By Alain C. Masquelet

The writer of a few acclaimed, best-selling surgical atlases has collaborated back with an award-winning artist to supply one other worthwhile surgical source. This extremely popular group offer a master-class within the demonstration of surgically appropriate anatomy. Masquelet has attained world-renown particularly for his leading edge flaps for reconstructive cosmetic surgery of the limbs, during this publication he monitors his unrivalled wisdom of surgical procedure of the trunk, head, and neck. each element of access in required surgeries is defined, and each method is illustrated with a series of drawings, displayed because the health care professional might see them, including anatomical cross-sections.

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Therefore, we can see the fixation of the tendon transfer on the ulnar side of the thumb. 38 Paralysis of all intrinsic muscles of the thumb. The best site for the pulley is at the proximal pole of the pisiform. The simplest procedure consists of passing the transfer around the tendon of the FCU. However, if this muscle is paralysed, its tendon stretches and the direction of the transfer will not be maintained. In this event it is advisable to perform a tenodesis of the paralysed FCU tendon to the ulna proximal to the pulley.

32 The ‘boutonnière’ deformity E The PIP joint is immobilised in extension with a wire. The central band of the tendon is sutured. F Distal suture of the lateral bands. 33 Hand and peripheral nerve surgery Arthrolysis of the PIP joint (limitation of extension) A The cruciate pulley of the sheath is incised and reflected. The blood supply is provided by a small artery which courses just beneath the ‘check rein’ of the capsule. 1 ‘check rein’ 2 palmar plate 1 34 2 Arthrolysis of the PIP joint (limitation of extension) C The check rein is divided, taking care of the small artery.

They pass beneath the ‘check reins’ of the capsule of the PIP joint and divide into several branches. One branch is devoted to the vinculum. Dorsal view 3 Palmar view 2 1 1 collateral artery 2 ‘check rein’ 3 palmar plate 25 Hand and peripheral nerve surgery D The blood supply to the profundus tendon comes from the vinculum of the superficialis tendon. Hence the superficialis tendon should not be excised when both tendons are divided; rather both tendons should be repaired. 26 The trapezium: volar approach The trapezium: volar approach The indications of this procedure are trapeziumectomy (for osteoarthritis) and internal fixation of intra-articular fractures.

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Atlas of Surgical Anatomy by Alain C. Masquelet
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