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SBA Answers and Explanations
Published in Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury, SBAs for the MRCS Part A, 2018
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury
Colles’ fracture is a distal fracture of the radius that is a known cause of carpal tunnel syndrome (compression of the median nerve in the carpal tunnel). It rarely results in ulnar nerve compression. A Colles’ fracture is extra-articular by definition and does not extend into the wrist joint, otherwise this would make it an intra-articular fracture (Barton’s fracture). The distal fragment in a Colles’ fracture is displaced dorsally, unlike in a Smith’s fracture where the distal fragment is displaced volarly (ventrally). Associated fracture of the ulnar styloid process may occur in more than 60 per cent of cases, although this does not form part of the true Colles’ fracture (especially as it may not occur in all cases) and is a common associated injury.
Injuries of the wrist
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
David Warwick, Adam Watts, Joanna Thomas
X-rays show there is a transverse fracture of the radius at the corticocancellous junction, and often the ulnar styloid process is broken off. The radial fragment is impacted into radial and backward tilt. Sometimes there is an intra-articular fracture; sometimes it is severely fragmented. If the configuration is not clear, a CT scan is very helpful in planning treatment.
Femur – Lateral
Published in A Stewart Whitley, Charles Sloane, Gail Jefferson, Ken Holmes, Craig Anderson, Clark's Pocket Handbook for Radiographers, 2016
A Stewart Whitley, Charles Sloane, Gail Jefferson, Ken Holmes, Craig Anderson
From the antero-posterior position, the elbow is flexed to 90 degrees.The humerus is internally rotated to 90 degrees to bring the medial aspect of the upper arm, elbow, forearm, wrist and hand in contact with the table.The image receptor is placed under the forearm to include the wrist joint and the elbow joint.The arm is adjusted such that the radial and ulnar styloid processes and the medial and lateral epicondyles are superimposed.The lower end of the humerus and the hand are immobilised using sandbags.
Dorsal dry needling to the pronator quadratus muscle is a safe and valid technique: A cadaveric study
Published in Physiotherapy Theory and Practice, 2023
Albert Pérez-Bellmunt, Carlos López-de-Celis, Jacobo Rodríguez-Sanz, César Hidalgo-García, Joseph M. Donnelly, Simón A Cedeño-Bermúdez, César Fernández-de-las-Peñas
Dry needling insertions were conducted by one clinician with 13 years of experience by using sterile stainless-steel solid filiform needles 30 mm in length and 0.32 mm caliber with a plastic cylindrical guide (APS, Agupunt, Barcelona, Spain). The PQ muscle was needled dorsally by using the ulnar styloid process as the anatomical landmark. With the forearm pronated, the needle was inserted 3 cm (assessed with a ruler) proximal and lateral (radially) to the ulnar styloid process (Choung et al., 2016) and advanced into an anterior direction to a depth judged clinically to be most likely in the PQ (Figure 1). To accurately identify the PQ, the clinician considered its location in the volar aspect of the distal forearm, and the needle should penetrate the PQ after piercing the interosseous membrane.
Incidence of distal ulna fractures in a Swedish county: 74/100,000 person-years, most of them treated non-operatively
Published in Acta Orthopaedica, 2020
Maria Moloney, Simon Farnebo, Lars Adolfsson
Fractures of the distal ulna may result in incongruence and instability of the distal radioulnar joint (DRUJ), which may result in chronic pain or limited forearm rotation (Kvernmo 2014). Fractures of the distal ulna most often accompany a distal radius fracture and in the majority of cases they affect the ulnar styloid process, while fractures of the ulnar head and/or neck are less common (Ring et al. 2004). Distal radius fractures and concomitant fractures of the distal radius and ulna are commonly caused by a fall from standing height on an outstretched arm with extended wrist. Isolated ulna fractures on the other hand are most often caused by a direct trauma to the ulnar border of the wrist (Richards and Deal 2014). Among patients with a Colles fracture, excluding ulnar styloid fractures, 5.6% have a concomitant fracture of the distal ulna (Biyani et al. 1995). Internal fixation of these fractures is typically difficult (Ring et al. 2004) as the distal fragment in most cases is small, consisting to a large extent of metaphysis and has a 270° articular surface.
Shoulder Muscle Activity Dampens Arm Swing Motion When Altering Upper Limb Mass Characteristics During Locomotion
Published in Journal of Motor Behavior, 2019
Michael J. MacLellan, Shannon Ellis
The function of the shoulder muscle activities during upper limb swing were quantified by dividing the swing cycle into distinct regions, as shown previously (Canton & MacLellan, 2018). In brief, the anterior-posterior trajectories of the right and left arms were separated into four functional phases using the velocity profiles of the ulnar styloid processes. These four regions were highlighted in order to identify if the function of the shoulder muscles was to accelerate or decelerate arm movement during these phases. In particular, these included: region 1) arm is accelerating while moving in the anterior direction; region 2) arm is decelerating while moving in the anterior direction; region 3) arm is accelerating while moving in the posterior direction; and region 4) arm is decelerating while moving in the posterior direction. To obtain the overall oscillating movement of the arm and minimize any effects due to experimental noise, the fundamental harmonic of the arm swing data was used to represent the motion. The functional regions (1, 2, 3 and 4) were determined using the peaks and zero-crossings of the velocity profile. Within each region, the integrated EMG (iEMG) was calculated per stride in each participant and averaged over 10 strides.