This chapter includes a discussion of anatomic, biomechanical, and kinematic aspects of wrist function and diagnostic methods, treatment options, and procedures for various wrist conditions. A considerable body of information on the wrist has developed in recent years. No attempt…
This chapter includes the essentials of treatment of nerve injuries in the digits, palm, and wrist. Although many of the principles discussed here can be applied to injuries in the forearm and arm, more detailed discussions of more proximal nerve…
Although general management principles apply to the hand, functional impairment may follow seemingly minor trauma from resultant secondary sensory loss, motion restriction, and weakness. When treating fractures, anatomic and radiographic perfection does not always lead to normal function and early…
Flexor Tendons A basic knowledge of the anatomy of the flexor tendons, especially in the forearm, wrist, and hand, is assumed, as is an understanding of the essential biomechanical aspects of flexor digitorum profundus and sublimis function in the fingers.…
The hand and fingers are the body parts most often injured in the workplace. In the United States, annually, more than 1 million emergency department visits are caused by work-related hand trauma. For an acutely injured hand, restoration of function…
The hand is the most complex and versatile structure in the human body. Formed of 27 bones, the hand and wrist require more than 30 muscles and a vast web of ligaments and tendons to move them into the myriad…
Microsurgery techniques are being applied to an expanding range of orthopaedic problems. Now the term super-microsurgery , coined by Koshima et al., is used to apply to the anastomosis of submillimeter vessels that is necessary in distal replants and perforator flaps.…
Peripheral nerve injuries are common. Despite numerous advances in microsurgical technique and interfascicular nerve grafting, many treatment principles obtained from World War II experiences as set forth in the cumulative works of Seddon and Woodhall are still applicable today. Current…
Any dislocation should be reduced as soon as reasonably possible. While a joint is dislocated, the metabolism of its hyaline cartilage is disturbed and synovial fluid functions are impaired. Hyaline cartilage may begin to degenerate during this brief period, and…
Open techniques are occasionally necessary for acute dislocations. Closed reduction with intravenous analgesia or sedation with general anesthesia should be attempted first for most uncomplicated dislocations. If general anesthesia is necessary, operating room personnel should prepare for the possibility of…