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2.
Semin Musculoskelet Radiol ; 23(5): 511-522, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31556086

RESUMO

Accessory bones, variants, and coalitions are not uncommon at the hand-wrist region. They are often overlooked because they are usually asymptomatic and found incidentally on imaging. However, they may sometimes present as a (painful) swelling or mimic a (sequel of a) fracture. Other symptoms may be attributed to impingement and exercise-related pain. Thorough knowledge of the anatomy, systematic imaging analysis, and the awareness of their existence are the clues to a correct identification. Plain radiography and magnetic resonance imaging (MRI) play a pivotal role in the correct diagnosis. In general, signal intensity on MRI is similar to the normal bony structures. However, concomitant bone marrow edema may indicate the presence of impingement. Therefore, MRI sequences with fat suppression should be included in case of symptomatic findings. This article provides a kaleidoscopic overview of some of the prevalent bony anomalies of the hand-wrist region and their potential pathogenic nature.


Assuntos
Doenças Ósseas/diagnóstico por imagem , Deformidades Congênitas da Mão/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Radiografia/métodos , Punho/anormalidades , Doenças Ósseas/patologia , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/patologia , Mãos/diagnóstico por imagem , Humanos , Punho/diagnóstico por imagem
3.
BMC Res Notes ; 11(1): 240, 2018 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-29642947

RESUMO

BACKGROUND: Volar locking plate fixation of distal radius fractures is commonly performed because of its good clinical outcomes. The flexor carpi radialis (FCR) approach is one of the most popular approaches to dissecting the volar side of the distal radius because of its simplicity and safety. We describe an extremely rare case of an absent FCR identified during a volar approach for fixation of a distal radius fracture. CASE PRESENTATION: A 59-year-old woman with distal radius fracture underwent surgery using the usual FCR approach and volar locking plate. We could not identify the absence of the FCR tendon preoperatively because of severe swelling of the distal forearm. At first, we wrongly identified the palmaris longus tendon as the FCR because it was the tendinous structure at the most radial location of the volar distal forearm. When we found the median nerve just radial to the palmaris longus tendon, we were then able to identify the anatomical abnormality in this case. To avoid iatrogenic neurovascular injuries, we changed the approach to the classic Henry's approach. CONCLUSIONS: Although the FCR approach is commonly used for fixation of distal radius fractures because of its simplicity and safety, this is the first report of complete absence of the FCR during the commonly performed volar approach for fixation of a distal radius fracture, to our knowledge. Because the FCR is designated as a favorable landmark because of its superficially palpable location, strong and thick structure, and rare anatomical variations, there is the possibility of iatrogenic complications in cases of the absence of the FCR. We suggest that surgeons should have a detailed knowledge of the range of possible anomalies to complete the fixation of a distal radius fracture safely.


Assuntos
Fixação Interna de Fraturas/métodos , Músculo Esquelético/anormalidades , Fraturas do Rádio/cirurgia , Punho/anormalidades , Feminino , Humanos , Pessoa de Meia-Idade
5.
Arch Iran Med ; 19(4): 285-7, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27041525

RESUMO

Carpal tunnel syndrome is the most common compression neuropathy and carpal tunnel surgery is the most frequently performed hand surgery. Anatomic anomalies may predispose the median nerve to compression. The aim of the current study was to search for anatomic anomalies in open carpal tunnel surgeries through a cross-sectional study. During a cross-sectional study in a one-year period, 436 consecutive patients (307 females and 129 males) with the average age of 50.3 ± 2.4 years underwent 467 classic open carpal tunnel surgeries. Thirty-one patients had bilateral surgeries. A thorough inspection of the incisions was conducted to search for vascular, neural, tendon and muscular anomalies. Forty-two (8.9%) hands (14 males and 28 females) had anomalies. The average age of the patients with discovered anomalies was 48.6 ± 7.6 years. Ten anomalies were seen on the left hands and 32 anomalies were seen on the right hands. Among the 42 anomalies, there were 16 persistent median arteries, 14 anomalies of the median nerve, 7 intratunnel intrusion of the flexor and lumbrical muscle bellies and 5 anomalies of the origin of the thenar muscles. There was no correlation between the discovered anomalies and the age, gender or hand sides. Anatomical anomalies are not uncommon in carpal tunnel surgeries. However, the frequencies of the reported anomalies vary among different studies. Familiarity with these anomalies increases the safety of the operation.


