– Discussion: – adduction contractures of shoulder and flexion contractures of elbow are not a problem in themselves, as muscle weakness renders patient unable to abduct the arm above the level of the shoulder or to extend the elbow against gravity; – pronation contractures of the forearm and flexion contractures … Read more
– See: Distal RU Joint – Surgical Options: – Hemi-resection Arthroplasty of RU Joint – Darrah’s Procedure – Modified procedure (Bower’s) – Sauve Kapandji – Complications: – distal ulna resection can lead to carpal migration and ulnar snapping; – w/ failed arthroplasty arthrodesis (in neutral or slight dorsiflexion) may be required; – fusion is often favored … Read more
– See: – Reduction of Dorsal Angulation – Discussion: – measured on lateral, from angle created between articular surface of distal radius & line perpendicular to long axis of radius; – normal volar tilt measures between 0 to 22 degrees (mean 11 to 14.5 deg); … Read more
– See: – Distal Radius Frx Menu – External Fixators for Distal Radius Frx – Intra-Articular Fractures of the Distal Radius – Unstable Distal Radius Frx – Radiographs: – scapholunate dissociation – Technique: – first perform closed reduction under … Read more
– See: distal radius fracture menu / percutaneous pin fixation – Discussion: – Kapandji’s Technique / Intra Focal Pin Fixation: – a technique in which pins are inserted into the fracture site which are then used to pry the distal fragment into optimal position; – indicated for extra-articular distal … Read more
– See: Palmar Tilt – Discussion: – frx needs to be reduced prior to skin incisions & Ex Fix application; – longitudinal traction combined w/ thumb pressure and wrist flexion restores palmar tilt; – progressive wrist flexion will not restor palmar tilt until dorsal ligaments begin to tighten … Read more
– See: – Distal Radius Frx Menu – External Fixators for Distal Radius Frx – Intra-Articular Fractures of the Distal Radius – Unstable Distal Radius Frx – Discussion: – clinical outcome studies – Radiographs: – r/o concomitant scapholunate dissociation; – Anatomic Considerations: – die punch fragment: – following fixation of the radial styloid fragment, the … Read more
– Discussion: (distal radius fracture menu) – technique of closed reduction – position of immobilization: – generally need to avoid positions of marked palmar flexion & ulnar deviation (Cotton-Loder position); – a truly stable fracture will probably be stable in any position once it is reduced; … Read more
– Discussion: – generally distal interlocks should be inserted prior to the proximal interlocks; – this allows the leg to be rotated in the most advantageous position for interlock insertion and allows more effecient compression across the frx site (by gently tapping the proximal nail assembly proximally); – … Read more
– See: – Phalangeal Menu: – Nail Bed Injuries: – Finger Tip Injuries: – Mallet Frx – Discussion: – fractures of the distal phalanx usually result from crushing injuries that produce significant soft tissue injury; – in such injuries the primary concern is soft tissue repair; – when the fractures are comminuted, the fragments are … Read more