Hand
Lunate Implant
– Discussion: – lunate shaped spacer implant made of silicone, vitallium, acrylic, or rolled-tendon is inserted into theresulting space to prevent migration of other carpal bones; – due to the high rate of synovitis, most surgeons are now reluctant to use lunate implants; – Technical Considerations: – dorsal approach is … Read more
Lunotriquetral Dissociation
– See: Triquetrium – Lunotriquetral Dissociation: – ulnar side carpal instability; – involves disruption of lunotriquetral & volar radiolunotriquetral ligaments & attentuation or rupture of dorsal radiotriquetral attachments; – w/ a isolated tear of the LT interosseous ligament, there will be only a small amount of increased motion, however, … Read more
Lumbrical Muscle Sheaths
– Discussion: – index lumbrical is adherent to roof of thenar bursa; – second, third, & 4th lumbrical sheaths are not so easily demonstrated, but when present usually overlie mid palmar bursa or space; – lumbar sheaths extend from the web area to the center of the palm; … Read more
Lumbar Stenosis
– Discussion: – spinal stensosis is a narrowing of the lumbar spinal canal and/or neural foramina; – results in compression of the cauda equina and lumbar nerve roots, producing neural root ischemia and neurogenic claudication; – compression of neural structures also compresses vascular supply of nerves so that symptoms are predominately those of … Read more
Low Ulnar Nerve Injury
– See: – Claw Hand: – Tendon Excursion: – Nerve Repair: – Combined Injuries of the Median and Ulnar Nerves: – Discussion: – lesion of ulnar nerve at or near wrist or base of palm will result in paralysis of hypothenar … Read more
Longitudinal Meniscal Tear
– longitudinal tears, which usually involve the posterior portion of the meniscus, are the most common meniscal lesions; – in many cases, gross inspection reveals only slight irregularities in inner border of the meniscus; – probing is necessary to establish the presence of a tear; – the meniscus should be probed from its … Read more
Hallux Valgus: Mau Osteotomy
Discussion: – oblique diaphyseal osteotomy that is directed proximal-plantar to distal-dorsal; – long dorsal shelf of bone supports the distal fragment, making dorsal displacement of the osteotomy unlikely; – type of intrinsically stable metatarsal osteotomy (weightbearing on the foot compresses the osteotomy) – other types of intrinsically stable osteotomies include the proximal … Read more
Lobster Hand
– See: – Congenital Deformities of the Hands: – Discussion: – rare anomaly – absence of digit, w/ cleft hand (“lobster claw” hand); – phalanges of middle finger, & sometimes corresponding metacarpal, are absent, & cleft in the plane of the missing digit & metacarpal separates … Read more
Local Anesthetic Properties for Lidocaine
– See: systemic lidocaine administration – Discussion: – maximum dose: 4.5mg/kg or 300mg (28 ml of 1% solution) or 50 mL of 1% solution w/ added Epinephrine (1:200,000); – duration of action: – anesthetic onset in 5-30 min, lasting 2-3 hr; … Read more