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Digital Deformities in Rheumatoid Arthritis
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
As rheumatoid disease progresses, the wrists are affected in more than 80% of cases and bilaterally in 95% of cases. The pathophysiology of wrist deformities has been well studied. The degradation of the radio-ulnar fibrocartilage associated with the volar dislocation of the extensor carpi ulnaris muscle-tendon induces a dorsal subluxation of the ulnar head. Palmar dislocation of the internal carpal column places the hand into supinate with respect to the forearm. As the extensor carpi radialis longus muscle becomes predominant, the carpal bones accentuate their radial inclination.
Quality of life and satisfaction in patients surgically treated for cubital tunnel syndrome
Published in Neurological Research, 2023
María Elena Córdoba-Mosqueda, Lukas Rasulić, Andrija Savić, Jovan Grujić, Filip Vitošević, Milan Lepić, Aleksa Mićić, Stefan Radojević, Stefan Mandić-Rajčević, Ivana Jovanović, Carlos Alberto Rodríguez-Aceves
AT involves placing the nerve in a new tissue bed either subcutaneously, submuscularly, or intramuscularly [1]. With the patient in the supine position under general anesthesia, a curvilinear skin incision was made posterior to the medial epicondyle, extending from 7 cm above to 5 cm below the condyle (Figure 3-A). After locating the ulnar nerve below the fascia proximally, the arcade of Struthers and the distal part of the medial intermuscular septum were excised. The cubital tunnel was then unroofed, and the nerve was dissected distally to free it from the posterior aspect of the condylar groove. Inferiorly, it was traced deep to the fascia of Osborne and between the two heads of the flexor carpi ulnaris. The arcade of Osborne, fascia, or the extensor carpi ulnaris muscle and its deep aponeurosis were then divided longitudinally, sparing the motor branches. Once the nerve was identified, it was isolated with a soft rubber loop that is used to decrease focal pressure on the nerve during gentle retraction (Figure 3-B).
End-to-side neurotization with the phrenic nerve in restoring the function of toe extension: an experimental study in a rat model
Published in Journal of Plastic Surgery and Hand Surgery, 2018
Xiaotian Jia, Chao Chen, Jianyun Yang, Cong Yu
The extensor digitorum communis muscle, the extensor carpi ulnaris muscle and the medial head of triceps muscle from both sides were cut from the origins and insertions. The wet muscle weights were measured with an electronic scale at the precision of 0.0001 g. The recovery rate of the wet muscle weight on the left side was expressed as a percentage of the weight from the other side. The muscle specimens were fixed in 10% paraformaldehyde and washed in buffer. The specimens were then dehydrated in alcohol and embedded in paraffin. The muscle specimens were cross-sectioned at the thickness of 5 μm at the same position of the muscle belly. The slices were stained with hematoxylin-eosin and examined under a light microscope. The mean cross-sectional area of the muscle fibers was calculated. The recovery rate of the cross-sectional area on left side was expressed as a percentage of the area from the other side.