Wrist Area Research Articles

Sensitivity to Vibrotactile Stimulation in the Hand and Wrist: Effects of Motion, Temporal Patterns, and Biological Sex.

We investigated the impact of low-tempo, repetitive hand movements on vibrotactile sensitivity by employing various temporal and spatial patterns in the hand and wrist area. The investigation of a human's ability to perceive vibrotactile stimuli during dynamic hand movements remains understudied, despite the prevalence of slow to mild hand motions in applications such as hand navigation or gesture control using haptic gloves in Virtual Reality (VR) and Augmented Reality (AR). We investigated vibrotactile sensitivity, analyzing the impact of various factors, including Motion (static and low-tempo repetitive hand movements), Temporal Patterns (Single or Double vibrations with varying onset times), Tactor Placements (hand and wrist), Spatial Patterns, and Biological Sex. Our study revealed that Motion significantly influences vibrotactile sensitivity in the hand and wrist areas, leading to reduced accuracy rates during dynamic conditions. Additionally, as the stimulus onset approached in Double vibrations, accuracy rates markedly decreased. Notably, Hand Placement resulted in significantly higher accuracy rates compared to the Wrist Placement. Our findings underscore the impact of motion in reducing vibrotactile sensitivity on the back of the hand and around the wrist. This research has wide-ranging practical applications, particularly in the field of VR/AR experiences, rehabilitation programs, and accessibility solutions through the use of haptic gloves. Insights from our study can be harnessed to enhance the efficacy of haptic gloves in conveying vibrotactile cues within these contexts.

Non-invasive laser therapy effect on lipid profile and renal function in metabolic syndrome: randomized control trial

INTRODUCTION. Metabolic syndrome (MetS) represents an assortment of interconnected metabolic risk factors, particularly central obesity, dyslipidemia, and hyperglycemia. These variables have a detrimental impact on renal function and contribute to increased mortality. This timeline necessitates a prompt approach that enables the deployment of safe and non-intrusive therapeutic equipment in conjunction with therapy for MetS patients. Accordingly, we aim to investigate whether using a low-level laser (LLL) watch device as a non-invasive instrument enhances multiple metabolic parameters, so it may be a practical therapeutic approach for managing metabolic disorders. AIM. To investigate the effect of non-invasive laser therapy on parameters of lipid profile and renal function in patients with metabolic syndrome. MATERIALS AND METHODS. This study enrolled 40 MetS patients of both genders aged 45–65 years. The study group received a 12-week treatment consisting of oral hypoglycemic medication and LLL therapy (LLLT), which involved three weekly sessions performed in the morning, targeting the wrist area using a continual output diode laser (skin contact mode, maximum power: 0.005 W, beam spot area: 0.03 cm2, energy density: 288 J/cm3, and radiation time: 1800 s). The control group only received hypoglycemia medications. Laboratory lipid profile and renal function measurements were conducted prior to and following the trial. RESULTS. Following a 12-week laser watch therapy, the results revealed a significant decline in total cholesterol (TC), triglycerides (TG), and low-density lipoprotein (LDL) levels and an increase in high-density lipoprotein (HDL) levels, which was slightly improved in the control (p 0.00). Moreover, glomerular filtration rate (GFR) and creatinine levels were significantly improved, while the control group did not experience any significant improvement (p 0.5). DISCUSSION. Combining non-invasive laser therapy with hypoglycemic medications significantly improved the lipid profile in patients with MetS; however, kidney function, like GFR and creatinine levels, was enhanced. Furthermore, lower TC and TG levels might be due to the reduction of glycation and promoted LDL receptors which increased LDL catabolism. CONCLUSION. Non-invasive laser therapy enhances lipid profile and renal function in MetS patients. Furthermore, the control group had a minimal effect on the lipid profile and no effect on renal function.

