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Combined radial and ulnar artery injuries are associated with a >35% amputation rate when not revascularized promptly. We describe a patient who suffered a penetrating injury to both the radial and ulnar arteries. Despite the ulnar artery being ligated and the radial artery primary repair becoming occluded after the index operation, his hand remained salvageable, likely because of collateral arterial pathways. The patient obtained a delayed radial-radial artery bypass and afterward achieved meaningful neuromotor function. This case emphasizes the importance of forearm vascular anatomy variability and the need for prompt management of arterial injuries to reduce limb loss and disability.

Objectives Digital annular pulleys (DAPs) are important anatomical structures for finger function. The anatomy, histology and imaging assessment of DAPs, particularly at the level of their entheses, are still not clearly defined. The advent of high-frequency US transducers opened new perspectives in evaluating submillimetre-scale structures, such as pulleys, paving the way for their global assessment. The study aimed to characterize DAPs from an anatomical, histological and US perspective, focusing on the detection and complete description of pulley entheses. Methods US assessment and gross anatomy dissection were conducted on 20 cadaveric hands to study DAP thickness and structure, including enthesis identification. The results of the US and anatomical measurements were correlated. DAP entheses identified by US were characterized via histological analysis. DAPs in 20 healthy controls (HCs) were detected and measured by US. The A1, A2 and A4 DAP entheses were assessed using a new dynamic manoeuvre to better evaluate those structures. Results A total of 1200 DAPs (400 cadaveric, 800 HCs) were analysed. The cadaveric study demonstrated strong correlation between anatomical and US measurement of DAPs (r  = 0.96). At the histological level, DAP entheses at the volar plate, sesamoid bones or phalangeal ridges contained fibrous and fibrocartilaginous tissue. US assessment of A1, A2 and A4 DAPs in HCs allowed the identification of 718/720 (99.73%) entheses. Conclusion US is an effective tool to detect and study DAPs. DAP entheses reveal both fibrous and fibrocartilaginous characteristics. A newly described manoeuvre to optimize DAP enthesis visualization enhances their detection by US. [ABSTRACT FROM AUTHOR]

Dissatisfaction among upper limb prosthetic users is high, reaching over 70%, and 52% of upper limb amputees abandon their prosthetic devices due to limitations such as limited functionality, poor design/aesthetic, and improper fit. The conventional procedure of making prosthetics is time-consuming and expensive. This study was conducted to provide an alternative solution for the several issues of current prosthetic devices. 3D printing technology offers a promising alternative, providing greater accuracy, reduced labor time, and improved fit and comfort. This research explores the application of 3D printing for creating custom silicone prosthetic fingers, using Fused Deposition Modelling (FDM) for the mold. A high-resolution 3D scanner was employed to capture the precise anatomy of the patient's hand, and CAD software was used to design molds that satisfied the patient preference and were reusable. The resulting prosthetics demonstrated good fit and patient satisfaction, though exact color matching remains a challenge, but still, it did demonstrate that it is possible to fabricate colored prosthetics. Performance tests, such as the Jebsen–Taylor Hand Function Test, indicated that while initial performance with the prosthetic was slightly lower, patient satisfaction and potential for improved functionality over time were high. This study underscores the potential of 3D printing to enhance the customization, cost-effectiveness, and overall quality of prosthetic devices, contributing to Sustainable Development Goals related to health and industry innovation. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to undertake an anthropometric assessment and to compare the muscular strength of elite athletes with that of a control group to predict Mallampati classification. Material and Method: The study group consisted of elite track athletes, and the control group consisted of volunteers with similar characteristics. Anthropometric measurements of the hand, fingers, and wrist were made; handgrip strength and the pinch strength of the fingers were also measured. A serum biochemical analysis was then performed. Participants were divided into two groups: those with Modified Mallampati Scores (MMS) I and II, and those with III and IV. A partial correlation test was used to examine the correlations of the variables according to the MMS groups. Results: The study included 32 elite athletes and 42 volunteer participants. Serum Na level, fingertip to root digit 3 (FTR3), and FTR4 were significantly lower in males in MMS groups 3-4. Among all cases, wrist extension angle (WEA) was found to be significantly lower in MMS group 3-4. However, hand breadth at thumb (HBT), hand depth radial (HDR), breadth at the first joint of digit 2 (BFJD2), pinch strength of thumb (PST), and PSLF were significantly higher in MMS groups 3-4. Among these variables, HBT, BFJD2, PST, and PSLF were significantly higher in elite athletes, but HDR was similar between the study groups. MMS groups showed the highest correlation with the pinch strength of the thumb. Conclusion: The pinch strength of the thumb and little finger was determined as the most important predictors for the MMS group rather than the handgrip strength (HGS). [ABSTRACT FROM AUTHOR]

The increase in repetitive strain injuries to the hand underscores the need for assessing and preventing musculoskeletal overuse associated with hand-intensive tasks. This study investigates the risk of overload injuries in soft tissue structures of the hand by analyzing the pressure distribution and location of peak pressure in the hand during snap-fit connection assembly in the automotive industry. The influence of the surface geometry of automotive trim components the pressure distribution and force imparted during strikes with the palm and the fist are investigated in a cohort of 30 subjects with extensive experience installing trim parts with snap-fit connections. Using the palm or fist (ulnar hand side) of the dominant hand, the subjects struck a simulation device with a flat, rounded, or edged surface geometry. The average peak force applied was 600 N (±122 N), nearly 3 times the force required to overcome the technical resistance of the snap-fit connector (220 N). Fist strikes exerted a 40% higher mean peak pressure and 18% higher mean pressure than did palm strikes. The pressure distribution in the region of the thenar eminence and soft tissue of the ulnar side of the hand did not differ between fist strikes on flat and edged surfaces. Considering the delicate anatomy of the hand, especially the hypothenar muscles on the ulnar side, assembling connection claps using the fist instead of the palm may prevent repetitive blunt trauma to the sensitive blood vessels and nerves in the palm. [ABSTRACT FROM AUTHOR]

