THE ANATOMY of the canine elbow has been fully

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "THE ANATOMY of the canine elbow has been fully"

Transcription

1 Veterinary Surgery 38: , 2009 INVITED REVIEW A Clinically Oriented Comprehensive Pictorial Review of Canine Elbow Anatomy GHEORGHE M. CONSTANTINESCU, DVM, PhD, mult Dr h c and ILEANA A. CONSTANTINESCU, DVM, MS The clinically oriented canine elbow anatomy in its complexity earned a high importance in surgery especially after multiple imaging modalities have been used in the benefit of diagnosis and treatment of canine elbow disorders. The bony, joint, and muscular structures, the arteries, the veins and the nerves supplying the elbow are described and illustrated in textbooks and atlases in the context of the comparative anatomy. Nevertheless, there is no publication focused on all of these structures described together from the skin to the bones in a systematic and topographic order, nor through cross and/or sagittal and coronal sections. The figures used in this article are original and drawn after dissection, cross, sagittal, and coronal sections of the elbow structures. The sections are correlated to the multiple imaging modalities shown in the next article. r Copyright 2009 by The American College of Veterinary Surgeons Keywords: clinical comprehensive anatomy, elbow, canine INTRODUCTION THE ANATOMY of the canine elbow has been fully presented in a number of texts, 1 7 but with one exception, 4 illustration and description from a diagnostic and therapeutic perspective is not readily available. We provide a comprehensive review of the anatomy of the canine elbow for clinical reference. Presentation of anatomic features of the canine elbow is presented so that it can be readily correlated to diagnostic imaging, used for understanding disease mechanisms, and applied to current and novel treatment strategies. A comprehensive review is provided covering all tissues from superficial to deep, cross-sectional anatomy to correspond to diagnostic imaging, and functional relationships to address disease mechanisms and treatment strategies, which are the topics of the subsequent articles in this issue. CANINE ELBOW ANATOMY Fasciae, Cutaneous Blood Vessels, and Cutaneous Nerves Just beneath the skin, a subcutaneous olecranon bursa may be present to facilitate the smooth gliding of the skin over the olecranon. The elbow is entirely surrounded by the brachial and antebrachial fasciae and on the medial aspect, the superficial antebrachial fascia is added. The arteries are cutaneous branches of the caudal circumflex humeral A. (cranially), thoracodorsal A. (caudolaterally and caudomedially), and superficial brachial A. (craniolaterally and craniomedially). Cutaneous branches of the recurrent interosseous A. reach the elbow caudoventrally. The superficial veins are branches of the collateral ulnar V. (caudally), cephalic V. (cranially), median cubital V. (medially), and branches of the collateral radial and From the Department of Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO. Address reprint requests to Dr. Gheorghe Contantinescu, DVM, PhD, mult Dr h c, Department of Biomedical Sciences, College of Veterinary Medicine, University of Missouri, 1600 E. Rollins, Columbia, MO Submitted April 2008; Accepted September 2008 r Copyright 2009 by The American College of Veterinary Surgeons /09 doi: /j x x 135

2 136 CANINE ELBOW ANATOMY Fig 1. Muscles, arteries, nerves lateral elbow of a dog. middle collateral Vv. (laterally). The recurrent interosseous V. may also supply the elbow. The cranial cutaneous antebrachial N. (branch of the axillary N.) runs on the cranial aspect of the elbow, in front of, and close to, the lateral cutaneous antebrachial N. (from the superficial branch of the radial N.); the latter splits into a lateral branch for the craniolateral aspect of the elbow, and a medial branch for the craniomedial aspect of the elbow. The medial cutaneous antebrachial N. (from the musculocutaneous N.) supplies the craniomedial aspect of the elbow, caudal to, and close to, the medial branch of the lateral cutaneous antebrachial N. The proximal branch of the caudal cutaneous antebrachial N. (from the ulnar N.) supplies the caudolateral and caudomedial aspects of the elbow. Branches of the intercostobrachial N., and lateral cutaneous branches of the intercostal N. II can also be found on the laterocaudal extent of the elbow. The arteries and nerves of the elbow, superficial and deep, in topographic relationship with the muscles are shown in Fig 1 (lateral aspect), Fig 2 (medial aspects), and Fig 3 (cranial aspect). Fig 2. Muscles, arteries, nerves medial elbow of a dog.

3 CONSTANTINESCU AND CONSTANTINESCU 137 Fig 3. Muscles and nerves cranial elbow of a dog. Muscles The muscles surrounding the elbow belong to the brachial and antebrachial groups of muscles. From the brachial group, the biceps brachii and brachialis Mm. run on the cranial aspect, the long and lateral heads of the triceps brachii M., and the anconeus M. cover the lateral aspect of the elbow, and the medial head of triceps runs on the medial aspect of elbow accompanied by the tensor fasciae antebrachii M. (Figs 1 3). A subtendinous bursa (of the triceps brachii M.) is located between the tendon of this Fig 5. Bicipitoradial bursa of a dog medial elbow. Fig 6. Elbow joint of a dog lateral aspect. Fig 4. Tricipital bursa of a dog lateral elbow. Fig 7. Elbow joint of a dog medial aspect.

4 138 CANINE ELBOW ANATOMY Fig 8. Elbow joint of a dog caudal aspect full flexion. muscle and the olecranon (Fig 4). Another subtendinous (bicipitoradial) bursa is located between the radius and the insertion of the biceps brachii M. (Fig 5). From the antebrachial group, starting on the cranial aspect and continuing laterally, caudally and medially, the muscles around the elbow are the brachioradialis M., the extensor carpi radialis M., the common digital extensor M., the lateral digital extensor M., the extensor carpi ulnaris M., the ulnar head of the deep digital flexor M., the ulnar and the humeral heads of the flexor carpi ulnaris M., the superficial digital flexor M., the humeral head of the deep digital flexor M., the flexor carpi radialis M., and the 2 deep muscles: the pronator teres M. and the supinator M. (Figs 1 3). Within the tendon of origin of the supinator M. an inconstant sesamoid bone can be found and is outlined as an interrupted circle in Fig 3. Fig 10. Radius and ulna in pronation cranial view. The insertions of the triceps brachii M. and its olecranon bursa, as well as the insertions of the biceps brachii and brachialis Mm. are shown in Figs 4 and 5. Fig 9. Elbow joint of a dog cranial aspect. Blood Vessels (Figs 1 3) The arteries supplying structures of the elbow accompanied by veins are the brachial A.V.; collateral radial A.V.; middle collateral A.V. forming an articular arterial network caudally and medially (medial cubital articular rete); collateral ulnar A.V. building an articular arterial network caudally and laterally (lateral cubital articular rete); recurrent interosseous A.V. contribute to the lateral cubital articular rete; recurrent ulnar A.V.; transverse cubital A.V.; and superficial brachial A.V. which continue as superficial antebrachial A.V. The veins without arterial satellite are the cephalic and the median cubital Vv.

