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Carpal Fractures and Ligamentous Instabilities

Carpal Fractures

Carpal Fractures

The human wrist joint is a complex arrangement of small bones and ligaments that form a mobile yet stable link from the powerful forearm to the hand. The normally functioning carpus can position the hand precisely relative to the forearm and provides remarkably stable transmission of forces. Motion and stability of […]

Technique

Operative intervention for biceps pathology begins with arthroscopic inspection and debridement. The proximal biceps tendon is easily visualized during standard glenohumeral arthroscopy. The tendon is first visualized thoroughly from the posterior portal. The tendon should be inspected from its origin on the superior glenoid tubercle and/or superior labrum all the way into the bicipital sheath. […]

Tennis injury and Medial epicondylitis

Tennis injuries are generally defined as either cumulative overuse or acute (traumatic) injuries.

Overuse injuries occur over time due to stress on the muscles, joints and soft tissues without proper time for healing. They begin as a small, nagging ache or pain, and can grow into a debilitating injury if they aren’t treated early.

Medial […]

ISOMETRIC CONTRACTIONS-Resisted extension

Positioning.

The subject lies in the supine position with the knee slightly bent. The examiner stands level with the knee. One forearm is placed under the knee with the hand resting on the other knee, proximal to the patella. The other hand is on the distal end of the leg just proximal to the […]

Passive medial rotation

Positioning.

The subject lies in the supine position with the knee and hip flexed to right angles. The examiner stands level with the subject’S knee.One forearm carries the lower leg. The other hand grasps the calcaneus from the lateral side.Both hands clasp tightly under the heel which is forced into dorsiflexion.

Procedure.

A combined movement […]

Fin kelstein’s test

Significance.

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

Positioning.

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 […]

Passive supination

Positioning.

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 […]

PASSIVE TESTS OF THE DISTAL RADIOULNAR JOINT

Passive pronation

Positioning.

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 contralateral hand is placed on the palmar aspect of the ulna and […]

Palpation of soft tissue

Feel for the pisiform bone and place the palpating finger against its proximal aspect. Ask the subject to actively abduct the little finger. The tightening of the flexor carpi ulnaris can be felt.The tendon can now be followed distal to the pisiform until its insertion on the base of the fifth metacarpal bone. The pisiform […]

ISOMETRIC CONTRACTIONS

Resisted flexion

Positioning

The subject stands with the arm hanging, the elbow flexed to a right angle and the forearm supinated. The examiner stands level with the elbow. One hand is on the distal part of the forearm and the other hand on top of the shoulder.

Procedure.

Resist the subject’s attempt to flex the […]