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Trapeziometacarpal osteoarthritis (TMC OA) is, also known as osteoarthritis at the base of the thumb, thumb carpometacarpal osteoarthritis, basilar (or basal) joint arthritis, or as rhizarthrosis. [ 3 ] [ 1 ] [ 2 ] This joint is formed by the trapezium bone of the wrist and the metacarpal bone of the thumb.
Symptoms are pain and tenderness at the radial side of the wrist, fullness or thickening over the thumb side of the wrist, painful radial abduction of the thumb, and difficulty gripping with the affected side of the hand. [2] Pain is made worse by movement of the thumb and wrist, and may radiate to the thumb or the forearm. [2]
Osteoarthritis commonly affects three main sites in the hand: the base of the thumb, where the thumb and wrist converge, known as the carpometacarpal (CMC) joint; the joint closest to the fingertip, referring to the distal interphalangeal joint (DIP); the middle joint of a finger, referring to the proximal interphalangeal joint (PIP). [5]
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The metacarpophalangeal joints (MCP) are situated between the metacarpal bones and the proximal phalanges of the fingers. [1] These joints are of the condyloid kind, formed by the reception of the rounded heads of the metacarpal bones into shallow cavities on the proximal ends of the proximal phalanges. [1]
In situations when only thumb mobility is desired, the extensor indicis proprius is an ideal transfer. [ citation needed ] For high median nerve palsy, the brachioradialis or the extensor carpi radialis longus transfer is more appropriate to restore lost thumb flexion and side-to-side transfer of the flexor digitorum profundus of the index ...
Swan neck deformity has many of possible causes arising from the DIP, PIP, or even the MCP joints. In all cases, there is a stretching of the volar plate at the PIP joint to allow hyperextension, plus some damage to the attachment of the extensor tendon to the base of the distal phalanx that produces a hyperflexed mallet finger.
The Hoffmann's reflex test itself involves loosely holding the middle finger and flicking the fingernail downward, allowing the middle finger to flick upward reflexively. A positive response is seen when there is flexion and adduction of the thumb on the same hand. [4] Eg. in hypertonia, the tips of other fingers flex and the thumb flexes and ...