Surgical management of hand, wrist and elbow injuries

Surgical management of hand, wrist and elbow injuries6th Singapore Sports Imaging Seminar - Imaging of Hand, Wrist and Elbow injuries 25 February 2017Mr Vaikunthan RajaratnamSenior Consultant Hand SurgeonMBBS(Mal),AM(Mal),FRCS(Ed),FRCS(Glasg),FICS(USA),Dip Hand Surgery(Eur), Dip MedEd(Dundee), MIDT Dist. (OUM), MBA(USA), FHEA(UK), FFST(Ed)vaikunthan@gmail.com

Learning PointsMost P3 fractures uniteORIF are possible with good resultsCan be done under LAGood exposure with J incision under the lateral nail fold

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10

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LeddyPacker TypeIII

Complex intra articular fractures

13

Results

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Buttress plating for dorsal unstable fracture-dislocations of the proximal interphalangeal joint Talvinder Singh, Ayaz Lakdawala, Dominic Power, Vaikunthan Rajaratnam, Michael Craigen

Buttress Plating using Cage Plate: Technique

Conclusion

Allows small fragments to be buttressed and held reduced.

Joint congruity can be maintained.

Early active and passive mobilisation can be achieved.

Can be applied to almost all types of dorsal fracture dislocations.

Range of motion same or better than most other techniques.

PIPJ Arthroplasty

Percutaneous

Open & graft

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Collateral Ligament Repair

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09/02/2017, 09:45 - Messages you send to this chat and calls are now secured with end-to-end encryption. Tap for more info.09/02/2017, 09:45 - Suresh: Paid advance to Paul Koh for Interior Deco! 17/02/2017, 10:23 - Suresh: Skiing was good, I was trying to do a ski jump,17/02/2017, 10:23 - Suresh: IMG-20170217-WA0003.jpg (file attached)17/02/2017, 10:24 - Suresh: Left mcpj painful, what to do?17/02/2017, 10:24 - vaikunthan: Come Down to dsot17/02/2017, 10:24 - vaikunthan: Game keepers thumb17/02/2017, 10:24 - Suresh: Still in Japan17/02/2017, 10:25 - vaikunthan: Ok when you back17/02/2017, 10:25 - Suresh: Arriving Sunday17/02/2017, 10:25 - vaikunthan: Monday in dsot17/02/2017, 10:25 - Suresh: Okay 17/02/2017, 10:25 - Suresh: Thanks20/02/2017, 09:10 - Suresh: S7087991C20/02/2017, 09:47 - Suresh: IMG-20170220-WA0003.jpg (file attached)20/02/2017, 09:48 - vaikunthan: Avulsion fracture20/02/2017, 09:48 - vaikunthan: Surgery bro20/02/2017, 15:43 - vaikunthan: IMG-20170220-WA0018.jpg (file attached)Instability under ga20/02/2017, 15:44 - vaikunthan: IMG-20170220-WA0019.jpg (file attached)UCL avulsed from proximal phalanx20/02/2017, 15:46 - vaikunthan: IMG-20170220-WA0020.jpg (file attached)Bone anchor with sutures in proximal phalanx20/02/2017, 15:47 - vaikunthan: IMG-20170220-WA0021.jpg (file attached)Sutures tied over UCL20/02/2017, 15:48 - vaikunthan: IMG-20170220-WA0022.jpg (file attached)Stability post repair under stress20/02/2017, 18:22 - Suresh: Thanks Boss20/02/2017, 18:22 - Suresh: You are the best20/02/2017, 18:22 - vaikunthan: How you feeling20/02/2017, 18:26 - Suresh: Okay20/02/2017, 18:37 - Suresh: Almost no pain now 20/02/2017, 18:37 - vaikunthan: Great anesthetics21/02/2017, 13:03 - Suresh: https://youtu.be/na1V6FrwHOM23/02/2017, 19:22 - Suresh: IMG-20170223-WA0021.jpg (file attached)23/02/2017, 20:05 - vaikunthan: This may be why Teachers retire early or turn to drinking: the following questions were in a (UK) GED (grade 12 equivalent) examination (they are genuine answers):

Q. What is a turbine?A. Something an Arab or Sheik wears on his head. Once an Arab boy reaches puberty, he removes his diaper and wraps it around his head.

Q. How is dew formed?A. The sun shines down on the leaves and makes them perspire.

Q. In a democratic society, how important are elections?A. Very important. Sex can only happen when a male gets an election.

Q. What are steroids?A. Things for keeping carpets still on the stairs.

Q. What happens to your body as you age?A. When you get old, so do your bowels and you get intercontinental.

Q. What happens to a boy when he reaches puberty?A. He says goodbye to his boyhood and looks forward to his adultery. I am

Q. Name a major disease associated with cigarettes.A. Premature death.

Q. What is artificial insemination?A. When the farmer does it to the bull instead of the cow.

Q. How can you delay milk turning sour?A. Keep it in the cow

Q. How are the main 20 parts of the body categorized (e.g. the abdomen)?A. The body is consisted into 3 parts - the brainium, the borax and the abdominal cavity. The brainium contains the brain, the borax contains the heart and lungs and the abdominal cavity contains the 5 bowels... A,E,I,O,U

Q. What is the fibula?A. A small lie.

Q. What does 'varicose' mean?A. Nearby.

Q. What is the most common form of birth control?A. Most people prevent contraception by wearing a condominium

Q. Give the meaning of the term 'Caesarean section.'A. The caesarean section is a district in Rome.

Q. What is a seizure?A. A Roman Emperor (Julius Seizure, I came, I saw, I conked out.)

Q. What is a terminal illness?A. When you are sick at the airport

Q. Name the four seasons?A. Salt, pepper, mustard and vinegar.

AND THEY CAN VOTE NOW? 23/02/2017, 20:08 - Suresh: 23/02/2017, 21:35 - vaikunthan: An old Italian Mafia Don is dying and he called his grandson to his bed

"Grandson I wanta you to listen to me. I wanta you to take mya 45 automatic pistol, so you will always remember me."

"But grandpa I really don't like guns, how about you leaving me your Rolex watch instead", answered the grandson

"You lisina to me, some day you goin a be runna da bussiness, you goina have a beautiful wife, lotsa money, a biga home and maybe a couple odd bambino, some day you goina come hom and maybe finda you wife in bed with another man. Whata you gonna do then?"

Pointa to you watch and say, "TIMES UP"?23/02/2017, 22:27 - Suresh: