Hand Anatomy for Injections

8/19/2019 Hand Anatomy for Injections

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BFO@ FOFPLAU FO@BEZPLILDU

(F^ÎEJFHIG CLX GZPBGPEJ PXGFPAGOPZ)

Jbrestefo @ualotegr, êgrrg @uafs

îfstej Zurdgry, Oejg


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TBFP FXG TG PFIKEOD FHLWP <

• Loiy tbg `lrsfi pfrt lc tbg bfo` es eovlivg` eo fdgeod fo`

jlsagtej jlosgqugojgs (tbeo, crfdeig, jilsg tl eaplr tfot foftlaejfi strujturgs,gxtgosehig, alheig wetblut f`bgselo tl tbg uo`griyeod strujturgs - jilsg tl tbg supgrelrgygie`)

• Olt tbg pfiafr skeo (tbejkgr, alrg rgsestfot, igss alheig, igss gxtgosehig, wetblutjutfoglus gxjgss, alrg sgosehig fo` stxg` tl tbg uo`griyeod strujturgs)

!


3/34

FOFPLAU <

• Oltbeod ogw= Hlogs, mleots, tgo`los,

ausjigs, ogrvgs, frtgregs,....

• Blwgvgr tbgy `l olt pfrtejepftg ft tbgsfag igvgi tl bfo` fdgeod

• Al`estjftelo lc tbg vliuag fo`

prlpgrtegs lc tbg hlogs/ausjigs/

tgo`los...fo` skeo

• Al`estjftelo lc tbg fppgfrfojg lc tbg

skeo


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PBG @LXZWA LC PBG BFO@

• Crla hlogs tl skeo

• Tbft frg tbg ifygrs <

Blw afoy ifygrs <

Tbgrg tl eomgjt sfcgiy <

• Blw `l tbgy al`ecy wetb

fdgeod


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@GG^ ZPXWJPWXGZ (IFUGXZ)

• Hlog fo` ausjigs

• Frtgregs

• Pgo`los


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LZPGL-FXPEJWIFX FDGEOD

• Hlog lstglplrlses bfs ol eougojg lo tbg

alrpblildy lc tbg bfo`

• " hlog aeogrfi `gosety lc >,48% pgr ygfr fctgr 7>

ygfrs lc fdg gxpifeo hlog crfdeiety (lstglplrlses)

• Mleot frtbretes blwgvgr `lgs pfrtejepftg tl

stodgr al`estjftelos

• 34% C, 77% A prgsgot wetb fo frtbrlses (KI? 8)fctgr 77 ygfrs, wetb fddrfvftelo wetb teag - jlsagtejjlosgqugojgs lo tbg stodgrs

vfo Zffsg Foo Xbgua @es 6525


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XFPEL ^6/^E^

^gfrslo= A=->.88, C= >.03 Mfkuhegtz, M^XZF 8>>2


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OGWXL-AWZJWIFX FDGEOD

• ? 3> ygfrs lc fdg= " lc Altlr uoet eo uiofr

eoogrvftg` ausjigs (eotgrlssglus) fo` alrg

sgvgrg eo ag`efo eoogrvftg` (tbgofr ftrlpby)

• ? 3> ygfrs

• ! ausjuifr afss (87-07%)

• ! Drep strgodtb (8>-87%)

• Fayltrlpby pfrtejepftgs siedbtiy tl

jlsagtej bfo` al`estjftelos


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PGO@LO FDGEOD

• ! tgo`lo vfsjuifresftelo " ! drep strgodtb, fppgfrfojg lc stodgrgxua, ! tgoseig strgodtb (:>-7>%)

• # crgqugojy lc tgo`lo rupturg (afiigt stodgr)

• Fdgeod lc tgo`lo sbgftb (treddgr stodgr,...)

@lgs olt pfrtejepftg


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ZW^GXCEJEFI IFUGXZ

• Ogrvgs

• Sgeos

• Zkeo

Ogrvg fdgeod

bfs ol

eougojg


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SGEOZ

•Hgjlag alrg vesehig wetbfdg (7>% lc pftegots ? 3> yrs vgolus

`eiftftelo, aejrltbrlahlses,...)

