Management of Complications of Wrist Arthroplasty and Wrist Fusion.
UL- Fascia of Wrist & Hand
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Transcript of UL- Fascia of Wrist & Hand
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FASCIA OF WRIST & HAND
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FLEXOR RETINACULUMStrong fibrous band- carpal tunnelAttachment- medially- pisiform
hook hamatelaterally- 2 laminaesuperficial-tubercles of scaphoid,
trapeziumdeep- groove on trapezium
superiorly- fascia of forearminferiorly- palmar aponeurosis
Relations- crossed superficially ulnar vessels &nerve
palmar cutaneous branches of radial & ulnar nerves
palmaris longusintrinsic muscles hand
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CONTENTS OF CARPAL TUNNEL1- flexor digitorum superficialis2- flexor digitorum profundus3- flexor pollicis longus4- median nerve5- ulnar bursa6- radial bursa
Arrangement of structures
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CARPAL TUNNEL SYNDROMECompression median nerve at wristCauses-
oedema, myxedema,osteo arthritis,rheumatoid arthritisSymptoms-
pain, numbness- radial three & half digits especially at nightExamination-
wasting thenar muscleshypo-aesthesiaskin over thenar eminence normal
Treatment-analgesic, splinting
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EXTENSOR RETINACULUMOblique bandBorders- superior & inferior continuous deep fascia
medial –attached triquetrallateral- attached anterior border radius
Compartments abductor pollicis longus, extensor pollicis brevisextensor carpi radialis longus, brevisextensor pollicis longusextensor digitorum, indicis, posterior interosseous nerves & vesselsextensor digiti minimiextensor carpi ulnaris
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FASCIA OF HANDFunctions-
chaneling of structures transmission of loadanchoragebindinglubricationframework muscle attachments
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PALMAR APONEUROSISParts- central, medial, lateralCentral part- thick, protects vessels, nerves
prevents tendons from bow- stringingLateral, medially- thinFeatures- triangular
apex proximaldistally- thick, four slips(superficial, deep)intervals traversed- digital vessels,nerves,lumbricals
Medial, lateral palmar septaFunctions- improves grip
protectionorigin- palmaris brevispotential spaces
Morphology- degenerated tendon
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FIBROUS FLEXOR SHEATHS
Extent- MP joint-base distal phalanxContentsEach crosses three jointsThick, thin zones
Digital synovial sheaths- vincula longa, brevia