– See: – Phalangeal Injuries – Rheumatoid Boutonniere – Thumb Boutonniere Injuries – Discussion: – an aquired lesion of the extensor mechanism, in which the PIP joint develops a flexion deformity and the the DIP joint develops an extension deformity; … Read more
– See: – Discussion: – refers to Boutonniere injuries more than 2 months after injury; – is difficult to treat due to shortening of: – central slip & contracture of the lateral bands; – transverse retinacular ligaments; … Read more
– Discussion: – injury may develop over weeks so patient needs to be followed closely; – need to determine if triangular ligament is intact; – see if pt can maintain active PIP Joint extension; – if triangular ligament is intact, then … Read more
– Discussion: – soft tissue procedures will work only passive ROM is re-established; – Staged Method of Treatment: (from Raymond et al 1982) – use a metacarpal block for anesthesia (for intial three stages); – stage I and II: – lazy “S” incision over … Read more
– Discussion: – used to determine if PIP Joint capsule & extensor mechanism are working normally; – if functioning normally, blocking MP joint hyperextension allows IP joint extension; – Diff Dx of Positive Test: – attentuation of central slip – adherent central slip at the PIP Joint; … Read more
– See: Bone Graft Menu – PreOp Planning: – if patient has undergone previous bone graft harvests, consider CT scan to determine amount of remaining bone left in the crest; – in the report by Ahlmann E, et al, the authors investigated whether there was less … Read more
– Discussion: (see fracture healing and management of tibial bone defects) – autograft: bone graft harvest techniques – allografts – induced membrane technique – bone marrow aspirates: – in order to maximum the concentration of osteoblast precursors, no more than 2 cc should be … Read more
– See: – Arteries of the Upper Limb – Vascular Anatomy of Scaphoid – Vascularity of the Lunate – Discussion: – vascular supply of wrist is obtained thru radial, ulnar, anterior interosseous arteries and the deep palmar arch; – extraosseous arterial pattern: … Read more
– See: Transfusion Therapy and Blood Prod Menu – Indications for Transfusion: – Transfusion Technique: – maximum time over which blood products can be administered is 4 hrs for 1 unit because of danger of bacterial proliferation & RBC hemolysis; – if slower infusion rate is required, … Read more
– See: – Anastomosis of lower limb arteries – Arterial supply of the femur – AVN of femoral head; – AVN following femoral neck fracture – Anatomy: – extracapsular arterieal ring at the base of the femoral neck; … Read more