Principles of Management The difficulties in treating congenital anomalies of the hand have long been recognized. Milford observed, “a single surgical procedure cannot be standardized to suit even similar anomalies.” Treatment of a congenital hand deformity may be sought at…
Factors Influencing Hand Infections The clinical course of most hand infections is affected by anatomic, local, and systemic factors, in addition to bacterial virulence and the size of the inoculum. Anatomic factors that to some extent determine the ease of…
Hand masses may result from tumors and tumorous conditions, and although most of these masses are benign, they should be considered potentially problematic and managed with great diligence. Because the hand has limited free space and exquisite sensitivity, even small…
Carpal Tunnel Syndrome Carpal tunnel syndrome, described by Paget in 1854, is the most common upper extremity compression neuropathy and results from median nerve compression within the carpal tunnel. The carpal tunnel is bound by the carpal bones arching dorsally;…
Stenosing Tenosynovitis Stenosing tenosynovitis in the hand and wrist are common conditions resulting in significant functional impairment for which treatments usually are straightforward; symptom resolution usually is complete with appropriate management. When the extensor pollicis brevis (EPB) and the abductor…
Dupuytren disease is a proliferation of previously normal subcutaneous palmar and digital tissues that may manifest as nodules and cords that may compromise hand function by the resultant finger and thumb joint flexion contractures. Other secondary changes include thinning of…
Definition and History Compartment syndrome is a condition in which the circulation within a closed compartment is compromised by an increase in pressure within the compartment, causing necrosis of muscles, nerves, and eventually the skin because of excessive swelling. Volkmann…
Rheumatoid Arthritis Rheumatoid arthritis is the most common idiopathic inflammatory arthritis, affecting approximately 0.8% of the population, and it is two to four times more common in women than in men. The disease is characterized by hypertrophic synovitis that leads…
Cerebral palsy is a nonprogressive, nonhereditary encephalopathy that occurs in the prenatal or perinatal period and is characterized by altered motor, sensory, and, often, intellectual function. Cerebral palsy occurs in the industrialized world with an approximate annual frequency of 2…
Sensation, mobility, and strength are required for the highly adaptive functions of pinch, grasp, and hook. Positional changes and delicate movements also are made possible by the many joints of the 29 hand, wrist, and forearm bones and by the…