5 CONSTANTINESCU AND CONSTANTINESCU 139 Fig 13. Distal humerus caudal view. Fig 11. Radius and ulna in supination cranial view. Nerves (Figs 1 3) The nerves around the elbow are the median N., deep and superficial branches of the radial N., and ulnar N. Fig 14. The Elbow Joint Distal humerus distal view. The elbow joint is a compound joint, consisting of the humeroradial, humeroulnar, and proximal radioulnar joints. There is a joint capsule, collateral ligaments, and other ligaments. The joint capsule covers only the cranial aspect of the elbow. The fibrous joint capsule is attached on humerus proximal to the radial fossa and foramen supratrochleare, and under the head of radius after blending with the annular ligament. The fibrous joint capsule ends laterally and medially at the lateral and medial collateral ligaments, respectively. The collateral ligaments attach proximally to the lateral and medial epicondyles of humerus, respectively, and are divided dis- Fig 12. Distal humerus cranial view. Fig 15. Capitulum of radius articular view.

6 140 CANINE ELBOW ANATOMY Fig 16. Proximalulna cranial view. tally into 2 crura. The crura of the lateral collateral ligament blend with the annular ligament and often contain a sesamoid bone. The cranial crura of both ligaments attach to the radius, whereas the caudal crura attach to the ulna. They are considered thickenings of the fibrous joint capsule. There is no fibrous joint capsule on the caudal aspect of the elbow in the dog. Despite the fact that the oblique ligament is not listed in the Nomina Anatomica Veterinaria (NAV), 8 it is a constant structure listed in books and atlases. It attaches proximal to the lateral aspect of the radial fossa and distally on the medial side of the neck of radius. The distal attachment is bifurcated to allow the passage of the tendons of biceps brachii and brachialis Mm. An additional elastic ligament joins the medial border of the olecranon Fig 18. Elbow in neutral caudal position. Fig 17. Elbow in neutral lateral position. Fig 19. Elbow in neutral medial position.

7 CONSTANTINESCU AND CONSTANTINESCU 141 Fig 20. Elbow in extreme flexed medial position. Fig 22. level. Transverse section through a dog elbow oleranon Fig 21. oblique. Elbow cranial aspect craniolateral caudomedial Fig 23. Transverse section through a dog elbow humeral epicondyle level.

8 142 CANINE ELBOW ANATOMY Fig 24. Transverse section through a dog elbow proximal radioulnar level. fossa to the medial aspect of the olecranon, just distal to the olecranon tuberosity. This is the olecranon ligament. The proximal radioulnar joint is provided with the annular ligament, which attaches to the lateral and medial ends of the radial notch of ulna and is covered by the collateral ligaments. It blends its fibers with the fibrous joint capsule. The annular ligament does not attach to the radius, to allow it to rotate during pronation and supination (Figs 6 9). Figures 10 and 11 show the relationships between the radius and ulna during the maximal pronation and maximal supination, respectively. The synovial membrane intimately lines the fibrous joint capsule, and also the olecranon fossa. During flexion and extension, several recesses are formed (Figs 6 9). Cranially, 1 recess lies in the fossa radialis. It delegates 1 small recess under the attachments of the biceps brachii Fig 26. Coronal section through distal humerus and proximal radius and ulna left thoracic limb in pronation. M. (medially) and another small recess under the attachments of the extensor carpi radialis and common digital extensor Mm. Distally, the synovial membrane insinuates under the annular ligament. Caudally, 1 recess is found in the olecranon fossa, which sends a small recess under the medial epicondyle of humerus. The caudal recess is covered by the olecranon ligament. The recesses communicate with each other. The elbow joint as a whole is a trochlearthrosis or ginglymus (a hinge joint), allowing flexion and extension of the humerus over the radius and ulna. In dogs, the circumference of the radius (on the caudal aspect of the head of radius) is capable of rotating in the radial notch of the ulna during pronation and supination. Fig 25. Sagittal section through a dog elbow. The Bones The distal extremity of the humerus and the proximal extremities of the radius and ulna including the olecranon are illustrated in Figs Figures 17 and 18 show the neutral lateral view, and the caudal view of the elbow bones, respectively. The neutral medial aspect is shown in Fig 19, and the extreme flexed medial aspect in Fig 20. The craniolateral caudomedial oblique aspect is shown in Fig 21.

9 CONSTANTINESCU AND CONSTANTINESCU 143 Topography The topography of the bones, ligaments, muscles, vessels, and nerves is shown in 3 cross sections, 1 sagittal and 1 coronal section, in conjunction with computed tomography images. The cross sections are made in a proximodistal direction, as follows: at the level of the olecranon tuberosity (Fig 22), at the level of the lateral and medial epicondyles of humerus (Fig 23), at the proximal radioulnar level (Fig 24). The sagittal section is made through the humerus, ulna and radius at the level of the medial coronoid process (Fig 25). The coronal section is made in front of cranial part of the medial coronoid process with the limb in pronation (Fig 26). REFERENCES 1. Baum H, Zietschmann O: Handbuch der Anatomie des Hundes (ed 2). Berlin, Germany, Paul Parey, Budras K-D, McCarthy PH, Fricke W, et al: Anatomy of the Dog An Illustrated Text (ed 4). Hannover, Germany, Schlu tersche, Constantinescu GM, Cook JL: Clinical anatomy and surgical approach to the elbow joint in the dog, in the XXIVth Congress of the European Association of Veterinary Anatomists, Brno, Czech Republic, July Constantinescu GM: Clinical Anatomy for Small Animal Practitioners. Ames, IA, IA Iowa State Press, Done SH, Goody PC, Evans SA, et al: Color Atlas of Veterinary Anatomy. Vol. 3 The Dog and Cat. Philadelphia, PA, Mosby, Evans HE: Miller s Anatomy of the Dog (ed 3). Philadelphia, PA, Saunders, Ruberte J, Sautet J: Atlas d Anatomie du Chien et du Chat. Vol. 2 Thorax et Membre Thoracique. Barcelona, Spain, Multime dica, Nomina Anatomica Veterinaria (ed 5, electronic version) Editorial Committee: Hannover (Germany), Columbia (Missouri, USA), Gent (Belgium), Sapporo (Japan), 2005

Elbow & Forearm H O W V I T A L I S T H E E L B O W T O O U R D A I L Y L I V E S?

