Nerves
Syndactyly
– See: Acrosyndactyly; – Discussion: – failure of differentiation of the tisses between the fingers at 5th-8th week of intrauterine life (see limb development); – most common in the middle and ring fingers; – syndactyly (webbing or fusion of two or more digits), a result of failure of … Read more
Swan Neck Deformity
– See: – Phalangeal Injury – Thumb Swan Neck Deformity – Transverse Retinacular Ligament – Discussion: – deformity involves hyperextension of PIP Joint w/ flexion of DIP joint; – deformity may start at either the PIP or DIP; – at PIP joint, there … Read more
Surgical Treatment of Scaphoid Frx
– Discussion: – primary internal fixation is treatment of choice for unstable scaphoid frxs; – frx treated by primary internal fixation, avg time for return to work is 3.7 wks w/ union rate, 97 %; – this compares very favorably with conservative treatment; … Read more
Surgical Technique of THR: Posterior Capsule
– Discussion: – insert blunt Homan retractors superiorly & inferiorly to obtain exposure of entire superior, posterior, & inferior portions of capsule; – divide exposed portion of capsule along its attachment to femur; – make a longitudinal or T shaped extension of capsular incision along axis of femoral neck, directing incision … Read more
Surgical Technique THR: Split the Maximus
– Discussion: – bluntly split gluteus maximus proximally in direction of its fibers & coagulate any vessels w/in substance of muscle; – note that muscle does not have to be split in line w/ incision, but can be split in line w/ its fibers in a direction superior to skin incision; … Read more
Surgical Treatment of Acute Gamekeeper’s Thumb
– See: – Incision: – skin incision begins on mid-lateral aspect of the ulnar side of the thumb, is curved over the MP joint, and extends proximally just ulnar to the EPL tendon; – take care to identify branches of the superfical radial nerve at the proximal aspect of … Read more
Surgical Treatment of Dupuytren’s Contracture
– Surgical Indications: – MCP contracture greater than 30 deg; – PIP joint: any significant contracture (more than 20); – precautions: – take care to note any sluggish filling of the digital vessels (Allen’s test); – women may have … Read more
Surgical Treatment of Gamekeeper’s Thumb
– See: Anesthetic Options – Skin Incision: – begins on mid-lateral aspect of the ulnar side of the thumb, is curved over the MP joint, and extends proximally just ulnar to EPL tendon; – take care to identify branches of the superfical radial nerve at the proximal aspect of the incision; – Adductor … Read more
Surgical Technique for TKR
– Main Menu: – PreOp Planning – radiographs and templating – Surgical Exposure: – Patient Positioning, Preping, Draping – Anterior Longitudinal Midline Approach – Deep Articular Exposure – Patellar Eversion: – Patella: – patellar resurfacing – prior to patellar resurfacing, determine the propensity for the native patella … Read more