![]() ![]() Abductor pollicis brevis also acts by drawing the thumb away from the midline, which is the action of abduction for all muscles. It originates at the tubercles of the scaphoid and trapezium and inserts at the lateral aspect of the proximal phalanx of the thumb. The abductor pollicis brevis muscle is positioned anterior to the opponens pollicis and is the primary muscle providing the act of opposition. It permits the thumb to perform opposition which is the motion of reaching across the palm towards the little finger, by flexing and medially rotating the metacarpal on the axis of the trapezium. The largest of the three muscles, opponens pollicis, originates at the tubercle of the trapezium and inserts at the lateral margin of the metacarpal of the thumb. These muscles form the bulge on the palmar surface of the thumb and palm, called the thenar eminence. The thenar muscles are a group of three muscles that act on the thumb. These muscles primarily produce fine motor movements. These muscles are divided into thenar, hypothenar, and adductor compartments. When performing fasciotomies for UECS, special emphasis must be placed to decompress the muscles of the deep flexor compartment due to their nonredundant blood supply which makes them especially prone to ischemic damage (Inoue and Taylor Plast Reconstr Surg 98:195–210, 1996).Intrinsic hand muscles originate and insert from the bones, ligaments, and fascia of the hand. There are ten designated hand compartments which can be affected in hand compartment syndrome as seen, for instance, in crushing injuries (exploded hand syndrome), fractures and dislocations, as well as extravasations. UECS is most commonly encountered in the forearm, which has three designated compartments (i.e., the lateral (mobile wad), the dorsal extensor, and the volar) of which contains the bulk of muscle mass in the flexor compartment. Orthopedics 36:e121–e125, 2013), and electrical trauma (Lee et al. ![]() ![]() Several additional etiologies are pertinent to UECS such as iatrogenic extravasations of intravenous fluids, upper extremity arterial catheterizations (Omori et al. UECS shares common etiologies for CS seen in other body areas: either an external reduction of CS size such as external pressure from casts, dressings, and gravity or increase in compartmental size as seen in bleeding and fracture displacement, microvascular barrier damage in ischemia, burn injury, and envenomations (Leversedge et al. Given this important physiologic function, one can argue that the functional loss due to an established CS is higher than that of the lower extremity.įor UECS, a high level of alertness to clinical symptoms such as pain to passive stretch and increasing pain or analgesic requirements is key to not miss the diagnosis in the alert patient. Injury 45(Suppl 6):S16–S20, 2014).ĬS of the forearm is the second most common cause of CS in the extremities given the injury proneness of the upper extremity and hand as a prime organ of prehension and grasp (Leversedge et al. J Am Acad Orthop Surg 25:e109–e113, 2017 Marchesi et al. Compartment syndrome (CS) is a feared orthopedic complication and common cause for permanent functional damage and limb loss as well as one of the most common causes for litigation in orthopedic surgery (DePasse et al. ![]() Early fasciotomy is the standard of care for upper extremity compartment syndrome (UECS) and may prevent the development of irreversible contractures of forearm and hand musculature, a pathology initially described by Volkmann (VOLKMAN Centralblat fur hirurgie 8:801–803, 1881). ![]()
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