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The wrist and hand
Published in David Silver, Silver's Joint and Soft Tissue Injection, 2018
This joint is the articulation of the first metacarpal with the trapezium bone of the wrist. Extension and abduction of the thumb causes pain and there is deep tenderness in the ‘anatomical snuffbox’ at the joint line, which is more easily palpable when the subject flexes and tucks the thumb into the palm. The joint space, although small, will accept an injection of about 0.5 ml of steroid solution.
The Pericardium (PC)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
Flexor retinaculum (includes the transverse carpal ligament): Holds the flexor tendons in place. The deep part of the flexor retinaculum, called the transverse carpal ligament, attaches to the hook of the hamate and the tubercle of the trapezium bone.5 The median nerve travels deep to the transverse carpal ligament on the radial aspect of the tunnel. While Figure 9-22 elucidates the anatomical relationships in cross section at PC 7, this is an oblique section, which changes the appearance of structures traversing this level. Nevertheless, Figure 9-22 does reveal the tight packing of tunnel contents.
The Articulations of the Upper Member
Published in Gene L. Colborn, David B. Lause, Musculoskeletal Anatomy, 2009
Gene L. Colborn, David B. Lause
Carpo-Metacarpal Joint of Thumb. The carpometacarpal joint of the thumb principally involves the articulation of the trapezium bone with the first metacarpal bone. This joint exemplifies the “saddle-type” joint and can be flexed, extended, abducted, adducted and circumducted, and is capable even of a slight degree of rotation. Which of the two bones actually possesses the “saddle” configuration? Close inspection will reveal that both articulating surfaces are of this form.
Patient-reported outcomes following interposition arthroplasty of the basal joint of the thumb
Published in Journal of Plastic Surgery and Hand Surgery, 2021
Rasmus Wejnold Jørgensen, Anders Odgaard, Frederik Flensted, Henrik Daugaard, Claus Hjorth Jensen
Complications following surgery are as shown in Table 2. FCR rupture and scar tissue formation around the extensor pollicis brevis were only seen in patients operated with Weilby or Burton–Pellegrini technique. There were few major complications but more than 10% returned to the outpatient clinic due to persistent pain. Twelve patients of 250 were revised due to complications. Four received further interposition arthroplasty following capsuloplasty, three received a MiniTight Rope (Arthrex®) suspension due to subsidence, one sensory nerve needed repair, one tendon needed repair, one debridement was performed due to infection, one had additional trapezium bone removed and one had a secondary capsuloplasty performed. Complication of any kind was associated with a mean improvement in Quick-DASH scores of only 13.76 points at six months follow up. Patients who did not have any complications had a mean improvement of 27.82 points (p<.001). The same results were seen when comparing the improvement in pain scores (p<.001). Complications of any kind were associated with 49% of patients being dissatisfied at 6 months follow up (p<.001). Gender was not associated with complications of any kind, but younger age was associated with a higher risk of complications (Pearson’s correlation 0.13, p=.03).