Alphonsus Chong's Personal Wiki md

md:2020assh_trauma

Anonymous (anonymous@undisclosed.example.com) — 2020-08-12T04:32:08+00:00

ASSH 2020 Precourse Hari - bridging long nerve gaps * nerve grafts - kids - good sensation, sometimes motor * running the nerve * combined nerve - do to both median and ulnar nerve * extensor only to MCPJ Safa: Composite flaps * one or more flaps?

md:abductor_hallucis

Anonymous (anonymous@undisclosed.example.com) — 2021-05-17T03:03:55+00:00

Abductor Hallucis Muscle Anatomy * Origin: Calcaneal tuberosity * Insertion: Base of great toe, proximal phalanx * Action: Abduct great toe * Innervation: Medial plantar nerve * Arterial Supply: Medial plantar artery See also * Abductor Hallucis Flap Meta

md:abductor_hallucis_flap

Anonymous (anonymous@undisclosed.example.com) — 2021-05-17T03:42:52+00:00

Abductor Hallucis Muscle Flap Key Points Supplied segmentally by medial plantar artery, and can be distally based. This is useful as the proximal part is muscular and can be used to cover various defects. Schwabeggar describes dividing the medial plantar artery proximally (it is smaller and less important for the foot than lateral plantar artery). Clamp and check flap and foot circulation before dividing it.

md:amputation

Anonymous (anonymous@undisclosed.example.com) — 2020-08-11T08:57:16+00:00

Amputation Injuries [Phantom hand and Stump pain] See also * chevrier1956

md:articularcartilage

Anonymous (anonymous@undisclosed.example.com) — 2020-04-17T06:02:57+00:00

Introduction Cells (chondrocytes) - 5% ---------- ECM ---------- - Fibers * Collagen Type II (10-20%) * Other collagens IX, XI, VI, X -Elastins Ground substance ---------- - H20 (75%) - Proteoglycans and glycosaminoglycans * aggrecan

md:assessment_g_w

Anonymous (anonymous@undisclosed.example.com) — 2020-08-04T22:03:21+00:00

Gartland and Werley Score * for distal radius fractures * demerit system * based on AROM * normal: 45 DF, 30 PF, 15 UD, 15RD, 50 PS * quite a low bar - may an issue with the young See also * Assessment Scores History * 2017-04-27 created on index card

md:carpal_tunnel_syndrome

Anonymous (anonymous@undisclosed.example.com) — 2020-09-02T05:24:04+00:00

Carpal Tunnel Syndrome Physical findings Wasting * thenars, sometimes only APB Sensory loss * 'palmar triangle' and sparing reasons - not served by PCBMN or PCMBN deep to retinaculum Tinel's sign * Mark carpal tunnel area * Used middle / IF-MF / tendon tapper to tap over the area

md:cerebralpalsy

Anonymous (anonymous@undisclosed.example.com) — 2020-03-24T02:34:20+00:00

Cerebral Palsy Some children exhibit hyperkinetic movements. These are excessive or unwanted movements. There are different types of hyperkinetic movements: dystonia, chorea, athetosis, tremor. (see this classification). Differentiating dystonia from chorea: *

md:dequervains

Anonymous (anonymous@undisclosed.example.com) — 2020-03-24T02:34:20+00:00

De Quervain's Tenosynovitis Clinical Assessment Surgery Pulley Reconstruction * Ὦ pulley reconstruction

md:distal_radius_fractures

Anonymous (anonymous@undisclosed.example.com) — 2020-08-31T13:00:45+00:00

Distal Radius Fractures Adult DR fx * meta: 2017-02-26 * importance - absolute number, less known " “The incidence of distal radius fracture in the adult population is significantly less than in other age groups. As a result of this lower incidence and apparently random occurrence of fracture in this lower risk group, little data is available on this population regarding epidemiology of these injuries

md:dupuytrens

Anonymous (anonymous@undisclosed.example.com) — 2020-03-24T23:57:42+00:00

PIPJ in Dupuytren's Disease (Thurston) 2004-03-14 PIPJ: fingers > 45 deg flexion need secondary release (Ritchie JHSB 2004) Sources of contracture: * accessory collateral ligament * volar plate * checkrein ligament * transverse retinacular ligament