Objectives We aimed to determine whether hand OA is characterized by systemic cartilage loss by assessing if radiographically normal joints had greater joint space width (JSW) loss over 4 years in hands with incident or prevalent OA elsewhere in the hand compared with hands without OA. Methods We used semi-automated software to measure JSW in the distal and proximal IP joints of 3368 participants in the Osteoarthritis Initiative who had baseline and 48-month hand radiographs. A reader scored 16 hand joints (including the thumb base) for Kellgren–Lawrence (KL) grade. A joint had OA if scored as KL ≥2. We identified three groups based on longitudinal hand OA status: no hand OA (KL <2 in all 16 joints) at the baseline and 48-month visits, incident hand OA (KL <2 in all 16 joints at baseline and then one or more joints with KL ≥2 at 48 months) and prevalent hand OA (one or more joints with KL ≥2 at baseline and 48 months). We then assessed if JSW in radiographically normal joints (KL 0) differed across these three groups. We calculated unpooled effect sizes to help interpret the differences between groups. Results We observed small differences in JSW loss that are unlikely to be clinically important in radiographically normal joints between those without hand OA (n  = 1054) and those with incident (n  = 102) or prevalent hand OA (n  = 2212) (effect size range −0.01–0.24). These findings were robust when examining JSW loss dichotomized based on meaningful change and in other secondary analyses. Conclusions Hand OA is not a systemic disease of cartilage. [ABSTRACT FROM AUTHOR]

Combined radial and ulnar artery injuries are associated with a >35% amputation rate when not revascularized promptly. We describe a patient who suffered a penetrating injury to both the radial and ulnar arteries. Despite the ulnar artery being ligated and the radial artery primary repair becoming occluded after the index operation, his hand remained salvageable, likely because of collateral arterial pathways. The patient obtained a delayed radial-radial artery bypass and afterward achieved meaningful neuromotor function. This case emphasizes the importance of forearm vascular anatomy variability and the need for prompt management of arterial injuries to reduce limb loss and disability.

Background: The present study was conducted to estimate gender from 2D:4D ratio and hand morphometry taken from participants by using machine learning (ML) algorithms. Materials and Methods: The study was conducted retrospectively on 88 men and 96 women between the ages of 18 and 30 who did not have any pathology, deformity or surgical interventions on their hands. Hand width (HW), hand length (HL), second digit length (2D), and fourth digit length (4D) of the individuals were measured as the right (R) and left (L) side by using digital calliper and recorded in Excel. In addition, the ratio between the second digit and fourth digit (2D:4D) of each individual was also recorded. Results: As a result of ML modelling, 0.92 accuracy was obtained with Random forest (RF) algorithm. With RF algorithm, all of the 16 women and 18 of the 21 men in the test set were estimated accurately. With SHAP analyzer of RF algorithm, HW-L parameter was found to have the highest contribution in estimating gender. The accuracy rates of the other ML models used in the study were found to vary between 0.78 and 0.89. Conclusions: It was found that 2D:4D ratio and hand morphometry measurements, which are frequently preferred in gender determination, have higher accuracy rate when examined with ML algorithms. In our study, we concluded that using 2D:4D ratio and hand morphometry in estimating gender provides accurate and reliable data. [ABSTRACT FROM AUTHOR]

Introduction: More than half of the patients with moderate and severe osteoarthritis (OA) report unsatisfactory pain relief, requiring consideration of intra‐articular (IA) injections as the second‐line management. Ultrasound‐guided IA injection has proven evidence of higher accuracy in administering IA injectates into the joints than landmark‐guided or blind IA injections. However, questions remain about translating higher accuracy rates of ultrasound‐guided injection into better clinical improvements. Therefore, we examined the symptomatic benefits (pain, function and patient satisfaction) of ultrasound‐guided injection in knee, hip and hand OA compared with blind injections by synthesising a systematic review and meta‐analysis of randomised controlled trials (RCT). Methods: PubMed, Medline and Embase databases were searched for eligible studies from their inception to August 28, 2023. Results: Out of 295 records, our meta‐analysis included four RCTs (338 patients with knee OA), demonstrating significant improvement in procedural pain [−0.89 (95% CI −1.25, −0.53)], pain at follow‐up [−0.51 (95% CI −0.98, −0.04)] and function [1.30 (95% CI 0.86, 1.73)], favouring ultrasound guidance. One single study showed higher patient satisfaction with ultrasound guidance. Conclusion: Ultrasound‐guided IA injection provided superior clinical outcomes compared with landmark‐guided IA injection. [ABSTRACT FROM AUTHOR]

Objective: There are various factors that affect bone mineral density (BMD) in postmenopausal women. The aim of this study was to evaluate the relationships between anthropometric characteristics and BMD in women with postmenopausal osteoporosis (PMO). Materials and Methods: Demographic features of the participants including age, menopause age, smoking habits, comorbidities, educational and marital status were recorded. Anthropometric characteristics such as height, weight, body mass index (BMI), waist-to-hip ratio (WHR), digit ratio of dominant hand (2D:4D), skeletal muscle mass index (SMI), hand and thigh circumferences were measured. In addition to L1-L4, femur neck (FN), femur total (FT) T-scores, serum calcium and 25(OH) vitamin D levels were noted. Results: This study included a total of 181 women with PMO (mean age 62.78±7.81 years, menopause age 45.69±5.58 years and BMI 27.24±4.87 kg/m²). 64.6% of the participants had at least one systemic disease and 71.8% were non-smokers. The mean values of serum calcium and 25(OH) vitamin D were 9.71±0.73 mg/dL and 26.22±15.34 ng/mL, respectively. Weight and BMI showed significant positive correlations with T-scores at L1-L4 total, FN and FT. While thigh circumference and SMI significantly correlated with T-scores at FN and FT, hand circumference only correlated with T-score at FN. On the other hand, no correlations were found between T-scores and other anthropometric measurements (height, WHR, 2D:4D). Conclusion: These findings have shown that the patients with lower weight and BMI have lower T-scores at lumbar spine and femur. Additionally, thigh circumference and SMI correlated positively with femur T-scores. Further studies are warranted to reveal the role of these anthropometric measurements in determining the risk of osteoporosis in postmenopausal women. [ABSTRACT FROM AUTHOR]

