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Ulnar Club Hand
Published in Benjamin Joseph, Selvadurai Nayagam, Randall T Loder, Anjali Benjamin Daniel, Essential Paediatric Orthopaedic Decision Making, 2022
Christopher Prior, Nicholas Peterson, Selvadurai Nayagam
Examination at the age of 5 years revealed a curvature to the leftforearm and a prominence over the lateral aspect of the elbow. The hand was held in a position of ulnar deviation at the wrist. There was loss of the terminal range of elbow extension and a reduction in the arc of pronationsupination to 60% of the normal range. X-rays showed a deficiency of the distal ulna and bowing of both the radius and ulna, and the radial head was dislocated (Figures 35.2a – c).
Digital Deformities in Rheumatoid Arthritis
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
The ulnar interossei and more specifically the abductor digiti minimi of the fifth finger, contribute not only to the MCP flexion but also to its ulnar deviation. At the level of the long and middle fingers, the palmar plate and the neighbouring structures which are detached from it move on the ulnar edge of the finger under the action of the flexors whose path is oblique with respect to the axis of the A1 pulley. Radial tilt of the wrist, collapsed wrist and flexion of the fourth and fifth metacarpals contribute to the aggravation of the ulnar deviation.
Surgery of the Wrist
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Ramon Tahmassebi, Sirat Khan, Kalpesh R Vaghela
A radially based capsular flap should be used with subperiosteal dissection to expose the ulnar head. The base of the ulnar styloid is osteotomised to allow preservation of the attachment of the TFCC and the dorsal radioulnar ligament. The ulna is osteotomised at its neck and the head excised. The remnant capsule and soft tissues around the distal ulna can then be utilised to stabilise the shaft by use of drill holes or suture anchors. The overlying retinaculum is then closed, but consideration must be made to the tendon of ECU. It may be inherently unstable now that the subsheath is no longer attached to the ulnar head. If this is the case, a slip of extensor retinaculum can be used to fashion a sling, keeping the ECU tendon located dorsally.
Dorsal dry needling to the pronator quadratus muscle is a safe and valid technique: A cadaveric study
Published in Physiotherapy Theory and Practice, 2023
Albert Pérez-Bellmunt, Carlos López-de-Celis, Jacobo Rodríguez-Sanz, César Hidalgo-García, Joseph M. Donnelly, Simón A Cedeño-Bermúdez, César Fernández-de-las-Peñas
The pronator quadratus (PQ) is a deep flat muscle covering the distal ends of the ulna and radius anteriorly. It originates from the anterior surface of the distal ulna and inserts onto the distal aspect of the anterior surface of the radius proximal to the wrist (Standring, 2016). This muscle is an important pronator of the forearm and also contributes to stability of the distal radio-ulnar joint. Therefore, due to its function, this muscle is susceptible to repetitive overload that may lead to development of myofascial pain. In fact, patients with TrPs in the PQ clinically report difficulty in using scissors for cutting heavy cloth, handling tools while gardening, or using tools that require stability and a forceful grasp. Similarly, injuries in the lower portion of the forearm, e.g., distal radius fracture, could also affect the PQ muscle (Donnelly, 2019). Interestingly, the pain referral pattern from the PQ muscle was not described by Simons, Travell, and Simons (1999). The pain referral pattern from the PQ was described by Hwang, Kang, and Kim (2005) in an experimentally induced pain model. These authors reported that PQ muscle referred pain pattern spreads both proximally and distally along the medial aspect of the forearm mimicking ulnar or median nerve sensory distributions (Hwang, Kang, and Kim, 2005).
Attitudes and beliefs of little league baseball parents regarding sport specialization and college scholarship availability
Published in The Physician and Sportsmedicine, 2022
Eric G. Post, Michael D. Rosenthal, Andrew T. Pennock, Mitchell J. Rauh
Youth baseball is the second-most popular sport among boys in the United States, with approximately 4 million participants in 2017 [11]. However, there is concern about the rise in serious overuse injuries among youth baseball players, as 60% of all ulnar collateral ligament reconstructions are now performed on pitchers between 10 and 19 years old [12]. Recent evidence in high school baseball players suggests that specialization in baseball is associated with worse throwing arm health and with upper extremity overuse injury history [13]. This concern about early specialization in baseball is reflected in the Pitch Smart guidelines developed by USA Baseball and Major League Baseball, which recommend that youth players should not specialize in baseball and should take time off from baseball during the year [14].
Refracture after plate removal following ulnar shortening osteotomy for ulnar impaction syndrome – a retrospective case–control study
Published in Journal of Plastic Surgery and Hand Surgery, 2021
Soo Min Cha, Hyun Dae Shin, Byung Kuk Ahn
The radiological features of each patient, such as the degree of dorsal subluxation of the ulna at the DRUJ and pre/postoperative ulnar variance were noted [17,18]. Dorsal subluxation of the DRUJ was quantified preoperatively by measuring the radioulnar distance on true lateral radiographs of the wrist, in which the pisoscaphoid distance was <3 mm [17]. Volar subluxation was described as a positive value regardless of the direction of subluxation. Perioperative ulnar variances were measured using the method of perpendiculars, whereby a line was drawn perpendicular to the longitudinal axis of the radius at its distal ulnar aspect, and the distance between it and the line at the end of the ulna was measured [18]. For accurate determination of ulnar variance, a posteroanterior radiograph of the wrist was obtained with the shoulder in 90° abduction, the elbow in 90° flexion, the forearm in neutral rotation, and the wrist in neutral alignment.