Hand & Upper Limb Orthopaedic Topics

Hand, wrist, elbow & shoulder. 137 evidence-informed references covering conditions, classifications, management and high-yield exam notes for FRCS (Tr&Orth), FRACS, EBOT and ABOS preparation.

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Adhesive Capsulitis (Frozen Shoulder)Exam-focused guide to adhesive capsulitis (frozen shoulder): what it is, the inflammation-then-fibrosis pathology of the capsule, the three clinical stages, how it is a clinical diagnosis with global loss of passive external rotation, the link with diabetes, the evidence behind injection, physiotherapy, hydrodilatation, manipulation under anaesthesia and arthroscopic capsular release, and the practical rules for the exam.
Adult Brachial Plexus InjuryExam-focused guide to adult traumatic brachial plexus injury: applied anatomy of the five-section plexus, preganglionic versus postganglionic injury, the supraclavicular versus infraclavicular patterns, how to examine and image (clinical signs, CT myelography, MRI), why timing of surgery matters, and the reconstructive ladder of neurolysis, nerve graft, nerve transfer and free functioning muscle transfer.
ALPSA LesionsComprehensive guide to Anterior Labroligamentous Periosteal Sleeve Avulsion (ALPSA), a variant of Bankart lesion characterised by medialized healing.
Animal BitesComprehensive guide to the management of animal bites, focusing on microbiology, antibiotic prophylaxis, and surgical indications.
Anterior Interosseous Nerve AnatomyComprehensive guide to the Anatomy of the Anterior Interosseous Nerve (AIN), including its course, innervation, variants (Martin-Gruber), and clinical syndrome (Kiloh-Nevin).
Anterior Interosseous Nerve SyndromeComprehensive guide to anterior interosseous nerve syndrome including anatomy, clinical presentation, differential diagnosis with Parsonage-Turner syndrome, and management from observation to surgical decompression.
Axillary Nerve AnatomyComprehensive guide to the anatomy, clinical assessment, and management of Axillary Nerve injuries
Blood Supply of the ForearmComprehensive anatomy of the Radial and Ulnar arteries, their branches, anastomoses, and clinical relevance.
Boutonniere DeformityComprehensive guide to Boutonniere Deformity (Central Slip rupture), covering anatomy, Elson's test, and management protocols.
Brachial Plexus AnatomyFellowship-level anatomy of the brachial plexus: roots, trunks, divisions, cords and terminal branches; the branch at each level; Erb's vs Klumpke's palsy; and the supraclavicular/infraclavicular surgical map.
Bristow-Latarjet ProcedureComprehensive guide to the Bristow and Latarjet coracoid transfer procedures for anterior shoulder instability with bone loss, including indications, surgical technique, complications, and outcomes.
CamptodactylyComprehensive guide to camptodactyly including classification, pathoanatomy, clinical presentation, conservative management with splinting, surgical indications, and FRACS exam preparation.
Carpal Boss (Carpometacarpal Boss)Fellowship-level guide to the carpal boss (carpe bossu) - a symptomatic bony prominence on the dorsum of the wrist at the second/third carpometacarpal joints (a localised osteoarthritic osteophyte/exostosis at the base of the index/middle metacarpal and adjacent trapezoid/capitate) - covering its presentation as a fixed, hard dorsal lump distinct from a ganglion, the diagnosis (the 'carpal boss view'/CT), and a non-operative-first management with simple excision of the exostosis for refractory pain (fusion reserved for secondary CMC instability).
Carpal Instability - DISI/VISIComprehensive guide to dorsal and volar intercalated segment instability patterns - classification, diagnosis, and management for orthopaedic exam preparation
Carpal Tunnel SyndromeComprehensive guide to carpal tunnel syndrome, including anatomy, diagnosis, electrodiagnostic criteria, and surgical release techniques for FRACS exam preparation
Central Slip InjuriesComprehensive guide to central slip extensor tendon injuries of the finger, including diagnosis, treatment, and boutonniere deformity prevention.
Charcot (Neuropathic) Arthropathy of the ShoulderFellowship-level guide to neuropathic (Charcot) arthropathy of the shoulder: the painless, grossly destructive glenohumeral joint of syringomyelia, its pathophysiology (loss of proprioception/protective sensation), the classic radiographic 'bag of bones' destruction, the crucial differential from tumour and infection, and the largely supportive management with surgery reserved for selected cases.
