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The tendon is finally inserted on the base of the distal phalanx of the thumb. [ 1 ] 6.7 to 9.7 centimetres (2.6 to 3.8 in) in length, the tendon passes through a long and superficial synovial sheath which, passing obliquely from the radial border of the forearm into the thumb, extends from the proximal border of the extensor retinaculum to the ...
In human anatomy, the annular ligaments of the fingers, often referred to as A pulleys, are the annular part of the fibrous sheathes of the fingers.Four or five such annular pulleys, together with three cruciate pulleys, form a fibro-osseous tunnel on the palmar aspect of the hand through which passes the deep and superficial flexor tendons.
The ring finger and thumb are most commonly affected. [1] The problem is generally idiopathic (no known cause). People with diabetes might be relatively prone to trigger finger. [3] The pathophysiology is enlargement of the flexor tendon and the A1 pulley of the tendon sheath.
Passing through the first tendon compartment together with the abductor pollicis longus, it is attached to the base of the proximal phalanx of the thumb. It extends the thumb and, because of its close relationship to the long abductor, also abducts the thumb. It is innervated by the deep branch of the radial nerve (C8-T1). [4]
The palmar plate moves in three phases during joint flexion. First, it slides back toward the hand. Next, it is lifted away from the proximal phalanx by the A3 pulley. Last, a lip on the middle phalanx rolls into a recess on the plate. If the A3 pulley is not intact, the normal three phases of motion do not occur and instead the plate crumples. [7]
Before the needle insertion the thumb is placed in extension, whereas when the needle is already inserted the thumb will be put into semi-flexion, so that the needle can be moved and the palmar skin is movable. The A1 pulley will then be cut with the needle longitudinally and parallel to the fibers of the tendon of the flexor pollicis longus ...
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The radial nerve innervates the finger extensors and the thumb abductor; that is, the muscles that extend at the wrist and metacarpophalangeal joints (knuckles) and abduct and extend the thumb. The median nerve innervates the flexors of the wrist and digits, the abductors and opponens of the thumb, the first and second lumbricals. The ulnar ...