TUBERCULOSIS OF THE WRIST

INTRODUCTIONTuberculosis (TB) is a public health challenge. However, musculoskeletal involvement represents 10–15% of all extrapulmonary cases. Upper extremity involvement is extremely rare. The slow progressive course of clinical symptoms and lack of radiological signs lead to difficulties in establishing early diagnosis. Hence, the patients who have tuberculosis of the wrist are usually misdiagnosed. We report 5 cases of tuberculosis of the wrist seen in our unit from the year 2012 to 2021.METHODSCases were retrospectively evaluated on demographics, nature of history, clinical presentation, culture finding, and histopathological findings from 2012 to 2021 at our unit.RESULTSA total of 5 cases were evaluated retrospectively. Three patients were more than 60 years old and two were less than 30 years old. Four of the patients presented with wrist swelling 2 of them had wrist pain and only 1 patient had discharge from the wound. The duration of the symptoms ranges from 2 months to 3 years. Only one of the patients had a history of pulmonary TB contact whereas the others didn't. All patients underwent surgery. All of the patients had positive cultures for Mycobacterium tuberculosis complex and histopathological examination showed necrotizing granulomatous inflammation from specimens taken intraoperatively, which confirmed the diagnosis of tuberculosis of the wrist.DISCUSSIONSOur cases show that the common presentation of tuberculosis of the wrist was comparable to other literature. Most of the patients presented with chronic wrist swelling with or without wrist pain. The diagnosis of the disease was delayed an average of 10 - 12 months from symptoms onset to diagnosis. S. Bayram et al reported a case where the diagnosis was made 45 months later. Due to its rarity, it often is misdiagnosed, resulting in delays in the proper treatment.CONCLUSIONThe diagnosis of the TB wrist remains difficult because of insidious and non-specific. presentation. However, early diagnosis is essential to avoid delays in treatment and complications. Hence, chronic wrist pain, and swelling with or without unexplained bone erosion around the wrist area must be highly suspected of being osteoarticular tuberculosis.

Monitoring of some minor human skin lesions using a skin calorimeter

The growing interest of human skin thermal properties is motivating the development of new instruments, either by contact or by remote sensing. In this work, we show the ability of a skin calorimeter to monitor the temporal evolution of the heat capacity and the equivalent thermal resistance of the skin, in two small skin lesions. The first one consists of a forehead wound of 10 × 2 mm2. The other injury consists of a second degree burn on the volar wrist area, of 10 × 20 mm2. We studied the temporal evolution of the thermal properties of both injuries. The variation of heat capacity was significant. For first injury, heat capacity decreased by 21% and full recovery was achieved after ten days. For the second case, the heat capacity decrease was 55% and recovery was achieved after 3 weeks. These skin recoveries are monitored by the measured heat capacity value. The returning of the heat capacity to its normal value coincides with the recovery from the injury.

Intermonitor Variability of Garmin Vivofit® Jr. Wristband

The main objective of this study was to evaluate the reliability of Garmin Vivofit® Jr. physical activity (PA) wristbands during daily life physical activities. Six wristbands were randomly selected from a stock of twenty-four. The wristbands were worn by a single four-year-old participant, with three on the right wrist area and three on the left wrist area. To assess device reliability under laboratory conditions on a treadmill (Powerjog, model JM200, Sport Engineering Ltd., Birmingham, UK), the participant wore the six wristbands while performing five work conditions: sitting and standing (30 times per minute, controlled by a metronome), walking at 3 km/h, walking at 4 km/h, running at 5 km/h, and running at 6 km/h. Throughout the six minutes, variables related to physical activity provided by the device, step volume, and minutes of physical activity were recorded using the specific application of the wristband (Garmin International Inc., Olathe, KS, USA). The intraclass correlation coefficients (ICCs) were high for all six wristbands with each other, for both the number of steps taken (ICC = 0.991–0.998) and the number of minutes of PA (ICC = 0.892–0.977). The critical alpha value of the Cusum test was highest at.050 for all wristband associations. In conclusion, good reliability was found among the six wristbands, which could be adopted for field-based research to quantify physical activities.

