Nerves
Plate Fixation of Humeral Shaft Fracture
– Considerations: – see plate fixation theory and bone healing with plate fixation; – candidates for ORIF are humeral shaft frx w/ no comminution w/ enough of an oblique component to allow lag screw fixation; – in contrast, comminuted transverse fractures may be less satisfying for fixation, and may require bone grafting; – w/ transverse … Read more
Plantar Fascia Release
– Anatomy: – plantar fascia: – plantar muscles of the foot: are arranged in four layers w/ the FDB lying most superficially, just under plantar fascia; – medial and lateral branches of tibial nerve pass superficial to abductor hallucis and the quadratus plantae (w/ exception of 1st branch of lateral … Read more
Plantar Fasciitis
– Discussion: – one of several causes of heel pain; – the pain is located somewhat more distally than in other causes of heel pain syndrome – symptoms include gradual onset of pain at the origin of the plantar aponeurosis and 1 cm distal to this area … Read more
Plantar Interossei
Origin: there are 3 plantar interossei arising from the base and medial plantar surface of the 3rd, 4th, and 5th metatarsal bones. Insertion: medial side of the base of the 1st phalanx of the same toe and into the tendons of the Extensor digitorum longus. Action: Flex the proximal and extend the distal phalanges … Read more
Pilon Frx: ORIF of the Fibula
– Discussion: (see pilon frx discussion) – fibula is usually fractured above the joint line; – some authors will avoid ORIF of the fibula in these injuries if there is excessive fibular comminution (ie poor chance of good fixation) and if there is excessive varus of the articular surface (ORIF would accentuate the varus); … Read more
Piriformis
– Anatomy: – origin: anterior surface of sacrum between and lateral to anterior sacral foramen, capsule of sacroiliac articulation, margin of the greater sciatic foramen, and sacrotuberous ligament; – insertion: superior border of greater trochanter of femur; – action: external rotation of hip & … Read more
Physical Exam for Carpal Tunnel Syndrome
– Discussion: – its essential to consider the differential dx and to examine the patient from the neck down to the finger tips; – in taking the history, be sure to inquire as to whether the patient’s main complaint is hand/wrist pain versus paresthesias; – it is also important … Read more
Physical Exam for Cervical Spondylosis
– Signs and Symptoms: (see C-spine Exam) – pain is earlly symptom, which may be ischemic in origin; – Myelopathy: – characterized by weakness (upper > lower extremity); – ataxic broad based suffling gait, sensory changes; – rarely urinary retention; – myelopathy hand: … Read more