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;…
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…
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…
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…
Acute fingertip and thumb injuries are common and require prompt and meticulous composite soft-tissue repair in incomplete amputations. Complete amputations proximal to the eponychial fold in the thumb or multiple digits may be salvaged by microvascular techniques (see Chapter 63…
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Surgical procedures commonly used in treating Dupuytren contracture are: (1) subcutaneous or percutaneous fasciotomy, (2) partial (selective) fasciectomy, (3) complete fasciectomy, (4) fasciectomy with skin grafting, (5) amputation, and (6) joint resection and arthrodesis. The appropriate procedure depends on the…