Securing reliable and high-quality peripheral intravenous catheter (PIVC) access is vital for patient-centered care. Factors such as patient condition, catheter type, and insertion method can influence PIVC dwell times. This review examines the differences in dwell times between traditional PIVCs and ultrasound-guided PIVCs (USGPIVCs) and their implications for patient care. Securing reliable and high-quality peripheral intravenous catheter (PIVC) access is vital for hospital patient-centered care. Factors such as patient condition, catheter type, and insertion method can influence PIVC dwell times. This review examines the differences in dwell times between traditional PIVCs and ultrasound-guided PIVCs and their implications for patient care. [ABSTRACT FROM AUTHOR]

This paper presents a model based on hand anatomy and neural network for the recognition of sign language. Feature extraction is done by using FAST and SIFT techniques. Out of these extracted features, only essential hand landmarks are selected using hand anatomy. NN is then used for the training and testing of the model. The proposed model is evaluated on sign language gestures used for medical purposes, general purposes, and family & relative purposes. The results prove that the proposed model has achieved fast and highly accurate results when compared with other available models. The model has achieved a recognizable accuracy of 99.85%, 97.55%, and 98.85%, on medical purposes, general purposes, and family & relative purposes, respectively. [ABSTRACT FROM AUTHOR]

This article will provide clinical guidance on carrying out venepuncture on an adult. It will discuss site, equipment selection and aseptic non-touch technique. The aims are to increase knowledge of the anatomical structures associated with venepuncture, demonstrate the clinical procedural technique of venepuncture, and provide an awareness of the dangers and complications of this invasive technique. [ABSTRACT FROM AUTHOR]

Introduction: Hand Grip Strength, measured by hand-grip dynamometry, is a measure of muscular strength. This cross-sectional study was performed to determine the correlation between Hand Grip Strength (HGS) and different anthropometric measurements like Body Mass Index (BMI), Hand Length (HL) and Mid Upper Arm Circumference (MUAC) among undergraduate medical students of a Tertiary Health Care Institute in West Bengal. Material and methods: This research, which was cross-sectional, analytical, and observational, had two groups of fifty male and fifty female participants in the 19-25 age range. An analogue, basic metal hand-grip dynamometer weighing 50 kg was used. The recorded HGS value was the average of three trials, with a 15-second inter-trial rest interval between each trial. For Statistical Analysis, Tests of Significance (Student's t-test and Pearson's Correlation Coefficient) have been used. P-values = 0.05 have been considered significant. Results: A hundred undergraduate medical students of the age group 19-25 years were divided into two groups, male (50) and female (50). A significant strong positive correlation of HL (r = 0.6308, p < 0.00001) with Dominant Hand Grip Strength (DHGS) was found in the general population. However, no significant correlation of BMI (r = 0.0831, p = 0.411091) with DHGS was observed. A significant weak positive correlation of age (r = 0.2790, p = 0.004939) with DHGS was observed and a significant moderate positive correlation of MUAC (r = 0.4035, p = 0.000031) with DHGS was seen. Significant weak positive correlations of HL (r = 0.3227, p = 0.022275) and MUAC (r = 0.3788, p = 0.006674) with DHGS were observed for females. Males recorded greater values of DHGS (17.6526 kg) and NDHGS (16.7430 kg) than females (DHGS = 7.3856 kg, NDHGS = 6.6404 kg) and the difference was statistically significant. Conclusion: Thus, it may be concluded that the most significant predictor of hand grip strength (HGS) is hand length (HL). [ABSTRACT FROM AUTHOR]

Aim: Accessory and sesamoid bones are hidden anatomical structures that fulfil a wide variety of functions in the human body. Therefore, studying the nature, formation and dimensions of these structures is of great importance for the medical literature. In our study, we aimed to measure the presence and area (size) of these ossicles. Material and Method: Our study was performed retrospectively on the images of individuals who applied to Ordu University and whose radiological images were obtained. The presence of accessory and sesamoid ossicles (present/absent) and their sizes (measured using the PACS system) were evaluated on radiographs and Computed Tomography (CT) images. The results of the ossicles were divided into gender, age, and bilateral groups. Statistical analyzes were performed with the SPSS program. Results: The most common and largest accessory ossicles in the foot were os peroneum (18.2%), os naviculare accessoria (17.4%), os trigonum (12.1%) and os intermetatarsarum (7.8%). Sesamoid ossicles at the level of the first metatarsophalangeal (mtp) joint of the foot and the first metacarpopgalangeal (mcp) joint of the hand were found to be 100% common. The second most common sesamoid bone in the hand and foot was at the fifth mtp (22.22%) and mcp (68.53%) joints. In the hand, the most common accessory ossicles were os triangulare (6.08%), os radiale externum (2.60%) and os centrale (1.73%). Accessory ossicles (fabella: 19%, cyamella: 17.5%) were found in 25.5% of the knee. Conclusion: Accessory and sesamoid ossicles are most commonly found in the hand, foot, and knee. The presence and size of these ossicles can be both beneficial and harmful. Sesamoids provide mechanical benefit, whereas accessory ossicles can be mistaken for fractures and may lead to unnecessary medical conditions. Knowing the dimensions of these ossicles allows them to be clinically differentiated from avulsion fractures. [ABSTRACT FROM AUTHOR]

Infections of the hand and wrist are thankfully rare, but they present esoterically dependent on the specific structures involved. When underappreciated, they lead to delayed or incomplete management and destruction of highly specialized functional anatomy in the hand which results in significant disability. The general signs, symptoms and investigations for infections in the hand mirror infections elsewhere, but the variety of potential spaces in the hand mean there is no single sensitive indicator clinically, biochemically or radiologically. A high index of suspicion and understanding of the anatomy which affects the presentation, progression, treatment and complications of hand infections is required. This review describes the specific anatomy to be aware of to diagnose and manage hand infections completely, and highlights the near universal requirement for surgery to adequately clear infections in the hand. [ABSTRACT FROM AUTHOR]

"The Anatomy Lesson of Dr. Nicolaes Tulp" is considered one of the greatest paintings of Dutch Artist Rembrandt which probably shows the anatomical dissection of the hand vividly probably for the first time on a canvas along with the demonstration of the surgical anatomy by the Praelector Dr. Nicolaes Tulp to fellow surgeons and surgical trainees. The painting has been subjected to various scrutiny and debate by the present researchers for wrongful depiction of the anatomy of the hand muscles, and there were omissions and commissions by Rembrandt. Nevertheless, Rembrandt's painting of "The Anatomy Lesson of Nicolaes Tulp" probably gave direction in understanding muscles and their attachments for future anatomy and surgery textbooks. This painting might also be the first-ever depiction of the diabetic gangrenous limb. [ABSTRACT FROM AUTHOR]