Assuntos
Síndrome do Túnel Carpal/cirurgia , Nervo Mediano/anormalidades , Músculo Esquelético/anormalidades , Punho/anormalidades , Síndrome do Túnel Carpal/patologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Punho/irrigação sanguínea , Articulação do Punho/anormalidades , Articulação do Punho/patologia
6.
Surg Radiol Anat ; 38(4): 497-9, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26253859

RESUMO

Among the muscles involved in thumb movement, the extensor pollicis longus (EPL) tendon of the hand is considered the most consistent structure with the least variation among individuals. There have been a few reports regarding different types of supernumerary tendons; however, an abnormal course of the EPL tendon is extremely rare. We describe a case of a variant course of a single EPL tendon appearing in the second extensor compartment of the wrist. This case was observed incidentally during wrist surgery, and demonstrates a unique variation of tendon course, which has not been reported previously. The knowledge of this anatomic variation is helpful in surgical planning and for making accurate diagnoses.


Assuntos
Mãos/anatomia & histologia , Tendões/anormalidades , Punho/anormalidades , Adolescente , Variação Anatômica , Humanos , Masculino , Traumatismos do Punho/cirurgia
7.
J Ultrasound Med ; 34(8): 1445-52, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26206831

RESUMO

OBJECTIVES: The purpose of this article is to show the anatomic variations of extensor tendon synovial sheaths in the wrist. METHODS: Videos from 157 patients that were available in the electronic database were reviewed. Sonography showed involvement of 186 tendon sheaths. RESULTS: We describe our center's experience with most tendon variants described in the literature and show the sonographic appearance of the most frequent ones. CONCLUSIONS: Sonography is an accepted, safe, and efficient method for evaluating conditions characterized by effusion into the synovial sheaths of the wrist extensor tendons. Knowledge of anatomy and anatomic abnormalities of these sheaths is essential for diagnosis and for correct ultrasound-guided injection therapy or, less frequently, planning a surgical approach.


Assuntos
Membrana Sinovial/anormalidades , Membrana Sinovial/diagnóstico por imagem , Tendões/anormalidades , Tendões/diagnóstico por imagem , Ultrassonografia/métodos , Punho/anormalidades , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Punho/diagnóstico por imagem , Adulto Jovem
8.
BMJ Case Rep ; 20152015 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-26174733

RESUMO

We describe two proof-of-concept trials of delayed non-operative therapy of multiple hand and wrist contractures in a woman with a severe expression of Freeman-Sheldon syndrome (FSS), at ages 24 and 28 years. Having presented as an infant to a university referral centre, passive correction was not accompanied by strengthening exercises, and correction was lost. FSS is described as a myopathic distal arthrogryposis; diagnosis requires the following: microstomia, whistling face appearance, H-shaped chin dimpling, nasolabial folds, and multiple hand and foot contractures. Spinal deformities, metabolic and gastroenterological problems, other craniofacial characteristics, and visual and auditory impairments, are frequent findings. To avoid possible FSS-associated complications of malignant hyperthermia and difficult intubation, and to reduce or eliminate need for surgery, we proceeded with passive manipulation without anaesthesia or sedation. We believe this is the first report of attempted non-operative correction of multiple hand and wrist contractures in an adult with FSS.


Assuntos
Anormalidades Múltiplas , Artrogripose/terapia , Contratura/terapia , Disostose Craniofacial/terapia , Manipulações Musculoesqueléticas , Punho/anormalidades , Adulto , Contratura/etiologia , Face , Feminino , Mãos , Humanos , Síndrome , Adulto Jovem
9.
Hand Surg ; 20(1): 161-5, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25609294

RESUMO

Ulnar deviation deformity of the wrist in patients with birth brachial plexus palsy is an important cosmetic concern among the patients and their relatives; especially in the patients who have recovered the basic limb functions. Though there is ample literature available regarding the management of the shoulder deformity there is paucity of literature regarding management of wrist ulnar deviation deformity. We report our experience with correction of this deformity in five cases with isolated ulnar deviation deformity without forearm rotational deformity or weakness of the wrist muscles. All the patients underwent extensor carpi ulnaris (ECU) to extensor carpi radialis longus (ECRL) tendon transfer. At a minimum of 18 months follow-up all the patients and their families were satisfied with the cosmetic appearance of the limb. Correction of the deformity improves the appearance of the limb, improves self-confidence of the child, and allows them to integrate well into the society. Interestingly, the patients expressed improvement in their grip strength and overall hand function after this surgery. The notable functions which improved were easy reach of the hand-to-mouth for feeding and easy handling of the things requiring bimanual activities. Although the main aim of this operation was to correct the appearance of the hand it was found to be also functionally useful by the patients and hence we are encouraged to report it for wider use. The results were maintained during the follow-up period of as long as 47 months.


