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Hand and wrist anatomy

David Kachlik, Vladimir Musil, Vaclav Baca
PURPOSE: The aim of this article is to revise and extend the existing sections of Terminologia Anatomica dealing with the upper limb structures, which nomenclature belongs to its most neglected and not developing parts, and to justify the use of the proposed anatomical terms in the clinical practice, research, and education. METHODS: A sample collected from own educational and research experience was matched in the main anatomical textbooks as well as old and recent anatomical journals and compared with four versions of the official Latin anatomical nomenclatures...
September 19, 2016: Surgical and Radiologic Anatomy: SRA
Giulia Colzani, Pierluigi Tos, Bruno Battiston, Giovanni Merolla, Giuseppe Porcellini, Stefano Artiaco
The extensor apparatus is a complex muscle-tendon system that requires integrity or optimal reconstruction to preserve hand function. Anatomical knowledge and the understanding of physiopathology of extensor tendons are essential for an accurate diagnosis of extensor tendon injuries (ETIs) of the hand and wrist, because these lesions are complex and commonly observed in clinical practice. A careful clinical history and assessment still remain the first step for the diagnosis, followed by US and MR to confirm the suspect of ETI or to investigate some doubtful conditions and rule out associate lesions...
April 2016: Journal of Hand and Microsurgery
Sean W Colio, Jay Smith, Adam M Pourcho
Acute and chronic wrist and hand conditions are commonly seen by neuromuscular and musculoskeletal specialists. High-frequency diagnostic ultrasonography (US) has facilitated advances in the diagnosis and interventional management of wrist and hand disorders. US provides excellent soft tissue resolution, accessibility, portability, lack of ionizing radiation, and the ability to dynamically assess disorders and precisely guide interventional procedures. This article review the relevant anatomy, indications, and interventional techniques for common disorders of the wrist and hand, including radiocarpal joint arthritis, scaphotrapeziotrapezoidal joint arthritis, trapeziometacarpal joint arthritis, phalangeal joint arthritis, first dorsal compartment tenosynovitis, ganglion cysts, and stenosing tenosynovitis...
August 2016: Physical Medicine and Rehabilitation Clinics of North America
Emily Altman
BACKGROUND: In the hectic environment of a hand therapy clinic, the opportunity to carefully consider the relationships among pathology, pathomechanics, surgical repair techniques, tissue healing, postoperative management, and rehabilitation program development and progression is limited. Clinicians often default to seeking a protocol, a recipe to follow. OBJECTIVES: Using the ulnar side of the wrist as an example, relevant anatomy and biomechanics are directly related to several commonly seen pathologies, including fractures, ligament injuries, and instability...
April 2016: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
Grzegorz Guzik
The most common neoplasms of the distal radius are primary tumors, of which aneurysmal bone cysts and giant cell tumors are seen almost exclusively. Chondrosarcomas are most commonly located in the pelvis, ribs and proximal segments of the extremities; they rarely occur in forearm bones. Bone defects after distal radial resection can be replaced with bone grafts, both autogenous and allogenic. There is always a risk of failure of the bones to mend or slower synostosis, which necessitates the search for new treatments...
January 2016: Ortopedia, Traumatologia, Rehabilitacja
Caroline Erolin, Clare Lamb, Roger Soames, Caroline Wilkinson
This study investigated the haptic 'dissection' of a digital model of the hand and wrist in anatomy education at both undergraduate (UG) and postgraduate (PG) levels. The study ran over five successive years and was split into three discreet phases. Phase one compared the results of PG students across control, non-haptic and haptic groups. Phase two compared the results of UG students between control and haptic groups. Phase three compared the results of UG students across control, non-haptic and haptic groups...
2016: Studies in Health Technology and Informatics
Luyao Shen, Sulabha Masih, Dakshesh B Patel, George R Matcuk
Ulnar neuropathy is a common and frequent reason for referral to hand surgeons. Ulnar neuropathy mostly occurs in the cubital tunnel of the elbow or Guyon's canal of the wrist, and it is important for radiologists to understand the imaging anatomy at these common sites of impingement. We will review the imaging and anatomy of the ulnar nerve at the elbow and wrist, and we will present magnetic resonance imaging examples of different causes of ulnar neuropathy, including trauma, overuse, arthritis, masses and mass-like lesions, and systemic diseases...
