Synopsis ■ Brachial plexus injuries (BPI) are characterized by many complex problems and remain a dilemma to many reconstructive microsurgeons. These complexities include: (1) diverse injury patterns; (2) disrupted anatomy; (3) unpredictable nerve degeneration and regeneration; (4) difficult physical examination…
Synopsis ■ Nerve regeneration after injury is orchestrated by delicate processes in neurons, non-neural cells, and other cells at various levels from the periphery to the central nervous system. ■ The clinical effects of a nerve injury include not only…
Synopsis ■ Chronic nerve entrapment syndromes in the upper extremity are common and their occurrence is only likely to increase as risk factors such as diabetes, obesity, and advanced age become more prevalent in the general population. ■ In most…
Synopsis Upper extremity problems that are attributed to the workplace require experience, a knowledge base, and skill set that set them aside from non-occupational injuries. A careful history, physical examination, and knowledge of current evidence is required to evaluate causation.…
Synopsis ■ Rheumatoid arthritis is a systemic autoimmune inflammatory disease that affects the joints of the hand and wrist. Rheumatoid arthritis also affects the soft tissues and can cause disease processes such as trigger finger and carpal tunnel syndrome. ■…
Synopsis ■ Osteoarthritis is characterized by a loss of articular cartilage. ■ The development of osteoarthritis is a dynamic process that represents an imbalance between destruction and repair of the articular cartilage. It can result from trauma, such as an…
Access video content for this chapter online at Elsevier eBooks+ Basic science and disease process Dupuytren’s disease (DD) is a primary fibroproliferative disorder of the palmar and digital fasciae of the hand. A similar disease process known as Ledderhose and…
Synopsis ■ Benign and malignant tumors of the hand arise from distinct tissue types. ■ The majority of these tumors are benign. ■ Accurate assessment, diagnosis, and treatment will optimize clinical outcomes. ■ Reconstructive procedures of the hand and upper…
Synopsis ■ Hand infections are common, with diverse etiologies. It is important to have a high index of suspicion to allow expeditious diagnosis and treatment in order to prevent morbidity and maximize outcomes. ■ A thorough understanding of hand anatomy…
Synopsis ■ Microsurgical toe-to-hand transplantation allows “like-with-like” reconstruction, achieving the best functional and aesthetic results. ■ Preservation of neurovascular bundles, flexor and extensor tendons, mobile joints, and viable skin with minimal bone shortening in the amputation stump ensures optimal functional…