– See: Trans-scaphoid Perilunar Dislocation – Discussion: – occurs as oblique frx through radial styloid, extending thru scapholunate ligament and around the lunate, through the triquetral attachments; – due to the radiocapitate ligament, the fractured styloid process migrates with the distal carpal row; – because styloid is held by radiolunate … Read more
– Transverse Retinacular Ligaments: – anatomy: – origin: edge of flexor tendon sheath at PIP; – insetion: lateral edges of conjoined lateral bands – function: – prevents excessive dorsal shift of the lateral bands when the PIP extends; … Read more
– Discussion: – transverse carpal ligament, is a heavy band of fibers which runs between hamate & pisiform medially to scaphoid and trapezium laterally, and forms fibrous sheath which contains carpal tunnel anteriorly within fibro-osseous tunnel; – posteriorly, tunnel is bordered by carpal bones, and transports median nerve & finger flexor … Read more
– See: – Avulsion Fracture – Comminuted Fractures – Fracture Dislocations – Oblique Fractures – Surgical Approach: – Discussion: – transverse frx enters semilunar notch, & amount of separation of is influenced by the pull of triceps muscle … Read more
– Evaluation of Muscle: – about 5% of shoulders that have had an anterior dislocation will sustain a irrepairable injury to the subscapularis, which will contribute to further instability; – in this case, a pectoralis transfer would be indicated; – Preparation: – identify the anterior humeral circumflex … Read more
– See: – Safe Zone of Pin Insertion Wires Insertion Techniques – Wire Characteristics: – in general 1.5 to 1.8 mm wires need no incision or drill sheath, but larger, 2.0 wires may be inserted w/ sheath through incision; – larger diameter wires will increase … Read more
– Discussion: – upper trunk brachial plexus injuries are common football tackling injuries, which may be refered to as “stingers;”; – named for temporary sensation that radiates from the shoulder to the hand; – most often involves C5 and C6 nerve roots, which make up the upper trunk of the brachial plexus … Read more
– Discussion: – used to evaluate capsule of shoulder, & glenoid labrum, subscapularis & long head of the biceps, and the humeral head; – glenoid labrum produces low signal intensity since it is made of fibrous tissue; – Hill-Sachs lesion, seen as a notched defect of flattening of humeral … Read more
– Discussion: – type of supracondylar fractures that occurs within joint capsule; – most commonly occurs w/ osteoporotic bone; – Treatment: – nondisplaced frxs are treated w/ splinting or percutaneous pinning; – displaced frx will require ORIF; – consider molding … Read more
– Discussion: – often more stable than pure perilunate dislocation if waist frx is transverse and the scapholunate ligament has remained intact; – it is usually more unstable than an isolated scaphoid frx because of ligament damage; – consider internal fixation for the scaphoid frx and a capsular repair … Read more