Nonunion of Scaphoid Proximal Pole Frx
– See: – Proximal Pole Frx: – Bone Grafting of Scaphoid Non Unions: – Scaphoid Nonunions: – Radiographs: – need to determine whether there is AVN of scaphoid: – classic signs of AVN include: … Read more
Nerves
Non Operative Treatment of Carpal Tunnel Syndrome
– Discussion: – most useful in patients with an acute flare-up and in patients with minimal and intermittent symptoms; – avoiance of use of wrist, placement of wrist splint in a neutral position for day and night use, and NSAIDS; – only 20% of these pts … Read more
Total Femoral Replacement
– Total Femoral Replacement: – indications: reconstruction following tumor resection – technique: – lateral position on a bean bag – begin proximally with a posterior approach to the hip – divide fascia laterally over femur and continue proximally to … Read more
Neuropathic Ulceration (Mal perforant)
– See: – Charcot Changes in the Diabetic Patient – Diabetic Foot Menu – Pathophysiology: – effects of neuropathy are simply those of the insensate foot; – in the last century the commonest cause of the insensate foot was syphilis, whereas it is now diabetes; … Read more
Neurosarcoma
– See: Soft Tumor Menu – Discussion: – also called malignant schwannoma or fibrosarcoma of nerve sheath; – extracompartmental high grade tumor that develops from sheaths (Schwann cells) of peripheral nerves; – usually is a primary lesion occuring along proximal major nerve trunks, – tumor is usually … Read more
Neurotmesis
– See: Nerve Repair: – Discussion: – most severe nerve injury; – complete disruption of axons, endoneurium, perineurium, & epineurium; – Wallerian degeneration occurs; – recovery requires operative repair and the prognosis is variable, ranging from complete recovery to no recovery; – factors that influence … Read more
Neurologic Deficits: following Supracondylar Frx
– See: Nerve Injury – Discussion: – always consider an occult compartment syndrome before a neurpraxia; – median nerve: – most common neural injury is to anterior-interosseous branch; – in type III frx, upto 50% of pts may show median … Read more
Neurologic Injury in Acetabular and Pelvic Fractures
– See: Neuro Exam – Discussion: – mechanism of injury: – direct neural injury from sacral frx; – indirect neural injury from traction accompanying pelvic displacement; – injury to lumbrosacral plexus is most common w/ L-5 & S-1 roots being at greatest … Read more
Neurontin / Gabapentin
– Discussion: – indicated for neuropathic pain conditions; – diabetic neuropathy – reflex sympathetic dystrophy; – radicular pain – peripheral nerve pain; – dose ranged: 300 to 600 PO tid; … Read more