Orthopaedics

Hand & wrist

Hand & wrist resources from the Orthopaedics Hyperguide.

31 resourcesAlphabetical A–Z

Hand & wrist · Article

Benign Soft Tissue Tumors of the Hand

O. Ugwonali, MD Vishal Sarwahi, MD Melvin P. Rosenwasser, MD

More than 90% of hand and wrist masses are benign soft tissue tumors.1 Tumor size, location, mobility, color, and texture provide clues to diagnosis. Biopsy is the only means for a definitive diagnosis.

Hand & wrist · Article

Bone and Cartilage Tumors of the Hand and Wrist

O. Ugwonali, MD Vishal Sarwahi, MD Melvin P. Rosenwasser, MD

Cartilaginous tumors are the second most common class of primary bone tumor,1 and the most common primary bone tumor of the upper extremity.1,2 Histologically, cartilaginous tumors contain some form of hyaline…

Hand & wrist · Article

Boutonniere Deformity

Melvin P. Rosenwasser, MD

Tutorial Boutonniere deformity is not synonymous with a proximal interphalangel joint (PIP) flexion contracture (i.e., post fracture, osteoarthritis or flexor tendon etiology). The position of a finger where the PIP…

Hand & wrist · Article

Brachial Plexus Injury

Maxwell Park, MD Vishal Sarwahi, MD Melvin P. Rosenwasser, MD

Traction is the most common mechanism of injury in brachial plexus palsies that are birth-related or traumatic in nature.1 Rupture of peripheral nerves, avulsion of nerve roots, neuroma-in-continuity, or a combination…

Hand & wrist · Article

Carpal Tunnel Syndrome

Margaret Lobo, MD Nathan L. Taylor, MD Melvin P. Rosenwasser, MD

Carpal tunnel syndrome (CTS) is a median neuropathy emanating at the wrist level. In the 1950s, George S. Phalen, MD, categorized the clinical signs and symptoms of CTS1,2 — which has become the most commonly diagnosed…

Hand & wrist · Article

Cubital Tunnel Syndrome

Floyd G. Shon, MD Melvin P. Rosenwasser, MD

Eversmann. Entrapment and Compression Neuropathies: Operative Hand Surgery. 3rd ed.; Green DP, (ed.); New York, NY:Churchill Livingstone 1993.

Hand & wrist · Article

De Quervain Disease

Floyd G. Shon, MD H. Matthew Quitkin, MD Alejandro Alves Melvin P. Rosenwasser, MD

De Quervain disease is a stenosing hypertrophy of the retinaculum over the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons in the first dorsal compartment of the wrist.

Hand & wrist · Article

Dupuytren Contracture

Floyd G. Shon, MD Melvin P. Rosenwasser, MD

Introduction Dupuytren contracture is a progressive fibromatosis of subcutaneous palmar connective tissue leading to the development of flexion contractures of the hand. The structures involved in this disease are the…

Hand & wrist · Article

Dupuytren's Disease

Brett Wasserlauf, MD Vishal Sarwahi, MD Melvin P. Rosenwasser, MD

Dupuytren's disease is a condition of the hand that is characterized by tissue neogenesis in the form of nodules and cords. The disease tissue is comparable to the tissue found in benign neoplastic fibromatosis, but it…

Hand & wrist · Article

Fingernail Injuries

H. Matthew Quitkin, MD Melvin P. Rosenwasser, MD

The term perionychium describes the region on the dorsal aspect of the distal phalanx that includes the nail bed and surrounding soft tissues. The "hard nail," referred to as the nail plate, overlies the nail bed, which…

Hand & wrist · Article

First Carpometacarpal Joint Arthritis

Nathaniel P. Cohen, MD Melvin Rosenwasser, MD

Introduction The carpometcarpal (CMC) joint of the thumb is formed by the articular surfaces of the distal trapezium and the proximal thumb metacarpal. Osteoarthritis (OA) of the CMC joint is a common and disabling…

Hand & wrist · Article

Frostbite

Carter Lipton, MD Ryan A. Beekman, MD Jerome D. Chao, MD Melvin P. Rosenwasser, MD

Frostbite, by definition, is freezing and crystalizing of fluids in cells and tissues due to prolonged exposure to freezing temperatures (-10° C).

Hand & wrist · Article

Hand and Wrist Ganglions

Sacha D. Matthews, MD H. Matthew Quitkin, MD Melvin P. Rosenwasser, MD

Ganglions are benign, mucin-filled, cystic lesions that account for the majority of all hand masses. They arise from joint capsules, tendons, and tendon sheaths, but ganglions may also be intratendinous or intraosseous.…

Hand & wrist · Article

Infections of the Hand

O. Ugwonali, MD Vishal Sarwahi, MD Melvin P. Rosenwasser, MD

Infections of the hand may occur secondary to injury or as a complication of elective surgery. Effective management of hand infections requires knowledge of the anatomy of the hand, infectious organisms likely to infect…

Hand & wrist · Article

Kienböck's Disease

Michael Lee, MD Melvin Rosenwasser, MD

Since its description by Robert Kienböck over 85 years ago, the disease bearing his name has remained a mystery to orthopedic surgeons. Neither the causes nor a universally accepted treatment for this condition has been…

Hand & wrist · Article

Lateral Epicondylitis

Craig S. Radnay, MD, MPH

Lateral epicondylitis is commonly referred to as tennis elbow, although the condition is caused by a variety of sports- and work-related activities and more frequently affects non-athletes.1 Lateral epicondylitis was…

Hand & wrist · Article

Macrodactyly

Jerome D. Chao, MD Melvin P. Rosenwasser, MD

Macrodactyly, which is a rare anomaly of the upper extremity, has also been referred to as megalodactyly, overgrowth, gigantism, localized hypertrophy, or macrodactylia fibrolipomatosis (Slide 1).