Charcot (Neuropathic) Joint of the ElbowFellowship-level guide to the Charcot (neuropathic) joint of the elbow - a progressive, destructive arthropathy of an insensate joint - whose classic cause is SYRINGOMYELIA (and other causes of upper-limb sensory loss), presenting with a strikingly swollen, often relatively painless, unstable elbow with marked radiographic destruction/debris - covering the work-up (notably MRI of the cervical spine for a syrinx), the differential from infection and tumour, and the largely supportive management.
Cleft HandComprehensive guide to cleft hand (typical and atypical ectrodactyly) including Manske-Halikis classification, associated syndromes, functional assessment, and surgical reconstruction for FRACS examination.
ClinodactylyComprehensive guide to clinodactyly including delta phalanx, bracket epiphysis, associated syndromes, indications for surgery, and corrective osteotomy techniques for Orthopaedic examination.
Complex Metacarpophalangeal Joint DislocationComprehensive guide to irreducible dorsal metacarpophalangeal joint dislocations, including Kaplan lesion, volar plate interposition, pathognomonic signs, and surgical approaches for reduction.
Congenital Clasped ThumbFellowship-level guide to congenital clasped thumb - a progressive flexion and adduction deformity of the thumb (held flexed/adducted into the palm) caused by a deficient or absent extensor mechanism (extensor pollicis brevis/longus), often with first-web narrowing and metacarpophalangeal-joint laxity - covering the supple vs complex (rigid) classification, the syndromic associations, and a management algorithm of early splinting first (effective for flexible types) and surgical reconstruction (tendon transfer, web release, capsular stabilisation) for complex or splint-resistant thumbs.
CRPS - Hand (Complex Regional Pain Syndrome)Diagnosis, Budapest Criteria, and multidisciplinary management of CRPS Type I and Type II in the hand.
Crystalline Arthropathy of the HandComprehensive guide to crystalline arthropathies affecting the hand including gout and CPPD, clinical presentation, crystal identification, medical management, and surgical indications for tophaceous gout and chronic arthropathy.
Cubital Tunnel SyndromeComprehensive guide to cubital tunnel syndrome including McGowan grading, Froment's and Wartenberg's signs, and surgical treatment options.
Cutibacterium acnes Shoulder Periprosthetic InfectionComprehensive guide to Cutibacterium acnes periprosthetic joint infection of the shoulder, including diagnosis, microbiology, surgical management, and antibiotic strategies.
De Quervain TenosynovitisComprehensive guide to first dorsal compartment stenosing tenosynovitis
Deep Space Infections - HandComprehensive examination guide to deep space infections of the hand including anatomical spaces, clinical presentations, surgical drainage techniques, and antibiotic management
Deltoid Rupture / AvulsionFellowship-level guide to deltoid muscle rupture/avulsion - an uncommon injury, most often IATROGENIC (notably anterior-deltoid detachment after open or arthroscopic acromioplasty/cuff surgery), occasionally traumatic or secondary to massive rotator cuff failure - covering the resulting deltoid insufficiency (weakness, pain, anterosuperior escape), the diagnosis, and the difficult surgical repair/reconstruction with the key principle that deltoid origin must be protected and meticulously repaired at the time of shoulder surgery.
Digit and Hand ReplantationComprehensive exam guide to digit and hand replantation - indications and absolute/relative contraindications, warm and cold ischaemia times for digits and the proximal upper limb, the classical sequence of repair (bone, extensor, flexor, artery, nerve, vein), microvascular anastomosis technique, anticoagulation, post-operative monitoring and salvage of the failing replant, Chen and Tamai functional outcome criteria, and the decision-making between replantation and revision amputation for FRACS, FRCS and board examinations
Digital Nerve CompressionComprehensive guide to Digital Nerve Compression syndromes, including Bowler's Thumb, Harpist's Finger, and their management.
DIP Joint ArthritisComprehensive guide to distal interphalangeal joint arthritis - classification, clinical assessment, non-operative and surgical management including arthrodesis and arthroplasty.
DRUJ Arthritis (Distal Radioulnar Joint Arthritis)Degenerative or post-traumatic arthritis of the distal radioulnar joint causing ulnar-sided wrist pain and forearm rotation limitation, managed with conservative measures or surgical procedures including DRUJ arthroplasty and salvage procedures
Dupuytren's DiseaseComprehensive guide to Dupuytren's contracture: pathophysiology, classification, surgical indications, treatment options, and recurrence management for FRACS exam preparation
Elbow Interposition / Distraction ArthroplastyFellowship-level guide to interposition (and distraction interposition) arthroplasty of the elbow: a joint-preserving, bone-preserving alternative to total elbow arthroplasty for the young, high-demand patient with end-stage (usually post-traumatic) elbow arthritis; the technique (resurfacing the debrided distal humerus with an interposed soft-tissue graft, with or without a hinged distraction external fixator), the central importance of elbow stability, the modest but useful outcomes, and conversion to total elbow arthroplasty.
