Clin Radiol. 2000 May;55(5):340-5.
Most insurance carrier will not cover chromosomal breakage test solely for a hand with radial hypoplasia
A 45-year-old carpenter sustained a table saw injury to his right hand while at work earlier today. Evaluation in the Emergency Department reveals the defect depicted in Figure A. An island volar advancement flap was selected for wound closure. This method of thumb reconstruction is best indicated for which of the following sized defects?
less than 1 cm
volar advancement flabs only can be advanced for 10 to 15 mm otherwise increase flexion and higher risk of stiffness what do you think?
J Wrist Surg. 2014 Feb;3(1):50-4.
An ulnar shortening osteotomy would be MOST indicated for which of the following patients presenting with longstanding ulnar sided wrist pain refractory to conservative measures?
34-year-old female with an ulnar neutral wrist and distal radioulnar joint incongruity
34-year-old female with an ulnar positive wrist and distal radioulnar joint incongruity
34-year-old female with an ulnar negative wrist and distal radioulnar joint incongruity
78-year-old female with ulnar positive wrist and distal radioulnar joint arthritis
78-year-old female with ulnar negative wrist and distal radioulnar joint arthritis
Dr. Manning - Here's an open access article on reverse obliquity DRUJ and notch incongruity, accompanied with some figures that help explain the matter a bit.Osteotomy for sigmoid notch obliquity and ulnar positive variance.Dickson LM, Tham SKJ Wrist Surg. 2014 Feb. doi: 10.1055/s-0034-1365827. pii: 1300075cr. 3. (1). :50-4PMID: 24533247 (Link to Abstract)
All of the following factors are favorable for digit survival after replantation surgery EXCEPT?
Sharply amputated digit
Crushed amputated digit
Warm ischemia time of 8 hours
Patient age of 10 years
BEFAVNS is still the correct answer on almost all questions I've seen, correlating with Miller Review
A link to an article regarding reverse obliquity DRUJ incongruity would be much appreciated. Thanks. great site.
De Quervain's Tenosynovitis
It is wrong to claim inflammation is not present in De Quervain's - if you look for it, it definitely is:http://journals.lww.com/annalsplasticsurgery/Abstract/2015/05002/Inflammation_Is_Present_in_De_Quervain.14.aspx?trendmd-shared=0
Peripheral Nerves Injury & Repair
Original Sunderland:https://academic.oup.com/brain/article-abstract/74/4/491/323666/A-CLASSIFICATION-OF-PERIPHERAL-NERVE-INJURIES?redirectedFrom=fulltextIn this Sunderland 3 is endoneural discontinuity - this has to be a form of axonotmesis as it is not that 'all parts of the nerve have been destroyed' as in a Seddon neurotmesisSunderland 4 is perineural discontinuity - again a form of axonotmesisSunderland 5 is epineural discontinuity - this is the only Sunderland which satsifies Seddon's 'neurotmesis' definition.Hence Duncan Smith is right, citing the JAAOS, which is supported by the original Sunderland article from 1951.Orthobullets needs to correct Sunderland 3/4 as being axonotmesis and NOT neurotmesis.
Nail Bed Injury
Don't think there is evidence to support nail removal when the nail is fully intact:https://www.ncbi.nlm.nih.gov/pubmed/22351556The 50% cut off is not based on evidence and there is no good reason for this cut off.
According to the 2000 JAAOS Article cited many times on this page, Sunderland's modification of Seddon's classification breaks Axonotmesis into 3 degrees. As written currently, this review page indicates that degrees 3 and 4 are types or neurotmesis. Should this be changes or clarified with further evidence?ThanksPeripheral nerve injury and repair.Lee SK, Wolfe SWJ Am Acad Orthop Surg. 2000 Jul-Aug. 8. (4). :243-52PMID: 10951113 (Link to Abstract)
The Dorsal PIPJ fx/disloc Hastings classification and orthobullets listed treatment options have conflicting indications. Also, there is no mention under operative treatment in same section for hamate autograft.
A 16-year-old football player sustains an injury to his ring finger after making a tackle. A clinical photograph is shown in Figure A. What is the most likely diagnosis?
Flexor digitorum superficialis avulsion
Central slip rupture
Sagittal band rupture
Distal extensor tendon rupture
Flexor digitorum profundus avulsion
DIPJ looks flexed to me. With that history and clinical photograph how do we discern FDP / FDS?
why there is no single video of wrist arthroscopyI think it is availableanybody could help post some
That was a typo. It has been fixed. Thanks for pointing it out!
Creation of a Stener lesion, as found in Gamekeeper's thumb, requires combined tears of the proper and accessory ulnar collateral ligaments in order for the ligament to be displaced by the adductor aponeurosis. Which of the following most accurately describes the role these ulnar collateral ligaments (PCL/ACL) play in thumb MCP joint stability?
PCL is primary restraint to radial deviation with MCPJ in flexion, ACL provides restraint to radial deviation with MCPJ in extension
PCL is primary restraint to radial deviation with MCPJ in extension, ACL provides restraint to radial deviation with MCPJ in extension
ACL is primary restraint to ulnar deviation with MCPJ in flexion, PCL provides restraint to ulnar deviation with MCPJ in extension
ACL is primary restraint to radial deviation with MCPJ in flexion, PCL provides restraint to radial deviation with MCPJ in extension
PCL is primary restraint to ulnar deviation with MCPJ in flexion, ACL provides restraint to radial deviation with MCPJ in extension
I don't know if others will find this useful but... ACL is more "anterior" (volar) and volar structures tension in extension. PCL is more "posterior" (dorsal) and dorsal structures tension in flexion. Figure A really drives that home. Hopefully this is helpful.
Flexor tendons of the fingers within Zone 2 receive their primary nutritional supply from:
Diffusion from the synovial sheath
I believe your statement is correct but that it does not change the answer. While the vinculae are the main blood supply, the blood supply provides less nutrition than diffusion.
Please reviseAnswer for (OBQ14.142)"The synovial tendons are nourished by vessels from 3 areas: the musculotendinous junction; the osseotendinous junction; and vessels from various surrounding connective tissue such as the paratenon, mesotenon and vincula. The main blood supply to the bulk of sheathed tendons is from the vincula."
Carpal Tunnel Syndrome
The tenosynovium excised at the time of a carpal tunnel release for idiopathiccarpal tunnel syndrome rarely shows signs of acute or chronic inflammation. Fibrosis, edema,and vascular sclerosis are the most common histologic findings. A tenosynovectomy with acarpal tunnel release usually is not necessary in the treatment of idiopathic carpal tunnelsyndrome.Shum C, Parisien M, Strauch RJ, et al: The role of flexor tenosynovectomy in the operative treatment of carpal tunnel syndrome.J Bone Joint Surg Am 2002;84:221-225.Fuchs PC, Nathan PA, Myers LD: Synovial histology in carpal tunnel syndrome. J Hand Surg Am 1991;16:753-758.Kerr CD, Sybert DR, Albarracin NS: An analysis of the flexor synovium in idiopathic carpal tunnel syndrome: Report of 625cases. J Hand Surg Am 1992;17:1028-1030. AAOS 2005
IN COMBINATION OF IDIOPATHIC CTS & RADICULOPATHY FROM PROXIMAL PATHOLOGY HOW TO DIFFRENTIATE