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Can a medically minded TWebber translate this for me?

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  • Can a medically minded TWebber translate this for me?

    Source: OpReport


    FINDINGS AT SURGERY:
    The findings at surgery and unusual and massive tear involving the TFC: at the distal surface. There was a ulnar rim tear of the fibrocartilage at the ligamentous junction, and a second radial tear. There was an unusual appearance to the TFC essentially a significant concave shape presumably due to the now significant ulnar negative variance. Beneath these 2 vertical splits. There was a multilayered delaminating tear within the whole structure of the cartilaginous part of the TFC, also extending into the anterior ligament capsule of the distal radioulnar joint. it was also noted that the ulnar head was sitting proximal to the sigmoid notch. The remaining joint was unremarkable. There was grade 2 widening of the LT interval with mild instability and grade two widening of the SL interval with mild instability. on examination of the joint at the end of the procedure, there was significant laxity in neutral of the distal radioulnar joint, but this was firm in both full pronation and supination. It was felt that in neutral. The ulnar head set subluxed proximally. He almost certainly will require a stabilisation procedure or the distal radioulnar joint, which should involve radial shortening to relocate the ulnar head and an Adams Berger type reconstruction.

    DETAILS OF PROCEDURE:
    Upper arm tourniquet. Routine prep and drape. The patient was positioned for wrist arthroscopy. The following portals were used. 3/4, 6R, mid carpal radial, mid carpal ulnar, proximal distal radioulnar joint, distal distal radioulnar joint. The radiocarpal joint was approached through first and there was the TFC tear, all of which were debrided initially superficially and then once this layer was opened. A second delaminating tear was noted eventually extending right through to the distal radioulnar joint. Through the midcarpal joint there was some arthroscopic widening of the scapholunate interval to arthroscopic grade 2 with mild instability and a grade 2 widening of the LT with mild instability. Through the distal radioulnar joint. There was a large flap tear as described above, which was debrided back to stability. at the end of the debridement, there was considerable debridement of the anterior capsule through towards the ulnar neurovascular bundle, which was palpated with the probe and felt to be at least half a centimetre anterior to the region of debridement. The stability of the joint was then examined and the findings as noted above. Wounds were closed with 4-0 nylon interrupted sutures and a well padded below elbow volar slab applied.

    © Copyright Original Source

    "If you can ever make any major religion look absolutely ludicrous, chances are you haven't understood it"
    -Ravi Zacharias, The New Age: A foreign bird with a local walk

    Be watchful, stand firm in the faith, act like men, be strong.
    1 Corinthians 16:13

    "...he [Doherty] is no historian and he is not even conversant with the historical discussions of the very matters he wants to pontificate on."
    -Ben Witherington III

  • #2
    Beyond the obvious of the elbow joint was messed up and they made some holes to go in a fix it by cleaning out the ragged areas?
    If it weren't for the Resurrection of Jesus, we'd all be in DEEP TROUBLE!

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    • #3
      There was a tear in your wrist cartilage involving both the radius and ulna. The end of the ulna is out of position, which will need to be fixed by shortening the radius. When your hand is in-line with your forearm, there's too much play in the joint (though it's okay when flexed all the way up or down). A grade 2 widening is of medium severity.
      Enter the Church and wash away your sins. For here there is a hospital and not a court of law. Do not be ashamed to enter the Church; be ashamed when you sin, but not when you repent. St. John Chrysostom

      Veritas vos Liberabit<>< Learn Greek <>< Look here for an Orthodox Church in America<><Ancient Faith Radio
      sigpic
      I recommend you do not try too hard and ...research as little as possible. Such weighty things give me a headache. - Shunyadragon, Baha'i apologist

      Comment


      • #4
        Medically speaking it means,


        "Welcome fellow pirate!!"

        FU9160_PIRATE_HOOK.jpg

        Comment


        • #5
          arthroscopy: we stuck a camera in your wrist and are going to clean up whatever else we find wrong with it.
          Debride: We Cleaned up some nasty scar tissue so that your cartilage is more normal and works better now. you also have some nice wearing on your carpal joints to the point of arthritis, don't worry we'll refer to someone who can do that, and un bundle your nerves, closing with sutures.
          A happy family is but an earlier heaven.
          George Bernard Shaw

          Comment


          • #6
            my new one:

            Source: OpReport


            PRE-OPERATIVE DIAGNOSIS: distal radioulnar joint, proximal dislocation with severe instability.

            POST-OPERATIVE DIAGNOSIS: same

            OPERATION: Right radial shortening osteotomy, distal radioulnar joint and ulnar aspect of radiocarpal joint capsular and TFC excision, palmar and dorsal distal radioulnar ligament reconstruction using palmaris graft

            FINDINGS AT SURGERY:
            The findings at surgery were that there was considerable shortening of the ulna relative to the radius, significant distal radioulnar joint and ulnar aspect of radiocarpal joint fibrosis, mild osteoarthritic change to the distal radioulnar joint.

