Ortho Oracle - orthopaedic operative atlas

Complex Dislocations of the MP Joint

– See Simple Dislocations of the MP joint – Discussion:     – by definition, an irreducible MP dislocation;     – involves infolding of the proximally disrupted volar plate between metacarpal head and base of proximal phalanx;     – complex dislocations occur most commonly in index finger followed in incidence by thumb & … Read more

Complex Elbow Dislocations

 – Discussion:     – dislocations of the elbow associated with fracture are termed complex;     – comprimise 49% of elbow dislocations;     – most of these fractures are inherently unstable and require surgery;     – prolonged elbow immobilization produces poor results.     – surgery must achieve sufficient stability to allow … Read more

Colles’ Fracture

– See:  Distal Radius Frx Menu / Intra-Articular Fractures of the Distal Radius – General Discussion:     – frx was described by Abraham Colles in 1814, originally described as low energy extra articular frx of distal radius occuring in elderly individuals; – frx is typically dorsally displaced and angulated; – mechanism: – fracture is also caused by … Read more

Collar Button Abscess

– See: Infections of the Hand – Discussion:     – type of web space infection, which involves both palmar and dorsal sides;     – frequently arises from a distal palmar callus, but spreads to the dorsal side;     – spread of infection is limited by palmarly by the adherence of the palmar … Read more

CMC arthritis: Resection Arthroplasty

– Discussion: – historically has yeilded good results in relieving pain; – disadvantages: – thumb shortening and subsidence, weakness of pinch, and decreased ability to adduct the thumb; – Operative Technique: – dorsal longitudinal incision centered over CMC joint; – incision is curved volarly at the base of thenar eminence; – superficial branches of the … Read more

CMT Type I

– See: CMT Menu: – Discussion:     – autosomal dominant inheritance;     – type-I and III disorders are due to demyelination of peripheral nerves;     – clinical presentation is most common during the second decade of life;     – due to defect in the gene coding for peripheral myelin protein-22 on chromosome … Read more

CMT Type II

– See: CMT Menu: – Discussion:     – autosomal dominant inheritance;     – type II is the neuronal form of CMT disease and is seen infrequently;     – onset is delayed until the second or third decade of life;     – sensory and motor nerve-conduction times that are only mildly abnormal, and … Read more

CMT Type III

– See: CMT Menu: – Discussion:     – includes the hypertrophic neuropathy of infancy (Dejerine-Scottas);     – autosomal recessive trait;     – begins in infancy;     – EMG in demyelinating neuropathies:            – marked slowing in nerve conduction velocity which is more extensive than those seen in … Read more