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Surgery for Repair of Webbed Fingers or Toes

Repair of webbed fingers or toes is surgery to fix webbing of the toes, fingers, or both. The middle and ring fingers or the second and third toes are most often affected.


This procedure is done using general anesthesia. The patient is asleep and pain-free.

Dr Kevin Yip will mark the areas of […]

Clinical Evaluation-Physical Findings

Distinguishing anterior shoulder pain caused by biceps tendon disorders as opposed to subacromial impingement can be difficult, as these two entities usually co-exist. Although there are some exam maneuvers, which attempt to isolate the biceps tendon, there is still a fair amount of overlap and the definitive diagnosis of isolated biceps tendon pathology is extremely […]

Physical Exam

A thorough physical examination should include careful evaluation of the cervical spine to rule out a neurologic problem such as a herniated cervical disc that can mimic shoulder pathology. This is especially true if a patient presents with bilateral symptoms.

If subacromial impingement is suspected, specific tests should be used and documented. The Neer and […]

Resisted extension of the knee


The subject lies prone with the knee flexed to 70°. The examiner stands level with the thigh and leans over the subject. The ipsilateral hand is placed on the distal end of the thigh to stabilize it on the couch. The elbow of the other arm is positioned ventrally around the distal end […]

Fin kelstein’s test


This test is meant to confirm the presence of de Quervain’s disease. It should be more painful than the ulnar deviation test.


The subject stands with the arm hanging, the elbow flexed to a right angle and the forearm pronated. The examiner stands next to the subject. The contralateral hand carries […]

Grind test for the trapezium-first metacarpal joint


This test is meant to detect crepitus as a symptom indicating arthrosis.


The subject stands with the arm hanging and the elbow 90° flexed. The examiner stands level with the subject’s hand. The contralateral hand grasps and stabilizes the wrist. The other hand takes hold of the distal part of the first […]

Resisted ulnar deviation


Resist the subject’s attempt to push the hand over to the ulnar side.

Common mistakes.

The elbow is not extended. Anatomical structures tested:

Muscle function:

• Importallt lIi1lnr deviators: – Extensor carpi ulnaris – Flexor carpi ulnaris • Less importallt ulnar deviators: – Extensor digitorum communis – Extensor digiti minimi.

Common pathological situations:

• […]

Muscles controlling the wrist

As most muscles take their origin at the elbow and overrun it, the subject’s elbow should always be held in extension to put maximal stress on these structures. All movements are executed with the wrist held in the neutral position:

• halfway between flexion and extension • halfway between radial and ulnar deviation.

The positioning […]


Backwards movement during extension


The subject stands with the arm hanging and the elbow bent to 90° and in supination.The examiner faces the subject. One hand grasps the hand and stabilizes it.


The other hand moves the thumb into extension first and then backwards.

Common mistakes.

The thumb is hyperextended in […]

Passive supination


The subject stands with the arm hanging and the elbow bent to 90°. The examiner stands in front of the subject. Both hands encircle the distal part of the forearm in such a way that the heel of the ipsilateral hand is placed on the dorsal aspect of the ulna and the fingers of […]