“The most common complication of hand fractures is not malunion or infection. Rather, it is joint contractures and tendon adhesions.” Baratz and Divelbiss, 1997 CRITICAL POINTS ▪ Fracture reduction ▪…
CRITICAL POINTS Conservative Treatment ▪ Complete clinical evaluation for the entire upper extremity ▪ Decrease carpal tunnel pressure/Improve local neural circulation ▪ Proper orthosis geometry ▪ Wrist position 2 degrees…
CRITICAL POINTS ▪ Perform a biopsy and culture all tumors treated operatively. ▪ Rheumatologic workup should be considered with suggestive synovitis pattern (i.e., atraumatic ulnar wrist swelling in young patient)….
CRITICAL POINTS ▪ The numerous ways and circumstances in which humans can position their hands places the hand and finger joints at risk for injury. ▪ A thorough knowledge of…
CRITICAL POINTS Surgical Timing ▪ For an injury less than 3 weeks old, nonemergent repair is indicated unless there is active purulent infection. ▪ An injury greater than 6 weeks…
CRITICAL POINTS ▪ Neuron: The primary cell of the PNS, which is polarized and has dendrites to receive information and axons to transmit information ▪ Nerves: Bundles of axons enclosed…
CRITICAL POINTS ▪ Peripheral nerve end-organs require innervation to stay viable. The loss of the trophic stimulus of the nerve axon dooms the end-organ to atrophy and eventual death. ▪…
Critical Points Biology ▪ Motion aids healing and reduces adhesions. ▪ There is no evidence that loading, in the absence of motion, is helpful, or that, once the tendon is…
CRITICAL POINTS ▪ Reconstructive surgery of the upper limb has been advanced by the continual addition and use of new flaps and the increasing use of functional free tissue transfer,…
A Context for Change The pressure for health care reform has increased awareness that rehabilitation costs are too high. As a result, both payers and consumers are demanding high-quality, cost-effective…
