![]() ![]() Thorough inspection within anatomic areas or generous release of the muscular origin along the metacarpal at the time of fasciotomy is suggested to ensure complete inspection. Subcompartmentalization of the enclosed myofascial spaces of the hand should be anticipated in cases requiring fasciotomy. The dorsal and palmar interosseous muscles were discrete compartments within the second interosseous compartment in 48% of the hands, within the third interosseous compartment in 67%, and within the fourth interosseous compartment in 33%. The interosseous compartments demonstrated significant variability. The adductor pollicis and first dorsal interosseous muscles were discrete compartments in 71% of the hands. In 76% of the specimens, the hypothenar space demonstrated at least 2 compartments. The results showed the thenar space to comprise 2 or more discrete compartments in 52% of the hands. Data were collected from the prepared cross-sections of each specimen. Intrinsic muscles ( mnemonic) whose muscle bellies are located within the handįascial layers subdivide the underlying musculature into functional compartments clinical relevance becomes manifest with pathologic increases in pressure resulting in ischemia and/or necrosis to the structures within the myofascial confines such as muscle and peripheral nerves.To determine the nature and number of enclosed myofascial spaces in the hand, an anatomic study that included 21 cadaver hands was conducted using a gelatin injection method. The inadequate tissue perfusion then leads to inadequate tissue oxygenation to the nerves as well as muscles. This happens when pressure is elevated over a certain level for some time sufficient to reduce capillary perfusion. MusclesĮxtrinsic muscles whose tendons arise from muscle bellies within the forearm, and Compartment syndrome is a condition in which increased tissue pressure within a limited space compromises the circulation and function of the contents of that space. Hand movement is complex and occurs across many joints, including those involved in wrist flexion. Dynamic scanning of the extensor tendons can be performed by placing the hand on a gel tube with the fingers. It is often easier to use radial and ulnar to refer to the lateral and medial aspects of structures in the hand, as these may be more intuitive without having to remember the anatomical position. This positions the thumb at the lateral aspect of the hand and the little finger at the medial aspect of the hand. In the standard anatomical position, the hand is flat and supinated with the fingers spread. This is shown in the illustration of a child with ischemic contraction of the forearm. Untreated compartment syndrome results in ischemic necrosis, with loss of nerve and muscle function, as well as joint contracture. ![]() From the radial to the ulnar aspect of the hand, they are named as follows: Compartment syndrome may also occur in the thigh, foot and hand. It can therefore confusing to refer to the fingers by number - is the "first finger" the thumb or the first of the four other digits? For this reason it is advisable to refer to the digits by names given to them rather than by number. Diagnosis is made clinically with pain over the dorsoradial forearm (5 cm from wrist joint) made worse with resisted wrist extension and thumb extension. See these articles for radiographic positioning:Īs the thumb is structurally different to the other digits of the hand, with different movements and musculature, there is debate as to whether the thumb is considered a finger 2. Intersection syndrome is an inflammatory condition that occurs at the crossing point of the 1st dorsal compartment (APL and EPB ) and the 2nd dorsal compartment (ECRL, ECRB).
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