Medical Blog

Flexor Tendon Lacerations

Introduction

Injuries to the flexor tendons of the hand are common. Each specific movement of the hand relies on the finely tuned biomechanical interplay of intrinsic and extrinsic musculotendinous forces. Considering the hand’s role in labor, entertainment, art, literature, and passion, hand surgeons should fully define the normal and pathologic boundaries in each patient examined. With injuries that involve flexor tendons, fully defining the pathology is especially important. In this article, the management of the flexor tendon injuries is addressed specifically, with emphasis on history, physical examination, surgical repair, and rehabilitation. (Also, see the eMedicine article Hand, Tendon Lacerations: Flexors.) For excellent patient education resources, visit eMedicine’s Hand, Wrist, Elbow, and Shoulder Center. Also, see eMedicine’s patient education articles Hand Injuries and Finger Injuries. Read more…

Elbow and Above-Elbow Amputations

Introduction

Upper extremity amputations largely follow the same basic principles as those of any amputation. This article highlights the special considerations involved in acquired amputations at or above the elbow. Below-elbow amputations are discussed in separate articles (see Wrist and Forearm Amputations and Digital Amputations). Although acquired amputations in children are discussed (because pediatric patients deserve special consideration), patients with congenital limb amputations and deficiencies are beyond the scope of this article. Read more…

Enkoprezis

Dörd yaş üzəri uşaqlarda nəcisin geyimlərinə ya da əlverişsiz hər hansı bir yerə qaçırılmasıdır. DSM-IV tanı ölçütlerine görə konstipasyonlu və konstipasyonsuz olaraq iki tipi təyin olunmuşdur.

Sıxlıq
Qərb mədəniyyətində 4 yaşındakı uşaqların %95′inin, 5 yaşında isə %99′unun nəcis idarəsini qazandığı qəbul edilməkdədir. Enkoprezis 7 yaşında %1.5, 10-11 yaşlar arasında %0.8 olaraq bildirilməkdədir.
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Enuresiz

Uşaqlar ümumiyyətlə iki yaş ətrafında böyük tualetlərini, iki-üç yaş ətraflarında da kiçik tualetlərini nəzarət edərlər. Altını islatma hadisəsinin romantik və bedensel pozuqluqlarla əlaqədar səbəbləri vardır.

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Narahatlıq

Məqsəd: Şagirdlərin narahatlıqlarıyla baş etmə bacarıqlarını artırmaq.
Material: Hər şagird üçün bir ədəd FORMA 1 və FORMA 2
Müddət:
1. Şagirdlərə formaları paylanın.
2. FORMA 1′ dəkı birinci hissəsini doldurmalarını istəyin və əməliyyat bitdikdən sonra şagirdlərdən cavablarını siniflə paylaşmalarını istəyin Read more…

Dupuytren Contracture

Introduction
Problem

Dupuytren contracture, a disease of the palmar fascia, results in the thickening and shortening of fibrous bands in the hands and fingers. This disease entity belongs to the group of fibromatoses that include plantar fibromatosis (Ledderhose disease), penile fibromatosis (Peyronie disease), and fibromatosis of the dorsal proximal interphalangeal (PIP) joints (Garrod nodes or knuckle pads). Guillaume Dupuytren received recognition for the condition that came to be associated with his name because of his expertise on the clinical findings, pathogenesis, prognosis, and treatment of this disease; however, Plater and Cline respectively provided the earliest known records of Dupuytren contracture and its surgical treatment (Verheyden, 1983). Read more…

Distal Humerus Fractures

Introduction

The elbow joint coordinates movements of the upper extremity, facilitating the execution of activities of daily living in areas such as hygiene, dressing, and cooking. When the distal humerus is injured, elbow joint function can be impaired. The goal of open reduction and internal fixation is restoration of normal anatomy. Distal humerus fractures continue to provide challenging reconstructive problems for the orthopedic surgeon.

For excellent patient education resources, visit eMedicine’s Breaks, Fractures, and Dislocations Center. Also, see eMedicine’s patient education articles Broken Arm and Broken Elbow.

History of the Procedure

Many physicians once believed that optimal recovery for complex distal humerus fractures could be achieved through conservative treatment. In 1937, Eastwood described the “bag of bones” technique, which involved compressive manipulation of the distal fragments with collar-and-cuff support and the elbow in flexion.1 After a 2-week period in which the elbow was immobilized at 120 º of flexion, extension was gradually increased. Better outcomes were observed in elderly patients, with ulnohumeral motion averaging 116 º after 2.5 years of follow-up. However, Evans observed that despite the functional range of motion, the final outcome often was a weak and unstable elbow.2 Read more…

Capitellar Fracture

Introduction

Fractures of the capitellum are rare. The complete capitellar fracture pattern was first described in the 19th century (1853) by doctors Hahn and Steinthal; the eponym for this fracture pattern includes their names. Later, doctors Kocher and Lorenz described an additional variation of this fracture pattern; a classification system includes their names.
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Bicipital Tendon Injuries

Introduction

Bicipital tendon injuries of the elbow most commonly occur in the dominant extremity of men aged 40-60 years. Injuries range from tendonitis to partial tears to complete ruptures. A rupture usually occurs at the insertion of the tendon to the radial tuberosity, resulting in pain and deformity about the elbow, as well as weakness, especially with supination. Most surgeons agree that the best results are obtained with early surgical intervention and reattachment of the tendon to the radial tuberosity.
History of the Procedure

Boyd and Anderson first described a modified 2-incision approach for repair of a distal biceps tendon in 1961. The original approach involved subperiosteal dissection on the ulna. This led to an increased incidence of synostosis and heterotopic bone formation. Read more…

Tarsal Tunnel Syndrome

Introduction

Tarsal tunnel syndrome is a condition that is caused by compression of the tibial nerve or its associated branches as the nerve passes underneath the flexor retinaculum at the level of the ankle or distally.
History of the Procedure

Tarsal tunnel syndrome is analogous to carpal tunnel syndrome of the wrist. In 1962, Keck and Lam first described the syndrome and its treatment.
Problem Read more…