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

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 ½ of Berger incision 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 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 Tm Td Sc FCR SLIP Radius FCR FCR SLIP DRC . Wrist Instability & Fusion Course Coventry, June 2015

STT Fusion Objectives • Expose STT joint • Dorsal approach • Stabilise & Ream • Expose EC 2-3 • Decorticate and graft (skip) • Retractor on ECRL/B • Insert plate & XR • Lift fat pad ulna ward • +/- styloidectomy Wrist Instability & Fusion Course Coventry, June 2015

4 Corner Fusion Objectives • Complete Berger • Stabilising K-wire • Remove Scaphoid • Ream & ROM • Decorticate joints • Distal radius graft • C-L, C-H, L-Tq & Tq-H • Insert plate & XR Wrist Instability & Fusion Course Coventry, June 2015