– Discussion: – deep arch is more consistent than superficial palmar arch – deep arch supplies all digits (complete) in about 97% of population; – anatomy: – large deep branch of radial artery, w/ pulsations is felt in anatomic snuff box, passes under snuff box tendons & … Read more
– Discussion: – classic delta phalanx is characterized by a triangular or trapezoidal shaped bone w/ C shaped epiphyseal plate; – proximal epiphysis curves around from its transverse orientation to a longitudinal one from proximal to distal along one side of the phalanx, thus forming a “C”‘ … Read more
– Discussion: (see osteochondral injury) – these injuries are distinct from degenerative arthritic lesions and management of these lesions should remain distinct as well; – theory is that penetration of subchondral bone causes bleeding from underlying vessels which allows clot formation in the cartilaginous defect and subsequent formation of fibrocartilage; – some argue that subchondral drilling … Read more
– Discussion: – first performed by Darrach in 1911 in New York City. – Indications: – for relief of pain following distal RU disruption and/or RU arthritis; – for symptomatic malunion of Colle’s frx in elderly patients, especially when stiffness is present; – procedure is generally performed … Read more
– Overlapping Toes: – involves an dorsal-adduction deformity of the 5th toe; – other components of the deformity include external rotation of the digit, contracture of the EDL tendon; – in some cases there may be dislocation of the MTP joint; – often the deformity is familial and bilateral; – clinical findings: – the deformity … Read more
– Second Generation Ceph – Semisynthetic broad spectrum cephalosporin – Gen II. – Adult:500mg-1gm IV/IM q4-6hr to max dose of 12gm/day (2gm q4hr); – usual dose is 1gm q6hr; – Peds: 50-100 mg/kg/day q6hr; – Good diffusion from blood into CSF only with inflammation; Ratio of CSF to Blood Level (%): Normal Meninges: nil; … Read more
(See also: Work Up for Scaphoid Frx) Discussion w/ proper casting nearly 100% of tubercle & distal third frxs will heal; in addition to healing considerations, the surgeon should note the position of healing (malunion); approximately 80-90% of scaphoid frx at the waist will heal, but only 60-70% of proximal pole frxs will heal; even … Read more
– Casting Technique: assistance provided by Jorge Garcia.
– Indication for Closed Treatment: – indications — These are based on “personality” of the fracture as described by Nicoll EA (1964) – he listed factors favoring union: – displacement: if the fracture fragments on are or can be opposed to 25% in a transverse fracture, casting or bracing is permissible – more than 50% initial frx … Read more
– See: Metacarpal Extra-articular Base Frx – Discussion: – relatively mobile ring and little CMC joints are more susecptible to dislocation than the immobile index and long rays; – fifth CMC is the most frequently injured; – pertinent anatomy: – ring and little metacarpals articulate w/ … Read more