Epidermal (Epidermoid) Inclusion Cyst of the HandFellowship-level guide to the epidermal inclusion cyst of the hand: a benign keratin-filled cyst that follows traumatic implantation of epidermis, presenting as a firm subcutaneous nodule (or an intraosseous lytic lesion of the distal phalanx) - covering pathogenesis, the differential (ganglion, GCTTS, enchondroma, osteomyelitis), histology, and treatment by complete excision/curettage.
Extensor Pollicis Longus RuptureComprehensive guide to attritional rupture of the extensor pollicis longus tendon at the wrist, including pathogenesis after distal radius fracture and rheumatoid arthritis, diagnosis with the retropulsion (drumming) sign, and EIP-to-EPL tendon transfer reconstruction.
Extensor Tendon InjuriesComprehensive guide to extensor tendon injuries for FRCS examination
FelonClosed-space infection of the pulp of the distal phalanx - surgical emergency requiring urgent drainage to prevent osteomyelitis, septic arthritis, and flexor tenosynovitis
Fingertip Injuries & AmputationsComprehensive guide to the management of fingertip injuries, including nail bed repair, local flaps (Atasoy, Moberg, Cross-Finger), and subungual hematomas.
Flexor Carpi Radialis (FCR) TendinitisFellowship-level guide to flexor carpi radialis (FCR) tendinopathy/tendinitis - a volar-radial wrist pain syndrome arising where the FCR runs in its tight fibro-osseous tunnel against the trapezial ridge and scaphoid tuberosity, often associated with trapeziometacarpal (basal thumb) osteoarthritis and seen as a complication of trapeziometacarpal suspension arthroplasty - covering its anatomy, the differential with de Quervain's and scaphotrapezial arthritis, and a non-operative-first management with surgery (tunnel release/debridement) for refractory cases.
Flexor Tendon LacerationsComprehensive guide to flexor tendon injury zones, repair, and rehabilitation for FRCS exam preparation
Flexor Tendon RehabilitationEvidence-based rehabilitation protocols for flexor tendon repairs across all zones, including early active mobilization, passive motion, and place-and-hold techniques
Flexor Tendon Repair TechniquesDetailed guide to flexor tendon repair, focusing on suture techniques (Kessler, Adelaide), strand numbers, and zone-specific management.
Flexor TenosynovitisComprehensive guide to suppurative flexor tenosynovitis for FRCS examination
Flexor-Pronator Mass Strain / TendinopathyFellowship-level guide to flexor-pronator mass injury at the medial elbow - strain, tendinopathy ('golfer's/medial epicondylitis') or, in throwers, partial tearing of the common flexor-pronator origin - covering its role as a dynamic stabiliser against valgus stress (protecting the ulnar collateral ligament), the overlap and crucial distinction from UCL injury and ulnar neuritis in the throwing athlete, the diagnosis, and management from rest/rehabilitation to (rarely) surgery.
Frostbite (Cold Injury)Advanced orthopaedic guide to frostbite of the hand and foot, covering pathophysiology, the freeze-thaw injury, field and hospital rewarming, classification, thrombolysis and iloprost, bone scanning, delayed amputation and rehabilitation.
Gamekeeper's ThumbComprehensive guide to thumb UCL injuries for Orthopaedic examination
Ganglion CystsComprehensive guide to ganglion cyst diagnosis, aspiration, and surgical excision for FRCS exam preparation
Glomus Tumour of the HandComprehensive guide to subungual and digital glomus tumours - benign neuromyoarterial hamartomas causing the classic triad of pain, cold sensitivity and pinpoint tenderness, with Love and Hildreth clinical signs, MRI and marginal excision.
HAGL LesionsComprehensive guide to Humeral Avulsion of the Glenohumeral Ligament (HAGL), including the MRI 'J Sign', West Point Classification, and surgical management.
Hand Examination and Clinical LocalisationAn advanced orthopaedic guide to examining the hand and localising pathology from clinical findings, including tendon testing, nerve localisation, sensory testing, deformity analysis, investigations and urgent decision-making.
