[15,16] Atasoy flap (transverse and dorsal oblique tip amputations), [17] Kutler flap (V-Y advancement flaps from both sides of the finger is midlateral distal amputations), [18] first dorsal metacarpal artery flap (kite flap), [19] cross-finger flap (in volar soft-tissue defects), [20]
thenar and hypothenar flaps (pulp and fingertip defects in young patients), [18] digital artery perforator flap (transverse or side oblique fingertip defects with exposed bone), [7] are among the most commonly used options which can be performed in emergency settings.
With the arm tourniquet inflated and magnification gained under corneal loupe, an incision was made over the
thenar skin crease where the swelling was prominent.
Electrodes were placed on the
thenar and hypothenar eminences of the participant's nondominant hand and data was collected with a wireless transmitter using a constant voltage (.5 V) technique.
This is accomplished by pressing (gently but firmly) directly midline on the thoracic spine of the prone client with the palm of the hand; placing the spinous processes in the intereminential groove (the groove between the
thenar and hypothenar eminences) and feeling for the end-feel motion of the joints (Figure 7).
For median nerve, the active surface electrode should be put over the motor point of abductor pollicis brevis in the upper third of
thenar eminence close to the 1st metacarpophalangeal joint and stimulating electrode was kept at the antecubital fossa proximally and wrist distally and ground electrode at the back of the palm.
He tied the knot dorsally and buried it in the
thenar muscles, then placed the Mini Tightrope across the bases of the thumb and index metacarpals to stabilize the thumb CMC joint.
Patients were covered and care was taken that the skin temperature of the
thenar region did not fall below 32degC.
A collegiate classification proposes finding three or more of the following signs and symptoms to establish the diagnosis: (1) paresthesia along the territory of median nerve, (2) nocturnal paresthesia, (3)
thenar atrophy, (4) positive Tinel test, (5) positive Phalen test, and (6) decreased sensitivity.
trapezius pars medialis 51.7 [+ or -] 14.3
Thenar eminence 58.0 [+ or -] 18.2 M.
Limbs examination showed atrophy of left
thenar muscles (Figure 2).
Physical examination revealed obvious subcutaneous tophi and
thenar muscle wasting.
C reflex was recorded with superficial electrodes placed on the
thenar muscles.
Old Doc studied the exceptional repair job, thought back a few hundred years to his school days, and said, "Injured my
thenar eminence, didn't I?"