Is Ultrasonography a Reliable Approach for the Evaluation of Carpal Tunnel Syndrome in Patients With Mucopolysaccharidosis?

BackgroundOne of the most common causes of carpal tunnel syndrome (CTS) in childhood is mucopolysaccharidosis (MPS). While ultrasonography (US) can aid in the diagnosis of CTS in adult patients, there is limited experience of this in the pediatric group. We aimed to investigate the results of wrist ultrasonography, which may be a candidate alternative to electrophysiological examination. MethodsThe participants were evaluated for symptoms, physical examination findings, electrophysiological tests and grayscale US. CTS was diagnosed in accordance with the American Academy of Orthopedic Surgeons Management of Carpal Tunnel Syndrome: Evidence-Based Clinical Practice Guideline. ResultsIncluded in the study were 27 MPS patients aged 4.5–32 years and 30 healthy control subjects aged 4.3–26 years. Of the 54 wrists in the MPS group, 30 were diagnosed with CTS. The median cross-sectional area (CSA) at the proximal carpal tunnel, the CSA at the forearm, and the wrist-forearm ratio (WFR) were higher in the wrists of the MPS with CTS group than in those without CTS and the healthy control subjects. The WFR cutoff of ≥1.35, 56.6% (95% CI: 437.4–74.5) sensitivity, and 89.8% (95% CI: 81.0–95.5) specificity were consistent with a diagnosis of CTS (receiver operating characteristics analysis, area under the curve = 0.775, 95% CI: 0.673–0.877). ConclusionAlthough the US provides results with unsatisfactory specificity and sensitivity, it is a candidate for further investigation for the diagnosis of CTS because it is an innovative, noninvasive, and more accessible method. WFR value may produce more meaningful results than wrist or forearm nerve area measurements.

An increase in animal-related occupational injuries at a veterinary medical center (2008-2022).

To characterize animal-related injuries in veterinary medical center staff at a veterinary medical center. 706 hospital staff injuries. Deidentified injury reports were submitted to Human Resources from 2008 through 2022. Injury data collected included the injury description, date of injury, occupation, and worker's compensation claim information. Data were summarized by year, cause of injury, total cost associated with injury, and occupation. There was an increase in injuries reported in recent years when compared to past years, with the plurality of injuries being bite injuries, specifically occurring on the hand, finger, and wrist area. Bite injuries had a higher average total worker's compensation cost paid to staff than striking injuries. There were more injuries reported by staff who had less experience working with animals. More injuries occurred during the summer months (June through September). There was not an unusual trend in the reporting of injuries due to COVID-19. Other injuries (eg, needlesticks and falls) were reported from only 2019 to 2022, but constituted a substantial burden for staff. These findings can help stakeholders at teaching hospitals and veterinary clinics to take steps toward creating a safer workplace environment for employees. It is important to identify work hazards and provide proper training and prevention methods to reduce the risk of injuries, especially among less experienced employees. Proper prevention methods will help reduce worker's compensation costs for the teaching hospital and reduce the number of workdays missed by staff.

Application of the Bair Hugger™ core body temperature at wrist region with upper body warming blanket: a prospective observational study.

