China
Africa
Explore chapters and articles related to this topic
Contracture of Muscles of the Upper Limb: Severe Volkmann's Ischaemic Contracture of The Forearm
Published in Benjamin Joseph, Selvadurai Nayagam, Randall T Loder, Anjali Benjamin Daniel, Essential Paediatric Orthopaedic Decision Making, 2022
The contracted atrophied flexor muscles were excised, and tendons of the flexor digitorum superficialis were also excised. The tendons of the flexor digitorum profundus were tenolysed to get passive finger flexion. The passive wrist extension improved, and the wrist could be brought to the neutral position after this softtissue release. The hand was splinted in maximum correction.
Surgery of the Peripheral Nerve
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Ravikiran Shenoy, Gorav Datta, Max Horowitz, Mike Fox
The approach may be extended proximally to expose the median nerve in the forearm. This may be required in cases of fracture fixation with concomitant carpal tunnel decompression. Extension is gained between the tendons of flexor carpi radialis and palmaris longus. The nerve lies on the deep surface of flexor digitorum superficialis in the forearm. The median nerve is retracted to the ulnar side and pronator quadratus incised to access the distal radius.
Orthopaedic Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
Assess for a flexor tendon injury: Flexor digitorum profundus causes flexion at the distal interphalangeal joint.Flexor digitorum superficialis causes flexion of the finger at the proximal interphalangeal joint, while the neighbouring fingers are held extended.Suspect a partial tendon division from pain or reduced function against resistance.
A mini hallux neurovascular osteo-onychocutaneous free flap for refined reconstruction of distal defects in thumbs and fingers
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Xianyu Zhou, Di Sun, Fei Liu, Wen Jun Li, Chuan Gu, Ling Ling Zhang
During the surgery, non-viable tissue and local scar were removed from the traumatized digits. The distal dorsal branch or the distal branch of proper palmar digital artery, the distal branch of proper palmar digital nerve, and 1–2 superficial dorsal digital veins were deliberately dissected. The flexor digitorum superficialis tendon and the distal insertion of flexor digitorum profundus on the distal phalanx were left intact. As a general principle, the non-dominant foot, mostly the left one, was chosen as the donor hallux. The nail width (W1), the nail length (L1) and the digital tip circumference (C1) in the intact contralateral thumb and fingers were measured. Similarly, W2, L2 and C2 indicated those parameters in the traumatized digits. ΔW (W1–W2) indicated the difference between W1 and W2, and so were the same as the ΔL and ΔC. The sizes of the mini neurovascular osteo-onychocutaneous flaps were calculated preoperatively as follows: W=ΔW + 0.2 cm; L=ΔL + 0.2 cm; C=ΔC + 0.5 cm, and then marked on the donor hallux (Figure 1).
Prognosis prediction of the effect of botulinum toxin therapy and intensive rehabilitation on the upper arm function in post-stroke patients using hierarchical cluster analysis
Published in Disability and Rehabilitation, 2022
Takatoshi Hara, Masachika Niimi, Naoki Yamada, Yusuke Shimamoto, Go Masuda, Hiroyoshi Hara, Masahiro Abo
BoNT-A was administered to the patients based on the guidelines of Sheean et al. [18]. The maximum dose for the upper limb was 240 units. Botulinum Neurotoxin A (OnabotulinumtoxinA) was diluted with saline to a concentration of 25 U/mL. A team consisting of two physicians, an occupational therapist, and a nurse observed the degree of upper limb paresis, degree of muscle contraction, the extent of dysfunction due to paresis and spasticity, and affected activities of daily living. On the basis of these observations, the team planned the sites and dosage of injection by estimating the possibility of upper limb functional improvement due to the reduction of muscle contraction. Injections of all patients were performed by the same physician. For the biceps, flexor digitorum superficialis, and flexor digitorum profundus, ultrasonography was used. At the time of Botulinum Neurotoxin A injections, the patient was in the supine position. The probe was positioned in the transverse view and perpendicular to the upper limb surface. Then, the needle was inserted into the target muscle at an angle of 30° with respect to the probe [19]. For all other muscles, anatomical landmarks were used to guide Botulinum Neurotoxin A injections. The sites of injection and the dosages are summarized in Table 1.
Progressing arthrosis and a high conversion rate 11 (4–19) years after four corner fusion
Published in Journal of Plastic Surgery and Hand Surgery, 2021
Ole Reigstad, Trygve Holm-Glad, Preben Dovland, Johanne Korslund, Christian Grimsgaard, Rasmus D. Thorkildsen, Magne Røkkum
There were five early complications. Three patients had infections, two were superficial and healed with oral antibiotics, one patient had a deep infection complicated with a septicemia (staphylococcus aureus) necessitating multiple wound revisions, intravenous antibiotics, negative-pressure wound therapy and secondary wound closure. The infection was treated successfully and the 4CF healed. He has been satisfied at follow-up (Figure 1(a–c)). Two patients had tendon ruptures, One extensor pollicis longus (EPL) rupture over Listers tubercle 2 weeks after surgery was sutured, functioning well at follow-up. Another had a flexor digitorum superficialis (FDS) 2 rupture due to K-wire irritation, which was sutured and has a normal function at follow-up. Two others had additional bone removed (one radial styloidectomy and one intraarticular exostosis). In three patients the fusion did not heal, all were initially considered healed, one pseudarthroses was evident on radiographs at later follow-up, two were only seen on CT scans (Figure 2(a–b)), giving a total non-union rate of 3/42 wrists (7%).