Hand pain and impairment

260 Pages·1988·11.535 MB·English

by  Rene Cailliet

_ EDITION 3
PAIN
and Impairment
CAILLIET. M.D. Fran SERIES
L" i”J AWS
HAND PAIN
and Impairment

EDITION 3
HAND PAIN
and Impairment
js Proper: ant ; il
f Whitak ery
Cr Librea ry i|
RENE CAILLIET, M.D.
Professor and Chairman
Department of Rehabilitative Medicine
University of Southern California
School of Medicine ,
Los Angeles, California
Illustrations by R. Caillet, M.J .
9 F. A. DAVIS COMPANY e Philadelphia
90504
Also by Rene Cailliet:
LOW BACK PAIN SYNDROME
SHOULDER PAIN
NECK AND ARM PAIN
FOOT AND ANKLE PAIN
KNEE PAIN AND DISABILITY
SOFT TISSUE PAIN DISABILITY
Copyright ©1982 by F.A. Davis Company
Rifth printing 1988
Copyright 1971 and 1975 by F A, Davis Company All rights reserved,
This book is protected by copyright. No part of it may be reproduced,
stored in a retrieval system, or transmitted in any form or by any means,
electronic, mechanical, photocopying, recording, or otherwise, without
written permission from the publisher.
Printed in the United States of America
Library of Congress Cataloging in Publication Data
Cailliet, René Ss >
<reh,
Hand pain toa impairment. ~~
Rev. ed. of: Hand pain and impairmenetend ed, 1975.
Includes bibliographies and index.
1, Hand—Diseases, 2. Pain, I. Title, [DNLM: 1. Hand.
2. Pain—Therapy. WE 830 C1S$4h]
RC851.C24 1982 617’. S75 82-2585
ISBN 0-80S6-1618-X AACR
PREFACE
Early evaluation and adequate treatment are necessary to the future
normal functioning of the impaired hand. Too often, however, early evalu-
ation and treatment are mismanaged because of the anatomic intricacy
involved. Adequately informed, the primary physician—who may be a
family physician, physiatrist, or internist—can reduce or avoid the need
for reconstructive surgery, or at least allow the patient to face surgery with
a salvageable hand.
This book provides the nonspecialist with information to better evaluate
the impaired hand and initiate proper treatment. Therefore, the text is not
exhaustive, and the presentation of the functional anatomy of the hand
remains simplified. Although a simple explanation of a complex subject is
possible, an easy understanding is not; it is hoped that this book will facili-
tate that understanding.
RENE CAILLIET, M.D.
CONTENTS
PAGE
Chapter 1. Functional Anatomy............eccseeceseeecenees 1
AT AtOMAY os 1. qaeeess ite .WSiiaiee? Sahl. aaiaaels em ela es eee 1
WISE teas seutigs whew dglsenetat ae. ddictalavad. setobeee 3K 1
CarpaliBonesiitasiads wats dned {2 ee RAS ap OR WOE poe
Garpal Arch); o4.55 fone ole daaske oot aine eo Re 10
Carpometacarpal Articulations ...............-0.00000- 14
Metacarpophalangeal Articulations...................4. 15
InterphalangealsJoints2 iii 3e-ecleiaulks Beapn ena.s e 19
Musculdr ‘Control: gjhinccda te hc hala peda wr a ne Reo 19
Extrinisie:Muscléss auiidsninonm priboaiiaiurries eee 19
Intrinsic: Muscles»: 3.30: Whine a ee ees Pe 33
Relerencorty: Soca Sih ss o's <n k cde oe-wtmoas ena ee 49
BIDMOCTADAY =< vee <5.v tus lck Cae facie gig Meee tee 49
Chapter 2. Nerve Control of the Hand ..............seeeceeees 50
INGRVE SeVETANCE.. fo.o at nd itnn, sr ee w eto are aie eee eee ee 50
MediamNerverss ois: Jin cecs as eh ete gn nee eee 58
Ulnar Nerves, 5 ic exe ahs os se cee a ee ee ee 71
RadialiNervége oic citiicy stent op tecgthaee Shoe eon was Berea we
Nerve Severance — A Summary... ..0....5.06.5.e"bess 80
RE AUIMODU ienaaiccins sso epee een ern ore eri tala ie Seer ne ge 85
Nerve Conipression’.; c+ sh an came wien wees eee ee 86
Mediati: Nervi. ..053 decalege ueuw neis ceea ne ee 86
UbiariNerveniigs a suk gianictanc$ mde Ae Ree te 93
Blood Supply seu: 2. Siseid Poke PO Ae Poa 98
Shiites 2535 Bagns. dese vaca sidi gee ete aes ee 99
References 49... + 6. S34 GaNs «5c ee ae ae 100
Bibliography. o <0. 02526. .ckabues i. Re eee 100
Chapter 3. Reflex Sympathetic Dystrophy ...............000005
CCAMISAL CTO mre en eA ee ee EES ee
PEECQUTILEREL fete wre re ee een ir itt alt eraeants LACERERRE Be oe5 0
Shoulder-Hand-Finger Syndrome ...............000eeegeees
RICALMELC Ne teen ee ee ae ee eee ne SEE ae ek
Relerencesse mice tere oe Raman n tie Slate OER
Chapter 4. Tendons: Injuries and Diseases ...............000005
