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Upper Limb Muscles
Published in Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Handbook of Muscle Variations and Anomalies in Humans, 2022
Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo
El-Beshbishy and Abdel-Hamid (2013) examined variations in abductor pollicis longus in 50 upper limbs. The tendon was not found to be single in any case (0%). It had two tendons in 20 cases (40%), three tendons in 17 cases (34%), four tendons in nine cases (18%), five tendons in two cases (4%), and six tendons in two cases (4%). The lateral tendons in all cases inserted onto the base of the first metacarpal bone (100%). The insertion of the medial tendons varied from the anterolateral surface of the first metacarpal (80%), lateral surface of the first metacarpal (20%), the trapezium (80%), abductor pollicis brevis (60%), thenar fascia (40%), the carpometacarpal joint of digit one (30%), and opponens pollicis (20%).
Upper limb
Published in Aida Lai, Essential Concepts in Anatomy and Pathology for Undergraduate Revision, 2018
Attachments of abductor pollicis longus– origin: dorsal surface of ulna and radius– insertion: lat. base of first metacarpal bone– nerve SS: post. interosseous n. (C7 and 8)– function: abduct thumb
Injuries of the hand
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
This fracture, too, occurs at the base of the first metacarpal bone and is commonly due to falling or punching; however, the fracture is oblique, extends into the CMC joint and is very unstable because of the strong pull of the abductor pollicis longus tendon that remains attached to the shaft of the metacarpal.
Long-term follow-up of patients treated with pyrocarbon disc implant for thumb carpometacarpal osteoarthritis: the effect of disc position on outcomes measures
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Janna S. E. Ottenhoff, Cecile M. C. A. van Laarhoven, Mark van Heijl, Arnold H. Schuurman, J. Henk Coert, Brigitte E. P. A. van der Heijden
Radiographs of the operated thumb were obtained at follow-up in lateral and posteroanterior (PA) views. Radiographs taken directly post-operative were compared with radiographs obtained at the follow-up and scored on disc position and bone stock resorption. The radiographic disc position was assessed in relation to the longitudinal axis of the CMC1 joint on PA and lateral views separately—according to a scoring system described by Barrera-Ochoa et al. and previously used in other studies on pyrocarbon disc position [2,3]. The base of the first metacarpal bone was divided into equal quarters and perpendicular lines were drawn parallel to the long axis (Supplementary Appendix 2). Potential ulnar or radial (sub)luxation of the disc was captured on a PA view; on a lateral view, any potential volar or dorsal displacement was assessed. Implant positioning was classified in one of four categories: centered (Grade 1 = no displacement), less than one-fourth displaced (Grade 2 = slight displacement) more than one-fourth but less than one-half displaced (Grade 3 = moderate displacement), or greater than one-half of the first metacarpal base (Grade 4 = severe displacement/luxation). The highest grade of implant displacement—either on PA or lateral view—was used for further analysis.
Salvage of Devascularized and Amputated Upper Extremity Digits with Temporary Ectopic Replantation: Our Clinical Series
Published in Journal of Investigative Surgery, 2022
Burak Sercan Erçin, Fatih Kabakaş, Burak Ergün Tatar, Musa Kemal Keleş, Ismail Bülent Özçelik, Berkan Mensa, Pedro C. Cavadas
A 61-year-old man was admitted to the emergency department with an industrial crush injury involving the radial rays of the left hand (Figure 11A). When we checked the X-ray first metacarpal bone, the mid-and distal phalanx of the index finder were intact (Figure 11B). Additionally, thenar and dorsal skin were crushed. The thumb was devascularized and useless. We planned to build one acceptable ray from two involved rays (Figure 12). At first, we wanted to transfer the mid-and distal phalanx of the index digit on top of the first metacarpal bone. However, the thenar and dorsal skin were severely injured, and it was better to wait for demarcation (Figure 12). The distal index digit was ectopically banked to the contralateral forearm (Figure 13A). Digital arteries were anastomosed to radial artery end-to-side fashion veins anastomosed to accompanying veins of the radial artery (Figure 13B).
Reverse homodigital dorsal wraparound flap for reconstruction of distal thumb
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Hui Wang, Xiaoxi Yang, Yongxin Huo, Ruizheng Hao, Bin Wang, Wei Wang
For the selection of the donor site, we prefer the dorsoradial side of the first metacarpal bone due to its glabrous skin and the lower incidence of abduction contracture of WS in case of no early rehabilitation exercise as compared to the dorsoulnar side. If the proximal edge of the defect was closer to the ulnar side, the dorsoulnar flap was harvested. If the extensive soft-tissue defect could not be covered by the dorsoradial or dorsoulnar flap alone, the flap was extended to include both the dorsoradial and dorsoulnar arteries.