Synopsis ■ Tendons transmit forces generated by muscles to move joints or to create action power. Flexor tendon injuries are common, but recovery of satisfactory function, particularly after injuries within the digital sheath, is sometimes difficult. Lacerated flexor tendons should…
Synopsis ■ Wrist injuries are common, and proper management relies on an understanding of normal anatomy, alignment, and kinematics. ■ Scaphoid fractures can be subtle, and due to the precarious blood supply to this bone, may go on to non-union…
Synopsis ■ Diagnosis of hand fractures and joint injuries requires history, examination, and adequate imaging studies. ■ Treatment decisions are based on fracture geometry, stability, and individual patient needs. ■ Nonoperative principles include reduction, maintenance of reduction through casting, splinting…
Synopsis ■ Fingertip and nail bed injuries are the most common injuries of the hand. ■ Large subungual hematomas should be drained to relieve pressure and pain; small and asymptomatic hematomas (<50%) can be observed. Trephination of a subungual hematoma…
Synopsis Careful preoperative planning facilitates safe and expeditious surgery. ■ Ligamentotaxis relies on the intact soft-tissue envelope. By applying linear traction, it indirectly reduces fragments via the intact periosteum, ligaments, and soft tissues. ■ The most appropriate method of fracture…
Synopsis ■ Optimal perioperative anesthetic outcomes are achieved by a thorough understanding of anatomy, pharmacology, techniques, and potential complications. ■ Local anesthetics (LA) make regional anesthesia possible by preventing the propagation of nerve conduction and by inhibiting or relieving pain.…
Synopsis ■ Radiographs form the cornerstone of diagnostic imaging of the hand and wrist, and are usually the first imaging modalities performed following clinical evaluation. ■ The keys to obtaining the most information from radiographs are ordering the correct radiographs…
Synopsis ■ Physical examination of the upper extremity starts with a detailed and accurate patient history. ■ Physical examination of the upper extremity consists of inspection, palpation, measurement of length, girth, and ranges of motion, assessment of stability, and detailed…
Synopsis ■ The hand is an incredibly designed structure with complex anatomy and precise biomechanics. The hand must be able to produce adequate force to allow performance of activities of daily living. Furthermore, it must ensure coordination of the fingers…
Introduction Reconstruction of the nipple–areolar complex (NAC) is most commonly performed for women as the final component of breast reconstruction following mastectomy to treat breast cancer. While a significant proportion of women ultimately forgo nipple reconstruction to avoid yet another…