– Outside Link: – An Approach to the Head Injured Patient by Paul Marik, MD – Trauma Menu: – Spine / C-spine – Orders for the Spine Injured Patient: Anesthesia in the Spinal Cord Injured Patient: Fluids in the Head Injured Pt: Hyperventilation Glasgow Coma Scale Head … Read more
– Discussion: – physical properties – state in body fluids – physiologic roles of calcium are well established; – abnormally low concentrations of Ca permit spontaneous discharges of both sensory & motor fibers in peripheral nerves, leading to tetany; – w/ elevated levels, … Read more
– Discussion: – see flexion and extension gaps: – quantification of joint line malposition: – joint line position lies about 3 cm distal to the medial femoral epicondyle and 15 mm above the fibular head; – if the opposite knee has … Read more
– See: – Burns of the Hand – Chemical Burns – Electrical Burns – Frost Bite – Initial Management: – trauma management: – patients require a generalized trauma assessment w/ all clothing removed; – determine nature of the burn (flame, chemical, electrical); … Read more
– Anticoagulant Induced Bleeding: – Coags – Coag Pathway – Platlet abnormalities: – Transfusion Rx – Dilution Coagulopathy: – may result from massive transfusions; – rarely occurs w/ < 12 units of transfused pRBC, but occurs in nearly all pts that have received > 20 units of pRBC; – note: coagulopathy associated with … Read more
– See: Tumors of Soft Tissue – Prognosis: – prognosis of malignant melanoma worsens w/ increasing tumor thickness and also appears to be related to tumor site, age, and sex; – lesions on the scalp, hands, and feet, particularly in older pts and males, all have a poorer prognosis; … Read more
– See: – Phalangeal Injury – Pediatric Mallet Finger – Mallet Frx – Anatomy: – extensor mechanism of digits; – terminal extensor tendon is comprised of the convergence of lateral bands, and more proximally by terminal fibers of the oblique retinacular ligament; – Acute Injury: – from forcible flexion of the extended DIP joint: – … Read more
– Non Operative Treatment: – indicated for small (< 30-40%) fragment or displacement < 2 mm; – use mallet finger splint; – Indications Operative Treatment: – fragments > 30% of joint surface or displacement > 3 mm may require ORIF; – volar subluxation from mallet fracture: – needs to be re-evaluated after application … Read more
– See: Distal Phalangeal Frx Mallet Finger – Discussion: – may result from forceful hyper-extension; – displaced frx fragment moves volarly with the distal phalanx w/ DIP flexion – diff dx: dorsal DIP dislocation; – indications for treatment: – … Read more
– Discussion: – a hamartomatous enlargement of soft tissue & underlying bone; – can be static, growing commensurately w/ hand, or progressive, growing faster than the rest of the hand; – involvement in the hand is more common than involvement in the foot; – “nerve territory-oriented macrodactyly”: … Read more