Volar Plate

The term volar plate can be used for a plate fixed on volar aspect of bone but in this article we discuss an anatomical structure.

Volar plate in the hand [also referred to as palmar or volar ligaments] are fibrocartilaginous structures found in the metacarpophalangeal and interphalangeal joints.

Their main function is reinforcement of the joint capsules, increase in joint stability, and limitation of hyperextension.

volar-plateThis fibrocartilaginous structure is attached to the base of the proximal phalanx distal to the joint. From there, it forms a palmar continuation of the articular surface of the phalanx bone and its inner surface thus adds to the articular surface during extension.

In its proximal end, the volar plate becomes membranous and blends with the volar capsule which is attached to the head of the metacarpal bone.

The volar plate of the distal interphalangeal joint has a proximal attachment weakly confluent with the distal extent of the flexor digitorum superficialis tendon

During flexion, the plate glides proximally down the volar surface of the metacarpal head. Its flexible attachment to the phalanx bone not only prevents it from restricting joint movements, but also prevents the long flexor tendons from being pinched in the joint.

Text adapted from Wikipedia

What Is Granulation Tissue?

Granulation tissue is collagen-rich tissue formed during proliferative phase of wound healing.

When initially formed, the granulation tissue is light red or dark pink in color and rich in capillary blood vessels. It is soft, moist and granular in appearance.

It is a natural stage in wound healing. But sometimes there is an overproduction and granulation tissue found in abnormal quantity, a condition known as proud flesh. [Read more...]

Lunula

The lunula literally means little moon in Latin or lunulae. Lunula is the crescent shaped whitish area of the bed of a fingernail or toenail. The lunula is the visible part of the nail matrix.

nail

It is located at the end of the nail (that is closest to the skin of the finger), but it still lies under the nail. It is not actually white but only appears so when it is seen through the nail.

Lunula is a very delicate part of the nail structure. Damage to lunula would result in permanent deformation of the nail.

The lunula is most noticeable on the thumb and it is not visible in every person.

Dimon Hughston Osteotomy

Dimon and Hughston described technique of trochanteric osteotomy which results in valgus angulation and medial displacement.

The osteotomy is used to improve stability in unstable intertrochanteric fractures.

Hyaluronic Acid

Hyaluronan (hyaluronic acid or hyaluronate or HA) is an anionic, nonsulfated glycosaminoglycan distributed widely throughout body and has highest concentrations in fluids in the eyes and joints.

In body, hyaluronic acid is involved in the wound repair process, inflammation, reepithelization of normal epidermis, cancer metastases.

Uses

Hyaluronan is used in eye surgery, osteoarthritis of knee, atopic dermatitis, tumor marker for prostate and breast cancer, to prevent postoperative adhesions in pelvic surgery. [Read more...]

What is Glycosaminoglycan?

Glycosaminoglycans or mucopolysaccharides are long unbranched polysaccharides consisting of a repeating disaccharide unit.

Functions

Glycosaminoglycans  form a part  of connective tissues. Heparin as an anticoagulant, hyaluronan is  a component in the synovial fluid and chondroitins are found in cartilage and tendon.

Chondrotoin sulphate is most prevalent glycosaminoglycan.

Chondrotoin has been used in osteoarthritis.

What is Polidocanol?

Polidocanol is a local anaesthetic and antipruritic component of ointments and bath additives.

The substance is also used as a sclerosant, an irritant injected to treat varicose veins leading to fibrosis inside varicose veins and occlusion the lumen of the vessel.

This helps to reduce varicosity.

Polidocanol injections for the treatment of

 

  • Uncomplicated spider veins (very small varicose veins < 1 mm in diameter)
  • Uncomplicated small varicose veins (1 to 3 mm in diameter) known as reticular veins

Polidocanol works by damaging the cell lining of blood vessels, causing them to close and eventually be replaced by other types of tissue.

Recently, Polidocanol has been reported to be used in tennis elbow.

 

Source

Wikipedia

What is Prolotherapy?

Other Names

  • Proliferation therapy
  • Regenerative injection therapy
  • Proliferative injection therapy

What is Prolotherapy?

Prolotherapy involves injecting a generally non-pharmacological  and non-active irritant solution into the body for the purpose of strengthening weakened connective tissue and alleviating musculoskeletal pain. [Read more...]

What Is Ulnar Translocation

Ulnar translocation results from ulnar migration of the carpus along ulnar inclination of the distal radius.

There are two types of ulnar translocations

Type I – Complete ulnar translocation of the carpus, sparing the scaphoid which maintains its normal elation to the carpus.
Type II – Associated with scapholunate dissociation, lunotriquetral dissociation and other forms of perilunate disability.

Causes

This pattern of instability has been well recognized in patients with rheumatoid arthritis as a result of articular erosions and attenuation of wrist ligaments. [Read more...]

Types of Carpal Instability

A wrist is considered stable when the modifications brought about by the various forces acting on it are restored when the said forces stop to act.

In contrast, the alteration of one or more of the structures responsible for stability lead to preclusion of the restoration of the order and leads to misalignment and decrease in performance of the organ.

This happens when takes wrist is damaged by trauma, chronic inflammation or anatomical alterations like ulnar variance and and neoplasms.

Carpal instability often depends on capsular integrity and on the interosseous ligaments. It can be

  • Dynamic instability – This occurs in incomplete injury. The wrist maintains normal alignment at rest but will collapse under applied load
  • Static Instability – This occur in complete injury to the structure involved. This kind would show  abnormal intercarpal alignment on static radiographs

Further, carpal instability is said to be of following types. Each link would take you to the details of the particular  instability [Read more...]