Body temperature monitoring is essential during the perioperative period. However, core body temperature measurement requires invasive device that may cause complications. This study aimed to evaluate the accuracy of non-invasive Bair Hugger™ core body temperature monitoring system (BHTMS) at the wrist compared with esophageal temperature under general anesthesia. Twenty adult patients of the American Society of Anesthesiologists physical status I or II were enrolled. BHTMS sensor was applied at wrist region. After tracheal intubation, an esophageal probe was inserted. Bair Hugger™ upper body warming blankets were used. Esophageal temperature (Teso) and BHTMS at wrist (Twrist) were recorded every 10 min. Total of 257 pairs of data sets were analyzed: Teso and Twrist had no statistically significant difference (P = 0.103). Median of Teso and Twrist were 36.5°C and 36.4°C. Bland-Altman analysis showed Teso - Twrist of 0.14°C ± 1.44. Subsequently, 99 pairs of 0-40 min data set were analyzed and showed significant difference at 0 and 10 min (P < 0.001) but no significant difference at 20, 30 and 40 min. Bland- Altman plot by times showed difference (Teso - Twrist) of 1.49°C ± 2.00, 0.82°C ± 1.30, 0.29°C ± 1.32, -0.03°C ± 0.84, and -0.12°C ± 0.82 at 0, 10, 20, 30 and 40 min respectively. BHTMS at wrist area under the upper body warming blanket is a potential alternative other than esophageal temperature for monitoring body temperature after 30 min of anesthesia induction.

Long-term functional result of vascularized bone graft for kienbock disease: A case report

Introduction: Kienbock's disease, or lunatomalacia, was a condition of aseptic osteonecrosis of the os lunatum, which can be progressively developed with a state of lunatum collapse, followed by complete os carpal collapse. This disease has been known for a long time, but until now, the exact cause of this disease could not be explained. . Case Presentation: We reported a 32-year-old female patient with pain in the right wrist; the pain was felt for five years before the surgery and is getting worse. On physical examination, Phalen's and Reverse Phalen's tests found pain and limited movement in the right wrist area. A collapse of the os lunatum was found after a radiological examination. The evaluation using the DASH score was an improvement in clinical conditions with the absence of pain on the right wrist after surgery using a vascularized bone graft. The clinical evaluation using Phalen's and Reverse Phalen's tests showed normal flexion and wrist extension results with no movement limitation around 0-90° flexion-extension. The wrist pronation and supination also showed normal results with pronation angles around 0-75° and supination angles around 0-85°. Conclusion: There were clinical, functional, and radiographic improvements in younger female patients with Kienbock's Disease treated with vascularized bone graft surgery six years after surgery.

Wrist Represent a Complex Anatomical System

The hand and wrist represent a complex anatomical system at the end of the upper limb of the human body, consisting of bones, joints, ligaments, tendons and muscles, nerves and blood vessels. This system allows a person to make very complex and precise movements and gives him the ability to use objects and move objects in space. The hand consists of 27 bones (8 bones of the carpus or metacarpus, 5 bones of the metacarpus or wrist and 14 phalanges or joints of the fingers), and in a broader sense we also include 2 bones of the forearm (radius or thumb bone and ulna). The upper arm bone, the humerus, and the forearm bones, the ulna and the radius, are the starting point for numerous muscles that very precisely move the joints and bones of the hand and wrist. Part of the muscle, the so-called short muscles of the hand, start and catch on the bones of the wrist and hand area. The range of motion in the joints, as well as the direction and position of the tendons next to the bones, is determined by the system of numerous ligaments. All these structures are subject to injuries and diseases caused by excessive use and pressure, as well as degenerative diseases. Numerous systemic diseases of an inflammatory nature and metabolic diseases also show their symptoms in the area of the hand and wrist.

Characteristics of Carpal Tunnel Syndrome Sufferers in Tailors at PT. Elite

Carpal Tunnel Syndrome (STK) is a condition of the median nerve in the wrist area compressed by the surrounding structure resulting in a tingling and numbness sensation in the hand. Risk factors such as occupational and non-occupational factors. There are still many cases in Indonesia because many tailors use manual sewing machines. Based on data from Basic Health Research (Riskesdas) in 2018, the prevalence of joint disease in Indonesia is 7.3%, especially in upper limbs as much as 32.7%. To determine the prevalence of STK incidence in employees at PT. Elite and assess the relationship of STK incidence with influencing factors. This research is an analytical research with a cross-sectional research design. Sampling is carried out using a non-random sampling technique of purposive sampling type. Data taken using questionnaires and physical examinations were then processed using SPSS statistical tests. The prevalence of STK incidence in employees of PT. Elite as many as 40 respondents from 107 respondents. Age factors ?40 and &gt;40 years, normal body mass index and obesity II and rheumatoid arthritis p value &lt;0.05. Pregnancy status, diabetes mellitus, length of service and smoking history p value &gt;0.05. There are &lt;50% of STK incidents in PT. Elite employees. There is a significant relationship between the ages of ?40 and &gt;40 years. Normal body mass index and obesity II and rheumatoid arthritis were significantly associated with the incidence of STK. There was no significant relationship between pregnancy status, diabetes mellitus, length of service and smoking history with the incidence of STK in PT Elite

