ABSTRACT
This chapter emphasizes the disorders of the hand interrelating with the clinical setting. It discusses the clinical assessment symptoms of hand which includes pain, deformity, swelling, sensory symptoms and motor weakness, and loss of function. Deformity of the hand may result from acquired disorders of the skin, subcutaneous tissues, muscles, tendons, joints, bones or neuromuscular function. Problems arise for three main reasons: the defect may be unacceptable simply because of its unsightly appearance; function is impaired; and the deformed part becomes a nuisance during daily activities. Assessment and management of hand deformities demands a detailed knowledge of functional anatomy and, in particular, of the normal mechanisms of balanced movement in the wrist and fingers. Long-standing fixed deformities are extremely difficult to correct and may be better left alone. Swan-neck deformity is the reverse of the boutonniere deformity; the proximal interphalangeal (PIP) joint is hyperextended and the distal interphalangeal (DIP) joint flexed.
