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Hands
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
Metacarpal fractures that are Spiral/long obliqueMultiple transverse
Boxer's fracture
Published in Alisa McQueen, S. Margaret Paik, Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
The most common metacarpal fracture occurs at the neck of the bone. The majority of fractures involve the fifth metacarpal. It is important to inspect the injuries for any skin trauma that might indicate an open fracture. Commonly used is the “10°, 20°, 30°, 40° rule” for metacarpal fractures. This refers to acceptable angulation of 10° for the second metacarpal progressing through each subsequent metacarpal to 40° of angulation for the fifth metacarpal. For fractures that exceed the tolerable amount of angulation, closed reduction is generally all that is required. Long-term function is preserved in the majority of cases despite a considerable amount of angulation of the fracture.
Bones and joints
Published in David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings, McMinn’s Concise Human Anatomy, 2017
David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings
Metacarpal bones and phalanges - bones of the hand and fingers. Each has a shaft with a base at the proximal end and a head at the distal end, so that the heads and bases of adjacent bones make metacarpophalangeal and interphalangeal joints for each digit. Metacarpal bases articulate with the distal carpal bones to form the carpometacarpal joints.
Metacarpal reconstruction with a medial femoral condyle flap based on a 3D-printed model: a case report
Published in Case Reports in Plastic Surgery and Hand Surgery, 2022
Manfred Schmidt, Matthias Holzbauer, Stefan M. Froschauer
Giant cell tumors (GCT) of bone represent approximately 5% of primary bone tumors [1], while the bony skeleton of the hand is rarely affected by this tumor entity. Metacarpals, followed by phalanges, are reported to be the most common site of GCT of bone in the hand accounting for 2−5% of all GCT of bone with a peak of occurrence in the fourth decade of life [2–4]. Despite being considered benign, GCT may progress aggressively and lead to considerable local bone destruction and functional impairment or even pulmonary metastases in 1–4% [1]. Thus, the eradication of the disease is the primary therapeutic goal, while secondary considerations are given to functional reconstruction and aesthetic integrity of the hand. These principles for surgical treatment of GCT of bone pose a reconstructive challenge, especially for repair of defects encompassing the majority of a metacarpal bone. Medial femoral condyle (MFC) flap has emerged as a versatile reconstructive option for a variety of small to medium sized bone defects of the hand [5]. It has also been reported for partial metacarpal reconstruction [6]. Three-dimensional (3D) printed models have recently been described as an innovative technology for facilitating MFC flap harvest and for precise tailoring of the required bone flap [7].
Conservative management of De Quervain’s tendinopathy with an orthopedic manual physical therapy approach emphasizing first CMC manipulation: a retrospective case series
Published in Physiotherapy Theory and Practice, 2022
Scott W. Young, Thomas W. Young, Cameron W. MacDonald
Active range of motion testing was performed with a goniometer. All AROM measurements were taken with the patient in a seated position. Metacarpal phalangeal (MCP) thumb flexion and extension were measured with the wrist in neutral flexion-extension, zero degrees of pronation-supination, and the PT stabilized the carpal bones to prevent compensatory movements. Wrist flexion and extension were measured with the patient placed in 90 degrees of elbow flexion, zero degrees of pronation-supination, and the PT stabilized the radius and ulna to ensure desired movement. Grip strength was assessed with the patient seated, the elbow in 90 degrees of flexion, and the wrist placed in zero degrees of pronation-supination. Measurements were taken in pounds with the Jamar hand dynamometer in the second handle position.
Structural validity and construct validity of the Dutch-Flemish PROMIS® physical function-upper extremity version 2.0 item bank in Dutch patients with upper extremity injuries
Published in Disability and Rehabilitation, 2021
Suus G. J. van Bruggen, Charlotte M. Lameijer, Caroline B. Terwee
A sample size of at least 300 participants was achieved, meeting the recommendations by Comrey and Lee [40]. Patients of all ages and with all kind of upper extremity injuries were included, which supports the representativeness of the study population. The main experienced upper extremity injuries were distal radius fractures, clavicle fractures and proximal humeral fractures. A study by Beerekamp et al., performed in the Netherlands, estimated the prevalence of extremity fractures in general [59]. The most commonly reported fractures, were hand and finger fractures (n = 34.144), wrist fractures (n = 25.432) and clavicle and shoulder fractures (n = 13.264) [59]. Hand and finger fractures included carpal, metacarpal and phalangeal fractures together [59]. In our sample the sum of these injuries was 20% (n = 57). These results were comparable to the results of the Beerekamp sample.