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Glossary

Hand-surgery terms, defined

A working reference of the anatomical structures, conditions, procedures, investigations, and outcome measures that recur across the articles and procedure pages on this site. Each entry is written in plain language for patients and links to the underlying clinical context.

1

  1. Anatomy

    1,2-ICSRA

    The vascular pedicle running between the first and second extensor compartments on the dorsal radius, used as the basis for the Zaidemberg pedicled vascularised bone graft for scaphoid non-union.

A

  1. Investigation tkliwość tabakierki anatomicznej

    anatomical snuffbox tenderness

    Tenderness on direct palpation of the depression on the dorsoradial wrist bounded by the EPL and EPB tendons, with the floor formed by the scaphoid. A traditional clinical sign of scaphoid injury.

  2. Condition martwica jałowa

    avascular necrosis (AVN)

    Death of bone tissue from interruption of vascular supply. In the scaphoid, AVN typically affects the proximal pole following waist or proximal pole fractures, where the dorsal ridge blood supply is disrupted.

B

  1. Condition

    Boutonnière deformity

    A finger deformity characterised by flexion at the proximal interphalangeal joint and hyperextension at the distal interphalangeal joint, produced by chronic disruption of the central slip with volar migration of the lateral bands.

  2. Anatomical structure

    bowstringing

    Anterior displacement of a flexor tendon away from the underlying phalanges during finger flexion, resulting from loss of the constraining annular pulleys (most consequentially A2 and A4). Visible as a cord across the palmar finger and clinically expressed as reduced flexion power, because the tendon's mechanical lever arm decreases as it travels along a chord rather than the curved path the pulleys would impose.

C

  1. Anatomy

    Central slip

    The central component of the extensor mechanism over the proximal interphalangeal joint, inserting on the dorsal base of the middle phalanx. Disruption causes a boutonnière deformity.

D

  1. Condition DISI (grzbietowa niestabilność segmentu pośredniego)

    DISI (dorsal intercalated segmental instability)

    A pattern of carpal malalignment in which the lunate adopts an abnormally extended (dorsiflexed) position, typically following loss of the scaphoid's stabilising effect through fracture, non-union or ligamentous injury.

  2. Procedure podwójna osteosynteza śrubowa

    dual-screw fixation

    Internal fixation of a scaphoid fracture or non-union using two parallel headless compression screws to provide rotational stability, proposed for selected unstable fractures and revision cases.

E

  1. Investigation

    Elson test

    A bedside test for central-slip integrity in which the patient attempts to extend the proximal interphalangeal joint with the finger flexed over a table edge; an extensor lag or rigid distal interphalangeal joint indicates central-slip disruption.

  2. Anatomy

    Extensor mechanism

    The composite tendon system over the dorsal aspect of the finger, formed by the extensor digitorum communis tendon together with contributions from the lumbrical and interosseous muscles, that collectively extends the metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints.

F

  1. Procedure artrodeza czterech kości nadgarstka

    four-corner fusion

    A motion-preserving salvage procedure for advanced wrist arthrosis in which the scaphoid is excised and the lunate, capitate, hamate and triquetrum are fused, preserving the radiolunate articulation.

H

  1. Investigation klasyfikacja Herberta

    Herbert classification

    The most widely used European classification of scaphoid fractures, grouping injuries by stability and chronicity into types A (stable acute), B (unstable acute, B1–B5), C (delayed union) and D (established non-union).

  2. Condition deformacja garbowa

    humpback deformity

    A flexion deformity of the scaphoid following waist fracture or non-union, in which the distal fragment flexes relative to the proximal fragment, producing a dorsal apex (humpback) on the lateral view and disrupting carpal alignment.

I

  1. Investigation

    iTAMe

    Intraoperative Total Active Movement Examination — testing of a flexor tendon repair under active patient flexion before wound closure, possible only with awake-patient anaesthesia (WALANT). Higgins and colleagues identified gapping or instability under active flexion in 7 of 122 tendons in their original 2010 series; all 7 were re-repaired and none subsequently ruptured.

J

  1. Anatomy

    Juncturae tendinum

    Fibrous interconnections between the extensor digitorum communis tendons over the dorsum of the hand, allowing one tendon to contribute partial extension to neighbouring fingers.

L

  1. Anatomy

    Lateral bands

    The two paired bands of the extensor mechanism that pass alongside the proximal interphalangeal joint and unite distally to form the terminal tendon over the distal interphalangeal joint.