March 2016: Clinical Imaging
Jason Silvestre, Ines C Lin, Benjamin Chang, L Scott Levin
BACKGROUND: Orthopedic and plastic surgery residents receive unique training yet often compete for similar hand surgery fellowships. This study compared didactic hand surgery training during orthopedic and plastic surgery residency. METHODS: The Plastic Surgery In-Service Training Exam and Orthopaedic In-Training Examination were analyzed for hand content for the years 2009 to 2013. Topics were categorized with the content outline for the Surgery of the Hand Examination...
March 2016: Plastic and Reconstructive Surgery
Denise Ramponi, Tara McSwigan
Wrist injuries are a common complaint in the emergency setting. Any disruption of the anatomy of the carpal bones can impair hand function, leading to pain, weakness, and complications. One of the most common forms of carpal bone instability is scapholunate dissociation. This injury can lead to significant morbidity including avascular necrosis, impaired healing, limited function, and arthritis. These diagnostic findings may be subtle, thus identifying high-risk mechanisms of injury, and clinical manifestations will assist the emergency practitioner with early diagnosis and treatment of this high-risk injury...
January 2016: Advanced Emergency Nursing Journal
Dane Salazar, Antony Hazel, Guido Marra
The mobile wad of the elbow provides a tremendous mechanical advantage with respect to elbow flexion and wrist extension. Injury to these structures causes significant upper extremity dysfunction. In this article, we report the case of a 31-year-old right hand-dominant man who sustained an isolated avulsion of the extensor carpi radialis longus and brachioradialis origins from the lateral epicondyle and lateral supracondylar ridge. We describe our diagnostic workup and present our surgical repair technique...
October 2015: American Journal of Orthopedics
Brandon Michael Henry, Helena Zwinczewska, Joyeeta Roy, Jens Vikse, Piravin Kumar Ramakrishnan, Jerzy A Walocha, Krzysztof A Tomaszewski
BACKGROUND AND OBJECTIVE: The course and branches of the median nerve (MN) in the wrist vary widely among the population. Due to significant differences in the reported prevalence of such variations, extensive knowledge on the anatomy of the MN is essential to avoid iatrogenic nerve injury. Our aim was to determine the prevalence rates of anatomical variations of the MN in the carpal tunnel and the most common course patterns and variations in its thenar motor branch (TMB). STUDY DESIGN: A systematic search of all major databases was performed to identify articles that studied the prevalence of MN variations in the carpal tunnel and the TMB...
2015: PloS One
Richard M Hinds, Michael B Gottschalk, John T Capo
Background The pronator quadratus (PQ) muscle is an important and commonly encountered structure in surgery of the wrist. A thorough understanding of the anatomy of the PQ and the anterior interosseous nerve (AIN), which innervates the PQ, is important, particularly during distal radius fracture osteosynthesis and distal AIN transfer to deep branch of the ulnar nerve. Furthermore, there is a paucity of literature regarding sex differences in the morphology of these structures. We describe the morphology of the PQ and AIN and compare PQ and AIN findings in male and female specimens...
August 2015: Journal of Wrist Surgery
Prashant V Rajan, Charles S Day
Injury to the scapholunate interosseous ligament is one of the most common causes of carpal instability and can impart considerable compromise to the patient's hand function. However, the management of scapholunate ligament injuries remains a dynamic concept, especially with regard to the multitude of options and techniques that exist for its surgical treatment. We present a thorough review of scapholunate anatomy and morphology, and the role of the scapholunate articulations in the kinetics and pathomechanics of wrist instability...
August 2015: Journal of Hand Surgery
C-H Lee, K-H Lee, B-G Lee, D-Y Kim, W-S Choi
BACKGROUND: Although malunion resulting from reconstruction for scaphoid fracture nonunion is a typical complication, there has been little consideration regarding its clinical outcomes. HYPOTHESIS: The quality of restoration of the scaphoid anatomy may have little effect on clinical outcomes. MATERIALS AND METHODS: Twenty-five patients with scaphoid fracture nonunion underwent curettage and internal fixation with bone grafting performed by a single surgeon, and they were followed up for a minimum of 5 years...
