The Collateral Ligament of the Digits of the Hand: Anatomy, Physiology, Biomechanics, Injury, and Treatment.

Ligament injuries are among the most common musculoskeletal injuries seen in clinical practice and ligaments are the most frequently injured structures in a joint. Ligaments play an important role in balancing joint mobility and joint stability. Disruption of joint ligaments severely impairs joint function.

Gouty Tenosynovitis of the Distal Biceps Tendon Insertion Complicated by Partial Rupture: First Case and Review of the Literature.

Given the appreciable prevalence of gout, gout-induced tendon ruptures in the upper extremity are extremely rare. Although these events have been reported only 5 times in the literature, all in patients with a risk factor for or history of gout, they have conspicuously never been diagnosed in the shoulder or elbow. A 45-year-old, right-hand-dominant man with a history of gout presented with pain in his right anterior elbow and weakness in his forearm after a trivial injury.

Central slip tenotomy with distal repair in the treatment of severe chronic mallet fingers.

The author is unaware of any studies that combine central slip tenotomy with a distal repair, using small transverse incisions at the proximal interphalangeal and distal interphalangeal joints, respectively, to repair chronic mallet fingers whose deformities exceed 36°. This article describes the technique in detail, as well as its indications, postoperative management, and complications. An illustrative review of a case series follows.

Decency, honor, integrity, and the law.

In its guidelines for hand care professionals, the American Society for Surgery of the Hand has set the following criteria as guidelines for the ethical hand surgeon in the 21st century: decency, honor, and integrity. This article reviews these criteria in detail, relates how they apply in practice, and describes how they interact with state and federal law in both legislative and judicial aspects. Matters pertaining to informed consent, privacy issues, patient autonomy, shared decision making, and conflict of interest are described, and recent developments in this area are examined.

The Ab-Adductometer: a new device for measuring the muscle strength and function of the thumb.

The purpose of this study was to present normative values for thumb abduction and adduction and also to present measures of reliability of the measuring system arising from the use of the Ab-Adductometer. With the Ab-Adductometer, we obtained abductor and adductor measurements of intrinsic muscle strength of the healthy hand thumb in 600 volunteers. Handgrip strength values were obtained with the Jamar dynamometer.

Metacarpophalangeal arthroscopy.

Although small joint arthroscopy has become commonplace over the past decade, relatively little attention has been paid to the investigation and clinical utility of metacarpophalangeal (MP) joint arthroscopy. The literature is scant in this area and consists of only a handful of case reports. In addition, the arthroscopic anatomy of the MP joint has not as yet been reported.

Arthroscopic synovectomy of the metacarpophalangeal joint in refractory rheumatoid arthritis: a technique.

Arthroscopic synovectomy was performed on 29 metacarpophalangeal joints belonging to 21 patients with refractory rheumatoid arthritis. This article describes the method of anesthesia, landmarks, and operative technique. Short-term (12-month) results and patient satisfaction have been excellent.

Overuse tendinitis of the intrinsic muscles.

Repetitive strain injuries are currently the leading cause of occupational illnesses. This report describes seven patients who presented with the sole symptom of hand pain and subsequently were diagnosed with intrinsic tendinitis. Six of the 7 patients were given injections of a local anesthetic and steroid solution into the region of the lumbrical tunnels for both diagnostic and therapeutic purposes.

Nerve and tendon gliding exercises and the conservative management of carpal tunnel syndrome.

While developments continue in the surgical management of carpal tunnel syndrome, little emphasis has been placed on the evaluation of a comprehensive non-surgical treatment. In this study, 197 patients (240 hands) presenting for treatment of carpal tunnel syndrome were divided into two groups. Patients in both groups were treated by standard conservative methods, and those in one group were also treated with a program of nerve and tendon gliding exercises.

Treatment of subungual myxoma preserving the nail matrix: a case report.

Subungual myxomas are uncommon, benign, expansile lesions that club the fingertip. Traditionally the nail matrix is incised, which results in permanent nail deformity. This report describes a midlateral approach that not only spares the nail apparatus but demonstrates that the nail can remodel even if a void is left under the nail matrix after excision of the tumor.

The workplace athlete.

Repetitive strain injury is rapidly becoming a problem of epidemic proportions in today's high technology workplace. It can take many forms and require a variety of different treatments. However, it is only with a combined, multidisciplinary approach that this problem can be prevented and tackled.

Upper extremity disorders in performing artists.

Studies in the past decade have shown that a significant proportion of instrumentalists report musculoskeletal problems severely affecting their musical performance. Musicians endure daily intensive use of their upper extremities, frequently placing them in bizarre positions. Their training schedules are rigorous and long term Predisposing factors to, and treatment for, overuse syndromes, tendinitis, and tendon trauma commonly encountered by musical performers are discussed at length.

Intraosseous glomus tumor in the ulna. A case report.

Glomus tumors are benign vascular tumors composed of round to oval uniform cells associated with vascular structures, usually found in the soft tissue of the nail bend. A 24-year-old woman with a two-year history of progressive right elbow pain and swelling was found to have a histologically characteristic intraosseous glomus tumor in this unusual location. Excision was followed by complete relief of symptoms.