The normal repose cascade. When the hand is at rest, the fingers should be held with the small finger flexed slightly more than the ring finger. The ring finger is slightly more flexed than the long finger, and the long finger is slightly flexed more than the index finger.
This patient has flexor tendon lacerations of the left index and long fingers. Note the disturbance in the repose cascade, as the index and long fingers are extended.
The left hand drawn with the relevant structures at the proximal hand and distal forearm. The median nerve (M) becomes more superficial as it approaches the distal one third of the forearm, but still deep to both the palmaris longus tendon (P.L.) and the flexor carpi radialis (F.C.R.). As the median nerve continues distally into the hand, it enters the carpal tunnel. The roof of the carpal tunnel is formed by the transverse carpal retinaculum (T.C.L). The recurrent branch (Rb) generally emerges at the distal edge of the transverse carpal ligament. Occasionally, it will emerge through the fibers of the ligament. The median nerve continues through the proximal hand and then divides into its digital sensory branches.
A patient with long-standing carpal tunnel syndrome with extreme hand weakness. Note the thenar atrophy. There is a hollowness at the proximal radial side of the palm. This is the classic appearance of thenar muscle atrophy due to severe and chronic median nerve compression at the wrist causing the carpal tunnel syndrome.
Picture of the ganglion cyst (arrow). It is located under the ulnar motor (deep branch).
The excised ganglion cyst measures approximately 1 cm in diameter.
Picture of the ulnar nerve at the elbow being compressed by a very muscular anconeous epitrochlearis prior to division.
The ulnar nerve released after the anconeous epitrochlearis has been divided.
This patient has locking of the left long finger due to stenosing flexor tenosynovitis, known commonly as trigger finger. She is unable to extend her affected finger without having to take the other hand and passively extend ...
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