Hand & wrist · Article

Malignant Soft Tissue Tumors of the Hand and Wrist

O. Ugwonali, MD Vishal Sarwahi, MD Melvin P. Rosenwasser, MD

Malignant tumors comprise 1% to 2% of all hand tumors and are most common in middle-aged and elderly patients.1,2 A multidisciplinary approach involving an orthopedic surgeon, radiologist, pathologist, and radiation…

Hand & wrist · Article

Mallet Finger

Frank J. Raia, MD Jerome Chao, MD Ryan Beekman, MD Melvin P. Rosenwasser, MD

The term mallet finger describes a spectrum of injuries that are related to loss of continuity of the conjoined lateral bands at the distal joint of the finger, leading to the characteristic deformity where the distal…

Hand & wrist · Article

Modern Flexor Tendon Repair

Scott Crow, BS Nathan Taylor, MD Ryan Beekman, MD Melvin Rosenwasser, MD

Although surgeons' understanding and techniques have improved significantly over the past 30 years, flexor tendon repair continues to be challenging and unpredictable outcomes often ensue. For many years, surgeons…

Hand & wrist · Article

Nerve Compression Syndromes

Michael L. Lee, MD Robert E. Carroll Melvin P. Rosenwasser, MD

Compression neuropathy of the radial nerve is much less common than in the ulna or median nerves. Five distinct clinical syndromes have been described.

Hand & wrist · Article

Proximal Median Nerve Compression Syndromes

Michael L. Lee, MD Melvin P. Rosenwasser, MD

Introduction The median nerve is formed by the anterior divisions of the lateral and medial cords. It travels down the arm adjacent to the brachial artery just anterior to the medial intermuscular septum and posterior…

Hand & wrist · Article

Radial Club Hand

Vishal Sarwahi, MD Melvin. P. Rosenwasser, MD

Radial club hand is classified as a pre-axial longitudinal deficiency. The axis of the forearm lies along the middle finger; the radial side is considered pre-axial and the ulnar side is post-axial. Radial club hand is…

Hand & wrist · Article

Radial Nerve Injury

Stefano M. Sinicropi, MD Vishal Sarwahi, MD Melvin. P. Rosenwasser, MD

The radial nerve is a continuation of the posterior cord of the brachial plexus as the axillary nerve branches off. The radial nerve receives contributions from the C5-C8 posterior divisions. In the axilla, the radial…

Hand & wrist · Article

Scaphoid Nonunion Fractures

Michael W. Grafe, MD Faiq Amin, MD Melvin P. Rosenwasser, MD

Patients with scaphoid fractures are commonly affected by scaphoid nonunion fractures. Treating patients with scaphoid nonunion fractures can be challenging for physicians. Many patients with scaphoid fractures have…

Hand & wrist · Article

Swan-neck Deformity

Andrew Zao, BA Michael L. Lee, MD Melvin P. Rosenwasser, MD

Swan-neck deformity describes a posture of the finger in which the proximal interphalangeal joint (PIP) is in hyperextension and the distal interphalangeal (DIP) joint is in flexion. Initially, this is a flexible…

Hand & wrist · Article

Syndactyly

H. Matthew Quitkin, MD Melvin P. Rosenwasser, MD

Syndactyly, derived from the Greek syn meaning together and dactylos meaning digit, defines a deficiency of the interdigital web space. Syndactyly may be either complete, in which the interdigital web extends the entire…

Hand & wrist · Article

Thoracic Outlet Syndrome

Sasha Ristic, MD H. Matthew Quitkin, MD Melvin Rosenwasser, MD

The thoracic outlet is comprised of the musculoskeletal structures traversed by the nerves and blood vessels to the upper extremity as they enter the arm. Thoracic outlet syndrome is a compressive neurovascular disorder…

Hand & wrist · Article

Thumb Metacarpophalangeal Joint Collateral Ligament Injuries

Sanjeev Suratwala, MD Ryan Beekman, MD Melvin P. Rosenwasser, MD

The thumb metacarpophalangeal (MP) joint in combination with the first carpometacarpal joint provides the hand with tremendous functionality. In addition to the primary arc of motion of flexion-extension at the MP…

Hand & wrist · Article

Ulnar Club Hand

Vishal Sarwahi, MD Melvin. P. Rosenwasser, MD

Ulnar club hand is classified as a post-axial longitudinal deficiency. The axis of the forearm lies along the middle finger; the ulnar side is considered post-axial and the radial side is pre-axial. Ulnar club hand is a…

Hand & wrist · Article

Ulnar Nerve Palsy - Tendon Transfers

Michael L. Lee, MD Melvin Rosenwasser, MD

Sensory loss extends distally to the underneath of the little finger and to the ulnar-volar aspect of the ring finger. There is also sensory loss proximally in the ulnar-dorsal aspect of the palm and the back of the…