– Discussion: – upper extremities are involved in as many as two-thirds of pts who have peripheral neuropathy, but the involvement tends to be milder & to become clinically symptomatic at later age than does involvement of the lower extremities; – intrinsic-minus hands develop with decreased stability
– See: RU joint – Discussion: – refers to impingement of the ulnar head against the carpi which can lead to TFCC tears and lunotriquetral ligament attrition; – lunotriquetral ligament attrition may occur from compression and translation shear as the lunate becomes impinged against the ulnar head; – causes: … Read more
– Discussion: – impingement of distal ulna on carpi which may arise from positive ulnar variance or non union of distal ulnar frx; – positive ulnar varience leads to loading of the ulnocarpal joint and resultant LT disruption, lunate chondral lesion, and TFCC tears; – diff dx: (ulnar sided … Read more
– Discussion: – most frequent radiocarpal instability; – the lunate is translocated ulnarly, and therefore is not supported by the radius; – ulnar translationn is also commonly seen in disease such as RA or in Madelung’s deformity; – in RA, may occur along … Read more
– Discussion: – mean ulnar variance is 0.9 mm (range: 4.2 to 2.3 mm); – functional anatomy: – w/ neutral variance, 80% of load is born by radius and 20% by ulna; – 2.5 mm increase in ulnar varience will increase … Read more
– See: – Vascular Problems of the Wrist and Hand: – Discussion: – traumatic thrombosis of superficial palmar arch of ulnar artery resulting from repetitive use of hand as hammer; – in this maneuver, maximum force of the blow occurs over hook hamate bone, stie of … Read more
– Anatomy: – ulnar bursae includes little finger tendon sheath which begins at terminal phalanx & extends proximally half way up the palm; – occassionally the distal unexpanded part of little finger tendon sheath does not communicate w/ ulnar bursae; – in the palm, the ulnar … Read more
– Discussion: – is classically characterized by a clinical triad of epileptic seizures, mental retardation and skin lesions which have been considered hamartomas of the skin and brain; – adenoma sebaceum is the most familiar cutaneous stigma; – high percentage of pts (66%) have radiographic findings … Read more
– DIP Joint Immobilization: – immoblization of the DIP joint is extremely useful in preventing triggering in all of the fingers including the thumb; – DIP immobilization (leaving the PIP free), has minimal functional limitations and most patients can work without restrictions; – technique: consider applying two layers of … Read more
– See: – Phalangeal Injury – Congenital Trigger Thumb – Rheumatoid Trigger Finger – Discussion: – results from localized tenosynovitis of superficial and deep flexor tendons adjacent to A1 pulley at a metacarpal head; – inflammation causes nodular enlargement of tedon distal to pulley; – occurs most often in middle or ring fingers (occassionally in … Read more