Herpetic WhitlowFellowship-level guide to herpetic whitlow: a herpes simplex virus infection of the fingertip that mimics a felon or paronychia but must NOT be incised - covering the HSV-1/HSV-2 aetiology and at-risk groups, the grouped-vesicle presentation, the critical differentiation from a bacterial felon, diagnosis, supportive/antiviral management, and complications including autoinoculation and recurrence.
High-Pressure Injection Injury of the HandAdvanced orthopaedic guide to high-pressure injection injury of the hand, including recognition, material risk, imaging, emergency management, operative debridement, complications and rehabilitation.
Human Bites & Fight BitesComprehensive guide to the management of human bites, specifically 'Fight Bites' (Clenched Fist Injuries), outlining the unique microbiology and surgical urgency.
Hypothenar Hammer SyndromeFellowship-level guide to hypothenar hammer syndrome: repetitive blunt trauma to the ulnar artery over the hook of hamate causing thrombosis, aneurysm and digital embolisation - the occupational vascular cause of ulnar-sided digital ischaemia, its workup (Allen's test, angiography, the corkscrew sign) and management.
Inflammatory Arthritis of the ShoulderComprehensive guide to Rheumatoid Arthritis and other inflammatory conditions of the shoulder - pathology, classification, and surgical management
Intersection SyndromeComprehensive guide to proximal and distal intersection syndrome of the dorsal wrist - an overuse tenosynovitis distinct from de Quervain disease
Jersey FingerComprehensive guide to Jersey Finger (FDP Avulsion), including Leddy-Packer classification, surgical repair techniques, and rehabilitation.
Kienböck's DiseaseComprehensive guide to Kienböck's disease including staging, pathophysiology, investigation with MRI, and treatment options from immobilization to salvage procedures.
Latarjet ProcedureComprehensive exam guide to the Latarjet coracoid transfer for recurrent anterior shoulder instability with glenoid bone loss - the triple-blocking effect of Patte, glenoid bone-loss thresholds and the glenoid track, the Instability Severity Index Score (ISIS), deltopectoral approach, operative technique, complications and long-term outcomes for FRACS, FRCS and board examinations
Latissimus Dorsi (and Teres Major) RuptureFellowship-level guide to latissimus dorsi and teres major tendon ruptures - uncommon injuries of the posterior axillary fold seen in throwing/overhead and high-demand athletes (and water-skiers), presenting with acute posterior-axillary pain, bruising and a palpable defect/weakness of extension/adduction/internal rotation - covering the spectrum from strain to complete avulsion, the role of MRI, and the management debate, in which the cohort evidence favours non-operative treatment even for avulsions in professional pitchers, with repair a good option rather than a demand-driven necessity.
Long Thoracic Nerve AnatomyFellowship-level anatomy of the long thoracic nerve: C5-C7 origin, its long superficial course on serratus anterior, why it is vulnerable, and the medial scapular winging that follows injury.
MacrodactylyRare congenital anomaly characterized by localized gigantism of digits, requiring staged surgical management and multidisciplinary care
Madelung DeformityExam-focused guide to Madelung deformity of the wrist: the abnormal distal radial physis and Vickers ligament, the link with Leri-Weill dyschondrosteosis and SHOX gene defects, how the radius deforms in three planes, the classic radiographic measurements, and how treatment is chosen between Vickers ligament release with physiolysis in the growing child and dome osteotomy or salvage in the mature wrist.
Mallet FingerComprehensive guide to the diagnosis and management of Mallet Finger (Tendinous and Bony), including splinting protocols and surgical indications.
Massive Rotator Cuff TearsComprehensive guide to massive rotator cuff tears and treatment options for FRCS exam preparation
MCP Joint ArthritisComprehensive guide to MCP joint arthritis including rheumatoid arthritis, post-traumatic arthritis, primary OA, clinical presentation, non-operative management, and surgical options including arthroplasty and arthrodesis for orthopaedic fellowship exam preparation.
Median Nerve AnatomyComprehensive guide to the anatomy, compression syndromes, and clinical pathology of the Median Nerve
Meralgia ParaestheticaCompression neuropathy of the lateral femoral cutaneous nerve causing burning numbness and paraesthesia over the anterolateral thigh
Metacarpal FracturesComprehensive guide to metacarpal fractures for Orthopaedic examination
Midcarpal ArthritisComprehensive examination guide to midcarpal arthritis patterns, diagnostic evaluation, and surgical management including limited wrist fusions and total wrist arthroplasty
Midcarpal InstabilityNon-dissociative carpal instability with abnormal motion between the proximal and distal carpal rows, presenting with a painful catch-up clunk and requiring dynamic clinical and fluoroscopic assessment
Milwaukee Shoulder (BCP Crystal Arthropathy)Comprehensive guide to Milwaukee shoulder syndrome - a rapidly destructive basic calcium phosphate (hydroxyapatite) crystal arthropathy of the shoulder in elderly women, covering crystal biology, alizarin red diagnosis, large bloody non-inflammatory effusions and management for fellowship exam preparation.
