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18 Cards in this Set
- Front
- Back
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Indications for replantation, hand |
Hand Replant Indications: Any Thumb Multiple digits Through Palm Through wrist or proximal |
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Ischemia Times allowed for replants (hand) |
Hand (less digits) - Warm < 6 hrs - Cole < 12 hours Digits - Warm < 12 hrs - Cold < 24 hrs |
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Contraindications to replant hand |
Primary Contraindications: 1- Crush/mangled extremity 2- Vascular disease, extensive 3- Ischemia Times 4- Segmental amp --> Hand: Warm < 6 h, Cold < 12 h --> Digits: Warm < 12 hr, Cold < 24h |
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Dupuytrens- What cord, what joint |
Duputyrens: Web Space: Natatory cord MCP: Central Cord PIP: Spiral Cord ( NV bundle: superficial and central) DIP: Retrovascular Cord |
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Poor prognostic factors, Duputyrens |
Poor Prognosis: - Little finger - Early age onset - PIP contracture |
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Vitamin C dose to prevent CRPS in DR Fx |
Vitamin C 500 mg po WD x 50 days |
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Pediatric Congenital Trigger Thumb treatment |
1st Nonop: Stretching, Splint 2nd: Release A1 pulley Etiology: Thickening of FPL tendon (abnl Collagen) |
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Pediatric Trigger Finger Treatment |
1st Nonop: Stretching, splint 2nd Line: Operate - Release A1 pulley AND FDS 1 slip (usually ulnar slip) ---> if need to can release 2nd FDS slip and A3 pulley) |
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Patient with hypoplastic chest wall, unilaterally...diagnosis.... |
Poland Syndrome - Unilateral chest wall hypoplasia -->absent Pec Major - Symbrachydactyly of middle finger |
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FPL Tendon rupute |
FPL want primary repair - may require sialistic rods, and staged reconstruction |
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Dorsal PIP dislocation-risks |
Dorsal PIP Dislocation - plantar plate and one collateral lig injury -> lead to swan neck |
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Dorsal PIP Fracture Dislocations |
Type I-Stable<30%-treat with dorsally based extension block splint Type II-Tenuous30-50%-if reducible in flexion, dorsally based extension block splint Type III-Unstable>50%-ORIF, hamate autograft, or volar plate arthroplasty |
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Surgical indications for dorsal PIP Fx-dislocations |
If > 40% joint involved and unstable - then ORIF vs CRPP If chronic: Arthrodesis vs volar plate arthroplasty |
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Nonop Splinting of dorsal PIP Fx dislocations |
If < 40% joint involved, stable - Dorsal EXTENSION block splinting |
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Left middle finger ulnar based FELON
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Rx: I+D using fish mouth incision (OITE 2014) |
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FDP - What does it do? - Where does it insert |
Flexor Digitorum Profundus - Flexes DIP joint Primarily - Inserts base of Distal Phalanges |
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FDS - what does it do? - Where does it insert? |
Flexor Digitorum Superficialis - Flexes PIP primarily - Inserts bodies of middle phalanges - FDS to V (little finger) absent in 25% |
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Most important pulley in the thumb? |
Thumb - 2 annular pulleys - 1 oblique pulley (most important) |