Elbow & Forearm H O W V I T A L I S T H E E L B O W T O O U R D A I L Y L I V E S? Elbow & Forearm H O W V I T A L I S T H E E L B O W T O O U R D A I L Y L I V E S? Clarification of Terms The elbow includes: 3 bones (humerus, radius, and ulna) 2 joints (humeroulnar and humeroradial)

More information

www.ghadialisurgery.com

www.ghadialisurgery.com P R E S E N T S Dr. Mufa T. Ghadiali is skilled in all aspects of General Surgery. His General Surgery Services include: General Surgery Advanced Laparoscopic Surgery Surgical Oncology Gastrointestinal

More information

THE SHOULDER JOINT T H E G L E N O H U M E R A L ( G H ) J O I N T

THE SHOULDER JOINT T H E G L E N O H U M E R A L ( G H ) J O I N T THE SHOULDER JOINT T H E G L E N O H U M E R A L ( G H ) J O I N T CLARIFICATION OF TERMS Shoulder girdle = scapula and clavicle Shoulder joint (glenohumeral joint) = scapula and humerus Lippert, p115

More information

The Muscular System. Appendicular Musculature

The Muscular System. Appendicular Musculature 11 The Muscular System Appendicular Musculature CHAPTER OBJECTIVES 1. Describe the functions of the appendicular musculature. 2. Identify and locate the principal appendicular muscles of the body, together

More information

Chapter 7 The Wrist and Hand Joints

Chapter 7 The Wrist and Hand Joints Chapter 7 The Wrist and Hand Manual of Structural Kinesiology R.T. Floyd, EdD, ATC, CSCS Many Archery, Relate wrist require sports require precise functioning of flexion, & hand & hand functional combined

More information

Muscles of the Forearm and Hand

Muscles of the Forearm and Hand 8 Muscles of the Forearm and Hand 132 PRONATOR TERES Strengthening exercises Pronation with strength bar Self stretches Weight of stick increases supination via gravity PRONATOR TERES 133 Latin, pronate,

More information

Coonrad/Morrey Total Elbow

Coonrad/Morrey Total Elbow Coonrad/Morrey Total Elbow Surgical Technique Interchangeability, Anterior Flange, Clinical History Coonrad/Morrey Total Elbow Surgical Technique 1 Coonrad/Morrey Total Elbow Surgical Technique Table

More information

CoNGRUENT RADIAL HEAD PLATE

CoNGRUENT RADIAL HEAD PLATE Mayo Clinic CoNGRUENT RADIAL HEAD PLATE Since 1988 Acumed has been designing solutions to the demanding situations facing orthopedic surgeons, hospitals and their patients. Our strategy has been to know

More information

The Elbow, Forearm, Wrist, and Hand

The Elbow, Forearm, Wrist, and Hand Elbow - Bones The Elbow, Forearm, Wrist, and Hand Chapters 23 & 24 Humerus Distal end forms the medial & lateral condyles Lateral: capitulum Medial: trochlea Radius Ulna Sports Medicine II Elbow - Bones

More information

Examination of the Elbow. Elbow Examination. Structures to Examine. Active Range of Motion. Active Range of Motion 8/22/2012

Examination of the Elbow. Elbow Examination. Structures to Examine. Active Range of Motion. Active Range of Motion 8/22/2012 Examination of the Elbow The elbow is a complex modified hinge joint The humero-ulnar joint is a hinge joint allowing flexion and extension The radio-ulnar joint allows for pronation and supination of

More information

Elbow, Forearm, Wrist, & Hand. Bony Anatomy. Objectives. Bones. Bones. Bones

Elbow, Forearm, Wrist, & Hand. Bony Anatomy. Objectives. Bones. Bones. Bones Objectives Elbow, Forearm, Wrist, & Hand Chapter 19 Identify and discuss the functional anatomy of the elbow and forearm Discuss the common injuries associated with these anatomical structures Bones Humerus

More information

Anatomical Consideration and Brachial Plexus Anesthesia. Anatomy

Anatomical Consideration and Brachial Plexus Anesthesia. Anatomy Brachial Plexus Anesthesia There are four approaches to the brachial plexus. These include the interscalene, supraclavicular, infraclavicular, and axillary approach. For the purposes of this lecture we

More information

Muscle Name Origin Insertion Action Innervation Muscles of Upper Extremity Pectoralis Major Medial half of clavicle, front of sternum, costal

Muscle Name Origin Insertion Action Innervation Muscles of Upper Extremity Pectoralis Major Medial half of clavicle, front of sternum, costal Muscle Name Origin Insertion Action Innervation Muscles of Upper Extremity Pectoralis Major Medial half of clavicle, front of sternum, costal Crest of greater tubercle (Lateral lip of bicipital groove)

More information

Boxing/Kickboxing Shoulder Injuries and Prevention

Boxing/Kickboxing Shoulder Injuries and Prevention Boxing/Kickboxing Shoulder Injuries and Prevention Dr. Paul Newhart, D.C. Kickboxing and boxing are an excellent workout regimen, as long as precautions are taken so as not to injure the shoulders, elbows

More information

Muscles of Mastication

Muscles of Mastication Muscles of Mastication Masseter Zygomatic Arch Mandibular angle Elevates mandible Mandibular ramus Temporalis Temporal fossa of the temporal bone Coronoid process of the mandible Elevates mandible Retracts

More information

Anatomy for Workers Compensation Attorneys

Anatomy for Workers Compensation Attorneys Anatomy for Workers Compensation Attorneys Donato J. Borrillo MD JD Plant Medical Advisor Chrysler/Jeep Assembly Toledo Zoll, Kranz, and Borgess May 16, 2015 Imaging studies neck 1 Bulge and herniation

More information

Lateral Epicondylitis Surgical Treatment and Rehabilitation

Lateral Epicondylitis Surgical Treatment and Rehabilitation 1 Lateral Epicondylitis Surgical Treatment and Rehabilitation Surgical Indications and Considerations Anatomical Considerations: Lateral epicondylitis primarily involves the origin of the extensor carpi

More information

This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and

This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution

More information

International Standards for the Classification of Spinal Cord Injury Motor Exam Guide

International Standards for the Classification of Spinal Cord Injury Motor Exam Guide C5 Elbow Flexors Biceps Brachii, Brachialis Patient Position: The shoulder is in neutral rotation, neutral flexion/extension, and adducted. The elbow is fully extended, with the forearm in full supination.

