether practiced in nature on cliffs and boulders or indoors on walls made of resin and wood, has gained tremendous popularity in recent decades. More people are exposed to injuries associated with the unique biomechanical forces of rock climbing. A series of repetitive high torque movements of the upper limbs are needed to ascend a wall or rockface. These movements subject the hand and wrist to large forces, potentially resulting in ligament and tendon sprains or rupture and even bone fracture...
July 2016: Harefuah
Aviv Kramer, Raviv Allon, Alon Wolf, Tal Kalaiman, Idit Lavi, Ronit Wollstein
BACKGROUND: Interpreting the structure in the wrist is complicated by the existence of multiple joints as well as variability in bone shapes and anatomical patterns. Previous studies have evaluated lunate and capitate shape in an attempt to understand functional anatomical patterns. OBJECTIVE: The purpose of this study was to describe anatomical shapes and wrist patterns in normal wrist radiographs. We hypothesized that there is a significant relationship in the midcarpal joint with at least one consistent pattern of wrist anatomy...
April 17, 2017: Current Rheumatology Reviews
Matthew Brown, Kevin C Chung
Postburn contractures are a common occurrence after severe burn injuries. It is important to understand the pathologic condition and anatomy of specific postburn deformities in order to provide comprehensive surgical care. Postburn contractures can result in a flexion contracture, boutonniere deformity, burn syndactyly, metacarpophalangeal extension contracture, wrist contracture, or claw hand. A patient evaluation is performed before proceeding to the operating room. Surgery sequences require proper incision design, release of the skin, and deeper contracted structures and coverage with an appropriate flap or graft...
May 2017: Hand Clinics
Zhi Yang Ng, Shaun Shi Yan Tan, Alexandre Gaston Lellouch, Curtis Lisante Cetrulo, Harvey Wei Ming Chim
BACKGROUND: Upper extremity soft tissue defects with complete circumferential involvement are not common. Coupled with the unique anatomy of the upper extremity, the underlying etiology of such circumferential soft tissue defects represent additional reconstructive challenges that require treatment to be tailored to both the patient and the wound. The aim of this study is to review the various options for soft tissue reconstruction of complete circumferential defects in the upper extremity...
March 2017: Archives of Plastic Surgery
Michael J Franco, Dennis C Nguyen, Benjamin Z Phillips, Susan E Mackinnon
Background: Nerve transfers have resulted in increased interest in the microanatomy of peripheral nerves. Herein, we expand our understanding of the internal anatomy of the digital nerve to the ulnar index and long fingers, the radial long and ring fingers, and the nerves to the second and third web spaces. Methods: The median nerve was dissected from the digital nerves to the antecubital fossa in 14 fresh upper extremities. The distance of proximal internal neurolysis of the fascicles to the second and third web space and proper digital nerves was measured relative to the radial styloid...
December 2016: Hand: Official Journal of the American Association for Hand Surgery
S Ahlawat, F M Corl, D M LaPorte, E K Fishman, L M Fayad
Hand and wrist infections can present with a spectrum of manifestations ranging from cellulitis to deep-space collections. The various infectious processes can be categorised as superficial or deep infections based on their respective locations relative to the tendons. Superficial hand infections are located superficial to the tendons and are comprised of cellulitis, lymphangitis, paronychia, pulp-space infections, herpetic whitlow, and include volar as well as dorsal subcutaneous abscesses. Deep hand infections are located deep to the tendon sheaths and include synovial space infections, such as infectious tenosynovitis, deep fascial space infections, septic arthritis, necrotising fasciitis, and osteomyelitis...
April 2017: Clinical Radiology
Marijn Zilverschoon, Koen L Vincken, Ronald L A W Bleys
INTRODUCTION: Virtual 3D models are powerful tools for teaching anatomy. At the present day, there are a lot of different digital anatomy models, most of these commercial applications are based on a 3D model of a human body reconstructed from images with a 1 millimeter intervals. The use of even smaller intervals may result in more details and more realistic appearances of 3D anatomy models. The aim of this study was to create a realistic and highly detailed 3D model of the hand and wrist based on small interval cross-sectional images, suitable for undergraduate and postgraduate teaching purposes with the possibility to perform a virtual dissection in an educational application...
November 21, 2016: Journal of Biomedical Informatics
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