Distal clavicle excision surgery - A year old female presents with an acute inability to extend her thumb four months after she was treated cast immobilization for distal radius fracture. There is no sign of infection
Week ago views Distal Radius Articular Fracture El bilek eklem par ali kirigi TraumaDistal Approaches How treated Male . Distal Radius Fractures Mark Vitale Introduction Most common orthopaedic injury with bimodal distribution younger patientshigh energy older patientslow falls intraarticular Associated injuries DRUJ must be evaluated radial styloid fxindication of higher soft tissue TFCC scapholunate ligament lunotriquetral Osteoporosis incidence women are predictor subsequent DEXA scan recommended woman Classification Fernandez based mechanism Frykman joint involvement radiocarpal radioulnar Melone divides fxs into types displacement AO comprehensive cumbersome Eponyms see table for list commonly used Diepunch depressed the fossa surface Barton dislocation involving volar dorsal lip Chauffer Colles dorsally displaced extraarticular Smith Imaging Radiographs View Measurement Normal Acceptable criteria height shortening inclination degrees change stepoff congruous LAT tilt angulation within contralateral scans important surgical planning MRI useful DISI VISI Treatment Successful outcomes correlate accuracy reduction restoration anatomic relationships early efforts regain motion wrist fingers Nonoperative closed cast immobilization indications technique below fixation CRPP External ORIF radiographic findings indicating instability prereduction best comminution margins severe comminuted progressive loss length following casting require rehabilitation significant benefit physical therapy over home exercises simple treated repeat reductions have less than satisfactory results Complications acute tunnel syndrome EPL rupture Percutaneous Pinning maintain sagittal alignment stable cortex cannot when unstable Techniques Kapandji intrafocal Rayhack assisted good appropriately alone reliably restore palmar therefore usually combined plate Technical considerations relies ligamentotaxis shaft pins under direct visualization avoid superficial nerve nonspanning exfix large fragment overdistraction neutral position excessive flexion deviation limit duration weeks perform aggressive digital adjunct excellent malunion nonunion stiffness decreased grip strength infections through site skin difficulties care comprising daily showers dry dressings neurologic iatrogenic sensory median neuropathy RSD extension plating preferred irritation both flexor extensor tendons FPL plates watershed area closest new locking offer improved support subchondral bone historically approach indicated other PCP grafting complex study showed facet fragments may specific prevent postoperative failure CTS frequent by avoiding CottonLoder release paresthesias weakness thumb opposition respond last hours seen nondisplaced rate spontaneous pollicis longus felt impinge causes either mechanical attrition local ischemia . Two weeks later he presents with significantly increased pain and deformity. Two hours following closed reduction the deformity is corrected but numbness and wrist pain worsening | Distal Clavicle Excision (Resection) - Arlington ...
What is the appropriate surgical treatment this time Review Topic QID FIGURES Distal radius corrective osteotomy Total wrist arthrodesis Proximal row carpectomy Scaphoid excision and four corner fusion Interposition arthroplasty Select Answer see Preferred Response OBQ. TraumaDistal Radius FracturesAll Current Concepts in the Management of Gregory Rafijah. Current radiographs are shown in Figure and clinical photograph of the affected wrist . She was initially treated with closed reduction and cast immobilization
A year old female sustains nondisplaced distal radius fracture and undergoes closed treatment using cast. A year old ballet dancer sustains distal radius fracture and subsequently closed reduced casted. Which of the following is most likely cause for failure fixation this patient Review Topic QID FIGURES B support lunate facet with fragment specific nonlocking plate Lack volar tilt restoration radial styloid column plating only three bicortical screws intact shaft proximally Select Answer see Preferred Response OBQ. Which of the following interventions should be taken Review Topic QID FIGURES Evaluation volar compartment pressures with needle monitor Icing and elevation arm followup hours Immediate EMG left upper extremity Closed reduction carpal tunnel release sugar tong splinting Emergent open internal fixation Select Answer see Preferred Response OBQ. Currently the wound has healed. Authors Orthobullets Team Questions of Previous Next Sorry this for PEAK Premium Subscribers only Upgrade to OBQ. What is the most appropriate treatment this time Review Topic QID Occupational therapy for strengthening Extensor carpi radialis longus transfer pollicus pollicis brevis indicis proprius Primary repair of Select Answer see Preferred Response OBQ. Radiographs are shown in Figures and B. She presents months later with the radiograph seen in Figure complaining of significant wrist pain. At the time of injury this was treated operatively with irrigation and debridement placement exfix spanning fractures. Adequate maintenance of reduction by nonoperative treatment is unsuccesful. The patient is neurovascular intact. Spontaneous rupture of the extensor pollicis longus tendon most frequently associated with which following scenarios Review Topic QID Nondisplaced distal radius fracture Rolando Second metacarpal base Boxer radial styloid Select Answer see Preferred Response OBQ. Following fixation shuck test is performed and shows persistent instability of the distal radioulnar joint. There is no sign of infection. Which of the following is true postoperatively regarding this patient ulnar styloid fracture Review Topic QID FIGURES B Worse outcomes on Mayo wrist score are expected without fixation Chronic distal radioulnar joint instability can be occur function depends level and initial displacement Grip strength range motion improved There no adverse effect Select Answer see Preferred Response OBQ. What is the most appropriate treatment this time Review Topic QID Strict elevation Removal of hardware Immediate carpal tunnel release if no resolution weeks Trial night splinting Select Answer see Preferred Response OBQ. There is no median nerve paresthesias