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The Journal of Bone and Joint Surgery 81:1628-51 (1999)
© 1999 The Journal of Bone and Joint Surgery, Inc.

Instructional Course Lecture

Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Treatment of the Severely Injured Upper Extremity*{dagger}

AMIT GUPTA, M.D., F.R.C.S.{ddagger}, RUSSELL A. SHATFORD, M.D.{ddagger}, THOMAS W. WOLFF, M.D.{ddagger}, TSU-MIN TSAI, M.D.{ddagger}, LUIS R. SCHEKER, M.D.{ddagger}, LOUISVILLE, KENTUCKY and L. SCOTT LEVIN, M.D.§, DURHAM, NORTH CAROLINA

An Instructional Course Lecture, American Academy of Orthopaedic Surgeons


   Introduction
 
The human hand is a supremely adaptable organ of prehension, sensation, expression, and communication. With its complex, integrated structures of skin, muscles, tendons, nerves, vessels, bones, and joints, the hand allows people to explore their environment, care for themselves, and earn a living. To watch a virtuoso pianist at work is to appreciate fully how the hand is capable of performing highly coordinated actions. The hand is so important as a tool and as a sensory organ that it could be claimed that the primary function of the upper extremity is to position the hand in space. Injuries of the upper extremity thus have a direct bearing on the function, sensation, and movement of the hand.

The upper extremity, our interface with the external world, is subjected to the forces of the world and is easily injured. Such injuries—industrial, agricultural, domestic, or vehicular—disrupt the fine, intricately balanced anatomy of the . . . [Full Text of this Article]


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