M

  1. Procedure

    M-Tang technique

    A four- or six-strand multistrand core suture technique for primary flexor tendon repair, formalised by Tang JB. Combines adequate purchase length (0.7–1 cm in each tendon end), modest tension calibrated to slight bunching at the repair site, locking grasps rather than simple grasps, and a peripheral epitendinous mattress.

  2. Treatment płat z kłykcia przyśrodkowego kości udowej

    medial femoral condyle (MFC) flap

    A free vascularised corticoperiosteal flap from the medial femoral condyle, anastomosed to recipient vessels at the wrist, used to reconstruct proximal pole scaphoid non-union with avascular necrosis.

N

  1. Treatment nieunaczyniony przeszczep kostny

    non-vascularised bone graft (NVBG)

    A bone graft harvested without preserving its blood supply, relying on creeping substitution from the recipient bed. Common donor sites for scaphoid reconstruction are the iliac crest and distal radius.

P

  1. Outcome measure skala PRWE

    Patient-Rated Wrist Evaluation (PRWE)

    A 15-item validated patient-reported outcome measure scoring wrist pain and function on a 0–100 scale, where lower scores indicate better outcome. The primary outcome measure of the SWIFFT trial.

  2. Procedure wycięcie szeregu bliższego nadgarstka

    proximal row carpectomy (PRC)

    A motion-preserving salvage procedure for advanced wrist arthrosis in which the scaphoid, lunate and triquetrum are excised, allowing the capitate to articulate with the lunate fossa of the radius.

R

  1. Treatment

    Relative motion orthosis

    A finger splint that holds the affected digit in fifteen to twenty degrees of metacarpophalangeal hyperextension relative to its uninjured neighbours, transferring extensor force away from the repair through the juncturae tendinum and permitting early protected active motion.

S

  1. Anatomy

    Sagittal band

    The transverse fibrous structure at the metacarpophalangeal joint that centralises the extensor digitorum communis tendon over the knuckle. Disruption causes ulnar tendon subluxation.

  2. Anatomy kość łódeczkowata

    scaphoid

    The most lateral bone of the proximal carpal row, articulating with the radius and four other carpal bones. Boat-shaped, with proximal pole, waist, and distal tubercle. Approximately 80% covered by articular cartilage; the dorsal ridge is the principal vascular entry.

  3. Condition nadgarstek SNAC

    SNAC wrist (scaphoid non-union advanced collapse)

    The pattern of progressive wrist osteoarthritis that develops over years from untreated scaphoid non-union. Three Watson stages: I radial styloid arthrosis; II scaphocapitate; III periscapholunate with capitolunate involvement.

  4. Condition

    Swan-neck deformity

    A finger deformity characterised by hyperextension at the proximal interphalangeal joint and flexion at the distal interphalangeal joint, often a late complication of untreated mallet finger or volar plate insufficiency.

T

  1. Procedure

    tenolysis

    Surgical division of peritendinous adhesions where mature scar tissue tethers a previously repaired or grafted tendon to the surrounding sheath. Indicated when active range of motion is restricted despite full passive motion six months or more after the index repair, and only when the underlying repair is intact.

  2. Condition uraz okołoksiężycowaty przezłódeczkowy

    trans-scaphoid perilunate injury

    A high-energy carpal injury in which the scaphoid fractures and the surrounding carpus dislocates around the lunate, classified as Herbert B4. Requires urgent reduction and surgical fixation.

V

  1. Treatment unaczyniony przeszczep kostny

    vascularised bone graft (VBG)

    A bone graft that retains its vascular supply through a pedicle or microsurgical anastomosis. In scaphoid surgery, VBG is preferred over non-vascularised graft for proximal pole non-union with avascular necrosis.

  2. Anatomy

    vinculum

    Mesenteric folds within the synovial flexor tendon sheath conveying segmental blood supply from the digital arteries to the flexor tendons. Each tendon typically receives a vinculum breve (short, near the insertion) and a vinculum longum (long, more proximal); precise anatomy varies considerably between digits and between individuals.

W

  1. Procedure

    WALANT

    Wide-Awake Local Anaesthesia No Tourniquet — local anaesthetic infiltration with lidocaine and epinephrine, without sedation or tourniquet, allowing the patient to remain awake and to actively flex through the surgical field. In flexor tendon repair, WALANT enables intraoperative testing of the construct under active load before closure (iTAMe).