This article provides clinical guidance on performing cannulation on an adult. The site, equipment selection and aseptic non-touch technique will be discussed. The clinical procedural technique of cannulation will be explained and the article will also provide an awareness of the dangers and complications of this invasive technique for both the patient and the health professional. [ABSTRACT FROM AUTHOR]

Forensic science plays a crucial role in the pursuit of justice, particularly through the identification of physical evidence found at crime scenes, such as human fingerprints and handprints. This study aimed to develop formulae for determining living stature using the handprint anthropometry of Tagalog people, an indigenous ethnic group in the Philippines. A total of 360 Tagalog volunteers, comprising 180 men and 180 women, were recruited. This study excluded subjects who had finger and hand-related diseases, injuries, or were under the age of 18. The materials used were a stadiometer for height measurement, a digital vernier caliper for handprint measurements, and a handprint kit to collect handprints. Five length measurements were collected for each handprint. The length measurement spanned the distance from the middle wrist crease to the tips of each of the five fingers. The data were analyzed statistically using regression analysis (p<0.05) in IBM SPSS Statistics for Windows, version 26.0 (IBM Corp., Armonk, N.Y., USA). The analysis results produced equations for determining stature using all the length measurements of the handprints. The study involved the calculation of correlation coefficients (r values) and standard deviations using the stature and handprint lengths of individuals of both genders. The results are presented in the form of tables and figures. The study concluded with the development of regression equations that may be utilized for determining stature based on various handprint length measurements of the Tagalog people. This study represents the first-ever anthropological study conducted on the Philippine Tagalog population within the scope of this research subject matter. The formulae can be applied to actual crime scenes for the purpose of personal identification. [ABSTRACT FROM AUTHOR]

Background: Atd angle indicates degree of axial triradius distal displacement. Triradius is the central point where ridges meet and radiate in three directions. Digital triradius is around base of digits II to V while axial triradius is near wrist crease of palms proximal portion. Type II diabetes is a polygenic illness that has higher heredity chance and disease susceptibility. Palm dermatoglyphics analysis can be used to study genetic disorders of hereditary origin although its accuracy is in question. Objective: to assess role of atd angle in screening of type II diabetics among adults in Western Kenya. Design: hospital based Cross-sectional study design Setting: Kakamega County Teaching and Referral Hospital, Western Kenya Participants: 150 diabetic patients (cases) compared with 150 non-diabetics (controls). Interventions: Demographic data was recorded and thereafter, palm prints taken using Indian-ink method. Main outcome measures: Atd angle was grouped in to 38º-40º; 41º -43º; 44º - 46º and ≥47º. Chi-square test was used to analyze difference in mean atd angle measurement. Results: Common atd angle measurement was between 38º-40º at 46.69% (280), and least common was ≥47º at 7.84% (47). There was no statistical difference in measurements among both males and female of diabetics and non-diabetics groups. Mean atd angle between non-diabetics and diabetics was 43.97º and 43.15º respectively but difference was not statistically significant (p=0.0998). Conclusion: Palm atd angle measurement did not contribute significantly in early screening of diabetes as there were no significant differences between diabetics and controls. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate hand muscle thickness in patients with rheumatoid arthritis (RA) and to investigate the relationship between muscle thickness and clinical factors and physical performance indicators. Materials and Methods: This cross-sectional study was conducted with 73 female participants between May 2022 and September 2022 (mean age: 60.83±9.73 years, range: 18-85). Among them, there were 37 RA patients (mean age: 60.8±9.9 years) diagnosed according to the 2010 American College of Rheumatology/European League Against Rheumatism RA classification criteria. The remaining 36 females were age- and sex-matched healthy subjects (mean age: 60.9±9.8 years). Thickness measurements of the thenar, hypothenar, and thigh muscles were obtained with ultrasound for all participants. In both groups, hand grip strength was measured using a hand dynamometer, and lower extremity performance assessments were made using 6-meter timed walk test (6MTWT) and a 5-time sit-to-stand test (5XSST). Disease activity score-28 (DAS-28), RA articular damage score (RA-ADS), and Duruöz Hand scale scores of RA patients were calculated. Results: Compared with the control group, thenar (p=0.004), hypothenar (p=0.000), and thigh (p=0.006) muscle thickness values were lower in RA patients. The RA group showed lower mean hand grip strength, longer time to complete 5XSST, and slower gait speed on 6MTWT (all p<0.01). Hand muscle thickness was negatively correlated with disease duration, RA-ADS, Duruöz Hand scale, and positively correlated with hand grip strength. Thigh muscle thickness was negatively correlated with age and 5XSST and positively correlated with hand grip strength and gait speed. Thickness measurements from all three muscles were not correlated with DAS-28. Conclusion: Hand muscle thickness of RA patients is affected by the disease regardless of age. Disease duration, articular damage, and decreased hand functions are closely related to muscle thickness. Low muscle thickness indicates reduced physical performance. [ABSTRACT FROM AUTHOR]

Body weight is a significant risk factor for the disease burden of noncommunicable diseases (NCDs). Anthropometric measurements are the first step in determining NCDs risk, and clinicians must have access to valid cutoffs. This study aims to review the literature of Saudi national guidelines and studies previously conducted in Saudi Arabia (SA) and to provide insights and recommendations to establish national guidelines in anthropometric measurements for Saudi adults/elderly in line with the Saudi 2030 Vision. In total, 163 studies were included, and 12 of them contributed to the development of specific anthropometric cutoffs. Cutoffs for metabolic syndrome, waist circumference, and body mass index were established in Saudi adults. However, limited studies were conducted in the elderly. This review warrants establishing standard cutoffs of Saudi adult anthropometrics to avoid over/underreporting of malnutrition and adiposity. This review will help policymakers and the Ministry of Health to establish national guidelines and standard cutoffs to be used in SA for anthropometric measurements that may assist in detecting malnutrition and NCDs. [ABSTRACT FROM AUTHOR]