Assuntos
Neuropatias do Plexo Braquial/complicações , Transferência Tendinosa/métodos , Ulna/anormalidades , Punho/anormalidades , Punho/cirurgia , Adolescente , Criança , Estética , Feminino , Humanos , Resultado do Tratamento
10.
Rev. chil. radiol ; 21(1): 18-21, 2015. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-749436

RESUMO

Madelung deformity is a common finding in various conditions affecting the wrist, with characteristic changes in the radius, carpus and ulna, the most characteristic being the triangular configuration of the carpal and the ulnar inclination of the distal radial epiphysis. It can be seen on simple radiography, computed tomography or magnetic resonance. As radiologists, we must know the currently recommended criteria, having it present for early diagnosis in young patients, or when the deformity is already established in older patients.


La deformidad de Madelung constituye un hallazgo común de varias patologías que afectan a la muñeca, con alteraciones características en el radio, carpo y cúbito, siendo la configuración triangular del carpo y la inclinación cubital de la epífisis distal del radio los más característicos. Puede ser visto en radiografía simple, tomografía computada o resonancia magnética. Como radiólogos, debemos conocer los criterios recomendados en la actualidad, teniéndolos presentes para su diagnóstico precoz en pacientes jóvenes o cuando la deformidad ya está establecida en pacientes de edad más avanzada.


Assuntos
Humanos , Pré-Escolar , Punho/anormalidades , Punho , Diagnóstico Diferencial
11.
Rev. chil. radiol ; 21(4): 138-143, 2015. ilus
Artigo em Espanhol | LILACS | ID: lil-773283

RESUMO

Although the accessories muscles are part of our nature, to recognize them allows us to avoid confusion with other pathologies. Even some accessories wrist muscles may be symptomatic and require surgical intervention. In this paper we present the anatomy and imaging aspects of ultrasound and magnetic resonance imaging of these muscles, so that the radiologist can become familiar with them, avoiding unnecessary interventions or diagnostic errors.


Si bien los músculos accesorios son parte de nuestra naturaleza, el saber reconocerlos nos permite evitar confusiones con otras entidades patológicas. Incluso algunos músculos accesorios en la muñeca pueden ser sintomáticos y requerir intervención quirúrgica. En este trabajo exponemos la anatomía y aspectos imaginológicos en ultrasonido y resonancia magnética de dichos músculos, para que el radiólogo esté familiarizado con ellos, evitando errores diagnóstico o intervenciones innecesarias.


Assuntos
Humanos , Anormalidades Musculoesqueléticas/diagnóstico , Imagem por Ressonância Magnética , Punho/anormalidades , Ultrassonografia , Variação Anatômica
12.
Clin Orthop Surg ; 6(3): 361-4, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25177465

RESUMO

During imaging studies or surgical procedures, anomalous forearm and wrist muscles are occasionally encountered. Among them, the flexor carpi radialis brevis is very rare. Because the trend is growing toward treating distal radius fractures with volar plating, the flexor carpi radialis brevis is worth knowing. Here, we report two cases with a review of the literature.


Assuntos
Antebraço/anormalidades , Músculo Esquelético/anormalidades , Punho/anormalidades , Feminino , Fraturas Cominutivas/cirurgia , Humanos , Pessoa de Meia-Idade , Fraturas do Rádio/cirurgia , Fraturas da Ulna/cirurgia
13.
AJR Am J Roentgenol ; 203(3): 531-40, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25148155

RESUMO

OBJECTIVE: The purpose of this article is to review a number of diagnostic pitfalls related to ultrasound evaluation of the hand and wrist. Such pitfalls relate to evaluation of ten-dons (extensor retinaculum, multiple tendon fascicles, tendon subluxation), inflammatory arthritis (incomplete evaluation, misinterpretation of erosions, failure to evaluate for enthesitis), carpal tunnel syndrome (inaccurate measurements, postoperative assessment), ulnar collateral ligament of the thumb (misinterpretation of the adductor aponeurosis and displaced tear), wrist ganglion cysts (incomplete evaluation and misdiagnosis), and muscle variants. CONCLUSION: Although ultrasound has been shown to be an effective imaging method for assessment of many pathologic conditions of the wrist, knowledge of potential pitfalls is essential to avoid misdiagnosis and achieve high diagnostic accuracy.


