– Metacarpal Incision: – always performed first, to ensure proper length of fixator; – make longitudinal incision from base of 2nd metacarpal to its midshaft; – terminal branches of radial sensory nerve can be identified & carefully retracted; – dissect down to bone, and insert … Read more
– Discussion and Indications: – definitive stabilization of frx may be achieved w/ external fixation in certain rotationally unstable but vertically stable injuries; – relative contraindication is iliac wing fractures; – antero-posterior compression injuries: – external fixation is most applicable to stable “open book” … Read more
– See: Over Distraction of Wrist – Discussion: – patient is instructed to move all unaffected joints throughout the joint; – avoid pronation and supination of forearm since this applies skin tension over most proximal screw; (infection is most common here); – when limited finger or … Read more
– See: – Discussion: – if the laceration occurs proximal to the junctura the diagnosis of an extensor tendon laceration can be missed; – have the patient extend the affected proximal phalanx w/ the remaining digits flexed; – lacerations of middle or little digits proximal to … Read more
– Anatomy: – transports APL & EPB tendons; – these tendons represent the radial border of the anatomic snuff box; – when pts thumb is extended, you can distinguish between the tendons as they exit the tunnel; – near insertions of tendons, distal to the tunnel, … Read more
– See: Extensor Tendon Lacerations: – the extensor apparatus is a “plexus of tendons with an aponeurotic sheet.” – from Stack, 1962. MP Joint Level: – extensor digitorum communis: (at the MP joint) – there may be some adhesion to the joint capsule, but there is … Read more
– Anatomy: – extensor tunnel I – origin: – posterior side at the distal end of the body of both the ulna and radius near their middle; – insertion: – posterior surface of the base of the proximal phalanx of thumb; … Read more
– See: Extensor Pollicis Longus Rupture: – Anatomy: – origin: posterior surface of the middle 1/3 of the ulna & interosseous membrane; – insertion: posterior surface of the base of the distal phalanx of thumb; – action: extends the distal phalanx of the thumb; continued action, extends proximal phalanx and adducts the … Read more
– See: Extensor Tendon Rupture in RA – Discussion: – this tendon is prone to rupture from synovitis and increases friction at Lister’s tubercle second to diseases such as RA and Lupus; – EPL is tendon that is most frequently ruptured from distal radius frx; – if … Read more
– See: – Extensor Tendon Rupture – Extensor Digitorum Communis – Extensor Mechanism of Digits – Anatomy of EDC: – note that EDC is less tolerant of shortening than FDS due to differential in tendon excursion (50 mm compared to 70 mm, respectively); – references: – The terminal tendon … Read more