Purpose: Exhaustive literature is available on the metacarpophalangeal joints of the long fingers, but the dorsal ligamentous structure overlaying the interosseous muscles and joining the metacarpal heads of the long fingers remains to be fully characterized. Previously, our surgical hand team observed a non-classically reported structure connecting the metacarpal heads of the long fingers, in the dorsal part of the intermetacarpal spaces. Therefore, the aim of this anatomical study was to characterize this ligamentous structure in terms of size, insertions, and anatomical position. Methods: Twenty-five hands were dissected for a total of 75 long finger intermetacarpal spaces. A ligamentous structure was exposed after cellular tissue excision and dorsal superficial fascia opening. The length and thickness were measured and anatomical position and insertions were studied. Histological analysis was performed on five specimens and ultrasound analysis in one healthy subject. Results: All 25 dissections revealed a dorsal ligamentous structure, hereafter named distal dorsal intermetacarpal ligament, which was inserted in the lateral tubercle of each adjacent long finger metacarpal head. This distal dorsal intermetacarpal ligament surrounded interosseous tendons. It was more proximal compared to oblique and transversal interosseous muscle fibers. Histological analysis confirmed the ligamentous nature of the structure. Ultrasound analysis showed that this structure was well identified under the dorsal aspect of the hand. Conclusion: All dissections revealed a tense ligamentous structure between each metacarpal head of the long fingers. This was a constant structure meeting the definition of a ligament. The distal dorsal intermetacarpal ligament seems to stabilize the metacarpal heads at the second and fourth spaces by limiting hyperabduction. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: Venous anatomy of the digits and the hand is poorly reported in the literature compared to arterial anatomy. While knowledge of the venous anatomy is crucial to ensure safe skin incisions, skin flap design, or blood return restoration for digital replantations, data in anatomical and clinical textbooks are rather limited. The purpose of this anatomical study was to describe the venous anatomy of the digits and the hand. Method: Our series reports descriptive results from 10 non-embalmed hand dissections from 5 different corpses. Hands were previously co-injected by arteries followed by veins with a different colored latex before being dissected under optical magnification (x4). Each anatomical specimen was photographed before being analyzed. Results: Each injection revealed both arterial and venous vascular systems. Latex injections were a useful technique to show the dorsal, volar superficial, and deep venous system. There was a constant and reliable topographic vascular anatomy of the superficial venous system of the digits and hand. However, we could not observe a high density of dorsal superficial venous valves as previously reported. Conclusion: The knowledge of the arrangement of the venous system of the digits and the hand should help the surgeon when performing surgical procedures in the hand. The surgeon should take into consideration this venous anatomy when performing skin incisions, skin flaps, or replantation procedures which would preserve the normal venous physiology as much as possible.

Objective: The present study is to document and provide information about both normal and variable morphology of the deep palmar arch (DPA) in adult human cadavers by the dissection method. Materials and Methods: We examined 12 upper extremities (6 cadavers). After the classification of the vascular patterns of DPA and its branches, measurements of the vessel diameters were carried out using a digital compass. Results: Deep palmar arch was found as a completed arch (100%) in all cases. The anastomosis between the distal deep palmar branch of the ulnar artery (DPBUA) and the terminal branch of the radial artery (RA) was the most common type in our study. The incidence of the DPA was reported as a complete arch ranging from 54.9% to 100%. Palmar metacarpal arteries (MPAs) originating from the DPA were divided into four branches (25%) in three cases and three branches (75%) in nine cases. The mean diameter of the MPAs at the point of origin at the DPA was between 0.3 mm and 0.6 mm. Conclusion: A comprehensive understanding of the DPA branching diameters in the hand will facilitate surgical and radiological approaches and contribute to a constantly expanding knowledge base in literature. [ABSTRACT FROM AUTHOR]

BACKGROUND: The hand anthropometric data is the baseline for design of hand tools and equipment. OBJECTIVE: This study aimed to generate the hand anthropometric database of male and female agricultural workers and compare it with the hand anthropometric data of other regions of India. The use of collected data is illustrated to design hand tools and protective gear. METHODS: Hand anthropometric data were collected from 228 male and 198 female agricultural workers of northeast India. A total of 35 hand dimensions, stature and body mass from different tribes in the age group of 18–60 years were precisely measured. Measured data were statistically analysed to study the effects of gender, ethnicity, and age on hand dimensions. Correlation coefficients were determined among hand dimensions and linear regression equations were developed between highly correlated dimensions. RESULTS: The results show that all hand dimensions of the male and female subjects are significantly different (p < 0.01). Most of the hand dimensions were significantly different (p < 0.05) among different tribes for the male subjects. However, less number of hand dimensions were significantly different among tribes for the female subjects. Age of the subjects has significant effects (p < 0.01) on dimensions related to thickness, depth and circumference of fingers. The use of these data in the ergonomic design of hand tools and personal protective gear is illustrated to increase safety and comfort as well as efficiency of operators. CONCLUSION: There is a difference in the hand dimensions of different tribes of northeast India. This needs to be considered when designing agricultural hand tools and equipment. [ABSTRACT FROM AUTHOR]

Context: Studies developed the frail elderly handgrip strength (HGS) diagnostic criteria using multiple types of handgrip dynamometers. If different handgrip dynamometers report different values, then this would have the potential to misclassify people into the wrong diagnostic category. Objective: To examine the characteristics of HGS measured by 2 standard handgrip dynamometers and to investigate the influence of hand size on HGS. Setting: University research laboratory. Participants: A total of 87 young and middle-aged adults between the ages of 20 and 60 years participated in this study. Main Outcome Measures: Standard methods of HGS measurements were used for hydraulic and Smedley spring-type dynamometers, although the participants were instructed to maintain an upright standing position in both tests. Results: Test–retest reliability of hydraulic and Smedley dynamometers provided comparable results to that observed with previous studies. However, the difference in HGS between the 2 dynamometers (Hydraulic–Smedley difference) was positively associated (r =.670, P <.001) with the mean of the 2 dynamometers. The participants who had relatively low HGS (at least <35 kg) produced similar HGS values when the 2 dynamometers were compared, whereas persons who had relatively higher HGS (at least >45 kg) produced greater strength values with the hydraulic compared with the Smedley. The hand and palm lengths were weakly correlated (r =.349 and r =.358, respectively, both Ps <.001) with the difference in HGS between the 2 dynamometers. Conclusions: Test–retest reliability of hydraulic and Smedley dynamometers provides comparable results to previous studies. However, the difference in HGS between the 2 dynamometers was positively associated with the mean of the 2 dynamometers. This Hydraulic–Smedley difference would not affect persons who have relatively low HGS (at least <35 kg), while when HGS is relatively high, the comparison between dynamometers should be done with caution. [ABSTRACT FROM AUTHOR]

