Ortho Oracle - orthopaedic operative atlas

Neurovascular Island Flap

– Discussion:     – defect of the thumb;     – long neurovascular island has be marked out to replace soft tissue & to increase the blood supply to the relatively avascular thumb;     – long flap has been marked out on the ulnar border of the middle finger & proximal incision marked on the … Read more

Nicardipine

– Discussion:  – Nicardipine is a calcium channel blocker related to nifedipine; – Dosing Information:  – Initial doses of immediate release nicardipine are 20 mg PO TID with dose titrations to 40 mg PO TID at 2 week intervals;  – Sustained release dosing begins with 30 mg BID ________________________________________________ Controlled multicenter double-blind trial of nicardipine … Read more

Neuropathic Shoulder

– Discussion:     – neuropathic shoulder may result from syringomyelia (most common), chiari malformation, or syphilis;     – in some cases, it may be confused w/ shoulder instability; – Management:     – arthrodesis should be avoided in the acute inflammatory stage of the disease; – Case Histories:           … Read more

Neurosarcoma

– See: Soft Tumor Menu – Discussion:     – also called malignant schwannoma or fibrosarcoma of nerve sheath;     – extracompartmental high grade tumor that develops from sheaths (Schwann cells) of  peripheral nerves;     – usually is a primary lesion occuring along proximal major nerve trunks,     – tumor is usually … Read more

Neurotmesis

– See: Nerve Repair: – Discussion:     – most severe nerve injury;     – complete disruption of axons, endoneurium, perineurium, & epineurium;     – Wallerian degeneration occurs;     – recovery requires operative repair and the prognosis is variable, ranging from complete recovery to no recovery;     – factors that influence … Read more

Neuroma

– See: Nerve Injury Menu: – Discussion     – occurs following nerve injury;            – schwann cells at the the site of injury express trophic factors inattempt to regenerate the nerve;            – neuroma occurs with aberant growth at the nerve injury site;       … Read more

Neurontin / Gabapentin

– Discussion:     – indicated for neuropathic pain conditions;           – diabetic neuropathy           – reflex sympathetic dystrophy;           – radicular pain           – peripheral nerve pain;     – dose ranged: 300 to 600 PO tid;   … Read more