Ortho Oracle - orthopaedic operative atlas

Natural History of DDH

    – See: DDH – Main Discussion – Discussion:       – 95-98% of DDH cases are possibly reversible;     – 2% of DDH cases may have teratologic dislocation which is generally not reversible;     – less than 2% of infants will have a positive Barlow’s test (dislocatable hip);     … Read more

Natural History of AVN

 Co-authored by Edward Harvey M.D. – Discussion:     – symptomatic hip almost uniformly progresses to further collapse without treatment;     – collapse rates approach greater than 85% in the symptomatic hips, even if first seen in the earliest stages;      – treatment plan for the asymptomatic AVN is controversial;     – approx … Read more

Natatory Ligament

  – Anatomy:     – other name for the superficial transverse metacarpal ligament;     – these ligamentous fibers extend between the web spaces of the digits, and lie immediately beneath the skin, and helps create web space;     – digital nerves & vessels pass deep or dorsal to natatory ligaments;     … Read more

Narcotics

Move to Restrict Pain Killers Puts Onus on Doctors Washington State’s guidelines on use of opioids for chronic non-cancer pain—frequently asked questions Guidelines For the Use of Analgesia and Sedation in the ICU, Paul Marik, MD http://www.agencymeddirectors.wa.gov/Files/DosingCalc.xls Pain and Policy Studies Group Reduction in narcotic use after primary total knee arthroplasty and association with patient … Read more

Naproxen / Naprosyn / Anaprox

– Discussion:      – NSAIA (member of the arylacetic acid group);      – for symptomatic RA, bone pain;      – primary dysmenorrhea, acute tendinitis and bursitis, mild to moderate pain: – Adult:      – typical dose: 250 mg PO bid or 500 mg PO bid (500-1250 mg/24hr PO divided bid);   … Read more

Naloxone/Narcan

– for reversal of narcotic effect or suspected narcotic overdose; – Adult: 0.2-0.8mg IV, IM, or SQ q5min for 3 doses; – May percipitate acute withdrawl in addicts, hence inorder to prevent vomiting and Aspiration Pneumoniae begin w/ 0.2mg IV, SC, or IM for several doses;    – if no response after 3 doses, suspect non-narcotic cause; … Read more

NALBUPHINE/NUBAIN

for moderate to severe pain;  Synthetic partial opiate agonist/antagonist;  Adult: 10-20mg IM, IV, SQ;  q4-6hr prn;  Causes CNS depression and drowsiness;  use with caution in patients receiving opiate drugs;  KEY PAIN OPIOID

Nail Bed Injury / Pathology

– See:        – Distal Phalangeal Frx:        – Finger Tip Injuries:        – Ingrown Toe Nail        – Paronychia:        – Matriectomy:        – Mucous Cyst:        – Nail Bed Biopsies: – Anatomy:       – nail plate:         … Read more

Nail Bed Biopsies

– Discussion:     – indicated for the diagnosis of nail tumors or unexplained deformities;     – may be performed using “punch method” or thru open nail bed biopsy;     – open biopsies should use transverse incisions in the nail matrix and longitudinal incisions in the nail bed;     – biopsy material should … Read more