Augmented reality (AR) and virtual reality (VR) hand hygiene training has been developed for healthcare workers, but has not yet been applied to care homes. This qualitative realist study seeks to capture care home workers' theories concerning how and in what contexts AR or VR training delivered via smartphone apps might work in promoting their hand hygiene practice. Semistructured interviews were conducted with 25 care home workers across three residential and three nursing care homes in Northern England. The interviews explored hand hygiene practices and training in care homes. Participants also provided feedback on an existing programme theory that explains how, for whom, and in which contexts AR/VR might be used to upskill health and care workers. Data were analysed on NVivo using a combined deductive and inductive approach. Participants had varying experiences with hand hygiene training, highlighting an opportunity to refresh skills. Repeated practice, interactive learning, feedback, reminding, and perceived task realism were considered important for hand hygiene and could be trigged by AR/VR. There was less support for other mechanisms including deep immersion, practice in a safe environment, visualisation of personal anatomy (hands) and mistakes, and perceived realism of the imagery and environment. Expected outcomes were effective learning, learner satisfaction, enhanced hand hygiene skills, and infection control. Three themes explained how context matters when implementing AR/VR training: learners (e.g., comfort and preference), care homes (e.g., policies, staffing, and infrastructure), and technology (e.g., cost and using a VR headset). Overall, participants theorised that AR/VR could refresh hand hygiene and trigger repeated practice, interactive learning, feedback and reminding, and task realism. Future work should test the mechanisms and technology in care homes. Hand hygiene training in care homes should consider implementation factors by offering alternative technologies, providing technical support, and working with managers to determine the most appropriate choice of technology. [ABSTRACT FROM AUTHOR]

Background: The estimation of gender using hand dimensions is a crucial role in forensic investigation and legal sciences. Objectives: In this study, the mean score of hand measurements have been derived and linear discriminant analysis has been applied to predict gender from hand dimensions. An independent t-test has been employed to know discrimination between male and female. The accuracy of gender estimation has been derived and checked by ROC curve. Material and Methods: A sample of 150 participants has been collected for the completion of this study, where 78 males and 72 females were found aged between 18 and 24 years. The breadths and lengths of left and right hands of the participants have been measured. Results: Respondents' mean score of length and breadth of left hand were found 17.69 ± 1.30 and 7.56 ± 1.17, respectively. It was found to be significantly different in the respondents' mean scores of males and females. Conclusions: The hand dimensions of males were higher than females. The prediction of a number of females and males were 76 and 74, respectively, and its accuracy was observed 0.87. This research can be applied for larger sample and would be helpful in predicting gender discrimination among adults through hand dimensions. [ABSTRACT FROM AUTHOR]

• Pinch MVC (maximal voluntary contraction) is not correlated to dexterity • Pinch MVC and E-MVC (extension maximal voluntary contraction) values have different decline over ageing. • No difference in E-MVC (extension maximal voluntary contraction) was observed between hands • In heaviest occupations there is no difference in Palmar pinch MVC between hands • The anthropometric factor most correlated with pinch MVCs is height Cross-sectional study. Flexion (Palmar Pinch, PP-MVC and Tip Pinch, TP-MVC) and extension (E-MVC) maximal voluntary contraction (MVC) of the index-thumb system offers a quick way to estimate the level of hands' impairment in several musculoskeletal and neurologic conditions. This study established normative data of PP-MVC, TP-MVC, E-MVC in the Italian population and evaluated their correlation with hand dominance, anthropometric factors, dexterity and workload level. In our study, 303 healthy people (150F, 153M) were recruited. Participants performed PP-MVC, TP-MVC and E-MVC tests per hand, conducted by using a pinch-gauge. T-test was used to analyze MVC means between sexes and between hands. One-way ANOVA was conducted to compare MVC means in male and female samples stratified by age (18-29, 30-44, 45-59, 60-74, +75). Spearman's correlation analysis was performed to determine anthropometric variables, dexterity and workload level effects on MVCs. Medium-to-large effect sizes of age were shown in the majority of tasks. The 30 to 44 years and then +75 years age groups showed the highest and the lowest values, respectively, for both sex and both hands. Men were meanly 50% stronger, and the dominant hand showed higher values (6-10%). MVC-tests correlated moderately with weight and height weakly with dexterity and workload level. After 30 to 44 years, hand strength declines in line with the normal process of aging that also entails muscle fibers and the reduction of daily activities in older adults. In relative terms, E-MVC showed the highest strength loss in the over 75 seconds. The difference between sexes was higher in E-MVC than in flexion MVCs. E-MVC seems to depend more on musculoskeletal architecture that differs from women to men, according to the highest correlation between E-MVC and anthropometric variables. Only high workload levels impacted hand strength. In heaviest occupations, no PP-MVCs differences were observed between hands. [ABSTRACT FROM AUTHOR]

