– Discussion: – comminuted fractures of the entire head; – classification: – type A: – fracture of the entire radial neck, with the head completely displaced from the shaft; – type B: – articular fracture involving the entire head, which consists of more than two large fragments; – each fragment is completely displaced from the … Read more
– Discussion: – used to show ulnar variance; – technique: – shoulder is abducted 90 deg, the elbow flexed 90 deg, and forearm is held in neutral rotation; – AP View: – patient places the forearm flat on … Read more
– Hand: Physical Exam Flex Ext R/Dev. U/Dev. Pro Sup Radial-Ulnar Art. 75 70 25 45 60 60 5/5 5/5 2+ … Read more
– Indications: – painful or unstable wrist joint w/ advanced destruction due to OA, RA, post traumatic arthritis, SLAC wrist, spastic flexion contracture, degenerative scaphoid non-union, unsuccessful wrist arthroplasty, and Keinbock’s dz; – this procedure is more beneficial for young, active pts or middle aged pts, but not for elderly pts; – PreOp Considerations: – in … Read more
– Discussion: – arthrography may be used in diagnosis of carpal instability because it is technically easy & is only minimally invasive; – normally there should be no communication between the radiocarpal, mid-carpal, and distal radial-ulnar joints; – it is noteworthy that in normal wrists there may be communications … Read more
– Positioning and Preparation: – joint is distended w/ finger traps (to index and long fingers) w/ about 10 lbs, using a pulley system; – counter traction is applied to the arm w/ use of a second 10 lb pulley – this allows the elbow to be flexed 90 deg; – gravity assistant inflow; – initially … Read more
– Discussion: – wrist disarticulation: include the removal of the radius and ulna to styloid processes; – shape of stump remains bulbous, thus permitting prosthetic attachment, leaving the elbow free and preserving full pronation & supination; – wrist disarticulation retains distal radio-ulnar joint preserves more forearm rotation, & retaining distal radial flare dramatically … Read more
– Discussion: – consequences of anterior instability include Bankart lesion, Hill Sachs lesion, erosion of the anterior glenoid, loose body formation, and stretching of the joint capsule; – features: – degree of trauma involved – distinguish between traumatic dislocations and recurrent … Read more
– See: brachial plexus – Discussion: – hx: persistant pain > 6 months: (poor prognosis); – diff dx: – breast cancer (lower plexus and painful) – radiation therapy (upper plexus and painless) – … Read more
– See: Compartment Syndrome – Discussion: – type of forearm ischemic contracture resulting from brachial artery injury usually associated w/ supracondylar frx of humerus; – may see loss of motor & sensory function, however, classic involvment is w/ anterior interosseous branch of median nerve; – pathology: … Read more