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24 Cards in this Set
- Front
- Back
Acceptable Parameters for Healed Radius Fracture in Active Healthy patient:
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Radial Length within 2-3mm of cotnralateral
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At what distance of radial shortening can you know that you have DRUJ disruption? |
5mm (based on cadaveric study) |
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What is an Essex Lopresti Lesion? |
Combined Injuries to the DRUJ + IO Membrane + Radial Head
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Indications for an Emergent Carpal Tunnel Decompression
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Worsening of Median Nerve Symptoms after radiographic and clinical reduction with elevation above heart and oral narcotics. Take down the dressing, apply ice, if no relief within 6 hours --> immediate decompression (Rockwood & Green p831) |
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Radial Length & Ulnar variance
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measured along the axis of the radius, difference between ulnar head (ignoring styloid) and and the radial styloid
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Radial Inclination |
angle between radial styloid and medial corner of radius vs long axis of radius
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Carpal Malalignment |
carpus flexes to compensate for malaligned radius
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Rotation from your true lateral view and its effect on assessment
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5 degree rotational change produces 1.6 degree change in palmar tilt on conventional lateral view
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Tileted Lateral View
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20 degree inclination allows visualization of lunate facet
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Palmar Tilt & Loss Thereof
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Loss of normal 11-12 degrees = 80% risk of arthritis
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ulnar variance loss
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loss of 2mm of ulnar variance results in symptomatic loss of strength
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Which distal radius corteces are thick vs thin: |
thinner dorsally and radially: collapse typically happens dorsoradially
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What is the keystone of the radius |
palmar ulnar corner: attachemtn for palmar distal RULigs and stout radiolunate ligament
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What is important about the orientation of the palmar extrinsic ligament:
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from aradial styloid is more oblique relative to those attached to lunate facet
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Prediction of instability: |
Elderly, lots of initial displacement, lots of metaphyseal comminution, displacement after closed treatment |
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Indications for operative intervention: |
Predicated or established metaphyseal instability
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for distal radius fracture:
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Timing of distal radius fracture surgical fixation: |
immediately unless using arthroscopy in which case wait for 5-15 days for capsule to close
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perc pinning vs age
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no benefit in older patients
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major complication of K wires
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damage to superficial branch of radial nerve
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benefits & contraindication to non-brdiging ex fix
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benefits: volar tilt
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Indication for palmar plates, where is incision
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dorsall comminution or partial articular fractures (shear)
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indications for corrective osteotomy:
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subluxation of radiocarpal joint
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Complexs regional pain syndrome type 1 vs 2
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Type 1: absnce of nerve path
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