Assuntos
Deformidades da Mão/diagnóstico por imagem , Traumatismos da Mão/diagnóstico por imagem , Artropatias/diagnóstico por imagem , Ultrassonografia/métodos , Traumatismos do Punho/diagnóstico por imagem , Punho/anormalidades , Punho/diagnóstico por imagem , Artefatos , Mãos/diagnóstico por imagem , Humanos , Aumento da Imagem/métodos
14.
J Bone Joint Surg Am ; 96(14): 1178-1184, 2014 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-25031372

RESUMO

BACKGROUND: Functional impairment in individuals with radial longitudinal deficiency can be influenced by several factors, including a short and bowed forearm, radial deviation of the wrist, a non-functional or absent thumb, limited finger motion, and impaired grip strength, but their relationship with activity and participation in adults with radial deficiency is not known. METHODS: Twenty individuals, eighteen to sixty years of age, who had Bayne type-II to V radial longitudinal deficiency, were examined in the context of the International Classification of Functioning, Disability and Health. Body function and structure were evaluated by measures of range of motion, grip strength, key pinch, sensibility, and radiographic parameters. Activity was evaluated by the Box and Block Test and the Sollerman test, and participation was evaluated by QuickDASH (the short form of the Disabilities of Arm, Shoulder and Hand outcome measure) and by the Medical Outcomes Study 12-Item Short Form Health Survey. Statistical correlations among assessments of body function and structure, activity, and participation were examined. RESULTS: The mean total active motion of the wrist (43°) and mean total active motion of the digits (377°) were less than the norms. The mean radial deviation of the wrist was 31°. The mean grip strength (4.0 kg), key pinch (1.4 kg), and scores for the Box and Block Test (55 blocks per minute) and the Sollerman test on hand function (56 points) were considerably lower than the norms. The mean scores were 18 points for QuickDASH, 51 points for Short Form-12 physical component summary, and 53 points for Short Form-12 mental component summary. Significant relationships were found between the Box and Block Test and grip strength (p = 0.012), key pinch (p < 0.001), and total active motion of digits (p < 0.001); between the Sollerman test and the total active motion of elbow (p < 0.001) and the total active motion of digits (p < 0.001); between the QuickDASH and forearm length (p < 0.001), the total active motion of elbow (p = 0.001), and the total active motion of digits (p < 0.001); between the Short Form-12 physical component summary and grip strength (p = 0.016), forearm length (p < 0.001), total active elbow motion (p < 0.001), and total active digit motion (p < 0.001); and between the Short-Form-12 mental component summary and radial deviation of the wrist (p = 0.019). No significant correlations were found between the radiographic measurement of the radial deviation of the wrist (total forearm angle) and the Box and Block Test (p = 0.244), the Sollerman test (p = 0.775), QuickDASH (p = 0.156), Short Form-12 physical component summary (p = 0.107), or Short Form-12 mental component summary (p = 0.129). CONCLUSIONS: In individuals with radial longitudinal deficiency, grip strength, key pinch, forearm length, and elbow and digital motion seem to be more important for the individual's activity and participation than the radial angulation of the wrist. LEVEL OF EVIDENCE: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.


Assuntos
Anormalidades Múltiplas/fisiopatologia , Antebraço/anormalidades , Mãos/fisiopatologia , Polegar/anormalidades , Punho/anormalidades , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
15.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 28(11): 1368-71, 2014 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-25639052

RESUMO

OBJECTIVE: To investigate the effectiveness of using radial mid-forearm perforator fasciocutaneous flap to repair soft tissue defect in lower segment of the forearm and the wrist. METHODS: Between May 2007 and July 2012, 7 cases of soft tissue defect of lower segment of the forearm and the wrist were repaired with radial mid-forearm perforator fasciocutaneous flap. There were 6 males and 1 female with an average age of 38 years (range, 22-45 years). Defects were caused by crushing injury in 4 cases with the disease duration of 3-22 days (mean, 14 days), by internal fixation of ulnar comminuted fracture in 2 cases after 16 and 20 days of operation respectively, and by focal cleaning of wrist joint tuberculosis in 1 cases after 24 days of operation. The locations of defect were the lower segment of the forearm in 5 cases and the dorsal side of the wrist in 2 cases. The area of soft tissue defect ranged from 4 cm x 3 cm to 9 cm x 5 cm. The size of flap ranged from 6 cm x 4 cm to 12 cm x 6 cm. The donor site was closed with direct suturing or skin grafting. RESULTS: The intraoperative blood loss was 50- 90 mL (mean, 64 mL); the operation time was 60-80 minutes (mean, 72 minutes). Six flaps survived with wound healing by first intention; partial flap necrosis occurred in 1 case, and delayed healing was obtained after dressing change. Skin grafting at donor sites survived with healing of incision bly first intention. The patients were followed up 3-14 months (mean, 9 months). No ulcer or sinus tract was observed; all flaps showed a slightly swollen appearance and had normal color. CONCLUSION: Radial mid-forearm perforator fasciocutaneous flap does not need to dissect the source of blood vessels due to constantly anatomical structure. It has the advantages of easy operation, rich blood supply, high survival rate, and satisfactory clinical effect, so it is an important supplement of the other non-main vessel pedicle flaps to repair soft tissue defect in the lower segment of the forearm and the wrist.


