– 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
– Diff Dx: slipped vertebral apophysis – Discussion: – disc herniation is uncommon in children; – herniations are most common at the disc spaces between the fourth and fifth lumbar vertebrae & between 5th lumbar and 1st sacral vertebrae; – Clinical Findings: – children experience little or no back … Read more
– Discussion: – extraarticular bleeding may involve muscles, nerves, blood vessels, and even bones; – slowly expanding hematoma will interfere w/ function & perfusion of surrounding tissues; – intramuscular hematomas that fail to resorb quickly lead to fibrosis, contracture, cyst formation, or myositis ossificans; – bleeding into the calf muscles may cause a severe equinus … 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
– Neurological: – two point discrimination: – used to test sensory innervation of the digits in adult patients, where as, the ability of skin to wrinkle (when placed in water) is used to test sensation in children; – normal values: … Read more
– See: Cerebral Palsy Menu: – Discussion: – most pts w/ hemiplegic cerebral palsy have functionless hand marked by: – flexion of the elbow with pronation of the forearm; – flexion of the wrist and fingers: spasticity, weakness, flexion deformity of the wrist … Read more
– Planning Pin Sites: – placement of skull pins in children requires preoperative CT scan of skull to assess thickness; – pins should avoid skull suture lines, and should generally not be placed in the temporal region or into the frontal sinus; – as in adults, avoid placing pins … Read more
– Technique: – place the leg in a figure of 4 position; – make a small longitudinal incision opposite the tibial tuberlce, midway between the tubercle and the the posterior edge of the tibia; – palpate the pes anserinus; – generally only the gracilis … Read more
– Discussion: – inflammation can be related to a Haglund deformity (postero-superior prominence – normal varient) which causes an overlying bursitis; – prominence of the posterior superior calcaneal tuberosity contributes to inflammation of the overlying tissues and the Achilles tendon; – most often occurs in women and is related to … Read more