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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 […]


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 […]

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 […]

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 […]

Resisted flexion of the elbow


The subject stands with the arm alongside the body, the elbow bent to a right angle and the forearm in full supination. The examiner stands level with the subject’s hand.One hand is on top of the shoulder and the other on the distal aspect of the forearm.

Procedure. Resist the subject’s attempt to […]

Resisted internal rotation


The subject stands with the upper arm against the body and the elbow flexed to a right angle. The forearm is held in the sagittal plane, so keeping the shoulder in a neutral position. The examiner stands level with the subject’s arm. He places one hand on the opposite shoulder and the other hand […]

Elbow, wrist and hand

Wrist and hand rehabilitation

Because the function of the wrist and hand is essential to daily activities, special care is needed to avoid compromising the functional integrity of these structures. In addition to range-of-motion and strengthening exercises, attention should be paid to dexterity exercises and to tactile senses. The wrist and hand are a series […]

Carpal Tunnel Syndrome

Carpal tunnel syndrome is most often caused by overuse of the wrist, which in turn causes narrowing and inflammation of the tunnel that houses the nerves and tendons that lead from the forearm to the wrist. Compression of the median nerve causes the symptoms. Overuse is common in hand-intensive activities, particularly when the wrist is […]

Fracture of the Distal Radius and Ulna

A fracture of the distal radius (Colles’ fracture) is the most common of all fractures. It usually occurs as a result of a fall on the extended arm, forcing the hand backwards and upwards. A less common injury is Smith’s fracture where the mechanism is a forward flexion (palmar flexion) of the wrist. The injury […]