Assuntos
Antebraço/cirurgia , Retalho Perfurante , Lesões dos Tecidos Moles/cirurgia , Retalhos Cirúrgicos , Punho/cirurgia , Adulto , Feminino , Antebraço/anormalidades , Fraturas Cominutivas , Humanos , Masculino , Procedimentos Cirúrgicos Reconstrutivos , Pele , Transplante de Pele , Retalhos Cirúrgicos/irrigação sanguínea , Resultado do Tratamento , Fraturas da Ulna , Cicatrização , Punho/anormalidades , Articulação do Punho
16.
J Hand Surg Eur Vol ; 39(9): 919-25, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23940102

RESUMO

The Liebenberg syndrome was first described in 1973 in a five- generation family. A sixth generation was added in 2001, and in 2009 a hitherto unknown branch of the same family with similar anomalies extended the family tree significantly. This article describes the clinical findings and illustrates the abnormalities with radiographs and three-dimensional computed tomography scans. We discuss the genetic abnormality that causes Liebenberg syndrome, the genomic rearrangement at the PITX1 locus on chromosome 5.The structural variations seem to result in an ectopic expression of paired-like homeodomain transcription factor 1 (PITX1) in the forelimb causing a partial arm-to-leg transformation in these patients.


Assuntos
Braquidactilia/diagnóstico por imagem , Braquidactilia/genética , Ossos do Carpo/anormalidades , Articulação do Cotovelo/anormalidades , Dedos/anormalidades , Deformidades Congênitas da Mão/diagnóstico por imagem , Deformidades Congênitas da Mão/genética , Fatores de Transcrição Box Pareados/genética , Linhagem , Sinostose/diagnóstico por imagem , Sinostose/genética , Articulação do Punho/anormalidades , Ossos do Carpo/diagnóstico por imagem , Aberrações Cromossômicas , Cromossomos Humanos Par 5/genética , Cotovelo/anormalidades , Cotovelo/diagnóstico por imagem , Articulação do Cotovelo/diagnóstico por imagem , Feminino , Dedos/diagnóstico por imagem , Rearranjo Gênico/genética , Genes Dominantes/genética , Mãos/diagnóstico por imagem , Humanos , Úmero/anormalidades , Úmero/diagnóstico por imagem , Imageamento Tridimensional , Masculino , Fenótipo , África do Sul , Tomografia Computadorizada por Raios X , Punho/anormalidades , Punho/diagnóstico por imagem , Articulação do Punho/diagnóstico por imagem
17.
J Child Neurol ; 29(2): 227-31, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24084629

RESUMO

Carpal tunnel syndrome rarely occurs in children. We retrospectively analyzed clinical data of 11 patients aged 5-17 diagnosed with carpal tunnel syndrome at a single pediatric neuromuscular center. Nerve conduction studies were performed according to the American Association of Electrodiagnostic Medicine recommendations. Additional imaging tests of the wrist were performed in 10 patients. In our group of 11 children, carpal tunnel syndrome was idiopathic in only 1 case. In the remaining subjects, it was secondary to congenital bone anomaly (6), hypothyroidism (2), or myopathic contractures (1). In 1 case, metabolic workup revealed an underlying mucopolysaccharidosis. Our results confirm that idiopathic carpal tunnel syndrome is rare in children. Hand clumsiness and thenar hypoplasia rather than sensory complaints are the presenting symptoms. Whenever carpal tunnel syndrome is diagnosed in a child, a thorough differential diagnosis should be made because of the secondary nature of this disease in most pediatric patients.


