Orthopedic Care and Consultation
Granulation tissue is collagen-rich tissue formed during proliferative phase of wound healing.
When initially formed, the granulation tissue is light red or dark pink in color and rich in capillary blood vessels. It is soft, moist and granular in appearance.
It is a natural stage in wound healing. But sometimes there is an overproduction and granulation tissue found in abnormal quantity, a condition known as proud flesh. [Read more...]
Hyaluronan (hyaluronic acid or hyaluronate or HA) is an anionic, nonsulfated glycosaminoglycan distributed widely throughout body and has highest concentrations in fluids in the eyes and joints.
In body, hyaluronic acid is involved in the wound repair process, inflammation, reepithelization of normal epidermis, cancer metastases.
Uses
Hyaluronan is used in eye surgery, osteoarthritis of knee, atopic dermatitis, tumor marker for prostate and breast cancer, to prevent postoperative adhesions in pelvic surgery. [Read more...]
Glycosaminoglycans or mucopolysaccharides are long unbranched polysaccharides consisting of a repeating disaccharide unit.
Functions
Glycosaminoglycans form a part of connective tissues. Heparin as an anticoagulant, hyaluronan is a component in the synovial fluid and chondroitins are found in cartilage and tendon.
Chondrotoin sulphate is most prevalent glycosaminoglycan.
Chondrotoin has been used in osteoarthritis.
The ulnar canal or Guyon’s canal, is a space at the wrist between the pisiform bone and the hamate bone through which the ulnar artery and the ulnar nerve travel into the hand.
Guyon’s canal is approximately 4 cm long.
It begins at proximal extent of transverse carpal ligament and ends at the aponeurotic arch of hypothenar muscles. [Read more...]
Gilula defined three carpal arcs whuch can be distinguished on the PA radiograph of the wrist.
Gilula Arcs
Discontinuity in the symmetry of these arcs is a sign of carpal instability.
Image Credit: http://www.aceproindia.com/ACE%20Sample%20Projects/ePUB/Examination%20and%20Diagnosis%20of%20Musculoskeletal%20Disorders/OEBPS/09_chapter03.html#f3.44
Hematoma block involves infiltration of local anaesthetic agent within the fracture. This technique is frequently employed for anesthesia during reduction of distal radius fractures but also in some cases of forearm and leg fractures.
The infiltratiractureon of local anesthetic agent within the fracture serves to block the nerve fibers of the surrounding soft tissues and the periosteum around the fracture. Whenever a bone breaks, bleeding occurs at the site of the fracture and collection is fracture hematoma.
By injecting the local anesthetic into the hematoma, the ends of the broken bone are bathed in the local anesthetic providing anesthesia to the area of the fracture. [Read more...]
A Herbert screw is a special purpose screw used to compress small fractures fragments. One of the unique feature of the screw is that it is threaded on the both sides. It is also called headless screw.
The screw was invented by Timothy Herbert.
One end of the screw has cancellous threads while the other end has larger diameter cortical screw threads. The cancellous screw is inserted first and crosses the proximal fracture, screwing into the bone of the distal fragment. As it is screwed in, the proximal cortical portion engages the proximal bone fragment.
Herbert screws are especially useful in articular fractures and small bones like scaphoid.
Because of difference in the pitch and the size of the threads, Each turn of the screw causes the distal end to travel farther into bone than the proximal end resulting in compression of the fracture.
Also called punctum nervosum, Erb’s point is a a landmark of the brachial plexus on the upper trunk, located about 1 inch (2.5 cm) above the clavicle at about the level of the sixth cervical vertebra.
It is located on the posterior border of the sternocleidomastoid muscle midway between its attachments to the mastoid process, and the sternum and clavicle.
Erb’s point is formed by the union of the C5 and C6 nerve roots, which later converge. Branches of suprascapular nerves and the nerve to the subclavius also merge. The merged nerve divides into the anterior and posterior division of C5 and C6.
Injury to Erb’s point is commonly sustained at birth or from a fall onto the shoulder.
The nerve roots normally involved are C5 and partly C6. [Read more...]
The erythrocyte sedimentation rate (ESR), also called a sedimentation rate or Biernacki Reaction, [The test was invented by the Polish doctor Edmund Biernacki] is a common test in hematology [A branch of pathology dealing in blood investigations] and measures the rate at which red blood cells sediment in a period of 1 hour.
The erythrocyte sedimentation rate (is a nonspecific because increased results do not tell the doctor exactly where the inflammation is in the body or what is causing it, and also because it can be affected by other conditions besides inflammation.
For this reason, the ESR is typically used in conjunction with other tests. [Read more...]
Hyperextension casting is a non operative method to treat thoracolumbar spine injuries where a cast
is applied in position of hyperextension.
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