Injuries to a ligament are common, especially during athletic activity. Ligaments in the ankle, knee, and wrist are consistently in action during athletic activity and thus are under a lot of stress.
Dr. Bharani Kumar Dayanandam is a prominent Orthopaedic Surgeon providing a wide range of treatments for Shoulder Injuries in Chennai, India
Visit us @ https://www.chennaiorthopaedics.com
Injuries to a ligament are common, especially during athletic activity. Ligaments in the ankle, knee, and wrist are consistently in action during athletic activity and thus are under a lot of stress.
Dr. Bharani Kumar Dayanandam is a prominent Orthopaedic Surgeon providing a wide range of treatments for Shoulder Injuries in Chennai, India
Visit us @ https://www.chennaiorthopaedics.com
Presentation on different levels of amputation of upper limb including hand amputations., thumb reconstructions, kruckenberg amputation, thumb poloicization.
Presentation on different levels of amputation of upper limb including hand amputations., thumb reconstructions, kruckenberg amputation, thumb poloicization.
references:
Campbell’s operative orthopaedics 11th edition
Text book of orthopaedics & fractures 5th edition Dr B. Aalami Harandi
Gray’s anatomy 2nd edition
Clinical anatomy Richard S. Snell
1.Anatomy
a.Course
b.Motor distribution
c.Sensory distribution
2.Common sites affected
3.Level of median nerve injury
4.Clinical feature with various test performed
5.Various syndromes related to median nerve
6.Treatment
7.Summary
Peripheral nerve damage affecting the upper extremities can vary widely in cause and extent.
Many disorders, ranging from mild carpal tunnel syndrome to severe brachial plexopathy, need to be considered in a patient presenting with pain, sensory loss, or weakness involving the shoulder, arm, or hand.
Hand splinting in common orthopedic & neurological condition 1POLY GHOSH
This Presentation is about role of splinting in orthopedic condition and neurological condition. This presentation can be benefitted for Orthotist, Occupational therapist, phyiotherapist and Physical medicine and rehabilitation specialist.
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
2. HAND INJURIES
• The hands as the human executing organs are in the
center of daily life activities’, thus are always exposed to
injuries and overuse .
• We are more aware of our hands than any part of the
body
• Are important out of all proportion to their apparent
severity ,because of the need for perfect functions .
• Local edema and stiffness of the joints –common
accompaniments of all injuries- are more threatening in
the hand than anywhere else .
3. HAND INJURIES
• Problems of hand arise for 3 reasons :
1- the defect may be unacceptable
2- function is impaired
3- deformed part becomes nuisance during
daily activities
4. HAND INJURIES
• Superficial injuries and severe fracture are obvious but
deeper injuries are often poorly disclosed ,so it is
important in the initial examination to assess the
• circulation
• soft tissue cover
• bones
• joints and tendon
• nerves
• X-rays should include at least 3 views PA ,Lateral and
oblique
5. HAND INJURIES
• Hand injuries the commonest of all injuries .
• in avarage the hand injuries account for 14-30% of all pt
in ED .
• Fractures 46% , tendon injuries 29% and skin lesions .
6. HAND INJURIES
general principle of treatment
• ABC
• Most hand injuries can be dealt with under local or
regional anaesthesia .
• Definitive treatment is dictated by the nature of the injury
, but common to all injuries are
• safe splintage
• prevention of swelling
• dedicated rehabilitation
7. HAND INJURIES
general principle of treatment
• Safe splintage
_ incorrect splintage is a potent cause of stiffness
so must be appropriate and kept to a minimum
-if the whole hand is splinted or bandage this must be in
‘’the position of safe immobilization’’
8. Anatomy of the hand
• Bones
• Areas
• Zones
• Arches
• Ligaments
• Muscles
• Innervation
⥤is a prehensile, multi-fingered extremity located at the
end of an arm or forelimb .
⥤...& are the richest source of tactile feedback, and have
the greatest positioning capability of the body; thus the
sense of touch is intimately associated with hands.
PALMAR DORSAL
11. Flexor Zones:
Flexor Zones: The hand is divided into following 5 zones, which would determine the prognosis and approach to
treatment.
Zone 1:
Only FDP involved
Loss of flx of DIP joint
Instability in pinch
Loss of grip strength
Good prognosis
Zone 2:
“No man’s land”
Pulleys present (prevent bow stringing) A2 and A4
Vincula in area–provide vascular supply. Injury thus causes decreased tendon vascular nutrition.
Poor prognosis
Zone 3:
Good prognosis
Good vascularity and no pulleys
Zone 4:
Carpal tunnel
Usually more than 1 tendon involved
Intendinous adhesions (close proximity of tendons)
Relatively good prognosis
Zone 5:
Usually presents with nerve involvement (ulnar / median nerve)
Tendons superficial, thus adhesions to skin probable
The hand is divided into 8 zones when dealing with extensor tendon injuries.
12.
13.
14. Muscles & tendons
* Extensor tendons of fingers :
-of the long extrinsic muscles .
