Wrist Instability and Fusion course Learning Objectives Slides - - PowerPoint PPT Presentation

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The Birmingham Hand Centre Wrist Instability and Fusion course Learning Objectives Slides Dorsal Approach Objectives Midline incision over 4 th EC 1. 2. Elevate ER over EC3+4 3. Retract tendons, dissect onto dorsal ligs 4. Open proximal

SLIDE 1

The Birmingham Hand Centre

Wrist Instability and Fusion course

Learning Objectives Slides

SLIDE 2

Wrist Instability & Fusion Course Coventry, June 2015

Dorsal Approach Objectives

1. Midline incision over 4th EC 2. Elevate ER over EC3+4 3. Retract tendons, dissect onto dorsal ligs 4. Open proximal ½ of Berger incision

SLIDE 3

Wrist Instability & Fusion Course Coventry, June 2015

SLIL Repair Objectives

1. K-wire into Scaphoid & Lunate 2. Rotate K-wires together to correct DISI 3. Insert anchor opposite ligament 4. Make radial incision 5. Site Sc-C and Sc-L wires (XR) 6. Suture and tie anchor

SLIDE 4

Wrist Instability & Fusion Course Coventry, June 2015

SLIL Reconstruction Objectives

1. Midline incision & Prox ½ Berger 2. K-wire scaphoid dorsal ridge to tubercle 3. Ream over wire 2.7/3.5 4. Harvest 8cm Ulna 1/3 FCR 5. Pass FCR though scaphoid then DRC 6. Correct DISI & Kwire (skip this step) 7. Mitek lunate & suture FCR

DRC FCR SLIP FCR FCR SLIP

Radius

Sc Tm Td

.

SLIDE 5

Wrist Instability & Fusion Course Coventry, June 2015

STT Fusion Objectives

Dorsal approach
Expose EC 2-3
Retractor on ECRL/B
Lift fat pad ulna ward
Expose STT joint
Stabilise & Ream
Decorticate and graft (skip)
Insert plate & XR
+/- styloidectomy

SLIDE 6

Wrist Instability & Fusion Course Coventry, June 2015

4 Corner Fusion Objectives

Complete Berger
Remove Scaphoid
Decorticate joints
C-L, C-H, L-Tq & Tq-H
Stabilising K-wire
Ream & ROM
Distal radius graft
Insert plate & XR