md:flexor_tendon

Anonymous (anonymous@undisclosed.example.com) — 2021-07-11T13:33:26+00:00

Flexor Tendon Repair and Healing Key Time Points * 1700s: John Hunter early work * 1940s?: Bunnell -- no man's land * 1967 ASSH Kleinert's paper (Singh 2015) -- clinical before experimental work Tendons and Ligaments in General * Structure and function (Leong 2019) - differences between the two may be semantic and degrees

md:flexor_tendon_adhesions

Anonymous (anonymous@undisclosed.example.com) — 2021-06-05T07:10:07+00:00

Preventing adhesions after flexor tendon repair Key points * Injury (including surgery) * breaches cell basement membrane * sparks inflammatory response * Interaction between inflammatory response, coagulation cascade, and angiogenesis

md:fracture_fixation

Anonymous (anonymous@undisclosed.example.com) — 2021-01-22T07:48:31+00:00

Fracture Fixation see Elements of Fracture Fixation meta * created 2021-01-22

md:genetherapy

Anonymous (anonymous@undisclosed.example.com) — 2021-06-22T01:39:44+00:00

Gene Therapy Abstract Gene therapy is at an inflection point. Recent successes in genetic medicine have paved the path for a broader second wave of therapies and laid the foundation for next-generation technologies. This comment summarizes recent advances and expectations for the near future.

md:gvhd

Anonymous (anonymous@undisclosed.example.com) — 2020-03-24T02:34:20+00:00

Hand Involvement in Graft vs Host Disease Nail involvement * < 50% * Nail severity not correlated with duration or severity of skin involvement * Reversibilty? * Prognosis: nails + edema + eosinophilia --> poor * DD: infection Neurologic and Vasculitis

md:hand_surgery_notes

Anonymous (anonymous@undisclosed.example.com) — 2021-10-15T13:50:42+00:00

dd Hand Surgery Notes Ideas * Intelligent Hand Trauma and Microsurgery * Distal Radius Fractures * Amputation Injuries * Replantation Surgery * Secondary Surgery after Extremity Trauma * Metacarpal Hand Wrist * Carpal Ligament Injuries Paediatric Hand * Polydactyly * Cerebral Palsy * Macrodactyly Tendon Injury and Conditions * Flexor Tendon Healing * Results of Flexor Tendon Repairs Nerve Conditions * Thoracic outlet syndrome * PIN/Radial nerve release …

md:handsurgerysg

Anonymous (anonymous@undisclosed.example.com) — 2020-03-24T02:34:20+00:00

md:hip_fractures

Anonymous (anonymous@undisclosed.example.com) — 2020-08-03T12:38:20+00:00

Hip fracture treatment Classification - Garden * 1 & 2 cancellous screws * 3 and above bipolar - Evans * Evans Jensen * unstable - lesser troch +/- greater troch -- unstable --> PFNA Pre- and post-x-rays - pelvis and lateral hip Post op x-rays - check hip enlocation - periprosthetic fracture - fixation

md:hrc2007

Anonymous (anonymous@undisclosed.example.com) — 2020-03-24T02:34:20+00:00

Hand Review Course 20007 Anatomy of hand (Lluch) * Ulnar styloid: distal continuation of olecranon * ECU: extensor or ulnar deviation dependent on wrist position Finger ROM arc different with or without intrinsic function The hand is not a specialized instrument (Lluch)

md:intelligent_hand

Anonymous (anonymous@undisclosed.example.com) — 2020-03-24T02:34:20+00:00

The Intelligent Hand & Plastic Brain 2007-03-14 * Increased hand activity >> increased sensory flow * plasticity - unmasking of existing synapses * making new synapses * influence of enriched environment on learning & effects of training

md:macrodactyly

Anonymous (anonymous@undisclosed.example.com) — 2020-03-24T02:34:20+00:00

Macrodactyly see my NUS wiki page for some basic information Surgical Treatment Ray Amputation * Middle ray amputation: ? transpose index finger * debulk palmar aspect Stopping Growth * Epiphysiodesis Reduction Surgery * Wedge/trapezoid osteotomy to make it straight

md:medicine

Anonymous (anonymous@undisclosed.example.com) — 2021-09-10T13:31:40+00:00

Medicine Orthopaedics * Lisfranc Injuries * Rotator Cuff Injuries Nutritional Deficiency * Vitamin B12 Deficiency Research Methodology * How to write a Systematic Review Others * Gene Therapy