More information

Review Article. Dislocation Of Shoulder Joint

Review Article. Dislocation Of Shoulder Joint Review Article Dislocation Of Shoulder Joint Hafizuddin Ahmed A. H. Introduction: Dislocation means complete loss of contact of the articular surfaces of bony components of a joint. Shoulder joint is the

More information

Radial Head Fracture Repair and Rehabilitation

Radial Head Fracture Repair and Rehabilitation 1 Radial Head Fracture Repair and Rehabilitation Surgical Indications and Considerations Anatomical Considerations: The elbow is a complex joint due to its intricate functional anatomy. The ulna, radius

More information

The Pilates Studio of Los Angeles / PilatesCertificationOnline.com

The Pilates Studio of Los Angeles / PilatesCertificationOnline.com Anatomy Review Part I Anatomical Terminology and Review Questions (through pg. 80) Define the following: 1. Sagittal Plane 2. Frontal or Coronal Plane 3. Horizontal Plane 4. Superior 5. Inferior 6. Anterior

More information

Basic Concepts. Focal and Entrapment Neuropathies and EMG. Pathophysiology. Median Nerve. A Clinical Approach

Basic Concepts. Focal and Entrapment Neuropathies and EMG. Pathophysiology. Median Nerve. A Clinical Approach Basic Concepts Focal and Entrapment Neuropathies and EMG A Clinical Approach Nerves predisposed by a narrow anatomic pathway or superficial course are most susceptible May occur acutely, intermittantly,

More information

Muscles of the Neck and Vertebral Column Sternocleidomastoid (anterior neck) Origin Insertion Action

Muscles of the Neck and Vertebral Column Sternocleidomastoid (anterior neck) Origin Insertion Action Muscular movements of the head (at the cervical spine/neck) and of the torso (thoracic and lumbar spine/upper, middle, and lower back): flexion, extension, lateral flexion, rotation. Muscles of the Neck

More information

Aus der Klinik für kleine Haustiere. des Fachbereichs Veterinärmedizin. der Freien Universität Berlin

Aus der Klinik für kleine Haustiere. des Fachbereichs Veterinärmedizin. der Freien Universität Berlin Aus der Klinik für kleine Haustiere des Fachbereichs Veterinärmedizin der Freien Universität Berlin Radius-Ulna Fracture and Post-Traumatic Radius-Ulna Synostosis in Dogs Inaugural-Dissertation zur Erlangung

More information

Elbow Tendinopathies

Elbow Tendinopathies Elbow Tendinopathies Tennis Elbow Biceps Ruptures Triceps Ruptures James T. Mazzara, M.D. Shoulder and Elbow Surgery Sports Medicine Occupational Orthopedics Patient Education Disclaimer This presentation

More information

Ergonomics Monitor Training Manual

Ergonomics Monitor Training Manual Table of contents I. Introduction Ergonomics Monitor Training Manual II. Definition of Common Injuries Common Hand & Wrist Injuries Common Neck & Back Injuries Common Shoulder & Elbow Injuries III. Ergonomics

More information

The wrist and hand are constructed of a series of complex, delicately balanced joints whose function is essential to almost every act of daily living.

The wrist and hand are constructed of a series of complex, delicately balanced joints whose function is essential to almost every act of daily living. TOPIC OUTLINE 9- THE WRIST AND HAND. Introduction. The wrist and hand are constructed of a series of complex, delicately balanced joints whose function is essential to almost every act of daily living.

More information

Ulnar Neuropathy Differential Diagnosis and Prognosis. Disclosures: None

Ulnar Neuropathy Differential Diagnosis and Prognosis. Disclosures: None Ulnar Neuropathy Differential Diagnosis and Prognosis Disclosures: None Goals of Lecture Describe anatomy: sites of entrapment Ulnar nerve Discuss differential diagnosis of ulnar nerve pathology Identify

More information

Anatomy & Physiology 120. Lab #7 Muscle Tissue and Skeletal Muscles

Anatomy & Physiology 120. Lab #7 Muscle Tissue and Skeletal Muscles Anatomy & Physiology 120 Lab #7 Muscle Tissue and Skeletal Muscles What you Need to Know Look briefly at the Structure of: 1) Skeletal, 2) Smooth & 3) Cardiac Muscle Naming, Identification, Functions You

More information

BODY BODY PEDICLE PEDICLE TRANSVERSE TRANSVERSE PROCESS PROCESS

BODY BODY PEDICLE PEDICLE TRANSVERSE TRANSVERSE PROCESS PROCESS Learning Objective Radiology Anatomy of the Spine and Upper Extremity Identify anatomic structures of the spine and upper extremities on standard radiographic and cross-sectional images Timothy J. Mosher,

More information

Elbow Examination. Haroon Majeed

Elbow Examination. Haroon Majeed Elbow Examination Haroon Majeed Key Points Inspection Palpation Movements Neurological Examination Special tests Joints above and below Before Starting Introduce yourself Explain to the patient what the

More information

Introduction. I. Objectives. II. Introduction. A. To become familiar with the terms of direction and location.

