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In the arm, a cylinder cast typically extends from the upper arm to just above the wrist, stabilizing injuries like isolated humeral fractures or post-surgical repairs that do not require elbow immobilization. For the leg, the cast extends from the thigh to just above the ankle, often used to manage patellar fractures, some types of tibial ...
Ulnar collateral ligament reconstruction, colloquially known as Tommy John surgery, is a surgical graft procedure where the ulnar collateral ligament in the medial elbow is replaced with either a tendon from elsewhere in the patient's body, or with one from a deceased donor.
[12] [5] Depending on the nature of the fracture, the cast may be placed above the elbow to control forearm rotation. However, an above-elbow cast may cause long-term rotational contracture. [5] For torus fractures, a splint may be sufficient and casting may be avoided. [14] The position of the wrist in cast is usually slight flexion and ulnar ...
Numerous pinning techniques have been proposed, however there is not enough evidence to determine which is more effective. [1] Pinning involves the manipulation, with X-ray guidance, of the fracture into an acceptable position, and the immediate insertion of metal pins, called Kirschner wires, through the skin, into one bone fragment and across the fracture line into the other bone fragment.
Surgical techniques in this type of hand surgery are mainly the same for the different transfers. [30] Technique for transferring the m. extensor carpi radialis longus: the m. extensor carpi radialis longus tendon is divided at its insertion on the second metacarpal. The muscle is separated, and freed entirely from the surrounding tissues.
External fixation is a surgical treatment wherein Kirschner pins and wires are inserted and affixed into bone and then exit the body to be attached to an external apparatus composed of rings and threaded rods — the Ilizarov apparatus, the Taylor Spatial Frame, and the Octopod External Fixator — which immobilises the damaged limb to facilitate healing. [1]
Monteggia fractures may be managed conservatively in children with closed reduction (resetting and casting), but due to high risk of displacement causing malunion, open reduction internal fixation is typically performed. [4] Osteosynthesis (open reduction and internal fixation) of the ulnar shaft is considered the standard of care in adults.
Tension band wiring is a technique in which the bone fragments are transfixed by K-wires which are then also used as an anchor for a loop of flexible wire. As the loop is tightened the bone fragments are compressed together. Fractures of the kneecap and the olecranon process of the elbow are commonly treated by this method.