– Full Thickness Skin Grafts: – skin can be taken from the hypothenar area or from the instep of the foot, but forthese grafts to provide truly critical sensibility, they must be full thickness grafts; – full thickness grafts will transfer Meissner’s corpuscles (required for … Read more
– See: – Diff Dx of Shoulder Pain: – Shoulder Examination Tests (from shoulderdoc.co.uk) – History: (questions for modified Simple Shoulder Test); – C-Spine: – r/o radiculopathy as well as axillary nerve hypaesthesia; – Spurling’s manuever: – mechanical stress, such as excessive vertebral motion, may exacerbate … Read more
– Discussion: – indicated for SI joint disruptions and for some sacral fractures; – Operative Technique: – radiographs: – surgical stratedgy: – if anterior pelvic injury: – note that the biggest … Read more
– Associated Injuries: – Bankart lesion – up to 90% of first time dislocators will have this lesion; – fracture dislocation: – fracture of humeral head, neck, or greater tuberosity; – associated greater tuberosity frx may actually have less … Read more
– Discussion: – impingement syndrome describes pain in subacromial space when the humerus is elevated or internally rotated; – during humeral flexion, the supraspinatus tendon and bursa become entrapped between the anteroinferior corner of the acromion (and CA ligament) and the greater tuberosity; – this syndrome is thought to precipitate attritional changes in the rotator … Read more
– Anterior Portal: – anterior portal is usually used for introduction of instruments; – this portal is placed under arthroscopic visualization from the posterior portal; – the needle is placed halfway between the AC joint and the lateral aspect of the coracoid; – this … Read more
– Discussion: – may be indicated for shoulder instability; – in the report by Greis PE, et al, the authors evaluated 4 cases in which axillary nerve injury which was observed after radiofrequency capsular shrinkage of the shoulder; – authors conclude that injury to the … Read more
– Discussion: – inflammation and swelling around the sesamoid (tibial > fibular) and FHB can be secondary to trauma, infection, AVN, stress fractures, or a systemic disorder; – sesamoiditis may also be precipitated by a cavus foot w/ excessive wt bearing under the first metatarsal; … Read more
– Discussion: – serratus anterior arises from upper eight ribs, inserts on vertebral border of scapula, is innervated by long thoracic nerve, and functions to draw scapula forward in sports such as a jab in boxing; – paralysis produces characteristic prominence (“medial winging”) of vertebral border of the scapula; … Read more
– Pts w/ RA: – may be prone to bacterial infections because of inherent phagocytic defect or because of long-term oral or intraarticular administration of corticosteroid or other immunosuppressive agents; – staph. aureus is recovered from 80 % infected rheumatoid joints; Nongonococcal Bacterial Arthritis in Adults Treated at Boston U.Med Center; … Read more