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The TMC joint is a synovial joint between the trapezium bone of the wrist and the metacarpal bone at the base of the thumb. This joint is a so-called saddle joint (articulatio sellaris), unlike the CMC joints of the other four fingers which are ellipsoid joints. [17] This means that the surfaces of the TMC joint are both concave and convex.
Most gamekeeper's thumb partial injuries are treated by simply immobilizing the joint in a thumb spica splint or a modified wrist splint and allowing the ligament to heal. However, near total or total tears of the UCL may require surgery to achieve a satisfactory repair, especially if accompanied by a Stener lesion. [6]
The mainstay of symptom alleviation (palliative treatment) is a splint that immobilizes the wrist and the thumb to the interphalangeal joint. Activities are more comfortable with such a splint in place. Anti-inflammatory medication or acetaminophen may also alleviate symptoms. [24]
Prolotherapy involves the injection of an irritant solution into a joint space, [22] weakened ligament, or tendon insertion to relieve pain. [ 7 ] Most commonly, hyperosmolar dextrose (a sugar) is the solution used; [ 23 ] glycerine , [ 20 ] lidocaine (a commonly used local anesthetic ), [ 24 ] phenol , [ 20 ] and sodium morrhuate (a derivative ...
Steroid injection is not effective in people with Type 1 diabetes. [12] If triggering persists 2 months after injection, a second injection can be considered. Most specialists recommend no more than 3 injections because corticosteroids can weaken the tendon and there is a possibility of tendon rupture.
Infectious tenosynovitis in 2.5% to 9.4% of all hand infections. Kanavel's cardinal signs are used to diagnose infectious tenosynovitis. They are: tenderness to touch along the flexor aspect of the finger, fusiform enlargement of the affected finger, the finger being held in slight flexion at rest, and severe pain with passive extension.
The needle size, length and type should be selected based on the site, depth and patient's body habitus. 22–24G needles are sufficed for most injections. [1] As an example, ultrasound-guided hip joint injection [16] can be considered when symptoms persist despite initial treatment options such as activity modification, analgesia and physical ...
Symptoms of Bennett fracture are instability of the CMC joint of the thumb, accompanied by pain and weakness of the pinch grasp. Characteristic signs include pain, swelling, and ecchymosis around the base of the thumb and thenar eminence, and especially over the CMC joint of the thumb. Physical examination demonstrates instability of the CMC ...
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