Purpose: Understanding the anatomy of the deep neurovascular structures of the hand is essential in surgical planning. There is a lack of literature regarding hand size and its influence in branching variation and the distances between branches of various neurovascular structures. Our study quantifies the variation in branching distances of the deep ulnar nerve and deep palmar arch branches. Methods: Twenty-five fresh-frozen cadaveric hands were dissected. Each branch of the deep ulnar nerve and deep palmar arch was identified. The distance from the most distal portion of the pisiform to the proximal aspect of the branch was measured. The relationship between the length of the third metacarpal and the distance of each branch from the pisiform was examined. Results: There was no relationship between branching differences in the deep ulnar nerve and the length of the third metacarpal. There was a significant association between the length of the third metacarpal and the second, third, and fourth branches of the deep palmar arch (p < 0.05). Conclusions: Our study found a significant association between the branching distances of the second, third, and fourth branches of the deep palmar arch and hand size as measured by the length of the third metacarpal. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate whether body proportions change as stature increases in elite Spanish athletes. The sample includes a total of 2,030 participants, comprised of 1,357 adult males, and 673 adult females. The male athletes were classified into five groups by stature, and the female athletes were classified separately into four stature groups. Ten anthropometric measurements were collected, and eleven body proportions were calculated. The body proportions with significant differences between stature groups in males were relative arm length (0.53–1.60%), relative forearm length (0.69–2.08%), relative thigh length (1.17–1.56%), relative tibial length (1.37–6.39%), cormic index (−0.94 – −4.49%), Manouvrier index (1.60–9.60%), and crural index (1.05–4.79%). In females, the body proportions with significant differences were relative forearm length (1.43%), relative thigh length (1.94–3.88%), relative tibial length (2.74–4.56%), cormic index (−0.74 – −3.72%), and Manouvrier index (1.97–8.71%). The distal parts of the upper and lower limbs increase proportionally as stature increases, whereas relative hand and foot lengths, which are the most distal parts of the extremities, remain constant in elite athletes. [ABSTRACT FROM AUTHOR]

Purpose: To explore the distribution and prevalence of osteoarthritis in metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints in long fingers in a cadaveric study, and to discuss potential biomechanical influences on these patterns., Methods: This cadaveric study evaluated 144 metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints from 12 embalmed cadaver hands. A dorsal dissection approach was used to expose the joints, which were then marked with color-coded pegs for consistent orientation during imaging. High-resolution digital images of the distal articular surfaces were captured for analysis. The images were analyzed using custom software to quantify osteoarthritic areas, distinguishing between radial and ulnar aspects. Percentage affected joint surface was calculated using pixel-based measurements. Statistical analysis was used the Student t-test and ANOVA, with the significance threshold set at p < 0.05 and 95% confidence intervals RESULTS: The ulnar side of the proximal interphalangeal joint in digits 2 and 3 showed higher prevalence of osteoarthritis (59.31% ± 15.48%) than the radial side (40.68% ± 15.48%), p = 0.007; in contrast, for digits 4 and 5, prevalence was greater on the radial (54.3% ± 10.99%) than the ulnar side (45.7% ± 10.99%), p = 0.007. No significant differences were noted in osteoarthritis distribution between the radial and ulnar aspects of the metacarpophalangeal and distal interphalangeal joints., Conclusions: This study identified distinct patterns of osteoarthritis distribution in long-finger joints, with greater prevalence in the proximal interphalangeal joints. Although there were differences between stable (digits 2 and 3) and mobile (digits 4 and 5) fingers, further research is necessary to conclusively determine the role of biomechanical forces in the development of osteoarthritis. These findings lay the groundwork for future studies of the pathophysiology of osteoarthritis in the hand, and could guide the development of preventive and therapeutic interventions., (Copyright © 2024 SFCM. Published by Elsevier Masson SAS. All rights reserved.)

Rock climbers believe chalk dries the hands of sweat and improves the static coefficient of friction between the hands and the surface of the rock. The purpose of this study was to assess whether chalk affects geometric entropy or muscular activity during rock climbing. Nineteen experienced recreational rock climbers (13 males, 6 females; 173.5 ± 7.0 cm; 67.5 ± 3.4 kg) completed 2 climbing trails with and without chalk. The body position of the climber and muscular activity of the finger flexors was recorded throughout the trial. Following the movement sequence participants hung from a standard climbing hold until they slipped from the climbing structure, while the coefficient of friction and the ratio of the vertical forces on the hands and feet were determined. Although there were no differences in the coefficient of friction (P = .748), geometric entropy (P - .359), the ratio of the vertical forces between the hands and feet (P = .570), or muscular activity (P = .968), participants were able to hang longer after the use of chalk 62.9 ± 36.7 s and 49.3 ± 25.2 s (P = .046). This is advantageous because it may allow for prolonged rests, and more time to plan the next series of climbing moves. [ABSTRACT FROM AUTHOR]

Date Presented 03/21/24 OT students benefit from detailed hand anatomy instruction. This study investigated students' perceptions of participation in a learning activity using a translucent, three-dimensional model of the hand with video narration. Primary Author and Speaker: Christine T. Myers Additional Authors and Speakers: Michael Cricchio, Rebecca A. Piazza, Morgan Yacoe [ABSTRACT FROM AUTHOR]

Many anatomical details and variants occur in the finger tendons and soft tissue structures. These may lead to misdiagnosis if the radiologist is not well aware of them. We discuss the midhand extensor tendons, dorsal hood, junctura tendinea, conjoint tendons, transverse retinacular ligament, triangular ligament as well as central and distal slip anatomy and ultrasound correlation. The dorsal hood is an important structure to center the tendons at the midportion of the MCP heads, and the sagittal bands are its main components. Two tendons are present at the second digit, and two or more at the fifth digit. The extensor mechanism is anatomically interrelated with the palmar lumbricals and interosseous tendons. At the palmar side, the flexor superficialis and profundus tendons show varying relationships along the finger. The flexor profundus passes through an opening in the flexor superficialis. We also discuss the chiasma crurale, ridges at the flexor superficialis insertions and bifid flexor profundus tendon. Although a typical distribution of annular pulleys can be observed, many variants may be present of which we address some. The volar plate is a midline fibro-cartilaginous meniscus attached proximally to the well-identifiable checkrein ligaments and distally to the base of the phalanges. Knowledge of these details and variations allows for better understanding of the finger and hand ultrasound.

