Surgical Treatment (RCH)

The surgery was frist performed in 1974 by orthopedic surgen Dr. Frank Jobe, was named after the first baseball player to undergo this surgery; Tommy John was the major league pitcher whose record of 288 career victories ranks seventh all time. This procedure is made to help a person with UCL also known as ulnar collateral ligament also known as the elbow. The procedure is common among collegiate and professional athletes in several sport, but most in baesball. The procedure goes as follow, the patient’s arm is open up aroung the elbow. Holes to accommodate a new tendon are drilled in the ulna and humerus ones of the elbow. The doctor then gets a tendon such as the palmaris tendon from the forearm of the same or opposite elbow, the patellar tendon, or a cadeveric tendon. Which are ten woven in a figure eight pattern through the holes and anchored. The ulnar nevre is usually moved to prevent pain as scar tissue can appy pressure to the nerve.

Some of the injuries that can occur in the hand are Cubital Tunnel Syndrome and Carpal Tunnel Syndrome along with many more. Cubital Tunnel Syndrome causes pain or numbness in the ring and little fingers, but could also go to the arm (Types of RSI, 2010). Occurs when the ulnar nerve is pinched along the elbow’s edge (“funny bone”), and has tingling or painful feeling (Types of RSI, 2010). Cubital Tunnel Syndrome can be treated by avoiding putting pressure on the “funny bone” (Types of RSI, 2010). Cubital could lead to surgery if the nerve needs to be relieved. Carpal Tunnel Syndrome is similar to Cubital but occurs in the three first fingers. A major nerve is compressed which passes over the carpal bones through the front of the wrist (ASSH, 2015). When the nerve is compressed it causes painful, tingling and numbness in the first three fingers (ASSH, 2015). Carpal Tunnel Syndrome can be treated without surgery by changing the patterns of hand use and/or wearing wrist splints at night (ASSH, 2015). If severe then surgery can take place to make the nerve have more

Cubital tunnel syndrome is a condition that affects the ulnar nerve in the arm. The ulnar nerve runs along the medial portion of the arm, behind the medial epicondyle of the humerus, and down into the hand where it innervates the fifth digit and the medial half of the fourth digit, as well as controlling most of the little muscles for fine movement in the hand and larger muscles in the forearm used for grip strength (The American Center for Spine and Neurosurgery [ACSN], 2015). The ulnar nerve can become compressed in several locations as it travels down the arm from the neck, such as beneath the collarbone, at the elbow, or at the wrist. When this compression occurs at the elbow, is referred to as cubital tunnel syndrome. The ulnar nerve at the elbow is commonly referred to as your “funny bone”, but those who have had the pleasure of hitting it know that it is not funny.

As the ASC continued to grow in response to the increasing number of members, the procedures that were internalized not only increased, and were more complex. During that that time of expansion, I help strengthen the collaboration among ASC leadership and personnel to ensure that all surgical initiative is a success. In my role as perioperative educator, I spearheaded the development, implementation and evaluation of training and education via clinical simulation of procedures internalized in the ASC in 2015.

The patient is a 74-year-old gentleman who was in elective surgical case on 10/10/2016 preoperative diagnosis spinal stenosis L4-L5 with facet cyst of the left side. The postoperative diagnosis was the same, however the patient underwent a decompressive lumbar laminectomy L4-L5 with repair of an incidental duratoma. The patient is known to have coronary artery disease, hypertension, diabetes mellitus, and dyslipidemia. The patient has undergone significant conservative care including epidurals but has been disabled by the pain. The fact that had an incidental duratoma the patient required acute inpatient admission to be placed on complete bedrest and to be observed for a spinal fluid leak. The patient was complete bedrest, flattened bed

The extensiveness of treatment for an ABC depends on the location, severity, and progression of the disease. Although the treatment spectrum ranges from minimally invasive to more invasive procedures, the standard of therapy is to resect the lesion and prevent it from returning in the future (Dhanasekaraprabu et al., 2013). However, complete resection is not always possible. For instance, it is difficult to completely remove lesion tissue from the proximal region of the metaphysis, and incomplete removal of the tissue leaves the patient susceptible to the development of another lesion at the site (Dormans et al., 2004). Cysts located at the proximal region of the femur are especially at an increased risk of recurrence (Mankin et al. 2005).

