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Integrating Principles and Evidence

Integrating Principles and Evidence

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MP chondrodesis and stiletto flap for Clasped thumb

Courtesy: Scott Kozin, Dan Zlotolow, Shirner’s hospital for Children, USA Children with distal arthrogryposis often are born with fixed clasped thumbs (Metacarpophalangeal joint flexion contractures). Children with the more common Amyoplasia-type of Arthrogryposis Multiplex Congenital (AMC) rarely have clasped thumbs. Instead, they get flexion deformities at the carpometacarpal (CMC) joint of the thumb. The results […]

Medial Epicondyle Fracture Fixation in the Lateral Decubitus Position

Courtesy: Scott Kozin, Dan Zlotolow, Shirner’s hospital for Children, USA   Medial Epicondyle Fracture Fixation (Pediatric) – Stepwise Approach 1. Indications for Surgery Absolute / Strong Indications Fragment incarcerated in the joint Associated elbow dislocation Ulnar nerve symptoms Relative Indications Displacement >5 mm (controversial threshold) Elbow instability (valgus instability) High-demand patients: Throwing athletes Weight-bearing upper […]

Thumb Reorientation Osteotomy for thumb-in-palm deformity

Courtesy: Scott Kozin, Dan Zlotolow, Shirner’s hospital for Children, USA Children with Amyoplasia often suffer from limited hand use due to a thumb-in-palm deformity. The thumb is underpronated and flexed at the carpometacarpal (basal) joint. The thumb reorientation osteotomy corrects all aspects of the apposition of the thumb by pronating, extending, and abducting the thumb […]

Partial Pectoralis Major Flexorplasty for Amyoplasia

Courtesy: Scott Kozin, Dan Zlotolow, Shirner’s hospital for Children, USA The partial pectoralis major flexorplasty muscle transfer is the best option for providing elbow flexion to patients with Amyoplasia who lack a latissimus dorsi.