– Discussion: – indicated for patients w/ delayed unions or non unions of scaphoid waist; – cautions: distal-waist fractures may not be amenable to this form of fixation if the screw threads cross the fracture site; – Technique: – see: volar surgical approach: – may result in … Read more
– Work Up for Scaphoid Fracture: (w/ discussion) – clinical differential diagnosis: – distal radius frx – transscaphoid perilunate dislocation: – scaphoid impaction syndrome – radiographs and determination of stability (CT scan) – non diagnostic radiograph (bone scan) – tubercle frx – transverse waist frx – proximal pole frx – treatment: … Read more
– Discussion: – scapholunate advanced collapse (SLAC) refers to a specific pattern of osteoarthritis and subluxation which results from untreated chronic scapholunate dissociation or from chronic scaphoid non-union; – degenerative changes occur most often in areas of abnormal loading; – radial-scaphoid joint is involved initially, followed by … Read more
– Clinical Manifestations: – may have fevers, rash, & iritis, which can resemble symptoms of JRA. – pulmonary dz, erythema nodosum, abdominal pain, liver enlargement, and perihilar adenopathy may also be present. – labs: elevated ACE serum level is considered to be the activity marker of the disease – … Read more
– Discussion: – may occur at any age – rare in the hand – type IV frx potentially interfere with normal growth; – frx line crosses physis, separating a portion of metaphysis-physis-epiphysis from the remaining metaphysis-physis-ephiphysis; – if frx is displaced, ORIF is indicated; … Read more
– See: – Bone Bridge – Distal Femoral Physeal Fractures – Epiphyseal Artery – Epiphyseal Plate – Humeral Physeal Injuries – Suprachondylar Fractures of the Humerus – … Read more
– See: – Posterior Pelvic Injury: – Sacroiliac Fracture Dislocations: – Sacral Stress Fractures: – Anatomy of Sacrum: – Classification: – zone I: – frx across sacral ala can cause L5 nerve root impingement; – about 6% … Read more
– See: neurological exam: – Discussion: – sacral segments must be carefully examined for sensation & motor power; – scaral sparing is evidenced by perianal sensation, rectal motor function, and great toe flexor activity; – in patient w/ an apparent complete neurologic injury, any sensory awareness distally or scant … Read more
– Bone scan: – generally considered sensitive but not specific; – bone scans may help to r/o associated conditions such as a stress frx; – Triphasic Bone Scan: – may add higher degree of specificity; – first stage is … Read more
– See: RU joint – Discussion: – involves resection of ulnar articular head, leaving shaft and styloid relationship intact; – in cases of distal radial malunion, a Bower’s hemiarthroplasty may be indicated to restore passive pronation and supination of the forearm; – this procedure should be considered before performing … Read more