Background: Rheumatoid arthritis (RA) is a chronic inflammatory that primarily affects the joints of hands, wrists, and feet. Anatomical damage (at bone, cartilage tendon level) occurs as consequence persistent synovial inflammation (1). In RA, periarticular soft tissues, including nerves, may also be involved. particular, there high prevalence neuropathic conditions such carpal tunnel syndrome...

Introduction The wrist, thenar, palmar, and digital flexion creases represent skin flexion lines in the vicinity of synovial joints, where the skin is attached to the underlying fascia [1]. Digital creases ease movement of the digits without impingement by providing “folding points” in the skin analogous to the creases in a folded roadmap, and due to strong attachments to the underlying fascia,...

BACKGROUND Dupuytren's disease is a fibro-proliferative disorder affecting ~3-5% of the UK population. Current surgical treatments for Dupuytren's contracture (DC) include fasciectomy and fasciotomy. We assessed the clinical management of DC in England over a 5-year period; associated NHS costs were assessed for a 1-year period. METHODS Hospital Episode Statistics were extracted from April 20...

Transthecal digital nerve block is performed by a palmar percutaneous injection of local anaesthetic into the flexor tendon sheath. Total analgesia of the digit is achieved rapidly. This technique was carried out on 46 patients in the accident and emergency department. Successful anaesthesia was obtained in 45 patients. There were no complications.

Dear Editor, A 45-year-old renal transplant recipient presented with a 2-week history of progressive painful mid-palmar swelling in his right hand and intermittent low-grade pyrexia. There was no history of trauma. He had been on transplant-related immunosuppression (cyclosporin and prednisolone) for 10 years, and had a significant past history of pulmonary tuberculosis treated 20 years ago wit...

BACKGROUND First suggested by Brent in 1979, the pocket principle is an alternative method for patients for whom a microsurgical replantation is not feasible. We report the successful results of a modified palmar pocket method in adults. METHODS Between 2004 and 2008, we treated 10 patients by nonmicrosurgical replantation using palmar pocketing. All patients were adults who sustained a compl...