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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
What is hemodialysis, and why would someone need it? How does hemodialysis work? Can people perform hemodialysis at home? John Kevin Tucker, M.D., Nephrologist at Brigham and Women's Hospital and Vice President for Education at Mass General Brigham, discusses hemodialysis and how it helps people who have lost their kidney function to maintain normal lives.
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0:00 - Intro
0:26 - The Condition
2:06 - Hemodialysis: How It Works
4:37 - In-Center Hemodialysis Care Team
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Mass General Brigham combines the strength of two world-class academic medical centers, five nationally ranked specialty hospitals, 11 community hospitals, and dozens of health centers. Our doctors and researchers accelerate medical breakthroughs and drive innovations in patient care. They are leaders in medical education, serving as Harvard Medical School faculty and training the next generation of physicians. Mass General Brigham’s mission is to deliver the best, affordable health care to patients everywhere. Together, we transform the health of our communities and beyond.
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Kidney Failure: Signs, Dialysis Options, and Hemodialysis Explained | Mass General Brigham
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Prostate biopsy is a procedure in which small hollow needle-core samples are removed from a man's prostate gland to be examined microscopically for the presence of cancer. It is typically performed when the result from a PSA blood test rises to a level that is associated with the possible presence of prostate cancer.
Breast implants do not last forever, and during its lifetime, it may rupture. Dr. Linder, Beverly Hills breast surgeon specialist, breaks down how removing breast implants works. To learn more about Dr. Stuart Linder and his expertise, Visit: www.drlinder.com
Shannon, who recently underwent gastric bypass surgery, discusses her hopes and aspirations for life after her upcoming abdominoplasty surgery in Austin. Abdominoplasty, more commonly known as tummy tuck surgery, is a procedure which removes excess skin from the midsection and tightens the abdominal muscles for a more sculpted, leaner appearance. Please visit http://www.personique.com/tummy-tuckabdominoplasty.php to learn more about abdominoplasty in Austin.
In this video, I have covered Inguinal hernia under the following headings: Definition, Parts of Hernia, Surgical anatomy, Types of inguinal hernia, Aetiology of hernia, Clinical features of hernia, complications of hernia, Clinical examination, Surgical principles, and explanation of a few surgeries (Herniotomy, Bassini suture repair, Shouldice repair, Lichtenstein tension-free open meshplasty, hernia plugs, Laparoscopic techniques like TEP(Totally extraperitoneal approach) and TAPP(Transabdominal preperitoneal approach) surgical procedures).
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How to study General Surgery in med school: (Tips and Tricks)
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1-minute hernia videos: (Complete playlist by Skeleton)
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(includes femoral hernia, obturator hernia, epigastric hernia, umbilical hernia, Spigelian hernia, Richter hernia, lumbar hernia, incisional hernia, Hiatal hernia, congenital diaphragmatic hernia, contents of spermatic cord, triangles of hernia)
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