HONUGHUSCVCEARCE A830, Ph attach Mets eh ee ee wc ale
POXCCSOT PLCRGONS. eee OEE NIN OPE ET eT ee Be
PIEKOTs TENCONS I ARs he ES Cee eee
Mer ClOn FU LUr tare emer acre iste, ene oar ONS
Extensor Tendon Rupture at Middle Phalanx ............
Extensor Pollicis Longus Rupture...................0.-
Rupture of Flexor Tendons............c.e.e .ce.ec ccue s
MEMIOU I ISCASES et ee NEG ee ee Oe et eee
PEDOSVTIOVIUIS re i Mee ere oe a ts Pee eee ae
de-Ouervain’s Diseases res ce Uae oes oe eee ea
Trigger numb ney ec mm nes rie ER na a 2
METIS QO EPA NCCLS.©, ote htica clots ait sata ee opere eet ee ee ele bs
Dupuytrens Contracture we. selves ieee oe tee eS 6 wma
ROLELOHOES teeta fa ita ahetetele so Gans Oe BIE eT bie aa Nae Been BG
BiO bCra y TRE etal, State Natcbs halle oe ee eet ee ne Bra ra
Chapter 5. Fractures and Dislocations of the Finger and Hand ... 128
Priniciples Of eAtIent ih tottke test viele bee ea ee ee
SDECHIC DILES’ OF ANIUTY losis idctatate coe att erete ets ara ee ae See tee
SPC EAIPI NIA TAAL ANIN Gogo fig am We ie Rs bari ed OS eee
iii VEGP alv eg dO ETc), Ga©rg arth utPe ning reata real Pa Pe
Metacaipale) pepe ie ns ean ee seater ee tees
ALES SCs Pate EM ITN tet, Mahal at eo etc Lee ee
Base of the Fifth Metacarpal.. o.0..00e0c.. e V.ee0 b0e e
WrIStY, aint PP PtP P Pgh ate gar nr ane te tt tolerate h ONE
LIE ATIT Son athe Ot Air ae ee Bech Ria te A MPR croydon taa t
Chapter 6. Joints: Injuries and Diseases ............cceeeeeeees
2)0 2 DB tance nae ehs eller Sees bagi e,r icer ert ace tile eri tee a oa ua tea
BVNCUIITATOIG SATUITIELS Sihotet sot helt ate ate ahs tatale ee stats oa Oe eos
TORyO OVSAL E eute t miele oP teca e etc lub esrent etat aler ate Mere ygo on d 8)o k
The Muscles of the Hands 2.0.0... 6.00 ee ea eens
“FU aD 0018 d atgh rees eS arothe Parrett ees at oro Or eec oye es ear Cora ar a ne
vii
Ulnar Shift cf <2 eco catptpes tee ee ae ies 155
Proximal Interphalangeal Joints .........s.ee.s .eu.ee e 163
Thum b JOM: osc ate as eee ea ote he saree eae ac 168
Intrinsi@ Muscles: 5... </+:i-+ incurs pens ciel. pal eacde 168
Evaluation of Functional Impairment .................. 168
Osteoarthritis. iss ietow ben oye hs ee ee eee ae Pp eee 173
CAUSES arcs 0 cs Mice DU ier ae ee dee ase oo ala rine ae ee 173
Classification. . os .chs.9 6 tere are yore ee tara teen eee ane ae 174
Signs and Syim PtOW Gag amstts fen Glied enon > 7 ous 174
[neidenee (05.3 scsi aie who ees ev Ae ear eee eg Ree 174
WWEQUHIONE snes ais tenis igen J nena kee Sareea NT eee eee 175
REPEPENCO S ss siden cbs cg cee giles ewe eaea 178
Bi DEGTO AB I Yer wk alee ccm wed Reopen ln i ee al 178
Chapter 7. The Spastic Hand ..............0000. eree 180
Upper Motor. Neuron Disease. ....ccwvcglcS pS,c peneptiersifee t2 6s 180
Treatinentand Recovery 1700. hes ccm tne cade pre ee, 184
SPONtANCOUS RECOVERY) isis. isc} ese «1 wba seersso a 184
Exercise TFR CTADY a... 0s. ones cee te ante edie ae ee 184
IMIECICAUION nian Oats ruc veces hares cornu eterna ee cara eeee ema 186
NIGER OS ie. Coteus es deers: ae Cease eae om ma 186
Surgical and Chemifeal’ Techniques ................0+.... 186
Preventiiig COMUrACtule. 0.525 + ar ss ea 90 peace 189
PAI PIEVENUOIN ac .2o steo < cic ve ne sone wees ve one 190
Shoulder-Hand-Finger Syndrome ..................005. 190
SUUMUALY eerste cal’ as sccatiSueaesn accongt ternethe: eaha a 194
WRCLELCTIGES rcs sentra’: Gand ar ev)o c ee ee ee ee 194
BiDNOSTADD Y) .2 ts crince coco aie Cot esce agente ao,e ee ae 195
Chapter§ .- Hand Burns... ioc. ¢ ayscce bs bemarabae aidart xe« <5 197
Second- And Third-Degree Burns ..............000eeeeeeeee 197
SERCO ELMOINE agate cet urne caAras cca ete o dea vant aie Bie ete ag 197
Meute Phase 02S. 5 tenet ie ae ie ea eee. 198
DUD ACULCG E HASE: sar conte uray Sem Saat eects ee aa 201
Helervencesic st ask 5c var a arne cons Pen enn ae ee 204
BiblOgrapa y tie x ce tere eee ae eee eae 204
Chapter 9. Infections and Vascular Impairment of the Hand ..... 205
TIPECUONS Fy, pics. s v.55 cM aie oe Rn a 205
|S (0) POEM annem e = ancdemrsse greasy pte Sa Pay 205
PAaTOMmyOnia fi. ly «nek She we har ee re 206
Fascia’and “Tendon Sheaths*.. 54.00.ke0 e0e)e 206
Principles of Tréatiment 4%. o.oo ae 208
Vascular Impairment... 20 weaee tee et ee 209