– Discussion: – numerous multinucleated giant cells, proliferative stroma, areas of necrosis, reactive peripheral bone, & occassional mitotic figures in the stroma (but no mitotic figures in the giant cells); – stromal cells appear elongate with oval nuclei; – giant cells may resemble osteoclasts; – Histologic Differential Dx: … Read more
– Considerations: – select point on lateral side of shaft of femur midway between anterior & posterior cortices at the midpoint of the lesser trochanter; – if pins are inserted below the level of the lesser trochanter, a stress riser will be created in cortical bone; … Read more
– Hip Arthroscopy: (see hip joint and hip capsule) – indications: – evaluation of hip pain- candidates are patients with nonspecific radiographic findings and reproducible, functionally-limiting exam findings; – false negative rate of plain x-ray, bone scan, CT, arthrogram, and routine MRI has been quoted as high as 80% in some patient populations. – gadolinium enhanced MRI demonstrated … Read more
– Discussion: – dislocate the hip posteriorly by flexing, adducting, and gently internally rotating the hip; – this may drive the femur against posterior edge of acetabulum; – place bone hook beneath femoral neck at level of lesser troch. to gently lift the head out of the acetabulum; … Read more
– See: – Tendon transfers: – Nerve Repair: – Combined Injuries of the Median and Ulnar Nerves: – Discussion: – ulnar innervated intrinsic muscles of hand, FCU, & FDP units to ring & little fingers & part of long finger; – functional deficit: … Read more
– See: – Entrapment of Median nerve at the Elbow and Forearm: – Combined Injuries of the Median and Ulnar Nerves: – Median Nerve – Nerve Repair – Deficit: – loss of pronation of forearm, wrist flexors, index & long finger … Read more
– Discusion: – high pressure grease and paint guns are most common cause of injury, & site of injury is often the pad od the thumb or index finger; – severity of injury is often underestimated due to the small punctate entrance wound; – injected substance passes rapidly thru … Read more
– See: Diff Dx of Hand Infections – Discussion: – most often involves the tip of the digit; – occurs from contact w/ oral tracheal secretions and self inoculation (common w/ dentists); – incubation period from two to 14 days; – characterized by … Read more
– See: – Calcinosis: – Hemangioma of bone – Discussion: – a benign, vascular tumor that occurs in children, usually in limbs or trunk; – hemangioma may be congenital, appearing as solitary tumor that infiltrates local tissue & adjacent neurovascular structures; – most common form … Read more
– Thumb: – typical problems: stability and retractability; – thumb adduction stop used to gain ROM in first web space; – rigid thumb orthosis allows for stabilizing thumb for prehension; – MP Joints: – usually a hand orthosis; – with no active extension of the … Read more