– See: Non-Displaced Scaphoid Frx – Discussion: – in up to 25% of cases, initial ER radiographs will fail to demonstrate a frx; – Management Options: – immobilization and repeat radiographs: – w/ positive exam findings and negative radiographs, immobilize wrist in a thumb-spica cast for … Read more
– Safe zone for implant insertion: (from Caputo A) – note that the posterolateral portion of the radial head does not articulate with the ulna, and this is termed the safe zone (since hardware placed here will not enter the articulation); … 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
– 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
– 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
– 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: – 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
– See: Rheumatoid Arthritis – Pathoanatomy: – RA Disease in the Wrist – Extensor Tendon Rupture – Tenosynovitis – diff dx: w/ RF negative tenosynovitis consider myobacterium marium infection; – Flexor Tendon Rupture – Ulnar drift – MP joint – PIP Joint – Boutonniere – Swan Neck Deformity – Thumb Deformities – Intrinsic Contracture – … Read more
– See: – Rheumatoid Hand – MP Ulnar Drift – Deformites of MP Joints; – approximately 40% of pts w/ RA will have intrinsic contracture; – in some cases the intrinsic contracture will result from MP joint dislocation, and in other cases, the intrinsic contracture will … Read more