Hematogenous Osteomyelitis
– Discussion: – general features: – pediatric bone circulation – age of patient: – osteomyelitis in the newborn – in infants below the ages of 1 year, some metaphyseal vessels may transverse … Read more
Elbow
Hanging Cast
– See: – Forces Displacing the Fracture – Cast Brace – Caldwell (1933) – for displace frx of the humeral shaft with shortening, and also for oblique and spiral fractures; – Indications: – used for comminuted humeral frx – disatl humeral shaft frx; – cast must be light wt. and must extend from at least … Read more
Hand and Wrist: Physical Exam
– 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
Upper Extremity in Cerebral Palsy
– 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 & fingers – thumb in palm deformity; – loss of sensation and … Read more
Green Stick Frx of Forearm
– See: – Greenstick Frx of Distal Radius & Ulna – Green Stick Frxs of Mid 1/3 of Radius & Ulna – Discussion: – frx may be incomplete (greenstick) in radius and/or ulna, or the frx may be complete in one bone and incomplete (green stick) in … Read more
Green Stick Frxs of Mid 1/3 of Radius & Ulna
– See: Green Stick Frx – Discussion: – occurs most often in children less than 8 yrs of age as a result of a fall on an outstretched hand; – anatomically the frx tends to occur just distal to insertion of pronator teres, and therefore distal fragment is supinated as compared … Read more
Gastrocnemius Flap
– Discussion: – medial and lateral muscle bellies each carry long flaps of skin and fascia from the posterior calf and are most often used as myocutaneous flaps; these flaps are most useful for upper tibial defect reconstruction; – Contra-indications: – knee dislocation or … Read more
Galeazzi’s Fracture (Adults)
Discussion frx of radial shaft (between middle and distal 1/3’s) & dislocation of distal radioulnar joint; usually the dislocation is dorsal, but in some cases can be palmar; frx is almost always located just above proximal border of pronator quadratus; usually there is anterior angulation w/ transverse or short oblique config; ref: A Historical Report … Read more
Galeazzi’s Fracture in Children
– Treatment in Children: – frx is usually displaced dorsally and shortened in bayonette position; – due to the significant force needed for reduction, consider GEA; – closed reduction w/ longitudinal traction, & correction of radial angulation; – … Read more
Full Thickness Skin Grafts
– See: STSG – Discussion: – full thickness grafts transfer all organs contained in the dermis in addition to some Pacinian corpuscles (when the graft is taken from the palm or sole); – these grafts allow more durable coverage and more sensation than STSG; – donor site: … Read more