Microscopic anatomical study of the hand requires difficult or destructive dissection techniques for each anatomical structure. Synchrotron phase‐contrast imaging (sPCI) allows us to study precisely, at a microscopic resolution and in a nondestructive approach, the soft tissues and bone structures within a single 3D image. Therefore, we aimed to assess the capacity of sPCI to study the arterial anatomy of the hand and digits in human cadavers for anatomical purposes. A non‐injected hand from an embalmed body was imaged using sPCI at 21‐µm pixel size. The vascularization and innervation of the hands were virtually reconstructed at 84‐µm resolution, and the medial neurovascular bundle of the third digit at 21 µm. The thinner‐most distal structures were observed and reported. The diameter and thickness of the vascular and neural structures were defined on 2D computed tomographic axial projections, and using a granulometry method coupled to the 3D reconstructions. The vascularization of the hand was visible from the radial and ulnar arteries to the distal digital transverse anastomoses. The thinnest structure observed was the anastomotic arterial network around the proper palmar digital nerve. The latter emerged from the proper palmar digital artery and vascularized the nerve around its whole length and circumference. The perineural arterioles individualizable at this resolution had a diameter of 66–309 µm. In conclusion, sPCI allows both the arterial and neural anatomy of the hand to be studied at the same time, as well as the anatomical interactions between both networks. It facilitates the study of structures that have different sizes, diameters, thickness, and histological origin with great precision, in a noninvasive way, and using a single technique. [ABSTRACT FROM AUTHOR]

PURPOSE: Multiple synostoses syndrome (MSS) is a rare genetic condition. Classical features consist of joint fusions which notably start at the distal phalanx of the hands and feet with symphalangism progressing proximally to carpal, tarsal, radio-ulnar, and radio-humeral joints, as well as the spine. Usually, genetic testing reveals a mutation of the NOG gene with variable expressivity. The goal was to present the anatomical, functional, and radiological presentations of MSS in a series of patients followed since childhood. METHODS: Patients with more than 3 synostoses affecting at least one hand joint were included. When possible, genetic screening was offered. RESULTS: A retrospective study was performed from 1972 to 2017 and included 14 patients with a mean follow-up of 18.6 years. Mutation of the NOG protein coding gene was seen in 3 patients. All presented with tarsal synostoses including 9 carpal, 7 elbow, and 2 vertebral fusions. Facial dysmorphia was seen in 6 patients and 3 were hearing-impaired. Surgical treatment of tarsal synostosis was performed in 4 patients. Progressing joint fusions were invariably seen on x-rays amongst adults. CONCLUSION: Long radiological follow-up allowed the assessment of MSS progression. Feet deformities resulted in a severe impact on quality of life, and neurological complications secondary to spine fusions warranted performing at least one imaging study in childhood. As there is no treatment of ankylosis, physiotherapy is not recommended. However, surgical arthrodesis for the treatment of pain may have reasonable outcomes. [ABSTRACT FROM AUTHOR]

Theoretical development of the inter-relationship between sex determination and hand dimensions is important in the identification of mutilated and skeletal remains found in several mass disasters and fatal assault cases. The primary aim of the study was to determine sex from hand dimensions (HL: hand length and HB: hand breadth) of adult Rajbanshi individuals. Data for the present study were obtained from 400 (200 males; 200 females) unrelated adult (aged 20-60 years) Rajbanshi individuals. The data was statistically analyzed using statistical tests such as descriptive statistics, one-way analysis of variance (ANOVA) and two-way ANOVA. Binary Logistic Regression was employed to develop predictive sex models. We found that the mean values of HL and HB of both hands were higher in males compared to females. Statistically significant sex differences were found in hand lengths only. Bilateral differences in HL and HB were found to be statistically significant in both sexes. Predictive sex models were found to be significant (p<0.05) and bear reliable accuracies for both sexes separately as well as combinedly. It could be inferred that hand dimensions can identify sex with reasonable accuracy. However, hand length appeared to be the most reliable sex discriminator. [ABSTRACT FROM AUTHOR]

Supplemental digital content is available in the text. Wrist/hand pain is a prevalent musculoskeletal condition with a great spectrum of etiologies (varying from overuse injuries to soft tissue tumors). Although most of the anatomical structures are quite superficial and easily evaluated during physical examination, for several reasons, the use of ultrasound imaging and guidance has gained an intriguing and paramount concern in the prompt management of relevant patients. In this aspect, the present review aims to illustrate detailed cadaveric wrist/hand anatomy to shed light into better understanding the corresponding ultrasonographic examinations/interventions in carpal tunnel syndrome, trigger finger, de Quervain tenosynovitis, rhizarthrosis, and the radiocarpal joint arthritis. In addition, evidence from the literature supporting the rationale why ultrasound guidance is henceforth unconditional in musculoskeletal practice is also exemplified. [ABSTRACT FROM AUTHOR]

Amaç: Bu çalışma, Resim-İş Eğitimi özel yetenek sınavına giren adayların el anatomisinin (parmak uzunlukları, el bileği çap, çevre ve hareket genişliği ölçümleri) desen sınavında aldıkları puan ile ilişkisi olup olmadığını ortaya koymayı amaçlamaktadır.Gereç ve Yöntem: Türkiye’deki bir üniversitenin Eğitim Fakültesi Güzel Sanatlar Eğitimi Bölümü Resim-İş Eğitimi Anabilim Dalı Özel Yetenek Sınavı’na giren adaylar çalışmaya dahil edilmiştir. Öğrencilerin dijital kaliper, esnek olmayan mezura ve dijital inklinometre kullanılarak parmak uzunlukları, el bileği çapı, çevresi ve hareket genişlikleri ölçülmüştür. Bulgular: Çalışmamıza 18-25 yaş arası 161 öğrenci (60 erkek, 101 kız öğrenci) dahil edilmiştir. Desen sınavında elli ve üzerinde puan alan 49 kız, 35 erkek öğrenci, kırk dokuz ve altında puan alan 52 kız, 25 erkek öğrenci bulunmaktadır. Çizim başarısı puanı elli ve üzerinde olan ile kırk dokuz ve altında olanların antropometrik özellikleri karşılaştırıldığında anlamlı fark elde edilememiştir. Sonuç: Bu çalışma, çizim becerisine etki eden pek çok unsurun olduğu ve tek başına antropometrik standartlarla çizim başarısı arasındaki ilişkinin ifade edilmesinin zor olduğunu göstermiştir.

The article presents a case study of a 77-year-old woman with left knee pain and swelling. Gray mode sonography revealed a large suprapatellar effusion containing rice bodies, along with large osteophytes and meniscal calcification. The patient was successfully treated with colchicine and an intraarticular injection of Depo-Medrol, leading to symptom resolution.