Thumb dislocations and ligament injuries 136Finger dislocations and ligament injuries 139Metacarpal fractures 145Finger fractures 147Associated with sports and motorcycle injuries. The mechanism of this injury is controversial, however likely to be axial loading of semiflexed thumb. Base of thumb metacarpal dislocates dorsally, rupturing the palmar oblique ligament (‘beak’ ligament). May reduce spontaneously....

Rationale: The role of the psychogenic component in chronic pain and delayed rehabilitation in patients with lumbosacral radiculopathy (LSR) has been extensively studied. However, there is a paucity of studies evaluating anxiety and pain in LSR patients early after microdiscectomy. Only a few studies have performed a differentiated assessment of state (SA) and trait (TA) anxiety. The effects of repetitive peripheral magnetic stimulation (rPMS) on the TA level in the Russian LSR patients have not been investigated. Aim: To assess changes in anxiety and pain over time in LSR patients with various rehabilitation programs at the early stage after microdiscectomy. Materials and methods: The study included 71 patients with LSR after microdiscectomy (mean age 46.8 ± 10.5 years). At Day 7 after surgery, the patients were randomized into two groups. The patients in the 1st group (n = 35) received a rPMS course in addition to conventional rehabilitation, whereas the patients in the 2nd group (n = 36) were rehabilitated only conventionally. Pain was assessed by a visual analogue scale (VAS), and anxiety levels by Spielberger StateTrait Anxiety Inventory (validated Russian version). Results: There was a significant decrease of SA and TA levels in the patients of both groups at Day 21 of rehabilitation, compared to those at Day 7 (p < 0.001). At Day 21, there was a significant inter-group difference (p = 0.036) in the leg pain VAS score and the TA frequency distribution (p = 0.042, Fisher test). Conclusion: Better improvement of pain and trait anxiety in the patients treated with rPMS indicates that it would be reasonable to include an rPMS course into the comprehensive rehabilitation program after microdiscectomy.

Bone and joint injuries—wrist and forearm 100Forearm fractures 102Ulnar corner injuries 106Fractures of the distal radius in adults 108Fractures of the distal radius in children 118Fractures of the scaphoid 120Fractures of the other carpal bones 127Carpal ligament rupture and dislocations ...

Anatomy 490Biomechanics 494Wrist pain 495Investigations for wrist disorders 496Crystal arthropathy 498Carpal instability 499Scapholunate instability 500Mid-carpal instability 503Wrist osteoarthritis 504Swellings around the wrist 506Avascular necrosis 508Wrist operations 511Tuberculosis 520Distal radius–lunate fossa (quadrangular/spherical), scaphoid fossa (triangular/spoon-shaped) sigmoid notch (articulates with ulnar seat in DRUJ, variable concavity)....

Introduction 42Exercise 44Splinting 48Oedema control 54Scar 56Hypersensitivity 60Pain 62Sensory re-education 66Psychological implications of hand problems 70Stiffness 74Complex regional pain syndrome (CRPS) 78Rehabilitation of the hand is critical to ensure the best outcome after hand surgery or injury. Whilst surgical and therapeutic interventions have progressed, the principles of treatment have remained much the same....