Hand clinics
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The importance of internal anatomy of the peripheral nerves to nerve repair in the forearm and hand.
We have completed and analyzed recent studies on the internal topography of the median and ulnar nerves of the forearm and hand. These findings have been compared with the classic studies of Sir Sydney Sunderland and more recent work by other authors has been included. Our studies confirm that there is a complex interfascicular relationship between the various components of the median and ulnar nerves in the forearm and hand, but, with careful dissection, several anatomic relationships can be defined. ⋯ Intraneural neurolysis can be safely performed if detailed knowledge of the internal topography of the peripheral nerves is understood. This knowledge may also be applied to the dissection and management of neuromas in continuity. The increased awareness of the interfascicular relationships of the peripheral nerves may well influence a more favorable outlook in the care of patients with nerve injuries.
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This article discusses the psychological problems that may arise following upper extremity traumatic amputation. Members of a health team consisting of surgeon, hand therapist, and counseling psychologist describe their individual and group functions in assisting the patient's recovery.