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Dislocation of the shoulder and instability of the glenohumeral joint Three broad groups of shoulder instability exist. Dislocation of the shoulder and instability of the glenohumeral joint Three broad groups of shoulder instability exist.

Dupuytren’s contracture Dupuytren’s contracture is most often characterised as an autosomal dominant condition, common in northern Europe, predominantly in men in the fifth to seventh decades of life. Four out of seven cases occur in those with a family histo...

FURTHER READING Burden EG, Batten TJ, Smith CD et al . Reverse shoulder arthroplasty: a systematic review and meta analysis of complications and patient outcomes dependent on prosthesis design. Bone Joint J 103-B (5): 813–21. Carr AJ, Cooper CD, Campbell AK e...

Ganglion cysts Ganglion cysts are the commonest cause of a swelling in the hand and they are found most often on the dorsal ( Figure 38.58 ) and volar ( Figure 38.59 ) surfaces of the wrist, over the dorsum of the DIP joint (digital mucous cyst) or within t...

HAND AND WRIST The hand and wrist work in concert to interact with the environment in which they are placed. The index finger works against the thumb for pinch grip; the thumb can press against the side of the flexed index finger for a key-pinch grip; the tips o...

Infections Paronychia Nail bed infection is the most common hand infection ( Figure 38.45 ). After initial inflammation, pus accumulates beside and sometimes under the nail. It is best treated with incision, drainage and appropriate antibiotic therapy . This i...

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Investigations Radiographs can be used to assess for arthritis or bone tumours. Electrophysiological studies may be required to evaluate nerve function, assessing both sensory and motor supply . Ultrasound is a very useful investigation as it can assess soft t...

Learning objectives To understand: Anatomy and physiology relevant to upper limb • pathology Learning objectives To understand: Anatomy and physiology relevant to upper limb • pathology Learning objectives To understand: Anatomy and physiology relevant to uppe...

Long head of biceps tendon rupture Rupture of the long head of biceps usually occurs in older adults and is due to constriction and degeneration of the tendon in the bicipital groove, especially at the superior end, beneath the anterior acromion. It is asso...

Loose bodies in the elbow The common causes are osteoarthritis, osteochondritis disse - cans in the young ( Figure 38.33 ) and synovial chondromatosis ( Figure 38.34 ). Patients describe sudden pain and locking, and the need to manipulate the elbow for relief....

Olecranon bursitis This is a relatively common disorder in which the point of the elbow becomes red, warm, swollen and painful. Initially , septic arthritis may be suspected. However, on examination signs and symptoms are confined to the extensor aspect of th...

SHOULDER GIRDLE Anatomy and function The shoulder girdle (clavicle, scapula and the humerus, which articulates directly with the scapula at the glenohumeral joint) is controlled and supported by muscles crossing between the spine, thorax, scapula and humerus. ...

TUMOURS OF THE UPPER LIMB Tumours are discussed in Chapter 42 . TUMOURS OF THE UPPER LIMB Tumours are discussed in Chapter 42 . TUMOURS OF THE UPPER LIMB Tumours are discussed in Chapter 42 .

Tendon disorders Trigger digit Triggering occurs in the fingers or in the thumb as a result of a size mismatch between the flexor tendon and the sheath (usually at the A1 pulley) in which it glides. The patient complains of painful locking or snapping of the fi...

Tennis elbow (lateral epicondylitis) and golfer’s elbow (medial epicondylitis) These are discussed in Chapters 35 and 36 .

Tennis elbow (lateral epicondylitis) and golfer’s elbow (medial epicondylitis) These are discussed in Chapters 35 and 36 .

Tennis elbow (lateral epicondylitis) and golfer’s elbow (medial epicondylitis) These are discussed in Chapters 35 and 36 .