Dupuytren’s Contracture: Subtotal Palmar Fascietomy
Case Example by James R. Urbaniak MD. – Discussion: – regional fasciectomy is the most commonly performed procedure … Read more
Hand
Dorsal Interossei
– See: Intrinsic Muscles of the Hand; – Origin: each from the 2 metacarpal bones between which it inserts; – Insertion: – superficial belly: – inserts onto the lateral tubercle at the base of the proximal phalanx (proximal phalanges of 2nd, 3rd, and 4th digits) to function as … Read more
Dorsal Approach to the Wrist
– See Compartments: I, II, III, IV, V,VI and approach to the distal radius; – Technique: – straight dorsal incision centered over the wrist; – because the skin is loose over the dorsum of the wrist, contractures are uncommon; – incise skin and subcutaneous tissue down to the retinaculum; – careful to preserve dorsal veins and … Read more
Dorsal Articular Lip Frx: (Dorsal Barton’s)
– Discussion: – dorsal rim frxs usually result from a fall on the outstretched hand; – proximal carpal row impacts against the dorsal lip of the articular surface of the radius, which fracture in compression and displaces proximally and dorsally; – volar radiocarpal ligaments fail in tension, and dorsal … Read more
Dorsal Barton’s Fracture / Dorsal Shearing Frx
– Discussion: – distal radius fracture w/ dislocation of radiocarpal joint; – most common frx dislocation of the wrist joint; – comminuted frx of distal radius may involve either anterior or posterior cortex and may extend into the wrist joint; – frx dislocation or subluxation … Read more
Dorsal Dislocation of the PIP joint
– See: – Differential Dx of PIP Injuries – Fracture Dislocations of the PIP Joint – Phalangeal Injury – Discussion: – anatomy of the injury: – volar plate is always detached (usually from middle phalanx) in PIP dorsal dislocations; … Read more
Dorsal Fracture Dislocations of the PIP Joint
– See: – Dorsal Dislocation of PIP joint – Extension Block Casting – Phalangeal Injury – Discussion: – long moment arm of the PIP joint, places this joint for higher risk of this injury; – mechanism and anatomy of injury: … Read more
Dorsal Intercalated Segment Instability: (DISI)
– See: – Carpal Instability – Kinematics of the Wrist – Discussion: – lunate will tend to flex w/ loss of ulnar ligamentous support from the triquetrum; – lunate extends when there is loss of radial ligamentous stability; – DISI may arise as a result of: – scaphoid frx; – scapho-lunate dissociation; – perilunate dislocation … Read more
Dorsal Approach (Thompson)
– See: – Plating Techniques – Radial Shaft Fractures: Discussion – Discussion: – dorsolateral approach is best suited to frxs of proximal & middle thirds of radius as well as to address injury to proximal RU joint; – advantages: – … Read more