Introduction. I. Objectives. II. Introduction. A. To become familiar with the terms of direction and location. E X E R C I S E Introduction I. Objectives A. To become familiar with the terms of direction and location. B. To become familiar with different types of planes and sections. C. To learn the names and locations

More information

Compression Neuropathies. Andrew Martin DO, MBA, CAQSM OMED 2013

Compression Neuropathies. Andrew Martin DO, MBA, CAQSM OMED 2013 Compression Neuropathies Andrew Martin DO, MBA, CAQSM OMED 2013 Compression Neuropathies Carpal Tunnel Syndrome Cubital Tunnel Syndrome Spinal Accessory Nerve Upper/Lower Trunk Plexopathy Long Thoracic

More information

SPORT AND PHYSICAL ACTIVITY

SPORT AND PHYSICAL ACTIVITY 2016 Suite Cambridge TECHNICALS LEVEL 3 SPORT AND PHYSICAL ACTIVITY Unit 1 Body systems and the effects of physical activity K/507/4452 Guided learning hours: 90 Version 2 - Revised content - March 2016

More information

Mink Dissection of Muscles

Mink Dissection of Muscles In this portion of our study of the Mink, we will be focusing on the muscular system. These instructions tell you what muscles you are to identify and provide instructions on information you are expected

More information

CHAPTER 9 BODY ORGANIZATION

CHAPTER 9 BODY ORGANIZATION CHAPTER 9 BODY ORGANIZATION Objectives Identify the meaning of 10 or more terms relating to the organization of the body Describe the properties of life Describe the function for the structures of the

More information

CERVICAL DISC HERNIATION

CERVICAL DISC HERNIATION CERVICAL DISC HERNIATION Most frequent at C 5/6 level but also occur at C 6 7 & to a lesser extent at C4 5 & other levels In relatively younger persons soft disk protrusion is more common than hard disk

More information

THE THERAPIST S MANAGEMENT OF THE STIFF ELBOW MARK PISCHKE, OTR/L, CHT NOV, 17, 2014

THE THERAPIST S MANAGEMENT OF THE STIFF ELBOW MARK PISCHKE, OTR/L, CHT NOV, 17, 2014 THE THERAPIST S MANAGEMENT OF THE STIFF ELBOW MARK PISCHKE, OTR/L, CHT NOV, 17, 2014 ELBOW FUNCTION 1. Required to provide stability for power and precision tasks for both open and closed kinetic chain

More information

Medical Report Checklist: Upper Extremities Peripheral Nerve Disorders Impairments (PND)

Medical Report Checklist: Upper Extremities Peripheral Nerve Disorders Impairments (PND) http://www.pdratings.com/ Craig Andrew Lange craig@pdratings.com California Workers Compensation Certified AMA Guides Impairment & Disability Rating Specialists Voice: (415) 861-4040 / Fax: (415) 276-3741

More information

The material in this ebook also appears in the print version of this title: 0-07-148980-0.

The material in this ebook also appears in the print version of this title: 0-07-148980-0. Case Files Anatomy Second Edition EUGENE C.TOY, MD The John S. Dunn, Senior Academic Chief and Program Director The Methodist Hospital-Houston Obstetrics and Gynecology Residency Program Houston,Texas

More information

www.ghadialisurgery.com

www.ghadialisurgery.com P R E S E N T S Dr. Mufa T. Ghadiali is skilled in all aspects of General Surgery. His General Surgery Services include: General Surgery Advanced Laparoscopic Surgery Surgical Oncology Gastrointestinal

More information

Evolution of the Computer Mouse Prevention of Pain & Discomfort

Evolution of the Computer Mouse Prevention of Pain & Discomfort Evolution of the Computer Mouse Prevention of Pain & Discomfort Anatomy shows more than seen only from an Ergonomic Aspect By Drs Ing Paul C. Helder November 12, 2014 Reference Study Fit for Work Musculoskeletal

More information

American Shoulder and Elbow Surgeons Elbow Curriculum

American Shoulder and Elbow Surgeons Elbow Curriculum American Shoulder and Elbow Surgeons Elbow Curriculum Section I: General Principles and Basic Science 1. Anatomy 2. Surgical Approaches 3. Elbow Arthroscopy General 4. Elbow Biomechanics 5. Outcome Evaluation

More information

TransFx External Fixation System Large and Intermediate Surgical Technique

TransFx External Fixation System Large and Intermediate Surgical Technique TransFx External Fixation System Large and Intermediate Surgical Technique TransFx External Fixation System Large and Intermediate Surgical Technique 1 Surgical Technique For TransFx External Fixation

More information

Ken Ross BSc ST, Nat Dip ST

Ken Ross BSc ST, Nat Dip ST Ken Ross BSc ST, Nat Dip ST Trunk Most people will suffer from back pain at some point in their lives. Good spinal posture places minimal strain on the muscles which maintain the natural curve of the spine

More information

Musculoskeletal Ultrasound Technical Guidelines. IV. Hip

Musculoskeletal Ultrasound Technical Guidelines. IV. Hip European Society of MusculoSkeletal Radiology Musculoskeletal Ultrasound Technical Guidelines IV. Ian Beggs, UK Stefano Bianchi, Switzerland Angel Bueno, Spain Michel Cohen, France Michel Court-Payen,

More information

Biomechanics. State of equilibrium is when the sum (or net effect) of forces acting on a body equals zero

Biomechanics. State of equilibrium is when the sum (or net effect) of forces acting on a body equals zero Biomechanics Kinesiology is the science of, or study of, human motion. It brings together the fields of anatomy, physiology, biomechanics, physics and geometry relating them to human movement. Bio refers

More information

Total Elbow Arthroplasty and Rehabilitation

Total Elbow Arthroplasty and Rehabilitation Total Elbow Arthroplasty and Rehabilitation Surgical Indications and Considerations Anatomical Considerations: There are three bones and four joint articulations that have a high degree of congruence in

More information

Hand and Upper Extremity Injuries in Outdoor Activities. John A. Schneider, M.D.

Hand and Upper Extremity Injuries in Outdoor Activities. John A. Schneider, M.D. Hand and Upper Extremity Injuries in Outdoor Activities John A. Schneider, M.D. Biographical Sketch Dr. Schneider is an orthopedic surgeon that specializes in the treatment of hand and upper extremity

More information

Dimensional Massage Therapy Techniques for Soft-tissue Conditions of the Elbow and Radioulnar Joints, Hand and Wrist. AMTA National Convention

Dimensional Massage Therapy Techniques for Soft-tissue Conditions of the Elbow and Radioulnar Joints, Hand and Wrist. AMTA National Convention Dimensional Massage Therapy Techniques for Soft-tissue Conditions of the Elbow and Radioulnar Joints, Hand and Wrist AMTA National Convention Date: Wednesday September 17, 2014 Place: Denver, CO By Nancy

More information

Laerdal' Human Anatomy Manual The Skeleton

Laerdal' Human Anatomy Manual The Skeleton Human Anatomy Manual The Skeleton Laerdal Texas P.O. Box 38.226 EM. 116 Gatesville,Texas U.S.A.76528 U.S.A.1-800-433-5539 IntemationaI1-254-865-7221 24 Hour Fax 254-865-8011 ~ Laerdal' TABLE OF CONTENTS

