– Discussion: – third generation cephalosporin; – adult: 1-2gm IV q12-24hr; t1/2=7.5hr; w/ long half life, allows once a day dosing, and home treatment; – peds: 100 mg/kg/day q12 or q24hr; – no need to change w/ renal failure; – broad spectrum Gm neg and … Read more
– See: Pes Cavus: – Discussion: – seldom present at birth, the deformity gradually becomes apparent as childs foot grows and matures; – components: – heightened longitudinal arch – cavus – – plantar flexion of 1st ray and pronation of the forefoot – responsible for cavus appearance of foot; – on wt bearing it forces … Read more
– Anatomy: – subarachnoid space is prolonged in a duralarachnoid sheath around each dorsal and ventral root, roughly to level of union of roots; – because the cord is shorter than vertebral column, nerves slope inferiorly from their levels of origin to appropriate intervertebral foramina, and the angle becomes more acute from … 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
Review Articles: Current Concepts: Entrapment Neuropathies of the Upper Extremities. Carpal tunnel syndrome in patients who are receiving long-term renal hemodialysis. The carpal tunnel syndrome. A study of carpal canal pressures. Spontaneous rupture of the flexor carpi radialis tendon. Deep postoperative wound infection after carpal tunnel release. Symptomatic restrictive thumb-index flexor tenosynovitis: incidence of musculotendinous … Read more
– See: Anatomy of Carpal Tunnel – TCL Incision: – transverse carpal lig is exposed, but this is generally obscured by origin of thenar & hypothenar muscles, which come to lie in opposition in midline; – palmar fascia is incised, & nerve is identified just proximal to the carpal canal; … Read more
– See: Anatomy of Carpal Tunnel – Anesthesia: – Bier Block: – proponents note that regional anesthesia allows a less rushed operation along w/ a synovectomy, if needed; – median nerve block at elbow; – w/ elbow extended brachial … Read more
– Discussion: – median nerve compression syndrome at the wrist; – most common form of nerve entrapment; – first described by Paget; – references: The First Description of Carpal Tunnel Syndrome. James Paget FRS – pathophysiology: – nerve compression may result in ischemia, focal demyelination, decrease in axonal caliber, and finally axonal loss; – ref: … Read more
– Injection of Steroid in pts w/ CTS: – injection of steroids into carpal tunnel can be an effective method of treatment in the short term; – if steroid is injected directly into median nerve, dysesthesias may occur and persist for several weeks; – note that steroid injections into … Read more
– Discussion: – are placed from the medial side to avoid damage to the posterior tibial neurovascular pedicle; – posterior tibial pulse should be palpated with one hand during the initial placement; – safe zone is outlined by a vertical line tangential to the posterior border of the medial … Read more