– Discussion: – a wafer of up to 2-4 mm of distal ulnar head is removed, while the styloid process TFCC, and attatched ligaments remain attached; – the procedure is contra-indicated if more than 4 mm of positive variance; – may be indicated for symptomatic … Read more
Carl J. Basamania M.D. – Discussion: – rotatory stress test was developed to reliably test for anterior instability of of the shoulder; – in most cases, the test will identify a Bankart Lesion, but on occassion the test will pick up a Hagl lesion (avulsion of IGHL); – Technique: – test begins on … Read more
– Discussion: – rotator cuff anatomy – frequency of tear – diff dx of cuff tears – etilogy of tear: – impingement syndrome: (75%) – shoulder instability (anterior or multi-directional) (15%) (should be considered in any young … Read more
– Discussion: – usually presents as irreducible dislocation of PIP joint (as opposed to dorsal dislocations which are usually reducible); – rotatory dislocation involves buttonholing of one condyle of head of proximal phalanx through longitudinal rent in extensor hood between central slip and lateral band; – see: … Read more
– See: – Anatomy of CMC joint – Bennett’s Fracture – Thumb Fractures / Dislocations – Discussion: – described in 1910 by Dr. Rolando; – involves 3 part frx at base of metacarpal; – in addition to volar lip frx (as seen w/ … Read more
– See: – Rheumatoid Arthritis – Rheumatoid Hand – RA Disease in the Wrist – Discussion: – tenosynovitis may present w/ difficulty w/ active PIP flexion, carpal tunnel symptoms, trigger finger, & deQuervain’s syndrome; – tenosynovitis will manifest as dorsal wrist swelling and may be isolated … Read more
– Discussion: – RA may cause symptoms because of pressure and location; – nodules may be cosmetically unacceptable; – nodulosis occurs in 20-25% of patients with RA – associated with strong seropositivity; – implies aggressive disease with poor prognosis; – may occur in benign … Read more
– See: Rheumatoid Hand – Sites of Triggering in the Rheumatoid Patient: – A1 pulley (as w/ convential trigger finger) – FDS decussation (may require excising slip of sublimis or an intratendinous nodule); – nodule in FDP near A2 can cause finger to lock into extension; – Non Operative … Read more
– See: – Caput Ulnae Syndrome – Rheumatoid Hand – Wrist Arthrodesis – Discussion: – wrist involvement w/ RA is common; – findings inlude peri-articular osteoporosis, destructive osteolysis, arthritis of distal RU joint, and carpal arthrosis; – final pattern is … Read more
– See: Traumatic Gamekeeper’s Thumb – Discussion: – characterized by abduction deformity of MCP joint; – results from attenuation of ulnar collateral ligament; – there is also an adduction contracture of the metacarpal; – Exam: – stability of the MCP joint should be tested by applying an ulnarly directed force to joint, both … Read more