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Fractures of the hand
Published in Peter Houpt, Hand Injuries in the Emergency Department, 2023
The fracture is usually caused by a direct trauma. Metacarpal II and III are rigidly fixed to the carpus, metacarpal IV and V have a greater mobility. This allows for more tolerance for angulation of fractures of metacarpal IV and V. Rotational errors must be corrected. These are mainly seen in metacarpal II and V because the intermetacarpal ligament is present on one side only.
Hand Trauma – Fractures and Dislocations
Published in Dorian Hobday, Ted Welman, Maxim D. Horwitz, Gurjinderpal Singh Pahal, Plastic Surgery for Trauma, 2022
Dorian Hobday, Ted Welman, Maxim D. Horwitz, Gurjinderpal Singh Pahal
Metacarpal fractures are generally caused by punching a hard object or from an impact to the dorsum of the hand. The most common fracture sites of the metacarpal are neck and shaft, with fractures to the base and head less common. The most common fracture you will encounter is a closed ‘boxers fracture’, which is a fracture to the neck of the 5th metacarpal.
A to Z Entries
Published in Clare E. Milner, Functional Anatomy for Sport and Exercise, 2019
The metacarpals of the hand are equivalent to the metatarsals of the foot (see ankle and foot – bones). They are long slender bones with a body and two articulating ends. The first metacarpal is that of the thumb and it articulates with the trapezium of the wrist. The second metacarpal articulates with the trapezium and the trapezoid as well as the third metacarpal. The third metacarpal articulates with the capitate of the wrist and the second and fourth metacarpals. The fourth metacarpal articulates with the third and fifth metacarpals, the capitate, and the hamate. The fifth metacarpal articulates with the fourth metacarpal and the hamate.
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.