– Neurological: – two point discrimination: – used to test sensory innervation of the digits in adult patients, where as, the ability of skin to wrinkle (when placed in water) is used to test sensation in children; – normal values: … Read more
– See: Cerebral Palsy Menu: – Discussion: – most pts w/ hemiplegic cerebral palsy have functionless hand marked by: – flexion of the elbow with pronation of the forearm; – flexion of the wrist and fingers: spasticity, weakness, flexion deformity of the wrist & fingers – thumb in palm deformity; – loss of sensation and … Read more
– Planning Pin Sites: – placement of skull pins in children requires preoperative CT scan of skull to assess thickness; – pins should avoid skull suture lines, and should generally not be placed in the temporal region or into the frontal sinus; – as in adults, avoid placing pins … Read more
– Technique: – place the leg in a figure of 4 position; – make a small longitudinal incision opposite the tibial tuberlce, midway between the tubercle and the the posterior edge of the tibia; – palpate the pes anserinus; – generally only the gracilis … Read more
– Discussion: – inflammation can be related to a Haglund deformity (postero-superior prominence – normal varient) which causes an overlying bursitis; – prominence of the posterior superior calcaneal tuberosity contributes to inflammation of the overlying tissues and the Achilles tendon; – most often occurs in women and is related to shoe wear w/ rigid heels … Read more
– See: – adolescent bunion – bunionette – Discussion: – pathophysiology – blood supply of MCP joint – windlass mechanism – diff dx: – gout – hallux rigidus (cheilectomy); – references: – Anatomic variations in the first ray: Part I. Anatomic aspects related to bunion surgery. – Muscle in hallux valgus. – Kinematics of the … Read more
– See: – Cervical Spine Menu: – Halo Placement in Children: – Discussion: – most effect orthosis for controling motion at C1-C2 articulation; – contra-indications: – unstable skull frx; – traumatized skin overlying pin sites; … Read more
– Discussion: – firearms tutorial – missile characteristics: – NRA website – Weapons Effects and Parachute Injuries – Shooting Soldiers: Civil War Medical Images, Memory, and Identity in America – General Management: – most important issue is to get the correct diagnosis (no viceral injury, no compartment syndrome, no … Read more
– Discussion: – general discussion of GSW: – care of the spine injured patient: – stability: – most gun shot wounds to the spine are stable, and therefore do not require operative stabilization; – indications for bullet removal: … Read more