-attaches to the middle phalanx in
central slip .
* system of flexor tendons of fingers :
-functional unit of tendons, tendon sheath and
pulleys .
- flexor digitorum profundus .
- flexor digitorum superficial .
- flexor pollicis longus of the thumb .
20. ligaments
• Tow important structures called collateral ligaments are
found in either sides of each finger joint .
• Volar plate is the strongest ligament .
21. Blood Supply
1. Ulnar A.
Forms the
superficial palmar
arch ?with
superficial palmar
br. of radial artery
Gives 4 common
palmar digital art.
2. Radial A.
Forms the Deep
palmar arch with
deep br. of ulnar ar. 1
cm proximal to
Superficial arch
27. Metacarpal Fractures
The metacarpal bones are vulnerable to blows and falls
upon the hands or the force of the boxer’s punch .
Injuries are common
Agulatory deformity is usually not very marked
,rotational deformity is serious .
28. 2)Metacarpal Fractures
Head
Intraarticular
Neck
Usually unstable
Forwards tilting of distal
fragement
Shaft
Direct blow
Transverse or oblique #
Base
Associated carpal bone injury
Impacted #
1st metacarpal
Usually occurs at base
29. Presentation
Pain/Tenderness
Swelling
Discoloration
Sensation
Circulation
ROM
Plain Films
Deformity of hand
Localized tenderness
Swelling of hand
Discoloration
Decreased movement
Numbness
Unequal temperatures
What next?
30. Midshaft vs. Base vs.
Neck
Complete vs.
Incomplete vs.
Comminuted
Dorsal vs. Volar
Angulation
Transverse vs. Oblique
vs. Spiral
Unstable vs. Stable
31. Management of metacarpal #
A- undispalced # :
require only a firm crepe-bandage for comfort
2-3 wks
32. Management of metacarpal #
B- dispalced # :
1-of the shaft
- reducion by traction and pressure hand then
held by plaster slap for 3 wks .
-ORIF with small plates and screws
or by percutaneous K-ware
is the best because these
unstable #
33. Management of metacarpal #
B- dispalced # :
2- of the neck (boxer’s fracture )
* usually of the 5th finger
* angulation of upto 40 degrees can be accepted as
long as there is no rotational deformity .
* reduction traction and pressure then held by
plaster slap 1-2wks
* fixation with percutaneous
intramedullary wires
usually preferred
34. Metacarpal Neck Fractures
(Boxer’s Fracture)
Common
Direct impact with closed fist
Dorsal angulation
Unstable
Treatment
Reduction (90-90 method)
Splint
Follow-up within 1 week
Complications
Malunion with volar angulation
Pain
Rotational deformity
Stiffness
36. Thumb Metacarpal Fractures
Uncommon
Most involve the base
Extraarticular
Direct trauma or impaction
20-30 degrees of angulation is
tolerated
Intraarticular
Bennett’s Fracture
Rolando’s Fracture
Treatment
Thumb spica
Complications
Malunion and arthritis
37. Bennett’s Fracture:
At base of first metacarpal
bone
Oblique intra-articular #
Unstable
Due to punching .
X-ray show that a small
triangular fragment has
remained in contact with
the medial edge of the
trapezium , while the
remainder of the thumb has
proximally pulled upon by
the abductor pollicis longus
tendon .
38. Bennett’s Fracture:
Perfect reduction is essential by pulling on the thumb
,abducting it and extending it .and then held by
plaster or internal fixation
Surgical fixation is achieved by passing a k-ware across
the metacarpal base into the carpus
41. fractures of phalanges
Phalangeal # usually result from direct trauma and
therefore any part may be affected .
Management :
A) undisplaced # :
functional splintage (buddy splintage )
for 2-3 wks .
- movement are encouraged from the outset .
42. fractures of phalanges
B) – displaced fractures
1- of the proximal or the middle phalanx :
* the bone # reduced and immobilized under
local anaesthesia , carefully avoiding
malrotation , then splintaed leaving the other
fingers free 3 wks .
43. fractures of phalanges
B) – displaced fractures
1- of the distal phalanx :
distal phalangeal # are usually due to crushing
injuries or a blow from a hammer .
- the soft tissue damage must be treated .
-The majority of fractures can be treated
conservatively, and it is normally the initial repair
of the surrounding soft tissues that is most
important .