Mucous Cysts (Digital Mucoid Cysts)Comprehensive guide to digital mucous cysts including pathophysiology, diagnosis, and surgical excision techniques with osteophyte removal
Musculocutaneous Nerve AnatomyFellowship-level anatomy of the musculocutaneous nerve: lateral cord origin (C5-C7), its course through coracobrachialis, the anterior-arm flexors it supplies, the lateral cutaneous nerve of the forearm, and its role in elbow-flexion nerve transfers.
Nerve Repair PrinciplesComprehensive guide to Peripheral Nerve Repair, including biology, classification, surgical techniques, and rehabilitation.
Nerve TransfersPrinciples and common techniques for Nerve Transfer (Neurotization) in peripheral nerve and brachial plexus surgery.
Neuroma ManagementPathophysiology, diagnosis, and management of painful neuromas, including modern techniques like RPNI and TMR.
Osteochondritis Dissecans of the CapitellumComprehensive guide to osteochondritis dissecans (OCD) of the capitellum in adolescent overhead athletes, including differentiation from Panner disease, MRI staging, and management from conservative rest to surgical fixation and cartilage restoration.
Paronychia (Acute & Chronic)Fellowship-level guide to the commonest hand infection: acute bacterial paronychia versus chronic inflammatory paronychia, the run-around abscess, drainage technique, distinguishing herpetic whitlow and felon, and the chronic-paronychia management ladder.
Parsonage-Turner Syndrome (Neuralgic Amyotrophy)Comprehensive guide to Parsonage-Turner syndrome (neuralgic amyotrophy): the classic painful-onset patchy upper-limb palsy, hourglass fascicular constrictions, MRI denervation, and observation-first management.
Pectoralis Major RuptureComprehensive guide to pectoralis major tendon rupture including mechanism, Tietjen classification, clinical assessment, imaging, and surgical management.
PIP Joint ArthritisComprehensive guide to PIP joint arthritis including anatomy, etiology, clinical assessment, conservative management, silicone arthroplasty, surface replacement, and arthrodesis.
PolydactylyComprehensive guide to polydactyly including preaxial thumb duplication, postaxial types, Wassel classification, and surgical management for Orthopaedic examination.
Posterior Interosseous SyndromeComprehensive guide to Posterior Interosseous Nerve (PIN) compression, including anatomy (Arcade of Frohse), clinical presentation (Finger Drop), and surgical decompression.
Posterolateral Rotatory Instability of the Elbow (PLRI)Comprehensive guide to posterolateral rotatory instability of the elbow, including LUCL insufficiency, Horii circle injury pattern, clinical tests, imaging, and ligament reconstruction.
Preiser DiseaseComprehensive exam guide to Preiser disease (idiopathic osteonecrosis of the scaphoid): pathophysiology, Herbert-Lanzetta and Kalainov classifications, MRI diagnosis, and stage-based treatment from immobilization to vascularized bone graft and salvage.
Pronator SyndromeComprehensive guide to pronator syndrome including differentiation from carpal tunnel syndrome, compression sites, and surgical treatment.
Proximal Biceps RupturesComprehensive guide to proximal long head of biceps tendon ruptures - anatomy, clinical assessment, Popeye deformity, tenotomy vs tenodesis decision-making
Proximal Row CarpectomyComprehensive exam guide to proximal row carpectomy (PRC) for SLAC and SNAC wrist arthritis and Kienbock disease - principle of capitate seating into lunate fossa, dorsal surgical approach, indications requiring intact capitate head and lunate fossa cartilage, PIN neurectomy, outcomes versus four-corner fusion, conversion to total wrist fusion, and evidence-based outcomes for FRACS, FRCS and board examinations
Psoriatic Arthritis - HandComprehensive examination guide to psoriatic arthritis affecting the hand and upper extremity, including diagnostic criteria, radiographic patterns, and surgical management strategies
Quadrangular & Triangular SpacesDetailed anatomy of the posterior shoulder spaces, their boundaries, contents, and clinical syndromes.
