ABPS Surgery of the Hand key terms

Congenital failure of the fingers to separate, producing webbing between adjacent digits. It may be simple or complex, complete or incomplete, and treatment is surgical release with skin grafting, usually before school age.

Presence of extra digits, most commonly on the thumb side of the hand. Preaxial duplication may range from a small bump to a fully formed extra thumb and often requires reconstruction of ligaments and tendons.

Underdevelopment or absence of structures on the radial side of the forearm and hand, ranging from a small thumb to complete absence of the radius. The wrist deviates radially, and treatment balances growth, function, and appearance.

A fixed flexion posture of the thumb interphalangeal joint in young children, caused by a nodule in the flexor pollicis longus tendon sheath. Many resolve spontaneously; persistent cases are treated by tendon sheath release.

A grading system for thumb hypoplasia, from a slightly small thumb with all elements present to complete absence of the thumb. Higher grades guide whether the thumb is reconstructed or amputated and replaced.

A break in the carpal scaphoid, usually from a fall on an outstretched hand. Because blood supply enters distally, proximal pole fractures risk avascular necrosis and nonunion, so immobilization and careful follow-up matter.

An intra-articular fracture of the base of the first metacarpal with a small volar fragment that stays attached to the trapezium. The shaft subluxates radially, and treatment requires anatomic reduction and stable fixation.

A sprain or avulsion of the palmar ligament at the proximal interphalangeal joint, typically from hyperextension. It may cause joint instability or a flexion contracture, and treatment ranges from splinting to surgical repair.

An injury to the ulnar collateral ligament of the thumb metacarpophalangeal joint, usually from forced radial deviation. Complete tears with a displaced ligament (Stener lesion) need surgical repair to restore pinch strength.

A high-energy carpal injury in which the lunate stays in its normal position while the rest of the carpus dislocates dorsally. It often accompanies scaphoid fracture and requires urgent reduction and stabilization.

Compression of the median nerve beneath the transverse carpal ligament, causing numbness and tingling in the thumb through ring fingers, night symptoms, and thenar weakness. Diagnosis is clinical with nerve studies; treatment ranges from splinting to release.

Compression or traction of the ulnar nerve at the elbow, producing numbness in the small and ring fingers, intrinsic weakness, and sometimes clawing. Treatment includes activity change, splinting, and surgical decompression or transposition.

A disorganized growth of nerve fibers at the end of a cut nerve, often painful and tender. It may be treated by excision and repair, burial of the nerve end, or other techniques to reduce painful signaling.

A three-tier system describing nerve injury severity: neuropraxia (conduction block with recovery), axonotmesis (axon damage with intact sheath), and neurotmesis (complete nerve disruption). It helps predict spontaneous recovery.

Tingling or electric sensation produced by tapping over a nerve, indicating regenerating or irritated nerve fibers. It is used to follow nerve recovery, locate compression, and evaluate neuromas.

Numbered regions from the fingertip to the wrist that describe where a flexor tendon is injured. The zone determines prognosis and repair technique because of differences in pulley anatomy and blood supply.

A system for flexor digitorum profundus avulsion injuries (jersey finger) based on how far the tendon retracts and whether a bony fragment remains in the joint. It guides timing and method of repair.

Loss of active extension at the distal interphalangeal joint after disruption of the terminal extensor tendon, often with a bony avulsion. Most cases are treated with continuous splinting of the joint.

A strong annular flexor tendon pulley at the proximal phalanx that prevents bowstringing. Its integrity is critical for finger flexion strength, and injuries may require reconstruction with tendon graft.

Arthritis of the trapeziometacarpal joint that causes thumb base pain, weakness, and deformity. Treatment begins with splinting and injections and progresses to trapeziectomy or fusion in advanced cases.

Removal of the trapezium combined with ligament reconstruction and tendon interposition to treat thumb basal joint arthritis. The procedure creates a stable, pain-free thumb while sacrificing some height and strength.

Scapholunate advanced collapse, a predictable pattern of wrist arthritis after scapholunate ligament injury, progressing from the radial styloid to the scaphoid fossa and then the capitate. It guides reconstruction or salvage procedures.

A common fluid-filled swelling arising from a joint capsule or tendon sheath, most often on the wrist. It may resolve spontaneously; treatment includes aspiration or excision when painful or limiting.

A benign cartilage tumor arising inside bone, most commonly in the phalanges of the hand. It often presents after a pathologic fracture and is treated with curettage and bone grafting.

A benign but locally recurrent solid tumor of the tendon sheath, common on the fingers. It is treated by careful surgical excision, and recurrence is reduced by removing satellite nodules.

A small, painful benign tumor of the glomus body, often under the nail, causing cold sensitivity and pinpoint tenderness. Excision is curative when the lesion is identified.

Four clinical findings of flexor tenosynovitis: finger held in slight flexion, symmetric swelling, tenderness along the flexor sheath, and pain with passive extension. They guide urgent surgical drainage.

An infection of the skin around the nail, usually from bacteria entering a small break. It causes redness, swelling, and pain and is treated with warm soaks, antibiotics, and drainage of an abscess.

A rapidly spreading bacterial infection of deep fascia that causes tissue death and systemic illness. It requires urgent surgical debridement and broad-spectrum antibiotics, and delay increases mortality.

Avascular necrosis of the lunate bone causing wrist pain and stiffness in young adults. Treatment aims to restore blood flow or unload the lunate and ranges from immobilization to vascularized bone grafting or salvage procedures.

Ulnar artery injury from repeated blunt trauma to the palm, producing thrombosis, aneurysm, or distal emboli and finger ischemia. Treatment includes stopping the trauma and sometimes arterial repair or sympathectomy.

Microsurgical reattachment of a completely amputated part, restoring bone, vessels, nerves, and soft tissue. Indications depend on the part, the patient, and the injury, and outcomes require rigorous rehabilitation.

Episodic vasospasm of digital arteries triggered by cold or stress, producing color changes and discomfort. Primary cases are managed with warmth and sometimes medications, while secondary cases require evaluation for systemic disease.

A benign fibroproliferative disorder of the palmar fascia that produces nodules and cords, leading to finger contracture. Treatment options include observation, collagenase injection, needle fasciotomy, and surgical fasciectomy.

Enzymatic treatment that dissolves collagen in Dupuytren cords, followed by manipulation to rupture the cord and straighten the finger. It is less invasive than surgery but recurrence is common.

A percutaneous procedure that uses a needle to divide Dupuytren cords and improve finger extension. Recovery is quick, but recurrence rates are higher than with surgical fasciectomy.

A surgical technique that transposes two triangular flaps to lengthen a scar or release a contracture along its line of tension. It is commonly used in burn and Dupuytren scar revisions.