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Introduction
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
The hand skeleton comprises of carpal bones, metacarpal and phalanges. There are eight carpal bones. Four in the proximal and four in the distal row. The scaphoid, lunate, triquetral and pisiform form the proximal row. The scaphoid, lunate and triquetrum form a convex arch and articulate with distal radius and inferior radioulnar joint. The pisiform articulates with triquetrum alone. The trapezium, trapezoid, capitate and hamate form the concave distal carpal row. The distal row and fourth and fifth metacarpal are a less mobile unit (Figure 1.7).
Other Complications of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Musculoskeletal complications of diabetes include carpal tunnel syndrome, Dupuytren contracture, adhesive capsulitis, and sclerodactyly. Carpal tunnel syndrome is compression of the median nerve along its course through the carpal tunnel in the wrist. Dupuytren contracture is progressive contracture of the palmar fascial bands, resulting in finger flexion deformities. Adhesive capsulitis is commonly known as frozen shoulder, associated with shoulder pain and stiffness. Sclerodactyly is a localized thickening and tightness of the skin on the fingers or toes.
Paper 1
Published in Aalia Khan, Ramsey Jabbour, Almas Rehman, nMRCGP Applied Knowledge Test Study Guide, 2021
Aalia Khan, Ramsey Jabbour, Almas Rehman
Carpal tunnel syndrome is diagnosed clinically by: Symptoms reproduced when the wrist is forcibly palmar flexed and pressure applied to the median nerveSymptoms reproduced by tapping directly on the ulnar nerveSymptoms reproduced by forcibly extending the wrist and applying pressure to the median nerveExtending both wrists for 30 seconds to reproduce symptomsDetecting the presence of hypothenar muscle wasting.
Prevalence and risk factors for self-reported symptoms of carpal tunnel syndrome among hospital office workers: a cross-sectional study
Published in International Journal of Occupational Safety and Ergonomics, 2023
Carpal tunnel syndrome (CTS) occurs as a result of compression of the median nerve in the carpal tunnel at the wrist joint level and is the most common peripheral nerve entrapment disease. CTS is not a simple condition but a serious cause of disability, and is defined as the upper extremity musculoskeletal disease associated with the highest cost among working-age patients in relation to taking sick leave, decreased productivity and personal financial losses [1]. The US Bureau of Labor Statistics reported that all musculoskeletal problems were responsible for an estimated 32.2 cases and an average 12 days off work per 10,000 workers in 2015, in all industries in the USA, while CTS accounted for the highest number of workdays lost (on average, 28 days off work per case) [2]. Early detection of CTS can also be a critical factor affecting the return to work. Workers with a correct and early diagnosis of CTS were found to be much more likely to return to work than workers diagnosed weeks or months later [3].
Multicenter pragmatic study of carpal tunnel release with ultrasound guidance
Published in Expert Review of Medical Devices, 2022
John R. Fowler, Kevin C. Chung, Larry E. Miller
The eligibility criteria for this observational study were purposely broad to reflect a heterogenous sample of CTS patients treated in routine clinical practice. Patient diagnosis was determined according to the practice patterns of each participating physician, all of whom were experienced in the diagnosis and management of CTS. Carpal tunnel syndrome was diagnosed primarily on clinical grounds, with ancillary testing such as electrophysiological studies ordered at the discretion of the physician. Eligible patients were adults (age ≥18 years) who were treated with CTR-US and demonstrated a willingness to participate in the registry and participate in specified follow-up activities. The decision to receive CTR-US was determined on a case-by-case basis considering physician and patient preferences. No limitations were imposed on maximum patient age, medical or surgical history, or clinical presentation.
A new musculoskeletal AnyBody™ detailed hand model
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
Lucas Engelhardt, Maximilian Melzner, Linda Havelkova, Pavel Fiala, Patrik Christen, Sebastian Dendorfer, Ulrich Simon
Although Eschweiler et al. (2016) had already developed a detailed model of the human wrist within the AMS, this model is not implemented in the proposed detailed hand model, mainly because of the reduction of complexity of the model. The eight carpal bones in the presented model are defined as one rigid segment, allowing no movement between the carpal bones. When the research questions do not address the force distribution inside the wrist joint, Schuind et al. (1995) showed that this lack does not have a great influence on the outcome of the muscle activities. This limitation can be addressed in a future version of the model, where splitting of the wrist joint into an ulnar and radial side might be convenient. Further enhancements might be the implementation of helical joint axes in the thumb joints, as proposed by Kerkhof et al. (2016).