– Discussion: – w/ Young-Burgess system, stability or lack of stability can be judged fracture pattern, direction of the force of injury, and by knowledge of pelvic ligamentous anatomy; – in Lateral Compression frx, force of injury is from side & is assoc w/ horizontally oriented pubic frx; – Lateral Compression Classification: … Read more
– Hand: Physical Exam Flex Ext R/Dev. U/Dev. Pro Sup Radial-Ulnar Art. 75 70 25 45 60 60 5/5 5/5 2+ … Read more
– See: – PA View – AP View – Radiology of Hand & Wrist – Radiology of Scaphoid Fracture – Discussion: – clenched fist AP – ulnar deviation view (see: AP view:) – proper technique: for visualizing … Read more
– Positioning and Preparation: – joint is distended w/ finger traps (to index and long fingers) w/ about 10 lbs, using a pulley system; – counter traction is applied to the arm w/ use of a second 10 lb pulley – this allows the elbow to be flexed 90 deg; – gravity assistant inflow; – initially … Read more
– Discussion: – wrist disarticulation: include the removal of the radius and ulna to styloid processes; – shape of stump remains bulbous, thus permitting prosthetic attachment, leaving the elbow free and preserving full pronation & supination; – wrist disarticulation retains distal radio-ulnar joint preserves more forearm rotation, & retaining distal radial flare dramatically … Read more
– Indications: – painful or unstable wrist joint w/ advanced destruction due to OA, RA, post traumatic arthritis, SLAC wrist, spastic flexion contracture, degenerative scaphoid non-union, unsuccessful wrist arthroplasty, and Keinbock’s dz; – this procedure is more beneficial for young, active pts or middle aged pts, but not for elderly pts; – PreOp Considerations: – in … Read more
– Discussion: – arthrography may be used in diagnosis of carpal instability because it is technically easy & is only minimally invasive; – normally there should be no communication between the radiocarpal, mid-carpal, and distal radial-ulnar joints; – it is noteworthy that in normal wrists there may be communications … Read more
– Discussion: – KCI Vacuum Assisted Closure Device: (Company Web Site) and V.A.C.® Therapy Indications and Safety Information – Soft Tissue Coverage (Austere Environment) – Flaps and Vacuum-Assisted Closure (VAC) – technique: – debride all devitalized tissue and contaminated material; – sterile reticulated … Read more
– Menu: – Antibiotic Beads – Antibiotic Prophylaxis – Carrier State – Contaminated Wound Care – Debridement of Muscle: (debridement of open tibia fractures); – Decubitus Ulceration – Drains and Closure of Wounds – Fracture Blisters – Gun Shot Wounds – Pressure Irrigation … Read more
– History and Exam: – fracture of the scaphoid is suspected w/ fall on an outstretched hand; – snuff box tenderness (see clinical differential diagnosis:) – scaphoid impaction syndrome – tenderness to palpation over scaphoid tuberosity and/or proximal pole just distal to Lister’s tubercle; … Read more