– 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
– See: – Cerebral Palsy: – Discussion: – 64% w/ spastic diplegia & quadriplegia had pes valgus; – spastic pes valgus foot is a flexible deformity until adolescence; – spastic peroneal muscles pull the forefoot laterally and with it supporting plantar ligaments for the talar … 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
– See: – Amputation of the Finger and Hand: – Above-Elbow Amputation – Below-Elbow Amputation – Upper Extremity Prosthetics: – Wrist Disarticulations – General Considerations: – Disability: – loss of one upper extremity … Read more
– Wrist: – exam: flexed & ulnarly deviated – synovectomy: – synovectomy is most indicates before joint changes occur; – flexion deformity: – 30 deg wrist flexion deformity can be treated by serial splinting & casting; … Read more
– See: Radiographic Findings – Unstable Frx Patterns: – Barton’s frx, Radial-styloid frx, and Smith’s frx, will often be unstable; – dorsal angulation: > initial 20 deg implies instability; – radial shortening of 5 mm or more; – articular frxs that involve radiocarpal joint; … Read more
– See: Radiographic Imaging – Discussion: – unstable scaphoid fractures not only impact the potential for healing with non operative treatment, but they also impact on the position of healing (and possible scaphoid non union or malunion); – indicators of instability: – trans-scaphoid perilunate dislocation; … Read more
– Discussion: – distal radioulnar subluxation/dislocation (see TFC Injury) – tear of the lunotriquetral – ulnocarpal impingement syndromes – pisotriquetral osteoarthritis – pisotriquetral loose bodies – subluxation/dislocation of the pisiform – fractures (ulnar styloid Process) – chondromalacia – calcific tendinitis – medial carpal instability – radioulnar arthritis – subluxation of the ECU The ulnar impaction … Read more