![]() He is also the hand and upper extremity consultant for the New Jersey Devils of the National Hockey League.ĭr. Niver is a team physician for Westfield High School, Madison High School and Fairleigh Dickenson University. In addition, it’s gratifying to improve my patients’ manual dexterity, limb use and quality of life.”ĭr. He says, “I enjoy hand surgery because it combines skills for a wide range of procedures, including fractures repair, nerve repair, tendon transfers and ligament reconstructions. Niver’s interest in hand surgery started when he learned about the intricacies of the forearm and hand compartments during his first-semester anatomy course in medical school. He has delivered local, regional, national and international invited presentations in his field.ĭr. ![]() He is the co-author of articles and abstracts on a wide range of topics in orthopedics, which are published in the prestigious, peer-reviewed scientific journals like American Journal of Sports Medicine and Orthopaedic Clinics of North America. ![]() He is a Fellow of the American Association of Orthopaedic Surgeons. Niver is an active member of the American Society for Surgery of the Hand and American Association of Hand Surgery. Niver, MD, is a double board certified orthopedic surgeon specializing in surgery of the hand, wrist, forearm, and elbow.ĭr. Because of the attachment of the muscles and the location of the hood, the small intrinsic muscles will produce flexion at the metacarpophalangeal joint while extending the interphalangeal joints.Genghis E. The small intrinsic muscles that attach laterally are responsible for delicate finger movements that would not be possible with the extensor digitorum, flexor digitorum superficialis, and profundus muscles alone. Laterally, the lumbricals and the dorsal and palmar interossei muscles attach. Proximally and centrally, the extensor digitorum, extensor digiti minimi, extensor indicis, and extensor pollicis brevis muscles attach to the dorsal digital expansion. An aponeurosis covering the dorsum of the digits and attaches distal to the distal phalanx. ![]() The extensor retinaculum works to retain the tendons that are near the bone while allowing proximal and distal gliding of the tendons ( Figure 33-1B). Continuous with the fascia of the forearm and attached laterally to the radius and medially to the triquetrum and pisiform bones. This ligament should not be confused with the flexor retinaculum, which is located deeper to the transverse palmar ligament. Continuous with the extensor retinaculum from the dorsal side of the wrist and wraps around, anteriorly, to form a fascial band around the flexor tendons. Laterally, the flexor retinaculum is anchored to the scaphoid and trapezium. The flexor retinaculum anchors medially to the pisiform and the hook of the hamate. The median nerve and the tendons of the flexor digitorum superficialis, flexor digitorum profundus, and flexor pollicis longus muscles, and their associated synovial sheaths, pass through this tunnel. Forms a roof over the concavity created by the carpal bones, forming a tunnel (i.e., the carpal tunnel).
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