COMPARISON OF THE TRADITIONAL TRAINING METHOD TO TEACH HANDSTAND AND TRAINING THROUGH A RESEARCHER-MADE DEVICE AND THEIR IMPACT ON THE HANDSTAND DURATION, PAIN AND QUALITY OF PERFORMANCE IN 8-10-YEAR-OLD BEGINNER GYMNAST GIRLS

This research was conducted with the aim of comparing traditional handstand training and handstand training using a researcher-made device among beginner gymnast girls aged 8 to 10 years. To achieve this, 30 qualified female gymnasts were purposefully and conveniently selected and randomly assigned to two groups: one receiving educational assistance with the researcher-made device (n=15) and the other using the traditional method (n=15). Over a span of eight weeks, handstand movements were taught, with one group following traditional methods and the other utilizing the researcher-made device. Upon completion of the training period, various measurements were taken, including the duration of balance maintenance, balance quality as judged by experts, the range of motion in the wrist, elbow, shoulder, and ankle joints, and the assessment of pain in the wrist, elbow, shoulder, and lower back areas. Data were analyzed using independent t-tests, MANOVA, and the Mann-Whitney test, with a significance level set at P≥ 0.05, and the analysis was conducted using SPSS 22 software. The results demonstrated that the use of the researcher-made balance training device led to a significant improvement in balance quality from the perspective of judges, as well as a notable reduction in pain in the shoulder, back, and wrist areas compared to the traditional training method. Additionally, there were no significant differences between the traditional method and the use of the device when considering factors such as balance performance quality as measured by deviation from the vertical line in various body joints, the duration of balance maintenance, the range of motion in the wrist, elbow, shoulder, ankle, and pain in the elbow and knee.

Analgesic efficacy of median nerve stimulation in mice with chemotherapy-induced peripheral neuropathymodulation of brain-derived neurotrophic factor expression.

Chemotherapeutic agents such as docetaxel (DTX) can trigger chemotherapy-induced peripheral neuropathy (CIPN), which is characterized by unbearable pain. This study was designed to investigate the analgesic effect and related neuronal mechanism of low-frequency median nerve stimulation (LFMNS) on DTX-induced tactile hypersensitivity in mice. To produce CIPN, DTX was administered intraperitoneally 4 times, once every 2 d, to male ICR mice. LFMNS was performed on the wrist area, and the pain response was measured using von Frey filaments on both hind paws. Western blot and immunofluorescence staining were performed using dorsal root ganglion and spinal cord samples to measure the expression of brain-derived neurotrophic factor (BDNF). Repeated LFMNS significantly attenuated the DTX-induced abnormal sensory response and suppressed the enhanced expression of BDNF in the DRG neurons and spinal dorsal area. LFMNS might be an effective non-pharmaceutical option for treating patients suffering from CIPN regulating the expression of peripheral and central BDNF.

Neurodynamic Techniques in the Treatment of Mild-to-Moderate Carpal Tunnel Syndrome: A Systematic Review and Meta-Analysis.