md:metacarpal_hand

Anonymous (anonymous@undisclosed.example.com) — 2020-08-03T12:59:46+00:00

Metacarpal Hand Definition * classical - all 5 digit - “transverse hemiamputation” * but extended definition: e.g. normal thumb, SF, partial thumb and SF Non-micro options * Phalangization: web deepening, adductor proximal transposition, bone lengthening - interposition or end with flap

md:mri

Anonymous (anonymous@undisclosed.example.com) — 2020-03-24T02:34:20+00:00

Magnetic Resonance Imaging Source: * protons magnetic field rf energy --> transmit radiofrequency(rf) electromagnetic waves. * signal strength <-- electromagnetic microenvironment of the individual protons and their movement within this environment

md:nf1

Anonymous (anonymous@undisclosed.example.com) — 2020-09-26T06:38:50+00:00

Neurofibromatosis NF 1 NF1 vs NF2 genetics * NF1 more common -- 1:3000 * both AD * NF1: 17q11.2 ~ 50% de novo, neurofibromin * NF1 * loss of function in NF1 genetics * diagnostic criteria: cafe au-lait spots, axillary/inguinal freckling, Lishch nodules, NF, osseous lesion (sphenoid dysplasia, cortical thining of long bones), astrocytomas, 1st deg relative with NF1

md:pollicization

Anonymous (anonymous@undisclosed.example.com) — 2020-08-26T03:45:28+00:00

Pollicization PLAS 2019 T2H 3B - vs IV/V 2 pt 1972 Kellikan p.861 has an interesting historical perspective & pre- Buck Gramcko description of pollicization

md:polydactyly

Anonymous (anonymous@undisclosed.example.com) — 2020-03-24T02:34:20+00:00

Polydactyly Outcomes

md:replantation

Anonymous (anonymous@undisclosed.example.com) — 2020-03-24T02:34:20+00:00

Replantation Surgery * Volume appears to make a difference. This paper showed centers doing more than 20 thumb replantations a year had a higher success rate than those doing 10 or less (85 vs 76%).

md:rom

Anonymous (anonymous@undisclosed.example.com) — 2020-03-24T08:58:29+00:00

Range-of-Motion * See Scott2019 for remote assessment of wrist AROM

md:secondary_surgery_trauma

Anonymous (anonymous@undisclosed.example.com) — 2020-08-11T09:27:12+00:00

Secondary Surgery after Extremity Trauma Introduction Classification of secondary surgery from rajasabapathy2013 * repair of structures not primarily repaired * promote healing/enhance function e.g. malunion, nonunion, tenolysis * enhance function - arthrodesis, bone lengthening, tendon transfers etc.

md:thoracicoutletsyndrome

Anonymous (anonymous@undisclosed.example.com) — 2020-03-24T02:34:20+00:00

Thoracic Outlet Syndrome Thoracic outlet syndrome surgical management William H. Pearce Precourse Notes Anatomy * shoulder - tripod on thorax * scalene muscles * vessels - fixed at posterior circumflex humeral and proximal subclavian * nerves - brachial plexus

md:trauma_pollicization

Anonymous (anonymous@undisclosed.example.com) — 2020-08-25T10:19:05+00:00

Pollicization Take home messages * prefer ring if using non-traumatized digit: web not too wide, tendon tension * different ways to deal with webspace * any finger possible - little finger least preferred * traumatic first Thumb needs *

md:vitb12deficiency

Anonymous (anonymous@undisclosed.example.com) — 2020-11-29T00:34:57+00:00

Vitamin B12 * aka cobalamin * important for cellular metabolism - DNA synthesis, methylation; mitochondria metabolism * classical pernicious anaemia with megaloblastic anemia uncommon * exact definition of deficiency contentious .. incidences 2.5 - 25%

md:workclassification

Anonymous (anonymous@undisclosed.example.com) — 2020-12-06T02:52:22+00:00

Work Classification SEDENTARY, LIGHT, MEDIUM AND HEAVY WORK–WHAT DOES IT MEAN? Posted by Louis B. Lusk | Feb 21, 2012 | 0 Comments SEDENTARY, LIGHT, MEDIUM AND HEAVY WORK–WHAT DOES IT MEAN? The Social Security Administration (SSA) classifies work into five different levels: sedentary, light, medium, heavy, and very heavy. These classification levels come from the Dictionary of Occupational Titles (DOT) and are based on the amount of physical exertion that the work requires. When you apply for …