May 2015: Orthopaedics & Traumatology, Surgery & Research: OTSR
M Nicoloff
BACKGROUND: For decades design and development of TWA has been accompanied by quite a few failures, so that it has been rejected by most surgeons until today. The difficult and complex anatomy of the wrist led to different ways of development and often ended in an impasse. Compared to knee and hip arthroplasties which could be conceived and developed further, a consistent method could not be applied. But in the last years some new concepts have established themselves, so that TWA is now not only applied in individual cases...
February 2015: Zeitschrift Für Orthopädie und Unfallchirurgie
Pushpender Gupta, Leon Lenchik, Scott D Wuertzer, David A Pacholke
OBJECTIVE. With high-resolution 3-T MRI, the complex anatomy of the fingers can be imaged in exquisite detail to provide an accurate diagnosis of clinically important ligament and tendon injuries. CONCLUSION. We present our 3-T MRI protocol using a dedicated hand-and-wrist coil and review normal MRI anatomy of the fingers. We emphasize a systematic approach to the interpretation of finger MRI examinations and illustrate this approach with examples of tendon and ligament abnormalities.
March 2015: AJR. American Journal of Roentgenology
Pietro Maria Ferrando, Lorenzo Garagnani, Rupert Eckersley, Justin Weir, Effie Katsarma
UNLABELLED: consequently reports in the international literature are mainly of individual cases and small series. MATERIAL OF STUDY: This is a retrospective review of a series of 25 patients with lipomatous tumours of the hand and wrist treated between 2001 and 2009. All patients underwent clinical and radiological assessment and a marginal excisional biopsy. 23 lipomas, 1 fibrolipomatous hamartoma (FLH) and 1 well differentiated lipoma-like liposarcoma/atypical lipomatous tumour (WDLLL/ALT) were identified...
November 2014: Annali Italiani di Chirurgia
Pawel Depukat, Ewa Mizia, Michal Klosinski, Miroslawa Dzikowska, Wieslawa Klimek-Piotrowska, Malgorzata Mazur, Marcin Kuniewicz, Tomasz Bonczar
Carpal tunnel syndrome is the first on the list of peripheral nerve lesions in the upper limb. Most of the anatomical facts about this syndrome are widely known. The Guyoun's canal is the second reason for compression syndrome in the wrist. Anatomy of this is region still remains controversial. This is why authors tried to compile some latest findings accompanied by their own observation, and added some clinical notes, which might be useful both for orthopedic surgeons and well as for representatives of basic sciences...
2014: Folia Medica Cracoviensia
Stephanie Morco, Anton Bowden
The objective of this article is to summarize current understanding of biomechanical factors that cause ulnar drift in the hands of patients with rheumatoid arthritis. This was done through literature review of published articles on the mechanical etiology of ulnar drift. There are several theories regarding the cause of ulnar drift, however conclusive evidence is still lacking. Current mechanical factors that are postulated to play a role include: failure of the collateral ligaments, intra-articular pressure changes, degenerative changes in the carpal and metacarpal anatomy, muscle hypoxia induced changes in wrist tension, and exacerbating activities of daily living...
February 26, 2015: Journal of Biomechanics
Joseph J Crisco, Eni Halilaj, Douglas C Moore, Tarpit Patel, Arnold-Peter C Weiss, Amy L Ladd
PURPOSE: The primary aim of this study was to determine whether the in vivo kinematics of the trapeziometacarpal (TMC) joint differ as a function of age and sex during thumb extension-flexion (Ex-Fl) and abduction-adduction (Ab-Ad) motions. METHODS: The hands and wrists of 44 subjects (10 men and 11 women with ages 18-35 y and 10 men and 13 women with ages 40-75 y) with no symptoms or signs of TMC joint pathology were imaged with computed tomography during thumb extension, flexion, abduction, and adduction...
February 2015: Journal of Hand Surgery
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