More information

7 Cubital Tunnel Release and Ulnar Nerve Transposition

7 Cubital Tunnel Release and Ulnar Nerve Transposition C H A P T E R 7 Cubital Tunnel Release and Ulnar Nerve Transposition Julia A. Kenniston and David R. Steinberg 70 Carpal tunnel syndrome is seen in 40% of patients with cubital tunnel syndrome. As it courses

More information

ANATOMY, BIOMECHANICS, PHYSIOLOGY, DIAGNOSIS AND TREATMENT OF TERES MAJOR STRAINS IN THE CANINE

ANATOMY, BIOMECHANICS, PHYSIOLOGY, DIAGNOSIS AND TREATMENT OF TERES MAJOR STRAINS IN THE CANINE ANATOMY, BIOMECHANICS, PHYSIOLOGY, DIAGNOSIS AND TREATMENT OF TERES MAJOR STRAINS IN THE CANINE Laurie Edge-Hughes, BScPT, CAFCI, CCRT Four Leg Rehabilitation Therapy & The Canine Fitness Centre Ltd, Calgary,

More information

Median Nerve Injuries in, Fractures in the Region of the Wrist

Median Nerve Injuries in, Fractures in the Region of the Wrist 252 Median Nerve Injuries in, Fractures in the Region of the Wrist N. MEADOFF, M.D., Bakersfield SUMMARY Injuries of the median nerve in fractures in the region of the wrist are not uncommon. Median nerve

More information

Keeping the Aging Worker Productive and Injury Free

Keeping the Aging Worker Productive and Injury Free Keeping the Aging Worker Productive and Injury Free Peter Goyert PT CCPE Senior Ergonomist WorkSafeBC Aging Some say aging is > 30 years. Everybody is aging. Generally aging workers refer to those in last

More information

Anatomy PHL 212. By Dr Tajdar Husain Khan

Anatomy PHL 212. By Dr Tajdar Husain Khan Anatomy PHL 212 By Dr Tajdar Husain Khan Overview of Anatomy Anatomy(from the Greek word anatome,"dissection") is a branch of natural science dealing with the structural organization of living things The

More information

Shoulder lameness in the dog- unraveling the mystery with arthroscopy

Shoulder lameness in the dog- unraveling the mystery with arthroscopy Shoulder lameness in the dog- unraveling the mystery with arthroscopy S.T. Kudnig BVSc, MVS, MS, FACVSc, DACVS Melbourne Veterinary Referral Centre 70 Blackburn Road, Glen Waverley, Victoria, 3150. Lameness

More information

Handbook of radiographic positions and projections in the dog

Handbook of radiographic positions and projections in the dog THE VETERINARY PUBLISHING COMPANY COMPANION ANIMALS Handbook of radiographic positions and projections in the dog Aimed at veterinary surgeons, students, teachers and other professionals in the veterinary

More information

DESPITE THE FACT that cubital tunnel syndrome is

DESPITE THE FACT that cubital tunnel syndrome is SURGICAL TECHNIQUE Endoscopic Cubital Tunnel Release Tyson K. Cobb, MD A minimally invasive endoscopic approach has been successfully applied to surgical treatment of cubital tunnel syndrome. This procedure

More information

Brachial Plexopathy, an overview

Brachial Plexopathy, an overview Brachial Plexopathy, an overview Learning Objectives: The brachial plexus is the network of nerves that originate from cervical and upper thoracic nerve roots and eventually terminate as the named nerves

More information

Avulsion Fracture of the Ulnar Sublime Tubercle in Overhead Throwing Athletes

Avulsion Fracture of the Ulnar Sublime Tubercle in Overhead Throwing Athletes 0363-5465/102/3030-0426$02.00/0 THE AMERICAN JOURNAL OF SPORTS MEDICINE, Vol. 30, No. 3 2002 American Orthopaedic Society for Sports Medicine Avulsion Fracture of the Ulnar Sublime Tubercle in Overhead

More information

The Symptomatic Upper Extremity: An Algorithmic Approach to Diagnosis, Part 2

The Symptomatic Upper Extremity: An Algorithmic Approach to Diagnosis, Part 2 Journal of the American Chiropractic Association May 1999 The Symptomatic Upper Extremity: An Algorithmic Approach to Diagnosis, Part 2 By David J. Schimp, DC, DACNB, DAAPM Dorsal scapular nerve entrapment:

More information

Rehabilitation Guidelines for Elbow Ulnar Collateral Ligament (UCL) Reconstruction

Rehabilitation Guidelines for Elbow Ulnar Collateral Ligament (UCL) Reconstruction Rehabilitation Guidelines for Elbow Ulnar Collateral Ligament (UCL) Reconstruction The elbow is a complex system of three joints formed from three bones; the humerus (the upper arm bone), the ulna (the

More information

Shoulder MRI for Rotator Cuff Tears. Conor Kleweno,, Harvard Medical School Year III Gillian Lieberman, MD

Shoulder MRI for Rotator Cuff Tears. Conor Kleweno,, Harvard Medical School Year III Gillian Lieberman, MD Shoulder MRI for Rotator Cuff Tears Conor Kleweno,, Harvard Medical School Year III Goals of Presentation Shoulder anatomy Function of rotator cuff MRI approach to diagnose cuff tear Anatomy on MRI images

More information

DEVELOPMENT AND GROWTH OF THE MANDIBLE

DEVELOPMENT AND GROWTH OF THE MANDIBLE 2012-2013 ORAL BIOLOGY DEVELOPMENT AND GROWTH OF THE MANDIBLE Ass. Prof. Dr. Heba M. Elsabaa Development and Growth of the Mandible DEVELOPMENT OF THE MANDIBLE The Mandible Is the largest and strongest

More information

CONTINUING EDUCATION COURSES. for Massage Therapists. Online!