Carpal tunnel syndrome (CTS) is a condition that affects the main nerves in the wrist area that causes numbness, tingling, and weakness in the hand and arm. CTS affects 5% of the general population and results in pain in the wrist due to repetitive use, most commonly affecting women and office workers. Conservative management of CTS includes neurodynamic modulation to promote median nerve gliding during upper limb movements to maintain normal function. However, evidence for the benefits of neurodynamic modulation found disparities, and hence, the effectiveness of neurodynamic modulation remains unclear. This study aimed to systematically review the current evidence from randomized controlled trials (RCTs) to establish the effectiveness of neurodynamic techniques as a non-surgical treatment option for CTS. Using the PRISMA guidelines, two authors searched four electronic databases, and studies were included if they conformed to pre-established eligibility criteria. Primary outcome measures included outcomes from the Boston carpal tunnel syndrome questionnaire, while secondary outcomes included nerve conduction velocity, pain, and grip strength. Quality assessment was completed using the Cochrane RoB2 form, and a meta-analysis was performed to assess heterogeneity. Twelve RCTs met our inclusion/exclusion criteria with assessments on 1003 participants in the treatment and control arms. High heterogeneity and some risks of bias were observed between studies, but the results of the meta-analysis showed a significant reduction in our primary outcome, the Boston carpal tunnel syndrome questionnaire-symptom severity scale (mean difference = -1.20, 95% CI [-1.72, -0.67], p < 0.00001) and the Boston carpal tunnel syndrome questionnaire-functional severity scale (mean difference = -1.06, 95% CI [-1.53, -0.60], p < 0.00001). Secondary outcomes such as sensory and motor conduction velocity increased significantly, while motor latency was significantly reduced, all positively favoring neurodynamic techniques. Pain was also significantly reduced, but grip strength was not significantly different. Our systematic review demonstrates significant benefits of neurodynamic modulation techniques to treat CTS and specifically that it reduces symptom severity, pain, and motor latency, while at the same time improving nerve conduction velocities. Hence, our study demonstrates a clear benefit of neurodynamic techniques to improve recovery CTS.

Visible-light optical coherence tomography platform for the characterization of the skin barrier.

We demonstrate a free-space, trolley-mountable Fourier domain visible-light optical coherence tomography (OCT) system for studying the stratum corneum in non-palmar human skin. An axial resolution of 1 µm in tissue and at least -75 dB sensitivity have been achieved. High-quality B-scans, containing 1600 A-scans, are acquired at a rate of 39 Hz. Images from the dorsal hand, ventral wrist and ventral forearm areas are obtained, with a clearly resolved stratum corneum layer (typically 5-15 µm thick) presenting as a hypoechogenic dark layer below the bright entrance signal, similar to that found in palmar skin with traditional OCT systems. We find that the appearance of the stratum corneum layer strongly depends on its water content, becoming brighter after occlusive hydration.

Physiotherapy management of Triangular Fibrocartilage Complex : Case Study

Martial arts is a sport that is enjoyed by many people, both men and women. According to the researchers' initial observations, these martial arts groups began to emerge. . Muay Thai is a martial art that uses kicks, punches and slams, and is more dominant in the form of free combat martial arts that first came from Thailand. Observations made by researchers at Medan Muay Thai Gajah Mada found that they experienced shortness of breath and fatigue, 30% had ankle injuries, another 20%. Minor injuries to TFCC can be classified as sprains of the wrist. As the name implies, the soft tissue of the wrist is complex. Disturbance to the area from injury or degeneration can result in more serious impairment of a wrist sprain, such as disability. pain occurs throughout the wrist area. The pain is aggravated by any activity or position that requires rotation of the forearm and movement toward the ulna. These movements are simple activities such as turning a doorknob or a lock. This study used physiotherapy interventions in the form of ice packs to reduce swelling and pain, then exercise therapy to improve wrist stability, ultrasound and also TENS to stimulate the surrounding muscles. Evaluation of the results aims to assess the reduction in swelling and pain and how much the stability of the wrist has increased postoperatively.

