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The Spastic Forearm and Hand
Published in Benjamin Joseph, Selvadurai Nayagam, Randall T Loder, Anjali Benjamin Daniel, Essential Paediatric Orthopaedic Decision Making, 2022
The neurovascular bundle was protected and retracted. The FCU tendon was detached from its insertion to the pisiform bone, and the muscle fibres of the FCU taking origin from the distal half of the ulna were carefully released. A short incision was made over the dorsum of the wrist just lateral to Lister’s tubercle. The ECRB and ECRL were identified by demonstrating extension of the wrist when the tendons were pulled up with a blunt hook. A tendon tunneller was passed from the second wound around the medial border of the ulna through a liberal longitudinal slit made in the medial intermuscular septum, and the free end of the FCU tendon was grasped and withdrawn into the dorsal wound. The forearm was held in supination and the wrist in extension, and the FCU tendon was passed through the ECRB and the ECRL tendons and sutured to itself under tension (Figure 54.4).
Musculoskeletal system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Using a high-frequency linear array transducer of at least 10 MHz, sonographic evaluation starts with the palm facing the examination table (Fig. 3.4a). On the dorsal side, the wrist is divided into six synovial compartments. The bony landmark used is the Lister’s tubercle in the transverse plane, separating the second and third compartments (Fig. 3.4b). The second compartment is lateral to Lister’s tubercle and consists of the extensor carpi radialis longus and brevis tendons. Placing the wrist in a halfway position between pronation and supination and moving the transducer to the lateral aspect of the radial edge of the dorsal wrist, the first compartment is examined. This contains the abductor pollicis longus and extensor pollicis brevis tendons. The retinaculum should be identified and examined for any sign of thickening. The probe is placed at Lister’s tubercle again and moved to its medial side to identify the third compartment, containing the extensor pollicis longus tendon. Distally, this tendon crosses anterior to the tendons of the second compartment. The probe is moved medially to examine the fourth and fifth compartment in the mid-dorsal wrist. Within the fourth compartment are the four extensor digitorum tendons and the extensor indicis tendon, while the fifth contains the extensor digiti minimi tendon.
Injuries of the wrist
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
David Warwick, Adam Watts, Joanna Thomas
A fall on the outstretched hand, rather than breaking a bone, may tear the all-important scapholunate ligament. There is pain and swelling with tenderness over the dorsum just distal to Lister’s tubercle. Pushing backwards on the scaphoid tubercle is very painful and, if performed while moving the wrist radialwards and ulnarwards, it can elicit a clunk (‘Watson’s test’).
Spontaneous rupture of the extensor pollicis longus tendon in a lacrosse player
Published in The Physician and Sportsmedicine, 2022
Jane-Frances Aruma, Paul Herickhoff, Kenneth Taylor, Peter Seidenberg
Musculoskeletal ultrasound was performed to evaluate the suspected tendon rupture, level of retraction of the proximal aspect, and the condition of the tendon ends. The EPL insertion at the distal phalanx of the thumb was found to be intact. The tendon was followed proximally but was unable to be identified beyond the level of the carpometacarpal (CMC) joint. At the level of the second and third compartment intersection, the EPL was located deep to the extensor carpi radialis brevis (ECRB) and extensor carpi radialis longus (ECRL). There was also fluid around the tendon (Figure 1). The EPL was unable to be identified more proximally. The tendon sheath at the third dorsal compartment at Lister’s tubercle was empty (Figure 2). All other dorsal compartment tendons were normal in appearance.
Anatomic surface landmarks to guide injection for posterior interosseous nerve block
Published in Journal of Plastic Surgery and Hand Surgery, 2021
Swapnil D. Kachare, Bradley J. Vivace, Luke T. Meredith, Milind D. Kachare, Christina N. Kapsalis, Michael Ablavsky, Rachel H. Safeek, Claude Muresan, Joshua H. Choo, Morton L. Kasdan, Bradon J. Wilhelmi
The study was performed at the Acland Fresh Tissue Lab at the University of Louisville, Louisville, KY. A total of 16 fresh frozen cadaver forearms were obtained. None of the specimens had a history of wrist surgery, and there were no visible external scars. Various external anatomic measurements of the wrists were performed using palpable external land marks on the dorsum of the wrist (i.e. ulnar styloid and Lister’s tubercle). Wrist circumference was obtained at the level of Lister’s tubercle.