^gfrslo= A= >.34, C= >.45

Mfkuhegtz, M^XFZ 8>>2


12/34@r IGCGHSXG-SEIFX@GHL

^bighgjtlay (ol alrg tbfo 6) bfs hggo prlplsg` clr ifrdgvgeos (3-4 aa `efagtgr)


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BLTGSGX

• Li` foftlaejfi pfpgrs bfvg stuèg`

tbg vgeos lc tbg `lrsua lc tbg bfo`

• Afoy fofstlalsgs eo èccgrgotpifogs

• Pbgrg es olt f seodig ifygr clr

vgeos= « Hfsg` lo tbes eovgstedftelo, wg tbeok tbft tbg frrfodgagot lc tbg suhjutfoglus vgeoseo tbg `lrsua lc tbg bfo` es f tbrgg

èagoselofi ogtwlrk . Et es fpprlpreftg tlève`g tbg vgeos eotl supgrstjefi fo` `ggp ifygrs.»

]bfod Z-R, Zjbae`t B-A. Jieoejfi foftlay lc tbg suhjutfoglusvgeos eo tbg `lrsua lc tbg bfo`. Foo. Foft 655:; 647= :26-:20.


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PBG ZKEO

• Pbg vesehig pfrt

• Al`estjftelo lc hltb

vliuag fo` fspgjt

Difoz Z gt fi. Fgstbgtej surdgry lc tbg fra. ^frt E. Fgst ^ifst Zurd 6526;7=6-64.


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ZKEO FDGEOD

• Gxtreosej fdgeod fccgjts tbg gpe`grafi fo` `grafi ifygrs (cliilweod

gxplsurg tl tbg suo, jbgaejfis fo` salkeod), fo` jfo afoecgst fs fjteoej

kgrftlses (prgafiedofot), slifr igotedeogs, puojtftg byplpedagotftelofo` slifr purpurf.

• Alst bfo` rgmuvgoftelo trgftagots cljus lo gxtreosej fdgeod

hy uoecyeod pedagotftelo fo` skeo rgsurcfjeod (tlpejfi fje`s, tlpejfi 7-ulrlurfjei, higfjbeod fdgots, aejrl`grafhrfselo, jbgaejfi pggieod, ifsgr lr eotgosg puisgiedbt trgftagots)

• (Zjigrltbgrfpy fo` pbighgjtlay tl aeoeaezg tbg fppgfrfojg lc vgeos)

Kubog W, Eablc A. Prgftagot lc tbg Fdgeod Bfo` wetb @grafi Ceiigrs. M Jutfo Fgstbgt Zurd. 8>68 Mui-Zgp; 7(:)= 63:‚635


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ZKEO FDGEOD

• Eotreosej fdgeod eojiu`g wreokigs, trfosiujgot, ifx

fo` tbeoogr skeo wetb prlaeogot vgeos, mleots

fo` tgo`los

• Fctgr 0> ygfrs li`, tbejkogss lc tbg `lrsfibfo` skeo `gjrgfsgs lc :% gfjb ygfr

• Bfo` vliuag rgstlrftelo lr jlotlureod jfo

f``rgss alst eotreosej sedos lc fdgeod.


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PBG ZKEO

• Pwl ifygrs lc `graes sgpfrftg`

hy tbg rgtg suhpfpeiifrg


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PBG ZKEO

• Pbgo tbg bypl`graes wetb f`eplsg

tessugs


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@LXZFI ZKEO

• Gpe`graes >,: aa;

• @graes 6 aa (ol

agessogr jlrpusjigs),

• Bypl`graes >,33 aa -ol

stxftelo tl `ggp

strujturgs)

^fiafr skeo= >,3 aa/6,7 aa/ 8 aa

8 aa tbejk


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@LXZFI ZKEO

• Ifrdg surcfjg

• @eccgrgot frgfs (gstbgtej uoets

lc Aejblo bfvg surdejfi

eapiejftelo)

65> ja8 67> ja8


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PBXGG IFAEOFG <

• Heèj rgplrtg` lc tbrgg èsteojt cftty ifaeofg (supgrstjefi,

eotgragèftg fo` `ggp) ève`g` hy tbeo cfsjef lo tbg `lrsua lc

tbg bfo`.

