In an effort to refine transcatheter vascular interventions, radial artery access has moved more distally at the anatomical snuffbox. Here, more challenges appear as the artery is smaller, more angulated, and more difficult to palpate. Including ultrasound guidance as a mandatory step during puncture may encourage more operators to switch to this approach. In the femoral approach, ultrasound guidance is strongly recommended because of bleeding complications, whereas in the proximal (conventional) radial approach, the role of ultrasound remains optional, and in current practice, almost all cases are performed by palpation of the pulse only. However, in distal radial access, the situation is different because the artery differs in caliber and position, and imaging can help the operator for a clean puncture, especially since repeated punctures are not only painful but also any hematoma formation leads to the complete compression of the artery and failure of access. The aim of this review is to investigate the rationale of vascular ultrasound during distal radial access and to establish some techniques and anatomical landmarks for the ultrasonographic exploration of the dorsal area of the hand.
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http://dx.doi.org/10.3390/life13010025 | DOI Listing |
BMJ Open
January 2025
Bio Heart Cardiovascular Diseases Research Group, Bellvitge Institute for Biomedical Research, L'Hospitalet de Llobregat, Barcelona, Spain.
Introduction: Chronic hand ischaemia may affect some haemodialysis patients with an arteriovenous fistula (AVF) or graft (AVG), a condition known as haemodialysis access-induced distal ischaemia (HAIDI). Duplex ultrasonography (DUS) can provide comprehensive insights into anatomical and perfusion properties, and measuring the hand acceleration time (HAT) has been demonstrated to be sensitive within the framework of chronic upper limb ischaemia.
Methods And Analysis: This single-centre, prospective cohort study will involve adult end-stage renal disease (ESRD) patients requiring either AVF or AVG for haemodialysis.
J Hand Surg Eur Vol
January 2025
University Hospital Southampton, Southampton, UK.
There are many good reasons to improve the anatomy of a distal radius fracture, such as early return to function and avoidance of sigmoid notch incongruity or ulnocarpal impaction. It is often feared by patients, and portrayed by some authors of scientific articles and medicolegal reports, that a fracture of the distal radius has a propensity to cause symptomatic osteoarthritis. This article examines some of the current evidence and shares the authors' experience.
View Article and Find Full Text PDFArch Orthop Trauma Surg
January 2025
Abteilung für Plastische und Handchirurgie UniversitätsCentrum für Orthopädie, Unfall- & Plastische Chirurgie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany.
Background: Kirner deformity is a rare anomaly of the little finger in adolescents, characterized by a deformity of the distal phalanx and a radiologically L-shaped epiphysis, along with palmar and radial angulation of the distal phalanx. Due to the rarity of these pathological findings, there are no systematic literature reviews available. This work serves as an overview of the clinical presentation, frequency and age distributions, as well as possible conservative and surgical treatment options.
View Article and Find Full Text PDFJ Mech Behav Biomed Mater
December 2024
School of Engineering, University of Guelph, Guelph, Ontario, Canada. Electronic address:
As a biarticular muscle, the biceps brachii both supinates the forearm and flexes the elbow and shoulder, thus allowing the upper limb to perform a variety of activities of daily living (ADL). The biceps brachii originates on the coracoid apex as well as the supraglenoid tubercle and inserts on the radial tuberosity. At the distal end, the bicipital aponeurosis (BA) provides a transition of the biceps tendon into the antebrachial fascia.
View Article and Find Full Text PDFJ Invasive Cardiol
December 2024
Division of Cardiology, Stony Brook University Hospital, Stony Brook, New York.
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