http://normallifemyself.blogspot.tw/2014/05/glomustumor_25.htm
Glomus tumor
75%
GANGLION VS GIANT CELL TUMOR
Giant cell tumor
Ganglion
Giant cell tumor Ganglion cyst
GIANT CELL TUMOR
• The second most common tumors in the hand (ganglion cysts are the most common). • Commonly occur in patients aged 30-50 years (peak incidence in those aged 40-50 years) • The incidence of local recurrence is high (ranging from 9% to 44%). • Most commonly adjacent to the distal interphalangeal (DIP) joint
INTRODUCTION
• Trigger finger: stenosing tenosynovitis of the thumb or finger flexor tendon • Clinically, symptoms are caused by a tendon nodule which usually locks the flexor tendon at the level of A1 pulley
VARIOUS TREATMENT METHODS •Non-operative treatments: •Extension splinting •NSAID •Steroid injection
If conservative treatment fails….
VARIOUS TREATMENT METHODS •Operative treatments Open release is traditionally performed under a local anesthesia through a small palmar incision Although digital the successful rate was nearly Including nerve injury, infection, 100%, many complications have beenand stiffness, weakness, scar tenderness, reported of the flexor tendons bowstring
PERCUTANEOUS RELEASE • Lorthioir reported good results without complications • Recently, several other studies have also reported favorable results
But incomplete release or the need to convert to open release with this technique varies from 0% to 11%
Volar plate avulsion fracture
4 months later, subluxation of PIP joint with malunion
Volar plate avulsion fracture
Residual subluxation may be seen as a “V� sign on a lateral radiograph and is associated with a poor prognosis
ONDYLAR FRACTURES OF THE PROXIMAL PHALANX
CONDYLAR FRACTURES OF THE PROXIMAL PHALANX
ONDYLAR FRACTURES OF THE PROXIMAL PHALANX
Volar pl
1st ORTHOPEDIC TRAUMA SYMPOSIUM
南區骨科月會 2008-0329
南區骨科月會 2008-0329
南區骨科月會 2008-0329
COMMON MECHANISM OF FAILURE
PREDICTION OF INSTABILITY IN DISTAL RADIAL FRACTURES • Patient age • Metaphyseal comminution • Ulnar variance
The most consistent predictors of radiographic outcome
INTRA-ARTICULAR FRACTURES • Intra-articular • Impaction/axial load •
Pattern varies
• Typically 3 major fragments • Radial styloid - 1 • Dorsal portion of lunate facet – 2 (die punch fragment) • Volar Portion of lunate facet - 3 •
Comminution varies
• Angle of impact • Energy imparted • Quality of bone
Three Column Theory Extra-articular fractures require avoidance of malunion with angulation and shortening. Malalignment results in limitations of movement, changes of load distribution, mid-carpal instability and increased risk of osteoarthritis in the radiocarpal joint.
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