Patient Positioning and Portal Placement

Chapter 39


Patient Positioning and Portal Placement




Elbow arthroscopy continues to evolve as a tool for diagnostic and therapeutic treatment of common and complex elbow problems. A thorough understanding of the anatomic structures and the surgical technique will allow safe and efficient treatment of these conditions.



Preoperative Considerations




Physical Examination


The physical examination of the patient goes beyond just the symptomatic elbow. An effort should be made to assess both upper extremities for evaluation of side-to-side asymmetry at the elbow and shoulder; the cervical spine should be examined when a patient gives a history of neurovascular complaints. Following these steps will aid in making a comprehensive decision about the diagnosis instead of an isolated decision based on examination of only the affected elbow.


The examination should proceed in a sequential manner, beginning with inspection for and notation of any previous incisions or scars, swelling or fullness, and notable erythema. After the elbow has been inspected, palpation, again in a sequential fashion, will help to localize any areas of tenderness or pain. The elbow should be delineated into four regions for assessment: lateral, posterior, medial, and anterior. Because each region has anatomic structures that may account for the patient’s symptoms, positive findings at a specific region or regions should aid in generating a differential diagnosis.




Physical Examination Maneuvers








Differential Diagnosis


The differential diagnosis can be based on the patient’s subjective complaints or objective findings or both.







Imaging





Elbow Arthroscopy




Contraindications



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Sep 11, 2016 | Posted by in SPORT MEDICINE | Comments Off on Patient Positioning and Portal Placement

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