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Millard criteria (Rule of 10) is a set of rules, which is to be fulfilled for undertaking elective surgery for children, and mostly used for reference in cleft lip surgery. The criteria includes these prerequisites: [ 1 ] [ 2 ]
The next joint, moving closer to the hand, is the proximal interphalangeal (PIP) joint. The thumb differs by only having two bones and one interphalangeal joint. [10] The injured finger may be examined to determine where the pain is worst. [3] If the finger is sprained or dislocated, pain will be worse at the joint rather than the bone. [3]
Hand injuries when not treated on time can result in long term morbidity. [6] Simple hand injuries do not typically require antibiotics as they do not change the chance of infection. [7] Many hand injuries need surgery, but the time from injury to surgery (delays of up to 4 days) doesn't increase the chance of infection [8]
Madelung's Deformity is usually treated by treating the distal radial deformity. However, if patients have a positive ulnar variance and focal wrist pathology, it’s possible to treat with an isolated ulnar-shortening osteotomy. In these patients the radial deformity is not treated. [5] The ulna is approached from the subcutaneous border.
Fractures in the joints are often caused by jammed finger injuries, the hand equivalent of a stubbed toe. If a tendon pulls away the bit of bone to which it is attached (an avulsion fracture , shown in the image at the top of the page, and in the Busch fracture images below), that will also lead to a fracture in a joint.
Instability in the wrist can be caused by a torn Scapholunate ligament. The Brunelli Procedure does not fix the torn ligament. A hole is drilled through the Scaphoid bone and a part of a tendon taken from the patient is put through this hole and attached to the nearby bones. The procedure usually results in reduced movement of the wrist.
A hand imitating an ulnar claw. The metacarpophalangeal joints of the 4th and 5th fingers are extended and the Interphalangeal joints of the same fingers are flexed.. An ulnar claw, also known as claw hand or Spinster’s Claw, is a deformity or an abnormal attitude of the hand that develops due to ulnar nerve damage causing paralysis of the lumbricals.
X-ray of the uninjured wrist should also be taken to determine if any normal anatomic variations exist before surgery. [5] A CT scan is often performed to further investigate the articular anatomy of the fracture, especially for fracture and displacement within the distal radio-ulnar joint. [5] Various kinds of information can be obtained from ...