Darrach's Procedure ,locking volar plate , bone graft

GCT

NEGLECTED Distal End Radius #

60 yr Male Right handed and farmer by occupation
History of fall 20 days back
Taken no treatment
Presents with
a deformity of left wrist
Ulcer over ulnar aspect of wrist
ROM Restricted and painfull
No neuro vascular deficits

ozone action on gloves

ozonolysis

L5 S1 disc bulge sagital section

axcial section

spinal needle in L5S! disc space n ozone gas injected
white shadow in disc shows ozone in nucleus of disc

lunate excission . palmaris longus interpositional arthroplasty

extended carpal tunnel release inscission taken

lunate visualized protruding in fossa

lunate excised,

palmaris longus tendon striped

tendon rolled . fixed vicril into the space

lunate dislocation 3 months old

we recived amputated thumb in packet with tap water .... but had crossed 6 hrs when reached us .. an related article



Salvage of amputated digits by temporary ectopic implantation
J. Bakhach, A.-A. Oufqir, J. Baudet, B. Panconi and J.-C. Guimberteau



We present two clinical cases with complete amputation of multiple digits that were salvaged after having been successfully implanted on ectopic sites.

The first case concerns a 73-year-old patient, who suffered a severe crush injury of his right hand that resulted in amputation of all four long fingers and an extensive tissue loss of the palm and the dorsum of the hand. Two of the amputated digits, that were considered to be replantable, were implanted on the dorsum of the left foot. The hand defect was covered with a pedicle groin flap. After six weeks, the two ectopically implanted fingers were transferred to their proper anatomical site. Several reconstructive procedures were performed later, in order to lengthen the first ray of the injured hand, and to deepen the first web space. Satisfactory functional results were recorded after eighteen months of follow-up.

The second patient concerns a 45-year-old male patient, who had a gun shot accident of his right hand. The injury resulted in a composite tissue loss of the hand with complete amputation of his four long fingers. All fingers were implanted on the left forearm, while the hand defect was reconstructed using an osteocutaneous free flap of the iliac crest. Six weeks after the initial procedure, the ectopically implanted digits were transferred — as a single free flap — to the hand.

We described with details the local conditions of the injured hands in both cases, and discuss the reasons we decided to perform this sophisticated method in order to preserve the viability and function of those totally amputated fingers. The recipient sites were selected in a distance from the injured area, always considering the availability and size of appropriate recipient vessels, and the safety of the surgical procedure. We agree that the whole concept of this procedure is very demanding, and requires several microsurgical operations with high risk of complications. However, it does deserve special consideration in reconstructive microsurgery, since it offers the possibility to salvage multiple amputated digits, by preserving the anatomy and restoring the function of severely injured hands.



Read more: http://blogs.myspace.com/idiotorial#ixzz10xClX4e5

MPNST

h/o swelling on dorsum of forearm since last 2 years .. previously tumor was exiced 2 yrs back / biopsy report peripheral malignant nerve sheath tumor

post op of pathological #femur, telescopic nail being used

63 m #humerus , im nailing ,no dnvc

9 year female presents with r fracture femur

increased venous markings