CONTINUING EDUCATION COURSES. for Massage Therapists. Online! CONTINUING EDUCATION COURSES for Massage Therapists Online! ccmh Halifax Canadian College of Massage & Hydrotherapy Online Continuing Education Program CCMH Halifax offers a variety of Continuing Education

More information

Fractures around wrist

Fractures around wrist Fractures around wrist Colles Fracture Smiths fracture Barton s fracture Chauffer s fracture Scaphoid fracture Lunate dislocation Vivek Pandey Colles fracture Definition: Fracture of the distal end radius

More information

KnifeLight. Carpal Tunnel Ligament Release. Operative Technique

KnifeLight. Carpal Tunnel Ligament Release. Operative Technique KnifeLight Carpal Tunnel Ligament Release Operative Technique Contents Page 1. Features & Benefits 3 Intended Use and Indications 3 Contraindications 3 Features & Benefits 3 2. Operative Technique 4 Antegrade

More information

Upper limb injuries. Traumatology RHS 231 Dr. Einas Al-Eisa

Upper limb injuries. Traumatology RHS 231 Dr. Einas Al-Eisa Upper limb injuries Traumatology RHS 231 Dr. Einas Al-Eisa Pain in the limbs: May be classified under 4 headings: 1. Joint pain 2. Soft tissue pain 3. Neurogenic pain 4. Orthopaedic causes (fractures,

More information

The Nervous System: The Spinal Cord and Spinal Nerves

The Nervous System: The Spinal Cord and Spinal Nerves 14 The Nervous System: The Spinal Cord and Spinal Nerves PowerPoint Lecture Presentations prepared by Steven Bassett Southeast Community College Lincoln, Nebraska Introduction The Central Nervous System

More information

Standard of Care: Radial Tunnel Syndrome

Standard of Care: Radial Tunnel Syndrome Department of Rehabilitation Services Occupational Therapy Case Type / Diagnosis / Anatomy: Radial tunnel syndrome (RTS) was first reported as a unique clinical syndrome in 1956. RTS has also been called

More information

Chapter 3. Ulnar nerve infiltration

Chapter 3. Ulnar nerve infiltration Chapter 3 LOCAL ANESTHESIA KEY FIGURES: Digital block/anatomy Sensation to hand Median nerve infiltration Ulnar nerve infiltration Facial block: skeleton Full surgical evaluation of a wound and suture

More information

Pediatric Sports Injuries of the Wrist and Hand. Sunni Alford, OTR/L,CHT Preferred Physical Therapy

Pediatric Sports Injuries of the Wrist and Hand. Sunni Alford, OTR/L,CHT Preferred Physical Therapy Pediatric Sports Injuries of the Wrist and Hand Sunni Alford, OTR/L,CHT Preferred Physical Therapy Wrist injuries TFCC ECU/ FCU tendonitis Instability Growth Plate Fractures Ulnar abutment syndrome Triangular

More information

Venepuncture Year 2 Dental Students Practical Skill Session

Venepuncture Year 2 Dental Students Practical Skill Session Venepuncture Year 2 Dental Students Practical Skill Session Page 1 of 13 Contents Anatomy And Physiology 3 Structure Of Veins 4 Superficial Veins 5 Antecubital Fossa 7 Veins 7 Arteries 7 Patient Assessment

More information

During routine dissection of an 81-year-old male embalmed. The Axillary Arch: Anatomy and Suggested Clinical Manifestations

During routine dissection of an 81-year-old male embalmed. The Axillary Arch: Anatomy and Suggested Clinical Manifestations The Axillary Arch: Anatomy and Suggested Clinical Manifestations A. Russell Smith, Jr, PT, EdD, OCS, FAAOMPT 1 John P. Cummings, PT, PhD 2 The purpose of this commentary is to describe bilateral anomalous

More information

Lumbar Spine Anatomy. eorthopod.com 228 West Main St., Suite D Missoula, MT 59802-4345 Phone: 406-721-3072 Fax: 406-721-2619 info@eorthopod.

Lumbar Spine Anatomy. eorthopod.com 228 West Main St., Suite D Missoula, MT 59802-4345 Phone: 406-721-3072 Fax: 406-721-2619 info@eorthopod. A Patient s Guide to Lumbar Spine Anatomy 228 West Main St., Suite D Missoula, MT 59802-4345 Phone: 406-721-3072 Fax: 406-721-2619 info@eorthopod.com DISCLAIMER: The information in this booklet is compiled

More information

Occupational Therapy Manual for Evaluation of Range of Motion and Muscle Strength

Occupational Therapy Manual for Evaluation of Range of Motion and Muscle Strength Licensed to: CengageBrain User Licensed to: CengageBrain User Occupational Therapy Manual for Evaluation of Range of Motion and Muscle Strength DONNA LATELLA, MA, OTR/L Assistant Professor Department of

More information

Rheumatoid arthritis of the elbow

Rheumatoid arthritis of the elbow Ann. rheum. Dis. (1975), 34, 403 Rheumatoid arthritis of the elbow Pattern of joint involvement, and results of synovectomy with excision of the radial head H. STEIN, R. A. DICKSON, AND G. BENTLEY From

More information

Musculoskeletal Ultrasound Technical Guidelines. V. Knee

Musculoskeletal Ultrasound Technical Guidelines. V. Knee European Society of MusculoSkeletal Radiology Musculoskeletal Ultrasound Technical Guidelines V. Knee Ian Beggs, UK Stefano Bianchi, Switzerland Angel Bueno, Spain Michel Cohen, France Michel Court-Payen,

More information

Ulnar sided Wrist Pain

Ulnar sided Wrist Pain Ulnar sided Wrist Pain 1 Susan Cross, 1 Anshul Rastogi, 2 Brian Cohen, 1 Rosy Jalan 1 Dept of Radiology, Barts Health NHS Trust, London, UK 2 London Orthopaedic Centre Contact: susan.cross@bartshealth.nhs.uk

More information

Employees Compensation Appeals Board

Employees Compensation Appeals Board U. S. DEPARTMENT OF LABOR Employees Compensation Appeals Board In the Matter of BARBARA SNYDER and DEPARTMENT OF THE TREASURY, INTERNAL REVENUE SERVICE, Germansville, PA Docket No. 03-1467; Submitted on

More information

Curriculum Vitae. Olathe, KS 66062 (913) 839-2780 (503) 984-6685 (mobile) Education. Experience

Curriculum Vitae. Olathe, KS 66062 (913) 839-2780 (503) 984-6685 (mobile) Education. Experience Curriculum Vitae Name: Anthony B. Olinger, Ph.D. Rank: Assistant Professor Date of Birth: November 10, 1973 Office Address: Home Address: e-mail Address: Department of Anatomy Kansas City University of

More information

QUESTION I HAVE BEEN ASKED TO REHAB GRADE II AND III MCL INJURIES DIFFERENTLY BY DIFFERENT SURGEONS IN THE FIRST 6WEEKS FOLLOWING INJURY.

