– See: Orthopaedic Infection Menu: and risk factors for TJR infection – Pre-Admission Considerations: – removal of hardware prior to joint arthroplasty: – High incidence of early periprosthetic joint infection following THA with concomitant or previous hardware removal – Hospital and OR Considerations: – perioperative oxygen – normothermia: – Perioperative normothermia to … Read more
– Discussion: – displacement of metacarpal shaft fractures is prevented by intermetacarpal ligaments and intrinsic muscles; – the border metacarpals (thumb, index, and little) are not supported as well as the ring and long metacarpals and are therefore more likely to displace; – effect of shortening: … Read more
– See: Extra-articular Thumb Metacarpal Fractures – Discussion: – interosseous muscles & intrinsically strong carpometacarpal capsular and interosseous ligaments provide intrinsic stability to extra-articular fractures at the metacarpal bases; – mechanism of frx of little CMC: – stability of CMC joint derives from articulation w/ carpal … Read more
– See: MP joint injuries – Discussion: – often badly comminuted; – consider a short period of splinting followed by early active motion; – this may mold the articular surface by using the soft tissue sleeve; – early motion will also prevent joint stiffness, but loos of … Read more
– carpometacarpal fracture dislocation – dislocation of MP joint: – complex dislocations of the MP joint – simple dislocations of the MP joint – thumb MP joint dislocation – metacarpal head frx – metacarpal neck fracture – metacarpal shaft fractures – MP … Read more
– See: metacarpal frx menu – Discussion: – frxs through neck & shaft of metacarpals usually angulate w/ apex dorsal, displacing the metacarpal head into the palm; – ring and little neck frx: (see boxer’s frx); – corresponding CMC joints are mobile (in contrast to … Read more
– Adult: 50-150mg PO/IM/SQ q3-4hr prn Pain; (75mg IM Demerol =10mg Morphine) 1-2 mg/kg/dose PO/IM/IV (including Peds q 6 hr) – PO: peak effect at 2 hrs; – IM/IV: onset at 2-5 min; Peak at 1 hr; lasts 2-3 hrs. – IV administration must be slow in diluted solution; – Peds: 1 mg/kg/dose IV/IM q2-4hr; 1.0-1.5 mg/kg/dose … Read more
– Components: Shaft, Radial Styloid, and Dorsal Medial and Palmar Medial Parts; – Type I: – colles frx equiv: undisplaced and minimally comminuted; – Type II: – die punch frx: unstable w/ moderate to severe displacement; – similar to Mayo class II: displaced frx involving radioscaphoid joint; … Read more
– Discussion: Zone IV: – extends from distal end of transverse retinacular ligament to proximal margin; – combined nerve – tendon procedure may be delayed for 21 days if wound is contaminated, if crushing trauma has occurred; – median nerve management: (nerve repair) – lacerations of flexor tendons within … Read more