Medicine an Surgery notes

Apr 24th, 2015
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FRACTURES PROXIMAL RADIUS AND ULNAMechanism of InjuryAdditional rotational deformity may be produced by the pull of muscles attached to the radius;# Upper ? - Biceps & supinator muscles# Middle ? - Pronator teres.# Lower ? - Pronator quadratus.MANAGEMENTChildrenClosed treatment is usually successful because the tough periosteum tends to guide & then control the reduction. The fragments are held in a well-moulded full-length cast, from axilla to metacarpal shafts to control rotation.The cast is applied with the elbow at 90. If the fracture is proximal to the pronator teres - The forearm is supinated; if it is distal to pronator teres, then the forearm is held in neutral position. The position is checked by x-ray after a week &, if it is satisfactory, splintage is retained until both fractures are united (usually 6-8wks)Indications for surgery;1.If the fracture cannot be reduced 2.If the fragments are very unstableFixation with a small plate, Kirschner wires or flexible intramedullary nails is then needed.AdultsORIF - The fragments are held by interfragmentary compression with plates & screws. Bone grafting is advisable if there is comminution of >? of the circum

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