Quadriga Effect & Lumbrical-Plus FingerFellowship-level guide to two classic flexor-tendon imbalance phenomena that share a common anatomical basis (the flexor digitorum profundus tendons arising from one common muscle belly, with lumbricals originating from the FDP tendons): the QUADRIGA effect - loss of active flexion and grip in the other fingers when one FDP is over-advanced, tethered or amputated - and the LUMBRICAL-PLUS finger - paradoxical IP-joint extension on attempted flexion when an FDP is divided, over-lengthened or grafted too long so its pull is transmitted through the lumbrical to the extensor mechanism.
Radial Nerve AnatomyComprehensive guide to the anatomy, course, branches, and clinical correlations of the Radial Nerve
Radial Tunnel SyndromeComprehensive guide to radial tunnel syndrome including PIN entrapment sites, clinical differentiation from lateral epicondylitis, diagnostic approach, and surgical decompression techniques for orthopaedic exam
Raynaud's Phenomenon (Hand)Fellowship-level guide to Raynaud's phenomenon of the hand: the triphasic colour change of digital vasospasm, the crucial distinction between primary Raynaud's disease and secondary Raynaud's phenomenon (especially systemic sclerosis), red flags and nailfold capillaroscopy/autoantibody workup, and a stepwise management from cold avoidance through calcium-channel blockers to prostacyclin and surgery for digital ischaemia.
Recurrent & Revision Carpal Tunnel Syndrome (and Endoscopic Release)Fellowship-level guide to persistent, recurrent and revision carpal tunnel syndrome and to endoscopic carpal tunnel release - covering the three failure patterns (persistent = never resolved, often incomplete release; recurrent = relief then return, often perineural scarring; new/iatrogenic = nerve/branch injury), the systematic work-up of the failed release (re-confirm the diagnosis, re-image, electrodiagnostics), and revision options (complete open re-release with external neurolysis, and vascularised flap coverage for scarred nerves), plus the evidence on endoscopic versus open release.
Remplissage ProcedureComprehensive guide to the arthroscopic remplissage procedure for engaging Hill-Sachs lesions in anterior shoulder instability, including glenoid track assessment, surgical technique, combined Bankart repair, outcomes, and stiffness.
Revision Total Elbow ArthroplastyFellowship-level guide to revision total elbow arthroplasty: why primary TEAs fail (aseptic loosening, polyethylene bushing wear, periprosthetic fracture, infection and instability), the central problem of periprosthetic bone loss, the reconstruction options from bushing exchange and re-stemming to impaction grafting and allograft-prosthetic composite, the high complication burden, and the principles of managing the infected TEA.
Rheumatoid Arthritis of the HandComprehensive guide to rheumatoid arthritis affecting the hand - pathophysiology, classification, medical and surgical management including synovectomy, arthroplasty, and arthrodesis
Ring Avulsion InjuryFellowship-level guide to ring avulsion injuries of the finger: the traction-degloving mechanism, the Urbaniak (and Kay) classification, the prognostic importance of an intact PIP joint and FDS, the extended zone of vascular injury requiring vein grafts, and the decision between microvascular revascularisation/replantation and completion amputation.
Sagittal Band InjuriesComprehensive guide to sagittal band injuries of the hand, including diagnosis, surgical repair techniques, and rehabilitation protocols for Orthopaedic exam preparation.
Scaphoid Excision and Four-Corner FusionComprehensive exam guide to scaphoidectomy and four-corner fusion for SLAC and SNAC wrist arthritis - indications, surgical technique including dorsal approach and fixation options (circular plate, K-wires, screws), preservation of radiolunate motion, outcomes compared with proximal row carpectomy, complications including nonunion and dorsal impingement, and evidence-based results for FRACS, FRCS and board examinations
Shoulder (Humeral Head) Resurfacing ArthroplastyFellowship-level guide to humeral head resurfacing arthroplasty: a bone-preserving, stemless cap that resurfaces the humeral head while keeping the metaphysis and shaft, its appeal in younger patients, the technical pitfalls (oversizing/overstuffing and excessive lateral offset that accelerate glenoid wear), the dominant failure mode of glenoid erosion and pain when metal articulates with native glenoid, registry survivorship including pyrocarbon, and the relatively straightforward conversion to a stemmed implant.
SLAC WristComprehensive guide to SLAC wrist - scapholunate advanced collapse including Watson staging, pathophysiology, surgical treatment options, four-corner fusion, and proximal row carpectomy for orthopaedic fellowship examination.