44. 3) Phalanx Fractures
15-30% of hand fxs
Tuft
Nail bed injury
Shaft
Intraarticular
Tendon injury
Complications
Pain, hyperesthesia, cold
sensitivity, osteomyelitis
1)Distal Phalanx Fractures
Mechanism:
45. No Problem Refer!
Treatment: padded or “C”
splint; extend past the tip
Refer: transverse, angulated
Healing Time: 3-4 weeks
Return to Work/Sport: okay
with splint as tolerated
exception: transverse fx –
needs longer protection
from potential re-injury
activity
46. •Mechanism: direct blow or
twisting
•Sxs & Exam: local swelling;
examine for deformity or
malrotation; check PIP and DIP
fxn
2)Middle Phalanx Fractures
•Transverse Fx or short oblique: Low risk
47. •Nondisplaced fx’s do well with buddy taping
•Healing Time: 4-6 weeks (buddy tape for 3-4 wk)
•Return to Work/Sport: okay as long as you have some
protection via splint or buddy tape
•Refer: displaced, long oblique, spiral or intra-
articular fx
48. •Mechanism:
direct blow: transverse; often unstable
due to tendon insertions
twisting: oblique or spiral; may be more
stable
Sxs & Exam: local
swelling; examine
for deformity or
malrotation
3)Proximal Phalanx Fractures
49. Apex volar angulation is common
•proximal fragment pulled into flexion by
interosseous
•distal fragment pulled into extension by
extensor mechanism
50.
51. •Nondisplaced fx’s do well with buddy taping; use
gutter splint for additional stability
•Healing Time: 4-6 weeks (buddy tape for 3-4
wk)
•Return to Work/Sport: okay as long as you have
some protection via splint or buddy tape
•Refer: angulated, displaced, intra-articular fx
Proximal Phalanx Fx: Treatment
54. CMC joint dislocation:
Mechanism :forceful dorsiflexion of the wrist
combined with longitudinal impact ,
Seen typically in boxers and in motorcyclists .
Dx : X-rays
After regional anaesthesia , the dislocation is reduced
by traction , manipulation, and pressure on the
metacarpal base , then protective slap is worn for 6
wks .
55. CMC joint dislocation
Carpometacarpal
(CMC) dislocation
(a) Thumb
dislocation.
(b) Dislocation of the
fourth and
fifth CMC joints
treated by closed
reduction and
Kirschner wires (c).
Complete CMC
dislocation (d).
56. Thumb CMC dislocation :
Isolated dislocation is rare
compared to the more common
Bennett fracture dislocation.
Easy to reduce but unstable after
reduction.
Apply thumb spica splint after
reduction.
Need surgical referral.
58. Metacarpophalangeal Joint
Relatively rare injury
Dorsal displacement
Hyperextension forces
Dorsal displacement
Volar plate can enter joint
space
Volar dislocations
Usually surgical
Treatment
Reduce
Splint in flexion
59. Dislocation of MCP joint
The thumb is most frequently affected and clinically
the injury resembles a BENNETT’ fracture –dislocation
Dx : by Xrays
The displaced is easily reduced by traction &
hyperpronation , but reduction is unstable and can be
held by a K-wire for 5 wks and then protective splint
for 8 wks because risk of instability .
60. MCP of the Thumb
Strong but vulnerable
5 times more likely to be injured
Difficult reduction
Volar plate entrapment
Ulnar collateral ligament
injury
Gamekeeper’s or Skier’s thumb
Radial collateral ligament
injury
Less common
Forced adduction with or
without hyperextension
61. Skier’s Thumb
Scottish gamekeeper’s
Repeated twisting
Forced radial deviation
Associated avulsion fracture
Valgus stress testing
Extension and flexion
Complete ligament tears
>35 degrees of laxity
Treatment
Thumb spica
63. 1)Proximal Interphalangeal Joint
Dislocation pattern
Dorsal
Most common ligamentous hand injury
Lateral
Volar
Associated fracture
> 33% of articular surface = unstable
Violent twist with finger
flexed (palmer) or extended
(dorsal)
SHARP, deformity, disability
RICE, splint, meds,
reduction/surgery, protect
64. • Nondisplaced Fx: Initially use extension block
splint for first 2-3 weeks followed by buddy
taping in sight flexion. Work on restoring ROM.
• Healing Time: 6-12 weeks; monitor progress
every 2-3 weeks
65. 2)Distal Interphalangeal Joint
Most are dorsal
Often open
Reduction
Traction
Hyperextension
Dorsal pressure
Irreducible
Avulsion fracture
Buttonhole tear
Open dislocation
Irrigation
Antibiotics
67. Tendon injuries
• Are the second most common injuries of the hand
• After clinical examination , ultrasound and MRI imaging
have provide to be important diagnostic tools .
• Treated by conservative or surgical
68.
69.
70.
71.
72.
73.
74.
75.
76.
77.
78.
79.
80.
81. • For later case where the joint is still passively correctable
, treated by is to divide the extensor tendon in just
proximal to its insertion into the distal phalanx .
• long standing fixed deformity may be better left alone .
82.
83.
84.
85.
86.
87. Carpal Tunnel Syndrome
pressure in carpal tunnel (swelling, inflammation) via
trauma, rep flexion
Pressure on median n
Sensory (lat palm), motor (wrist, finger flex) deficits
A. Mechanism: overuse, congenital, trauma
B. Pathology: Compression of the median nerve in the
tunnel
, surgical decompression
88. Signs and Symptoms:
Pain in wrist
Numbness and tingling in the thumb and first two fingers
Positive Phalen’s test
Positive tap test