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Closed Reduction of Distal Radius Fractures - Discussion: (distal radius fracture menu) - closed reduction & immobilization in plaster cast remains accepted method of treatment for majority of stable distal radius frx; - unstable fractures will often lose reduction in the cast and will slip back to the pre-reduction position; - patients should be examined for carpal tunnel symptoms before and after reduction; - carpal tunnel symptoms that do not resolve following reduction will require carpal tunnel release; - cautions: - The efficacy of closed reduction in displaced distal radius fractures. - Technique: - anesthesia: (see: anesthesia menu) - hematoma block w/ lidocaine; - w/ hematoma block surgeon should look for "flash back" of blood from hematoma, prior to injection; - references: - Regional anesthesia preferable for Colles' fracture. Controlled comparison with local anesthesia. - Neurological complications of dynamic reduction of Colles' fractures without anesthesia compared with traditional manipulation after local infiltration anesthesia. - methods of reduction: - Jones method: involves increasing deformity, applying traction, and immobilizing hand & wrist in reduced position; - placing hand & wrist in too much flexion (Cotton-Loder position) leads to median nerve compression & stiff fingers; - Bohler advocated longitudinal traction followed by extension and realignment; - consider hyper-extending the distal fragment, and then translating it distally (while in extended position) until it can be "hooked over" proximal fragment; - subsequently, the distal fragment can be flexed (or hinged) over the proximal shaft fragment; - closed reduction of distal radius fractures is facilitated by having an assistant provide counter traction (above the elbow) while the surgeon controls the distal fragment w/ both hands (both thumbs over the dorsal surface of the distal fragment); - flouroscopy: - it allows a quick, gentle, and complete reduction; - prepare are by prewrapping the arm w/ sheet cotton and have the plaster or fibroglass ready; - if flouroscopy is not available, then do not pre-wrap the extremity w/ cotton; - it will be necessary to palpate the landmarks (outer shaped of radius, radial styloid, and Lister's tubercle, in order to judge success of reduction; - casting: - generally, the surgeon will use a pre-measured double sugar sugar tong splint, which is 6-8 layers in thickness; - more than 8 layers of plaster can cause full thickness burns: - reference: Setting temperatures of synthetic casts. - position of immobilization - follow up: - radiographs: - repeat radiographs are required weekly for 2-3 weeks to ensure that there is maintenance of the reduction; - a fracture reduction that slips should be considered to be unstable and probably require fixation with (pins, or ex fix ect.) - there is some evidence that remanipulation following fracture displacement in cast is not effective for these fractures; - ultimately, whether or not a patient is satisfied with the results of non operative treatment depends heavily on th
Nasal polyps are associated with inflammation of the lining of your nasal passages and sinuses that lasts more than 12 weeks (chronic rhinosinusitis, also known as chronic sinusitis). However, it's possible — and even somewhat more likely — to have chronic sinusitis without nasal polyps. Nasal polyps themselves are soft and lack sensation, so if they're small you may not be aware you have them. Multiple growths or a large polyp may block your nasal passages and sinuses.
“Complete cure from groin hernia is now possible with Dr.Desarda's repair technique.......” Mesh is a foreign body. Therefore, its use in hernia repairs is known to cause all sorts of complications like pain, recurrence, infection etc. We have developed an innovative new technique of inguinal hernia repair without mesh. It uses your own body muscle for repair and gives virtually complete cure from inguinal hernia problem. An undetached strip of the external oblique aponeurosis is stitched on the weak area between the muscle arch and the inguinal ligament to form a new, strong and physiologically dynamic posterior wall that gives protection and prevents re-herniation. Normally patient goes home in a day after surgery and can drive car and go to office in 3-4 days time. This "Dr.Desarda's hernia repair" is now followed in many countries all over the world. We are surprised to see the enquiries from many patients in the developed countries asking for this repair in their country. This is because this operation does not use any foreign body like mesh for repair and therefore there are no complications that are seen in mesh repairs. A visit to Topix or other hernia forums show thousands of posts showing sufferings of many patients due to mesh repairs. But still why surgeons from developed countries are interested in mesh repairs is a big question for us. Please visit our website for more details: http://herniasurgery.tripod.com Our cell number: +91 9373322178
Colon polyp facts Colon polyps are growths on the inner lining of the colon and are very common. Colon polyps are important because they may be, or may become malignant (cancerous). They also are important because based on their size, number, and microscopic anatomy (histology); they can predict which patients are more likely to develop more polyps and colon cancer. Changes in the genetic material of cells lining the colon are the cause of polyps. There are different types of colon polyps with differing tendencies to become malignant and abilities to predict the development of more polyps and cancer. It is important to recognize families with members who have familial genetic conditions causing polyps because some of these conditions are associated with a very high incidence of colon cancer, and the cancer can be prevented or discovered early.
The typical radiograph is of a well-defined, rounded, retrocardiac opacity with an air-fluid level. In this image, the radiolucent gas is highlighted in blue, while the gastric contents are highlighted in the green. In many cases of hiatal hernia, there will not be an air bubble below the left hemidiaphragm. This is a relatively expected finding considering that the stomach is no longer in its usual position. The anatomical position of the herniated organ can be further elucidated on the lateral radiograph. Here we can see that the stomach is in the middle mediastinum posterior to the heart and above the diaphragm. Hiatal hernias can look similar to a retrocardiac lung abscess or another cavitary lesion, but it will change in size and shape between radiographs. Large hernias can shift the mediastinum to the right and result in a widening of the carinal angle. They can even give the appearance of cardiomegaly. In this radiograph, the cardiac silhouette is distinctly visible within the confines of the hiatal hernia. To review, a hiatal hernia on an AP chest radiograph typically appears as a round retrocardiac opacity with an air-fluid level.
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Disclaimer: All the information provided by Medical Education for Visual Learners and associated videos are strictly for informational purposes only. It is not intended as a substitute for medical advice from your health care provider or physician. It should not be used to overrule the advice of a qualified healthcare provider, nor to provide advice for emergency medical treatment. If you think that you or someone that you know may be suffering from a medical condition, then please consult your physician or seek immediate medical attention.
Hypothyroidism during pregnancy is treated with synthetic thyroid hormone, thyroxine (T4). Postpartum thyroiditis—inflammation of the thyroid gland—causes a brief period of hyperthyroidism, often followed by hypothyroidism that usually goes away within a year. Sometimes the hypothyroidism is permanent.
CORRECTION: After review of this video, it is clear that this video is of a baby who is near full term (40 weeks) based on the size. Late trimester "abortions" are defined only to viability of a baby (24 weeks) A 24 week baby is much smaller than this baby shown and by definition this is not a late "abortion" procedure. The proper labeling of this video should be management of a deceased breech baby with "head entrapment" as this was almost certainly a naturally occuring delivery and an OB nightmare (Reviewed by Dr. Frederick Bright)
Bacterial vaginosis is a type of vaginal inflammation caused by the overgrowth of bacteria naturally found in the vagina, which upsets the natural balance. Women in their reproductive years are most likely to get bacterial vaginosis, but it can affect women of any age. The cause isn't completely understood, but certain activities, such as unprotected sex or frequent douching, increase your risk.