Small Joint Arthroplasty of the HandComprehensive guide to metacarpophalangeal (MCP), proximal interphalangeal (PIP), and carpometacarpal (CMC) joint arthroplasty including silicone Swanson implants, surface replacement, pyrocarbon designs, indications, surgical techniques, and complications
Snapping / Subluxing Extensor Carpi Ulnaris (ECU)Fellowship-level guide to extensor carpi ulnaris (ECU) tendon instability: subluxation/dislocation of the ECU out of its groove on the dorsal ulna when the subsheath tears, causing painful dorsoulnar snapping on supination - covering the anatomy, the provocative supination/ulnar-deviation test, dynamic ultrasound, conservative immobilisation in pronation, and subsheath repair/reconstruction.
Stemless / Short-Stem Shoulder ArthroplastyFellowship-level guide to stemless and short-stem humeral components in anatomic total shoulder arthroplasty: the bone-preserving, metaphyseal-fixation rationale (preserve humeral bone, shorten operative time, avoid diaphyseal stem complications and stress shielding), the requirement for adequate proximal humeral bone quality, the comparable clinical outcomes with fewer radiolucent lines, and the ease of conversion to a stemmed implant at revision.
Sternoclavicular Joint DislocationComprehensive guide to sternoclavicular joint dislocation, including anterior versus posterior types, mediastinal compromise in posterior dislocations, CT diagnosis, closed reduction, and reconstruction risks.
Subcoracoid ImpingementFellowship-level guide to subcoracoid impingement of the shoulder: anterior shoulder pain from narrowing of the coracohumeral interval, with the subscapularis caught between the coracoid tip and the lesser tuberosity; its anatomy and the 'roller-wringer' effect, the coracohumeral distance on MRI, the provocative tests, the genuine controversy over whether it causes subscapularis tears, and the conservative-then-arthroscopic-coracoplasty management.
Subscapularis AnatomyDetailed anatomy of the Subscapularis muscle, its critical role in shoulder stability, innervation, and clinical pathology.
Suprascapular Nerve EntrapmentComprehensive guide to suprascapular nerve entrapment at the suprascapular and spinoglenoid notches, including ganglion cyst association, clinical presentation with infraspinatus wasting, EMG diagnosis, and surgical decompression techniques.
Swan Neck DeformityComprehensive guide to Swan Neck Deformity, covering Nalebuff classification, intrinsic tightness testing, and management strategies.
SymphalangismFellowship-level guide to symphalangism - a congenital failure of differentiation of the finger (or toe) joints producing ankylosis/stiffness of the interphalangeal joints, most often the proximal interphalangeal joint - covering its forms (proximal/true vs distal symphalangism, isolated vs syndromic), the genetics and syndromic associations, the characteristic clinical and radiographic features (absent flexion crease, no IP-joint motion), and the largely supportive management given the lack of a true joint to reconstruct.
SyndactylyComprehensive guide to syndactyly including classification, surgical timing, web space reconstruction, and associated syndromes for Orthopaedic examination.
TFCC and Ulnar-Sided Wrist PainAdvanced orthopaedic guide to triangular fibrocartilage complex injury and ulnar-sided wrist pain, including anatomy, clinical localisation, imaging, Palmer and arthroscopic classifications, DRUJ stability, operative decision-making and rehabilitation.
The Intrinsic Hand: Intrinsic-Minus (Claw) and Intrinsic-Plus DeformityFellowship-level guide to intrinsic muscle function and the two opposite deformities: intrinsic-MINUS (claw hand - MCP hyperextension + IP flexion from intrinsic paralysis, e.g. ulnar palsy/leprosy) and intrinsic-PLUS (MCP flexion + IP extension from intrinsic tightness/spasticity) - covering the ulnar paradox, the Bouvier and Bunnell tests, and the splinting/tendon-transfer/release management.
The Rheumatoid Hand and WristComprehensive guide to rheumatoid arthritis of the hand and wrist, covering MCP volar subluxation, ulnar drift, swan-neck and boutonniere deformities, caput ulnae, Nalebuff thumb classification, tendon ruptures, and surgical sequencing.
The Six Dorsal Extensor Compartments of the WristFellowship-level anatomy reference for the six dorsal wrist extensor compartments beneath the extensor retinaculum: their tendon contents (1 APL/EPB, 2 ECRL/ECRB, 3 EPL, 4 EDC/EIP, 5 EDM, 6 ECU), Lister's tubercle, and the high-yield clinical correlations - de Quervain's (compartment 1), intersection syndrome, EPL rupture at the third-compartment watershed, and the ECU of the sixth compartment.
