Data Trace Editor Review Articles: Current Concepts: Entrapment Neuropathies of the Upper Extremities. Carpal tunnel syndrome in patients who are receiving long-term renal hemodialysis. The carpal tunnel syndrome. A study of carpal canal pressures. Spontaneous rupture of the flexor carpi radialis tendon. Deep postoperative wound infection after carpal tunnel release. Symptomatic restrictive thumb-index flexor tenosynovitis: incidence of musculotendinous … Read more
– See: Anatomy of Carpal Tunnel – TCL Incision: – transverse carpal lig is exposed, but this is generally obscured by origin of thenar & hypothenar muscles, which come to lie in opposition in midline; – palmar fascia is incised, & nerve is identified just proximal to the carpal canal; … Read more
– See: Anatomy of Carpal Tunnel – Anesthesia: – Bier Block: – proponents note that regional anesthesia allows a less rushed operation along w/ a synovectomy, if needed; – median nerve block at elbow; – w/ elbow extended brachial … Read more
– Discussion: – median nerve compression syndrome at the wrist; – most common form of nerve entrapment; – first described by Paget; – references: The First Description of Carpal Tunnel Syndrome. James Paget FRS – pathophysiology: – nerve compression may result in ischemia, focal demyelination, decrease in axonal caliber, and finally axonal loss; – ref: … Read more
– Discussion: – used to image an axial view of the carpal canal with particular attention to the hook of the hamate and pisiform bone; – Technique: – hand is maximally dorsiflexed using the opposite hand or a strap – palmar surface of the wrist rests on … Read more
Discussion vital capacity < 75% (of predicted values) is seen in thoracic curves > 75 deg; significant reductions in pulmonary function are seen in curves > 80 deg; although some effect on pulmonary function can be seen at 60 deg, significant compromise is not seen until the curve is > 90 deg curves greater than … Read more
Class I Class II Class III Class IV
– Discussion: – certain rhythms are very sensitive to cardioversion, & low energy levels are likely to bring about conversion: (e.g. A. Flutter and V. Tach); – A. Fib & V. Fib are more resistant to cardioversion & require higher energy levels; – Pre-Medication: – anticoagulants may be administered prior to the procedure; – sedation … Read more
– Discussion: – average carpal height ratio is 53 % (range, 45-60 %) – carpal height ratio may be used to follow progression of degenerative disease, carpal instability, osteonecrosis, & osteoarthrosis; – decrease in carpal height ratio, indicates carpal collapse; – Measurement: – carpal height is distance … Read more
– See: – Kinematics – Dynamic Instability – Ligaments of the Wrist – Perilunate Dislocations – Instability Patterns: – ulnar translocation: carpus shifts ulnarward (frequently seen in rheumatoid wrist); – dorsal intercalated segment instability; – present when lunate has rotated into dorsiflexion, as seen on lateral x-rays; – capitate displaces dorsal to long axis of … Read more