            DETAILS OF PROCEDURE:
            Upper arm tourniquet. Routine prep and drape.
            The forearm was positioned supine and an anterior approach as described by Henry was made. The incision was marked in line with the biceps tendon proximally and the radial styloid distally. Radial shortening plate was used as a template for the length of skin incision. The incision was made estimating the junction between the middle and distal thirds as the site of the osteotomy. Incision was taken down through soft tissue and the lateral cutaneous nerve of the forearm mobilised. The deep fascia was opened in line with the anterior border of the brachioradialis, which was mobilised in a lateral direction, and then the fascia between the radial nerve and radial artery was opened to the lateral border of the radius between the pronator teres and the flexor digitorum profundus muscle. The anterior border of the radius was opened subperiosteally and with the use of the Acumed radial/ulnar shortening system. A 4 mm shortening took place. The image intensifier was used to confirm screw lengths and position of the wrist. This wound was then closed with 4-0 nylon interrupted sutures.

            The forearm remained in the supine position, and a zigzag incision was made to allow access to the palmaris tendon and the ulnar neurovascular bundle. A flap was created on the deep fascia and a very satisfactory tendon was noted. The tendon was incised about one cm distal to the distal wrist crease, after the deep fascia was opened and the median nerve located and preserved throughout, with the use of the tendon stripper. A very satisfactory length of tendon was created. At this point, this wound
            remained open.

            The forearm was repositioned prone on a hockey-stick incision was made centred on the distal aspect of the distal radioulnar joint and the proximal limb in line with the interosseous membrane and the distal limb at 45 towards the ulnar border of the hand. The dorsal branch of the ulnar nerve was located and preserved throughout. An incision was made in the deep fascia and extensor retinaculum between the fifth and sixth compartments were mobilised in a medialward and lateral direction. There was dense scar involving the capsule of the radiocarpal joint, distal radioulnar joint and intervening triangular fibrocartilage . This was completely excised en masse exposing the sigmoid notch and medial border of the distal radius. A secondary interval was created through the fourth compartment by opening the deep fascia by about 2 cm. With the use of a 2.7 mm cannulated drill a drill hole was created in the radius under image intensifier control, and deemed satisfactory in position. This hole was then curetted. A second hole was then created centred on the fovea and exiting the medial aspect of the distal ulna using a 3.2 mm cannulated drill. Again under image intensifier control, and again deemed satisfactory. This was also curetted.

            With the use of wire loops. The tendon graft was passed from anterior to posteriorly through the 2.7 mm radial hole and then passed through the remaining anterior capsule over the ulnar head. Then deep to the fourth compartment posteriorly. Both loops of tendon graft were then passed through the 3.2 mm all tunnel looped around the distal ulna. At this point. Finger traps were used to place the hand in the standard position for wrist arthroscopy before the tendons were tightened in slight supination and sutured to each other. Very satisfactory stability and full pronosupination of the distal radioulnar joint was noted and the deep fascia was closed with 3-0 PDS suture. All wounds were closed with 4-0 nylon interrupted sutures and a well-padded above elbow dorsal slab in slight supination was applied.

            © Copyright Original Source



            I will be in plaster for another 5 weeks
            "If you can ever make any major religion look absolutely ludicrous, chances are you haven't understood it"
            -Ravi Zacharias, The New Age: A foreign bird with a local walk

            Be watchful, stand firm in the faith, act like men, be strong.
            1 Corinthians 16:13

            "...he [Doherty] is no historian and he is not even conversant with the historical discussions of the very matters he wants to pontificate on."
            -Ben Witherington III

            Comment


            • #7
              Wwhen they started surgery, they confirmed the pre-surgical diagnosis. They shortened the longer bone to correct the dislocation, removed some significant scar tissue, and reconnected two tendons using grafts from elsewhere in the forearm. As far as they could tell, the procedure corrected the instability and will give you full wrist movement.
              Enter the Church and wash away your sins. For here there is a hospital and not a court of law. Do not be ashamed to enter the Church; be ashamed when you sin, but not when you repent. St. John Chrysostom

              Veritas vos Liberabit<>< Learn Greek <>< Look here for an Orthodox Church in America<><Ancient Faith Radio
              sigpic
              I recommend you do not try too hard and ...research as little as possible. Such weighty things give me a headache. - Shunyadragon, Baha'i apologist

              Comment


              • #8
                here's mine: OWWW
                A happy family is but an earlier heaven.
                George Bernard Shaw

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