Thoracic Outlet SyndromeComprehensive guide to Thoracic Outlet Syndrome (TOS), including Neurogenic, Venous, and Arterial types, anatomy of the thoracic outlet, and management strategies.
Thromboangiitis Obliterans (Buerger's Disease)Fellowship-level guide to thromboangiitis obliterans (Buerger's disease) - a non-atherosclerotic, segmental, inflammatory occlusive disease of the small and medium arteries and veins of the extremities, strongly tied to tobacco, presenting in young smokers with distal ischaemia, digital ulceration/gangrene and migratory thrombophlebitis - covering its diagnosis (clinical criteria and the corkscrew-collateral angiogram), the absolute primacy of complete smoking cessation, and the role and limits of revascularisation and amputation in the hand and foot.
Thumb CMC ArthritisComprehensive guide to thumb carpometacarpal arthritis - anatomy, Eaton-Littler classification, grind test, trapeziectomy, LRTI, CMC arthroplasty, and surgical decision-making for orthopaedic exam
Thumb HypoplasiaComprehensive guide to thumb hypoplasia including Blauth classification, associated syndromes, clinical assessment, reconstruction versus pollicization, and surgical management for Orthopaedic examination.
Total Wrist Arthroplasty vs Arthrodesis (Wrist OA Reconstruction)Fellowship-level guide to reconstruction of the arthritic wrist: the decision between total wrist ARTHRODESIS (the durable, reliable fusion - the historical benchmark for high-demand patients and salvage) and total wrist ARTHROPLASTY (motion-preserving, improved with fourth-generation implants but with loosening/instability risks and not for heavy manual labour); indications, the patient factors that drive the choice, outcomes, and the failed-arthroplasty-to-fusion conversion.
Trigger Finger (Stenosing Tenosynovitis)Comprehensive guide to trigger finger including diagnosis, Green classification, injection technique, and surgical release.
Trigger Thumb (Pediatric)Comprehensive Exam-ready guide to pediatric trigger thumb including Notta's node pathophysiology, observation vs surgical decision-making, A1 pulley release technique, and exam scenarios
Triscaphe Arthritis (STT Arthritis)Degenerative arthritis of the scaphotrapeziotrapezoid joint causing radial-sided wrist pain, managed with activity modification, injections, or surgical options including excision arthroplasty and arthrodesis
Ulnar Club Hand (Ulnar Longitudinal Deficiency)Complete guide to ulnar club hand including classification, surgical management, and functional outcomes in longitudinal upper limb deficiencies
Ulnar Impaction SyndromeComprehensive guide to ulnar impaction syndrome including positive ulnar variance, TFCC tears, ulnar shortening osteotomy, and wafer procedures.
Ulnar Nerve AnatomyComprehensive guide to the anatomy, course, branches, and compression syndromes of the Ulnar Nerve
Ulnar Nerve PalsyComprehensive guide to Cubital Tunnel Syndrome, Guyon's Canal Syndrome, and Ulnar Nerve mechanics.
Ulnar Tunnel Syndrome (Guyon's Canal)Comprehensive guide to ulnar tunnel syndrome including anatomy of Guyon's canal, classification zones, diagnosis, and surgical decompression techniques.
Valgus Extension Overload of the ElbowComprehensive guide to posteromedial olecranon osteophyte impingement in throwing athletes, UCL insufficiency relationship, imaging, and surgical debridement considerations.
Wartenberg's SyndromeComprehensive guide to Wartenberg's Syndrome (Cheiralgia Paresthetica), involving entrapment of the Superficial Radial Nerve, identifying clinical features, and distinguishing it from De Quervain's Tenosynovitis.
Wrist ArthroplastyComprehensive guide to total wrist arthroplasty - indications (RA, OA), implant types (Universal 2, Maestro, ReMotion), surgical technique, complications, and outcomes vs arthrodesis
Wrist Ligament InstabilityAdvanced orthopaedic guide to wrist ligament instability: examination technique, radiographic measurements, staging, arthroscopy, acute repair, chronic reconstruction, lunotriquetral instability and salvage surgery.

Other subspecialties

Trauma Spine Foot & Ankle Sports Medicine Adult Reconstruction Paediatrics Oncology Basic Science Radiology Infection Anatomy & Approaches Professionalism & Ethics

All Hand & Upper Limb topics (137)

Other subspecialties

All Hand & Upper Limb topics (137)

Other subspecialties