Orthopedics

Download ASSH Manual of Hand Surgery by Warren C. Hammert MD, Martin I. Boyer MD FRCS(C), David J. PDF

By Warren C. Hammert MD, Martin I. Boyer MD FRCS(C), David J. Bozentka MD, Ryan Patrick Calfee MD

Published along with the yank Society for surgical procedure of the Hand (ASSH), the ASSH handbook of Hand Surgery is a realistic, accomplished handbook at the analysis and administration of hand difficulties. each one bankruptcy starts off with a bit at the anatomy of the sector in query. info is gifted in easy-to-scan bullet issues, with various lists and algorithms. every one bankruptcy ends with board-type questions and solutions, annotated references, and a listing of what junior and senior point citizens have to know.

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Their anti-inflammatory properties are used by hand surgeons to treat a variety of musculoskeletal conditions. They are injected into joints, bursae, and tendon sheaths. Injection into such enclosed spaces maximizes local effects and minimizes systemic effects. The steroid selected is largely driven by previous experience, as firm guidelines do not exist. In general, short-acting compounds are used for acute conditions, whereas long-acting compounds are used in chronic conditions. Corticosteroid injections into the small joints of the hand and wrist are effective adjunctive management for rheumatoid and osteoarthritis.

Indd 30 2/13/2010 3:46:45 PM Chapter 3 • Anesthesia 31 1. The palmar cutaneous branch of the median nerve This purely sensory branch of the median nerve provides sensation to the thenar palm. It arises 5 to 7 cm above the wrist; however, it travels with the median nerve for 16 to 25 mm before diverging from the palmar-radial aspect of the median nerve. It then runs distally along the ulnar border of the flexor carpi radialis (FCR) to the proximal margin of the transverse carpal ligament (TCL). The palmar cutaneous branch of the median nerve travels in a separate tunnel within the TCL, piercing the ligament in line with the ring finger to enter the subcutaneous tissue.

It is also important in platelet aggregation. COX-2 is an inducible enzyme expressed at sites of inflammation. Conventional NSAIDs inhibit both COX-1 and COX-2. Many of their side effects are related to the inhibition of COX-1. Conventional NSAIDs are known to cause peptic ulceration and gastric bleeding as well as acute renal failure. indd 38 2/13/2010 3:51:08 PM Chapter 4 • Pharmacology 39 Conventional NSAIDS include aspirin, diclofenac, etodolac, ibuprofen, indomethacin, ketoprofen, ketorolac, nabumetone, naproxen, oxaprozin, piroxicam, salicylsalicylic acid, sodium salicylate, and sulindac.

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