Ortho Oracle - orthopaedic operative atlas

Upper Extremity

– Discussion:     – upper extremities are involved in as many as two-thirds of pts who have peripheral neuropathy, but the involvement tends to be milder & to become clinically symptomatic at later age than does involvement of the lower extremities;     – intrinsic-minus hands develop with decreased stability

Upper Extremity Arteriogram

– Discussion:     – it is important that the injection site be at distance proximal to site of injury;          – if this cannot be performed w/ ease, retrograde axillosubclavian technique should be utilized;     – insertion of needle into brachial artery is facilitated by immobilizing artery against humerus;     … Read more

Unstable Distal Radius Fracture

– 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

Unicompartmental Knee Arthroplasty

– Discussion:     – unicompartmental arthroplasty serves a specific nitch for knees that are too severe for arthroscopic management of medial DJD (see mosaicplasty) but are not severe enough for total knee replacement; – best indications: – UKR for patients with partial thickness cartilage loss in the affected compartment. – The implications of damage to the lateral … Read more

Ulnar Wrist Pain

– 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

Ulnocarpal Impaction / Impingement Syndrome

– See: RU joint – Discussion:     – refers to impingement of the ulnar head against the carpi which can lead to TFCC tears and lunotriquetral ligament attrition;     – lunotriquetral ligament attrition may occur from compression and translation shear as the lunate becomes impinged against the ulnar head;     – causes:   … Read more

Ulnocarpal Impingement Syndrome

– Discussion:     – impingement of distal ulna on carpi which may arise from positive ulnar variance or non union of distal ulnar frx;     – positive ulnar varience leads to loading of the ulnocarpal joint and resultant LT disruption, lunate chondral lesion, and TFCC tears;     – diff dx: (ulnar sided … Read more

Ulnar Sided Wrist Pain

– Discussion:     – osseous related pain:           – hamate fracture            – pisiform fracture           – ulnar styloid frx           – base of the fifth metacarpal     – TFCC     – radioulnar joint           – … Read more

Ulnar Styloid Process Frx

– Anatomy:      – Tunnel V:           – overlies distal ends of radioulnar articulation on dorsum of wrist, contains EDM;     – Tunnel VI:           – in groove between the apex of ulnar styloid process & ulnar head, contains ECU tendon which is palpable from … Read more