QUESTION I HAVE BEEN ASKED TO REHAB GRADE II AND III MCL INJURIES DIFFERENTLY BY DIFFERENT SURGEONS IN THE FIRST 6WEEKS FOLLOWING INJURY. QUESTION I HAVE BEEN ASKED TO REHAB GRADE II AND III MCL INJURIES DIFFERENTLY BY DIFFERENT SURGEONS IN THE FIRST 6WEEKS FOLLOWING INJURY. SOME ARE HINGE BRACED 0-90 DEGREES AND ASKED TO REHAB INCLUDING

More information

Minimally Invasive Spine Surgery

Minimally Invasive Spine Surgery Chapter 1 Minimally Invasive Spine Surgery 1 H.M. Mayer Primum non nocere First do no harm In the long history of surgery it always has been a basic principle to restrict the iatrogenic trauma done to

More information

NOW PLAYING THE WRIST. David Costa, OTR/L October 20, 2007

NOW PLAYING THE WRIST. David Costa, OTR/L October 20, 2007 NOW PLAYING THE WRIST David Costa, OTR/L October 20, 2007 Starring Radius Ulna Scaphoid Lunate Triquetrum Trapezium Trapezoid Capitate Hamate Pisiform TFCC Transverse Carpal Ligament Scapholunate Ligament

More information

Repetitive Strain Injury (RSI)

Repetitive Strain Injury (RSI) Carpal Tunnel Syndrome and Other Musculoskeletal Problems in the Workplace: What s the Solution? by Richard N. Hinrichs, Ph.D. Dept. of Kinesiology Arizona State University Repetitive Strain Injury (RSI)

More information

EXTENSOR CARPI ULNARIS TENDINOPATHY. Amanda Cooper

EXTENSOR CARPI ULNARIS TENDINOPATHY. Amanda Cooper EXTENSOR CARPI ULNARIS TENDINOPATHY Amanda Cooper OVERVIEW Anatomy Biomechanics Injury Pathology Assessment Treatment Anatomy Origin: Middle third of the posterior border of ulna Lateral epicondyle of

More information

WRIST EXAMINATION. Look. Feel. Move. Special Tests

WRIST EXAMINATION. Look. Feel. Move. Special Tests WRIST EXAMINATION Look o Dorsum, side, palmar- palmar flex wrist to exacerbate dorsal swellings o Deformity e.g. radial deviation after colles, prominent ulna o Swellings e.g. ganglion o Scars, muscle

More information

Biceps Brachii Tendon Proximal Rupture

Biceps Brachii Tendon Proximal Rupture 1 Biceps Brachii Tendon Proximal Rupture Surgical Indications and Considerations Anatomical Considerations: Biceps brachii, one of the dominant muscles of the arm, is involved in functional activities

More information

Shoulder Arthroscopy

Shoulder Arthroscopy Copyright 2011 American Academy of Orthopaedic Surgeons Shoulder Arthroscopy Arthroscopy is a procedure that orthopaedic surgeons use to inspect, diagnose, and repair problems inside a joint. The word

More information

MD 2016. Back Muscles & Movements Applied Anatomy. A/Prof Chris Briggs Anatomy & Neuroscience

MD 2016. Back Muscles & Movements Applied Anatomy. A/Prof Chris Briggs Anatomy & Neuroscience MD 2016 Back Muscles & Movements Applied Anatomy A/Prof Chris Briggs Anatomy & Neuroscience WARNING This material has been provided to you pursuant to section 49 of the Copyright Act 1968 (the Act) for

More information

Most active and intricate part of the upper extremity Especially vulnerable to injury Do not respond well to serious trauma. Magee, 2008. pg.

Most active and intricate part of the upper extremity Especially vulnerable to injury Do not respond well to serious trauma. Magee, 2008. pg. PTA 216 Most active and intricate part of the upper extremity Especially vulnerable to injury Do not respond well to serious trauma Magee, 2008. pg. 396 28 bones Numerous articulations 19 intrinsic muscles

More information

by joe muscolino body mechanics

by joe muscolino body mechanics by joe muscolino body mechanics carpal tunnel syndrome The word carpal means wrist. Therefore, the carpal tunnel is a tunnel that is formed by the structural configuration of the wrist (carpal) bones.

More information

Coding for Difficult Tendon Repairs and Transfers. Current Procedural Terminology 2013 American Medical Association. All Rights Reserved.

Coding for Difficult Tendon Repairs and Transfers. Current Procedural Terminology 2013 American Medical Association. All Rights Reserved. Coding for Difficult Tendon Repairs and Transfers Rotator Cuff Repair 23420 February 2002 page 11 Code 23420 describes a repair of a complete shoulder (rotator) cuff avulsion, referring to the repair of

More information

Normal vascular variants of the upper extremity

Normal vascular variants of the upper extremity Normal vascular variants of the upper extremity Poster No.: C-1039 Congress: ECR 2014 Type: Educational Exhibit Authors: P. Paixao, A. P. Gomes, M. S. C. Sousa, I. Santiago, A. S. C. C. Germano; Amadora/PT

More information

SCAPULAR FRACTURES. Jai Relwani, Shoulder Fellow, Reading Shoulder Unit, Reading.

SCAPULAR FRACTURES. Jai Relwani, Shoulder Fellow, Reading Shoulder Unit, Reading. SCAPULAR FRACTURES Jai Relwani, Shoulder Fellow, Reading Shoulder Unit, Reading. Aims Anatomy Incidence/Importance Mechanism Classification Principles of treatment Specific variations Conclusion Anatomy

More information

CORRESPONDENCE EDUCATION PROGRAM

CORRESPONDENCE EDUCATION PROGRAM Deep Tissue Massage CORRESPONDENCE EDUCATION PROGRAM Check your receipt for course expiration date. After that date no credit will be awarded for this program. 1 How to Complete this Program Thank you

More information

THE WRIST. At a glance. 1. Introduction

THE WRIST. At a glance. 1. Introduction THE WRIST At a glance The wrist is possibly the most important of all joints in everyday and professional life. It is under strain not only in many blue collar trades, but also in sports and is therefore

More information