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The ulna and radius are parallel bones of the antebrachium or the forearm. The ulna lies medially and consists of a bony tip called the olecranon process at its proximal end. This hook-like projection articulates with the olecranon fossa of the humerus and forms the "hinged" ulnohumeral part of the elbow joint. This joint facilitates forearm extension and flexion while preventing its hyperextension. Similarly, the coronoid process, another bony projection on the proximal/anterior side...
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The radius is longer of the two bones that make up the human antebrachium or forearm. At the proximal end, the radius articulates with the capitulum of the humerus and the radial notch of the ulna to form the elbow joint. At the distal end, the radius articulates with the ulna via the ulnar notch, forming the distal radioulnar joint. Distally, the radius also attaches to the carpal wrist bones (scaphoid and lunate) to form the radiocarpal joint.
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The muscles that move the forearms can be divided into four groups: forearm flexors, forearm extensors, forearm pronators, and forearm supinators. The flexors and extensors act on the elbow joint, while the pronators and supinators act on the radioulnar joints.
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Metacarpal Small Incision for Carpal Tunnel Syndrome
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Demystifying Palmar Midcarpal Instability.

Shan Shan Jing1, Gemma Smith1, Subodh Deshmukh1

  • 1Royal Orthopaedic Hospital, The Woodlands, Bristol Road South, Birmingham, United Kingdom.

Journal of Wrist Surgery
|April 5, 2021
PubMed
Summary
This summary is machine-generated.

Palmar midcarpal instability, a wrist condition causing a painful clunk, often stems from congenital ligament laxity. Management involves conservative treatments like proprioceptive training, with surgery considered if conservative methods fail.

Keywords:
arthrodesischronichypermobilityinstabilitymidcarpalproprioception

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Hand and Wrist Anatomy

Background:

  • Palmar midcarpal instability is an uncommon wrist condition characterized by a painful clunk during terminal ulnar deviation.
  • Congenital laxity of carpal ligaments is a suspected primary contributor to this instability.
  • Current understanding and management are hampered by a lack of high-level evidence and consensus.

Purpose of the Study:

  • To review existing evidence on palmar midcarpal instability.
  • To conceptualize the underlying mechanisms of this infrequent condition.
  • To propose a management algorithm for palmar midcarpal instability.

Main Methods:

  • Literature review of current evidence on palmar midcarpal instability.
  • Analysis of clinical diagnostic criteria and proposed etiologies.
  • Synthesis of treatment strategies, including conservative and surgical options.

Main Results:

  • Palmar midcarpal instability diagnosis relies on clinical findings, notably a pathognomonic clunk.
  • Conservative treatment focuses on proprioceptive training, utilizing sensorimotor wrist function concepts.
  • Surgical intervention is reserved for cases unresponsive to conservative management.

Conclusions:

  • Palmar midcarpal instability remains a poorly understood condition despite clinical recognition.
  • A structured approach integrating conservative measures and timely surgical consideration is recommended.
  • Further research is needed to establish evidence-based guidelines for diagnosis and treatment.