– See: Carpal Instability – Discussion: – by definition, consists of volar flexion of the lunate relative to the longitudinal axis of the radius and capitate, when the wrist rests in a neutral position; – lunate will tend to flex when there is loss of ulnar support from the triquetrum; … Read more
– See: Venous Repair – Discussion: – veins accompany the arteries of the lower limb, and those that parallel the large arteries of leg are paired; – five major venous structures of leg are greater and lesser saphenous veins, posterior & anterior tibial veins, & peroneal veins; – Greater Saphenous Vein: … Read more
– See: – Burns of the Hand – Thrombolytic Therapy – Ischemia of the Hand: – History: – infection, cold intolerance, pain, tenderness, of mass, cyanosis – Treatment of digital ischemia with liposomal bupivacaine. – Diff dx: – Aneurysms of the Upper Extremity … Read more
– See: – Blood Supply to the Wrist – Kienbock’s Disease – Discussion: – majority of lunates have both dorsal & palmar vessels & are thus as well vascularized as the other carpal bones; – neither single intraosseous nor extraosseous disruption alone will cause avascular necrosis … Read more
– See: Blood Supply to the Wrist: – Discussion: – scaphoid receives majority of its blood supply via dorsal vessels at or just distal to waist area; – these vessels perfuse the proximal pole in a retrograde fashion; – most important vascular branches of … Read more
– Discussion: – vascular compromise occurs in about 5-20% of children w/ supracondylar frx; – less than 1% will be complicated by compartment syndrome and the resulting sequelae of Volkmann’s contracture; – note that a median nerve palsy, may mask a pending compartment syndrome (because there … Read more
– See: – Nail Bed Injuries – Finger Tip Injuries: – Discussion: – may be used for finger tip amputations which have more dorsal soft tissue loss than palmar loss); – advancement flaps from same finger provide advantage of rapid healing, limited morbidity, and critical sensibility … Read more
– Tensioning the Graft: – as a muscle is tensioned to mid stretch, most of the potential energy generated results from passive tension of elastic recoil; – note that the tenodesis effect can effectively increase tendon excursion by 2-3 cm; – Mayer’s Rule: – … Read more
– Forearm: – in the report by Edwards et al, the authors performed a prospective study was undertaken to compare the use of forearm and upper arm tourniquets for local anaesthetic procedures on the hand; – 100 consecutive patients with an upper arm … Read more
– Discussion: – upper extremities are involved in as many as two-thirds of pts who have peripheral neuropathy, but the involvement tends to be milder & to become clinically symptomatic at later age than does involvement of the lower extremities; – intrinsic-minus hands develop with decreased stability