Experimental study of the thermal probing depth of a skin calorimeter

In this work we perform an experimental study of the thermal probing depth of a skin calorimeter developed to measure in vivo the heat capacity and the thermal resistance of a 4 cm2 skin region. To determine these properties, a small thermal excitation is applied to the skin and then, the static and dynamic response of the calorimetric signal is studied. This excitation consists of a periodic change of the calorimeter thermostat temperature while the device is applied on the skin. We have found that the thermal penetration depth depends mainly on the period of this periodic thermal excitation. This time dependence is exponential for non-semi-infinite domains. Using a time–variant model, we performed measurements on the dorsal and volar areas of the left wrist of a healthy 64-year-old male subject. For a 4 cm2 region of skin, the results show that the heat capacity in both zones are of the same order of magnitude. Its initial value is 4 J/K and increases exponentially up to 7 J/K with a time constant of 6.5 min. Thermal resistance also increases exponentially with time: from 27 to 36 K/W for the volar zone, and from 32 to 45 K/W for the dorsal zone.

Texture Analysis for the Bone Age Assessment from MRI Images of Adolescent Wrists in Boys.

The use of magnetic resonance images (MRI) to assess the age of the patient would extend diagnostic possibilities. The bone age test could then become a routine screening test. Changing the method of determining the bone age would also prevent the patient from taking a dose of ionizing radiation, making the test less invasive. The regions of interest containing the wrist area and the epiphyses of the radius are marked on the magnetic resonance imaging of the non-dominant hand of boys aged 9 to 17 years. Textural features are computed for these regions, as it is assumed that the texture of the wrist image contains information about bone age. The regression analysis revealed that there is a high correlation between the bone age of a patient and the MRI-derived textural features derived from MRI. For DICOM T1-weighted data, the best scores reached 0.94 R2, 0.46 RMSE, 0.21 MSE, and 0.33 MAE. The experiments performed have shown that using the MRI images gives reliable results in the assessment of bone age while not exposing the patient to ionizing radiation.

Scaphoid fractures in athletes – the importance of a diagnostic process

Introduction and purpose: Scaphoid fractures are the most common fractures in the wrist area, yet they are still a diagnostic problem. This injury is usual among athletes, especially soccer players, basketball players, and cyclists. Early diagnosis allows for making an appropriate therapeutic decision, and thus a more efficient recovery. Imaging methods for a scaphoid fracture include X-ray, computed tomography, magnetic resonance imaging, bone scintigraphy and ultrasonography. This paper discusses and compares available diagnostic strategies and their impact on recovery in athletes. Brief description of the state of knowledge: The article contains the current knowledge about the epidemiology, anatomy, mechanism of injury and complications of scaphoid fractures, as well as illustrates and compares the possibilities in the field of imaging diagnostics of the injury. Conclusion: The commonness and availability of the X-ray image does not translate into a better diagnostic result. The use of computed tomography or magnetic resonance imaging as the first choice gives certain confirmation or exclusion of a scaphoid fracture, and thus accelerates the therapeutic process and return to sport

Simultaneous Limited Incision Carpal Tunnel Release and Flexor Digitorum Superficialis Opponensplasty Using a Transverse Carpal Ligament Pulley: Surgical Technique and Case Series.

Severe thenar muscle atrophy resulting in dysfunctional thumb abduction and opposition is a well-documented finding associated with long-standing severe carpal tunnel syndrome. This problem has been addressed in the past through various opposition tendon transfers. Historically, the Camitz procedure, or its modifications using the palmaris longus tendon, were recommended. However, this procedure requires a long incision in the palm, extensive dissection including the wrist area, and may not produce active thumb pronation. Our surgical technique describes an open limited palmar-only carpal tunnel release with ring finger flexor digitorum superficialis opponensplasty using a slit through the released transverse carpal ligament as a pulley and dual insertion of the tendon in both the extensor hood and the tendon of the abductor pollicis brevis. The Kapandji evaluation of thumb opposition was used to determine the outcome after surgery.