– Discussion: – two fat planes on lateral view & 5 fat planes on PA view are useful for analysis; – deep fat pad of pronator quadratus (lateral view), which lies between the pronator quadratus muscle and the flexor tendon sheaths, normally forms a slight ventral concave line and is convexly bowed in a ventral … Read more
– See: Metacarpal Extra-articular Base Frx – Discussion: – oblique and comminuted frx predispose to shortening and malrotation; – displacing forces: – these frxs are displaced by tendons inserting into each fragment; – distal metacarpal fragment is flexed into … Read more
– See: orthofix fixator – Discussion: – convential “bridging” external fixation relies on ligamentotaxis to apply traction & restore displacement; – indications: – active pts when radial length is decr by > 3-4 mm; – presence of dorsal comminution; – when closed reduction fails to restore anatomic palmar tilt; – for any unstable or intra-articular … Read more
– See: – Over Distraction of Wrist Joint – Palmar Tilt Reduction – Radial Inclination Reduction – Wrist Position: – wrist is placed in neutral to slight extension w/ care taken not to over distraction the hand; – over distraction is related … Read more
– Metacarpal Incision: – always performed first, to ensure proper length of fixator; – make longitudinal incision from base of 2nd metacarpal to its midshaft; – terminal branches of radial sensory nerve can be identified & carefully retracted; – dissect down to bone, and insert … Read more
– Discussion and Indications: – definitive stabilization of frx may be achieved w/ external fixation in certain rotationally unstable but vertically stable injuries; – relative contraindication is iliac wing fractures; – antero-posterior compression injuries: – external fixation is most applicable to stable “open book” … Read more
– See: Over Distraction of Wrist – Discussion: – patient is instructed to move all unaffected joints throughout the joint; – avoid pronation and supination of forearm since this applies skin tension over most proximal screw; (infection is most common here); – when limited finger or … Read more
– Anatomy: – transports APL & EPB tendons; – these tendons represent the radial border of the anatomic snuff box; – when pts thumb is extended, you can distinguish between the tendons as they exit the tunnel; – near insertions of tendons, distal to the tunnel, … Read more
– See: – Discussion: – if the laceration occurs proximal to the junctura the diagnosis of an extensor tendon laceration can be missed; – have the patient extend the affected proximal phalanx w/ the remaining digits flexed; – lacerations of middle or little digits proximal to … Read more
– See: Extensor Tendon Lacerations: – the extensor apparatus is a “plexus of tendons with an aponeurotic sheet.” – from Stack, 1962. MP Joint Level: – extensor digitorum communis: (at the MP joint) – there may be some adhesion to the joint capsule, but there is … Read more