Indications and Clinical Considerations Metacarpal nerve block is used primarily in 2 clinical situations: (1) to provide surgical anesthesia in the distribution of the digital nerves for laceration, tendon, and fracture repair and (2) to provide postoperative pain relief after…
Indications and Clinical Considerations Dupuytren contracture is caused by a progressive fibrosis of the palmar fascia. Initially, the patient may notice fibrotic nodules that are tender to palpation along the course of the flexor tendons of the hand. These nodules…
Indications and Clinical Considerations The dorsum of the wrist is especially susceptible to developing ganglion cysts ( Fig. 98.1 ). These cysts are thought to form as a result of herniation of synovial-containing tissues from joint capsules or tendon sheaths…
Indications and Clinical Considerations Accessory bones of the wrist are relatively uncommon, with a reported incidence of 0.75% to 2.0% ( Fig. 97.1 ). They are thought to be a remnant of separate ossification centers found in the human embryo…
Indications and Clinical Considerations Secretan syndrome is caused by a peritendinous fibrosis that occurs after trauma to the dorsum of the hand. Often the traumatic event is seemingly minor, such as hitting the back of the hand on the corner…
Indications and Clinical Considerations Carpal boss is a relatively uncommon pain syndrome that affects the dorsum of the hand. It is characterized by localized tenderness and sharp pain over the junction of the second and/or third metacarpal joints ( Fig.…
Indications and Clinical Considerations Entrapment neuropathy of the ulnar nerve at the wrist is known as ulnar tunnel syndrome and is the much less common than carpal tunnel syndrome ( Fig. 94.1 ). The clinical presentation of ulnar tunnel syndrome…
Indications and Clinical Considerations Carpal tunnel syndrome is caused by compression of the median nerve as it passes through the carpal canal at the wrist ( Figs. 93.1 and 93.2 ). The most common causes of compression of the median…
Indications and Clinical Considerations The interphalangeal joint is susceptible to developing arthritis from a variety of conditions that all have the ability to damage joint cartilage. Osteoarthritis of the joint is the most common form of arthritis that results in…
Indications and Clinical Considerations The metacarpophalangeal joint is susceptible to developing arthritis from a variety of conditions that all have the ability to damage the joint cartilage. Osteoarthritis of the joint is the most common form of arthritis that results…