• Pgo`los frg iljftg` eo tbg `ggp ifaeof.

• Sgeos fo` sgoslry ogrvgs frg iljftg` wetbeo tbg eotgragèftg

ifaeof Heèj gt fi. @lrsfi Bfo` Foftlay Xgigvfot tl Sliuagtrej Xgmuvgoftelo. ^XZ 8>6>;683= 63:-632


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PBXGG IFAEOFG <

• Pbg tbejkogss lc tbg supgrstjefi ifaeof sggas tl jlrrgiftg wetb

hl`y afss eo`gx, fo` tbgrg frg ol vfsjuifr lr ogurlofi strujturgs

eo tbes ifaeof.


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TBGXG PL EOMGJP <

• Fhlvg tbg vgeos <

• Eo tbg suhjutfoglus tessug (supgrstjefi ifaeof) fs tbg `graes es tl

tbeo eo fdg` pgrslo <


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TBGXG PL EOMGJP <

• Et es tgjboejfiiy eaplssehig tl

eomgjt eotl tbg supgrstjefi ifaeof

wetblut puojtureod tbg vgeos !.

• Eotl tbg `ggp ifaeof, fhlvg tbg

agtfjfrpfi pifog, es gccgjtevguseod f 87- tl :8-dfudg ogg`ig

lr f hiuot jfoouif.


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PBG E@GF LC EO@G^GO@FOP IFUGXZ EZOLP FJJWXFPG

• Igcghvrg-Seifr`ghl bfs `galotrftg` f vgrtejfi ogtwlrk wetbvgeos olt pfsseod crla f ifygr tl foltbgr hut ruooeod crla

supgrstjefi tl `ggp pfrt lc tbg `lrsua lc tbg bfo` eo f olo-

frrfodg` cfsbelo

• Dueahgrtgfu bf` ilod fdl sblwo f tbrgg `eagoselofi ogtwlrk eo

tbg suhjutfoglus tessugs

Dueahgrtgfu= ̂ rlagof`gs slus if pgfu, Gisgvegr


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Tbgo ylu gotgr tbg skeo


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Ol lr`gr, sthreis hrfojbeod lut eo gvgrytbeod `ergjtelo !


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Cehreis, af`g lc jliifdgo fo` gifsteo `gieaet aejrlvfjuligs

stiig` wetb prltgldiyjfos.


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Pbes gxehig frjbetgjturg bfs drgft agjbfoejfi rgsestfojg wbejbeojrgfsgs tbg pltgotefi rgsplosg tl strgss


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• Zl wbgrg tl eomgjt <


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PBGXG FXG OL XGFI ^IFOGZ

• Eomgjt olt tll supgrstjefiiy tl fvle` tbgPyo`fii gccgjt (iedbt sjfttgreod hy pfrtejigs eo stogsuspgoselo- Fs tbg eotgosety lc tbg sjfttgrg` iedbt `gpgo`slo tbg clur tb plwgr lc tbg crgqugojy, hiug iedbt essjfttgrg` aujb alrg)

• Fvle` vgeos eomury (hiuot jfouifs)


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BFO@ FDGEOD -

JLOJIWZELO• Jutfoglus al`estjftelos frg tbg alst vesehig

• Hut tbg bfo`s frg fo gxpfoselo lc tbg hrfeo, f agfo

lc olo-vgrhfi jlaauoejftelo, f sgoslry lrdfo, f tlli

clr jrgftevety,...

• Fo` fdgeod es rgsplosehig clr tbg ilss lc `gxtgrety fo`strgodtb

@l olt clrdgt tbft bfo` rgmuvgoftelo es loiy tbg jlsagtej

t t t c i h i ` ie

Hand Anatomy for Injections

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