Assuntos
Síndrome do Túnel Carpal/diagnóstico , Síndrome do Túnel Carpal/fisiopatologia , Adolescente , Síndrome do Túnel Carpal/etiologia , Criança , Pré-Escolar , Diagnóstico Diferencial , Eletromiografia , Potencial Evocado Motor , Potenciais Somatossensoriais Evocados , Feminino , Antebraço/anormalidades , Antebraço/fisiopatologia , Humanos , Masculino , Nervo Mediano/fisiopatologia , Condução Nervosa , Estudos Retrospectivos , Nervo Ulnar/fisiopatologia , Punho/anormalidades , Punho/fisiopatologia
18.
PLoS One ; 8(11): e79273, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24265763

RESUMO

PURPOSE: The purpose of this study was to compare the properties of the median nerve and the flexor retinaculum within the carpal tunnel with Magnetic Resonance Imaging (MRI) under two conditions: (a) fingers extended, and (b) fingers in an isometric squeeze grip. METHODS: Thirty-Four volunteers participated in this experimental study. The flexor retinaculum and median nerve characteristics were measured during both conditions using MRI. RESULTS: The isometric squeeze grip condition resulted in significant palmar bowing of the flexor retinaculum (t = 7.67, p<.001), a significant flattening-ratio of the median nerve (t = 4.308, p<.001), and no significant decrease in the cross-sectional area of the median nerve (t = 2.508, p = 0.017). CONCLUSION: The isometric squeeze grip condition resulted in anatomical deformations within the carpal tunnel, possibly explained by the lumbrical muscles incursion into the carpal tunnel during finger flexion.


Assuntos
Dedos/inervação , Dedos/fisiologia , Força da Mão/fisiologia , Imagem por Ressonância Magnética , Nervo Mediano/fisiologia , Punho/anatomia & histologia , Punho/inervação , Adolescente , Adulto , Humanos , Contração Isométrica , Ligamentos/anatomia & histologia , Ligamentos/inervação , Ligamentos/fisiologia , Condução Nervosa , Punho/anormalidades , Adulto Jovem
19.
Acta Chir Plast ; 55(1): 23-5, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24188319

RESUMO

Macrodystrophia lipomatosa (MDL) is a rare, congenital, developmental anomaly causing localized overgrowth of a digit(s) or extremity. Trigger wrist is a relatively rare entity, which may be caused by a mass originating from a tendon, an anomalous muscle or intracarpal pathologies. A 42-year-old male patient presented with triggering during active motion of the fingers and intractable pain and numbness in fingers to our emergency department. He had hypertrophy of the entire right upper extremity and his huge thumb was amputated due to MDL four years ago. The index finger was bigger than the other fingers and thenar eminence area of the hand looked like a large mass. Resection of hypertrophic carpal bone and debulking of large soft tissue mass removed the carpal tunnel symptoms and limited the range of motion of the wrist and fingers. This is a case report of triggering at the wrist and severe carpal tunnel syndrome due to carpal bone enlargement and lipofibromatous hamartoma (LH) of the median nerve in a patient with MDL.


Assuntos
Síndrome do Túnel Carpal/etiologia , Dedos/anormalidades , Deformidades Congênitas dos Membros/complicações , Lipomatose/complicações , Punho/anormalidades , Adulto , Síndrome do Túnel Carpal/cirurgia , Dedos/cirurgia , Humanos , Deformidades Congênitas dos Membros/cirurgia , Lipomatose/congênito , Lipomatose/cirurgia , Masculino , Procedimentos Cirúrgicos Reconstrutivos/métodos , Punho/cirurgia
20.
Clin Ter ; 164(1): 31-3, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23455740

RESUMO

The present article highlights an unusual combination of variations of the extensor digitorum and extensor carpi radialis brevis muscles in the dorsum of forearm and hand. The extensor carpi radialis brevis exhibited an accessory musculotendinous belly which inserted into the dorsal digital expansion of index finger. The extensor digitorum showed trifurcation into three distinct parts. Resultant multiple extensor tendon insertion pattern is reported upon highlighting the embryological basis and clinical importance. Knowledge of such anatomical variations adds upon the already existing information in literature and is also of profound interest to the clinician. Anatomical awareness of accessory multiple extensor tendons in the dorsum of hand is essential for successful management of extensor tendon injuries and graft transfer operations.


Assuntos
Músculo Esquelético/anormalidades , Tendões/anormalidades , Adulto , Cadáver , Dedos/anormalidades , Antebraço/anormalidades , Humanos , Masculino , Punho/anormalidades
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