– See: Phalangeal Boutonnere Injuries – Discussion: – most common thumb deformity in RA; – results from arthritic involvement of MP joint and elongation or erosion of the attachement of the EPB tendon to the base of proximal phalanx (leading to flexion deformity); – EPL tendon & adductor expansions … Read more
– See: – Phalangeal Injuries – Rheumatoid Boutonniere – Thumb Boutonniere Injuries – Discussion: – an aquired lesion of the extensor mechanism, in which the PIP joint develops a flexion deformity and the the DIP joint develops an extension deformity; … Read more
– See: – Discussion: – refers to Boutonniere injuries more than 2 months after injury; – is difficult to treat due to shortening of: – central slip & contracture of the lateral bands; – transverse retinacular ligaments; … Read more
– Discussion: – soft tissue procedures will work only passive ROM is re-established; – Staged Method of Treatment: (from Raymond et al 1982) – use a metacarpal block for anesthesia (for intial three stages); – stage I and II: – lazy “S” incision over … Read more
– Discussion: – used to determine if PIP Joint capsule & extensor mechanism are working normally; – if functioning normally, blocking MP joint hyperextension allows IP joint extension; – Diff Dx of Positive Test: – attentuation of central slip – adherent central slip at the PIP Joint; … Read more
– Diff Dx: Painful Joint: – four conditions may cause an excruciatingly painful joint; – infection – Gout or, rarely, Pseudogout; – Rheumatic Fever; – Tumor; – Diff Dx Tumor: – osteoid osteoma … Read more
– See: – Total Hip Replacement Menu: – International Bipolar News – Discussion: – Gilberty & Bateman in 1974, reported use of bipolar prosthesis; – rationale was that erosion and protrusion of acetabulum would be less because motion is present between metal head & … Read more
– Discussion: (see: necrotizing fascitis ) – human bite wounds – snake bite: – Bacteriology of rattlesnake venom and implications for therapy. – cat bite: (see cat scratch disease) – consider pasteurella multocida; note P. multocida infection develops within 24hrs; – with bites on the finger observe for osteomyelitis; … Read more
– Indirect Reduction Stratedgy: – statedgy forgoes attempts at meniscal reduction (or repair), ligamentous repair, or direct joint reduction; – longitudinal traction is used to align proximal tibial condyles over shaft; – depressed fragments are reduced w/ a bone tamp thru cortical window; – frx reduction is … Read more
– See: Septic Hip – Discussion: – after age two years, most septic arthritis in children is caused by S. aureus (about 50%) or streptococci (25 %) so empiric coverage is directed toward these pathogens; – in teenagers, gonococcal arthritis now predominates and is exquisitely sensitive to penicillin; – … Read more