– Chronic Injury: – flexion deformity of PIP & an extension deformity at DIP joint; – MCP hyperextension deformity; – after the central slip has been disrupted for some time, there will be volar migration of lateral bands, and contracture of oblique retaincular lig. – after the lateral bands … Read more
– Discussion: – radial head frx plus dislocation of distal RU joint (& interosseous membrane disruption); – mechanism: fall from height; – in this type of frx, radius will also migrate proximally if radial head is excised; – if injury is not found when it is acute, pt may develop severe wrist pain from radial migration … Read more
– See: Osteoporosis – Discussion: – for most postmenopausal women with osteoporosis, estrogen therapy also should be instituted at a dose of 0.625 mg of conjugated estrogen per day or its equivalent; – administration of estrogen by transdermal patch is effective and may result in more stable plasma estrogen concentrations; … Read more
– See: – Obstetrical Paralysis: – Upper Trunk Brachial Plexus Injuries in Adults; – Discussion: – most common birth related neuropraxia (about 48%); – lesion of C5 & C6 roots are usually produced by widening of the head shoulder interval (in some cases C7 is involved as … Read more
– Discussion: – implantation of epithelioid tissues into deeper areas as a result of penetrating trauma; – often the inciting trauma occurs well into the past (patients may or may not remember); – mass is often mildly painful but is non tender, most often lies on … Read more
Images kindly provided by Donald Serafin M.D., Duke University Medical Center – Discussion: – epineural repair is currently the gold standard for repair, as no prospective studies have indicated than fasicular repair is superior; – it is probably most indicated w/ pure sensory or pure motor nerves; – Technique: … Read more
– See: Anterior Interosseous Nerve Sydrome: – Site of Proximal Forearm Compression; – supracondylar process of the humerus and struther’s ligament: – median nerve may be compressed as it passes under the bondy spur – pt c/o of weak hand grip and in pronating, … Read more
– Clinical Presentation: – sudden onset of pain, pallor, paresthesias, variable paralysis, and absence of distal pulses; – only 15% of all arterial emboli lodge in the upper extremity; – sudden atraumatic onset in conjunction with atrial fib or recent MI strongly implicates an embolic event; – … Read more
– Discussion: – RA manifests itself in many ways in elbow joint, including nodules and bursae, synovitis, progressive joint destruction, antecubital cysts, & ulnar or, rarely posterior interosseous palsy; – note that involvement of the RA elbow is infrequently an isolated and therefore it is important to consider possible involvement in the wrist … Read more