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Metatarsal

March 31, 2010 By Leave a Comment

The metatarsus or metatarsal bones are of five long bones in the foot located between the tarsal bones and the phalanges of the toes. The metatarsal bones are numbered from the medial side (side of big toe): the first, second, third, fourth, and fifth metatarsal.

The metatarsals are analogous to the metacarpal bones of the hand.

Like metacarpals, they are dorsally convex long bones consisting of a shaft or body, a base, and a head.

The base of each metatarsal bone articulates with one or more of the tarsal bones at the tarsometatarsal joints [Lisfranc Joint]. Their bases also articulates with each others at the intermetatarsal joints.

  • The first metatarsal articulates with the medial cuneiform, and to a small extent to the intermediate cuneiform.
  • Second metatarsal articulates with all three cuneiforms.
  • Third metatrsal with lateral cuneiform.
  • Fourth metatarsal articulates with the lateral cuneiform and the cuboid.
  • Fifth metacarpal articulates with the cuboid.

The head articulates with one of the first proximal  phalanx at the metatarsophalangeal joints.

Filed Under: Definitions, I-M Tagged With: , ,

What Is Debridement

March 31, 2010 By Leave a Comment

Debridement is defined as the removal of a patient’s dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue.

The removal may be achieved by  autolytic (self-digestion), chemical and surgical. Maggot therapy is debridement where certain species of live maggots selectively eat only necrotic tissue.

Debridement is an important part of the healing process for burns and other serious wounds.

Autolytic Debridement

It uses  body’s own enzymes and moisture to re-hydrate, soften and finally liquefy hard eschar and slough.  Autolytic debridement can be achieved with the use of occlusive or semi-occlusive dressings  with hydrocolloids, hydrogels and transparent films. [Read more...]

Filed Under: A-D, Definitions, Wound Healing Tagged With: , , , ,

Metacarpal

March 30, 2010 By 1 Comment

Metacarpus is the region of  the hand skeleton  located between the phalanges (bones of the fingers) distally and the carpus. It consists of  five metacarpal bones.Its foot equivalent is the metatarsus.

Together five metacarpals form a transverse arch to which the rigid row of distal carpal bones are fixed. Beginning from lateral side {Thumb articulates with first}, the metacarpals are numbered from 1 to 5.

A metacarpal has three parts

  • The body  is prismoid in form, and curved, so as to be convex in the longitudinal direction behind, concave in front.
  • The base or carpal extremity articulates with the carpusand with the adjoining metacarpal bones
  • The head or digital extremity articulates with the proximal phalanx.

Metacarpals and Phalanges

Each metacarpal articulates with the proximal phalanx of corresponding digit. On carpal side the articulations are as follows

  • The first metacarpal articulates with the trapezium
  • The second metacarpal articulates with the trapezium, trapezoid, capitate and third metacarpal
  • Third metacarpal articulates with the capitate and second and fourth metacarpals
  • Fourth metacarpal articulates with the capitate, hamate, and third and fifth metacarpals
  • Fifth metacarpal articulates with the hamate and fourth metacarpal.
Filed Under: Definitions, I-M Tagged With: , , ,

Different Types of Bone Grafts

March 30, 2010 By Leave a Comment

Autogenous Grafts

Also called autograft. This graft comes from patient’s own body.The grafts usually are removed from the tibia, fibula, or ilium. These three bones provide cortical grafts, whole bone transplants, and cancellous bone.

Disadvantages to the use of the tibia as a donor area include the following:

  • Morbidity of the patient is increased.
  • Removal of the graft adds to the duration and magnitude of the procedure.

For these reasons, structural autografts from the tibia are now rarely used. [Read more...]

Filed Under: Basics Tagged With: , , , ,

Carpus

March 29, 2010 By 1 Comment

Carpus is the region between metacarpals and distal ends of radius and ulna. It corresponds to the region of wrist.

the main role of the carpus is to facilitate effective positioning of the hand and powerful use of the extensors and flexors of the forearm, but the mobility of individual carpal bones increase the freedom of movements at the wrist.

Carpus has eight bones arranged in two rows, proximal and distal.

Carpal Bones - Distal and Proximal Rows Proximal: A=Scaphoid, B=Lunate, C=Triquetral, D=Pisiform Distal: E=Trapezium, F=Trapezoid, G=Capitate, H=Hamate

Proximal row has from lateral to medial side scaphoid, lunate, triquetral and pisiform
Distal row has trapezium, trapezoid, capitate and hamate

Filed Under: A-D, Definitions Tagged With: , ,

Classification of Open Fractures

March 29, 2010 By 1 Comment

Open fracture is the fracture in which there is an associated wound over or near fracture site and that commmunicates with fracture hematoma.
Classification of open fractuers put them into increasing grades of severity. Open fractuers in general take longer time to unite than closed fractures

There are many classifications of open fractures but most followed has been that of Gustilo. It was later modified by Anderson ans the classification now used is thus Gustilo Anderson.

This classification is as follows [Read more...]

Filed Under: Fractures-Dislocations

What Is Nucleoplasty?

March 28, 2010 By 2 Comments

Nucleoplasty is a percutaneus procedure where a catheter is percutaneously inserted into the intervertebral disc under fluoroscopy. The catheter has low-temperature resister probe to disintegrate and evacuate disc material causing disc decompression.

The nucleoplasty is percutaneous and does not require any incision.

Indications

It is most useful in patients with nerve root irritation due to smaller disc bulges or contained ruptures.

The indications include discogenic low-back pain due to disc degeneration, as well as the treatment of lumbar disc bulges or disc ruptures causing radiculopathy. [Read more...]

Filed Under: Spine, Thoracic-Lumbar Sacral Spine Tagged With: , , , ,

Torticollis

March 28, 2010 By 2 Comments

Torticollis, or wry neck, is a condition in which the head is tilted toward one side (cervical Lateral flexion), and the chin is elevated and turned toward the opposite side (cervical extension).
Torticollis can be congenital or acquired.

Filed Under: Definitions, S-Z Tagged With: ,

Flexor Carpi Ulnaris

March 27, 2010 By Leave a Comment

The flexor carpi ulnaris muscle (FCU) is a muscle of the human forearm that causes flexion and adduction of the hand. It arises by two heads from humerus and ulna connected together by a tendinous arch.

The humeral head arises from the medial epicondyle of the humerus by the common flexor tendon and ulnar head arises from the medial margin of the olecranon of the ulna and from the upper two-thirds of the dorsal border of the ulna.

It inserts into the pisiform bone and then via ligaments into the hamate bone and 5th metacarpal bone.

Flexor carpi ulnaris is the most medial tendon visible on resisted flexion of wrist.

It is supplied by ulnar nerve.

Filed Under: Definitions, E-H Tagged With: , , ,

Tubular Fixator With Bent Pins In Open Fracture Lower Third Tibia – Lateral View

March 27, 2010 By Leave a Comment

Following xray belongs to 33 years old lady who had an open fracture tibia grade III [Bone stripped of soft tissue cover] with closed fracture of fibula.
The patient was initially treated with wound debridement and external fixation with across the ankle fixator.

This xray was done after two months of application of the fixator and top two pins were found bent, a sign of imminent implant failure.
By that time, however skin wound had healed completely. Therefore, external fixator was removed and patient limb was splinted using a slab.

It was followed by internal fixation and bone grafting.

Filed Under: Leg Injuries, Musculoskeletal Radiology, Orthopaedic Images Tagged With: , , ,
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