In December of 2013, Caroline Carcerano went to Tufts Medical Center in Boston, Massachusetts to have done what her surgeon said would be a “brief” procedure to relieve her lingering back pain. This was not the case and two days later, Carcerano was dead. Carcerano’s surgery was supposed to be a simple procedure where surgeons were going to insert a pump under her skin so that medication could get into her spine quickly and help alleviate her lingering pain. Carcerano has previously fallen and broken several vertebrae, but even after fusing the vertebra together, the pain, along with leg spasms and weakened bones, was still a chronic issue.

The symptoms of pain, numbness, tingling or weakness are the result of the inflammatory process within the carpal tunnel that leads to compression of the median nerve. The compression and resulting impingement of the median nerve results in ischemia. The ischemia leads to the symptoms of numbness, tingling, pain and weakness of the hand and/or forearm. The FNP should inspect the wrist and hands of the patient with symptoms of CTS, looking for skin color and temperature changes, deformities and muscle wasting. The active and passive range of motion (ROM) of the neck, shoulders, elbows, wrists and fingers should be accessed. Muscle strength should be assessed at the shoulder, elbow, wrist and fingers. Spurling’s test for cervical radiculopathy should be performed. A plain x-ray can be ordered by the FNP if ROM of the wrist is limited. The FNP should also assess capillary refill of the fingers (Dunphy, Winland-Brown, Porter, & Thomas,

The extensor tendons are muscles that allow your fingers and thumbs to extend. The location of this muscle is right under the skin at the back of your finger. The location of the muscle can cause problems because if the finger is bent back to the palm the muscle can tear. The most common name for this injury is baseball finger also known as mallet finger. When this tendon is damaged the top of your finger

2a), the distal radius shortening osteotomy technique consisted of placing an anterior distal radius plate (Initial-R®, Newclip Technics ™, Goulaine, France) upstream of the dividing line of the anterior cortex of the distal radius, then installing all the epiphyseal screws, removing the screws and the plate, performing a metaphyseal osteotomy of the distal radius with the oscillating saw d A width of 2 saw blades to simulate the shortening, to replace the plate and the epiphyseal screws, and finally to put in place all the diaphyseal screws. At all stages, learners were free to use the

DOI: 3/22/2012. Patient is a 57-year-old female office coordinator who incurred a work-related injury due to repetitive computer business. As per OMNI, the patient was seen and examined for left elbow radial tunnel syndrome. He is status post left elbow surgeries on 01/16/13, 07/11/14 and 2/23/2015. He is also status post left open cubital tunnel release with anterior ulnar release on 12/02/15. Patient was evaluated by Orthopedic Panel QME Dr. Sherman on 01/06/15 and he indicated that the IW has 12 % whole person impairment. Patient has achieved her maximum medical improvement and that no further surgery, physical therapy, or treatments to the neck or left upper extremity should be administered.

Olecranon bursa swelling and thickness is noted without pain or effusion. There is tenderness over the ulnar aspect of the wrist. Strength is 4+/5 to the supraspinatus, internal/external rotators and deltoid. Elbow strength testing is positive for pain with resisted wrist extension and pain with resisted long finger extension. Wrist strength flexion/extension is weakness is noted at 4+/5.

There was decreased range of motion and positive Spurling’s. Trigger points were noted over the bilateral trapezius, suprascapularis, and dullness to pinprick to both hands. There was weakness to grip 1st and 2nd digit opposition, and 1st and 5th digit opposition bilaterally. Deep tendon decreased 1/4 bilateral triceps/biceps.

Workers compensation insurance companies have routinely faced the issue of ‘chronic and co-morbid’ claims when the validity of an employee’s claim is addressed. The ‘chronic and co-morbid’ issue looked at situations where an employee suffered an on-the-job injury while also having a pre-existing medical condition in place. Examples of pre-existing conditions included diabetes, smoking and obesity. Insurance claims adjusters, employers, medical practitioners and other relevant individuals were held to the understanding that employees are taken in the condition that employers found them.

I concur with your statement pertaining to the implementation of non-traditional treatment methods within a treatment plan. I also agree with the growing need for alternative therapeutic treatment, theses second opinion treatment options have been very beneficial to the client's overall lifestyle especially for those patients seeking antidepressant regiments such as acupuncture. With a diverse in cultures patients seeking mental health services alternative methods are culturally diverse, eliminates the medication regiment most tradition treatment methods implement, and serves as a dual purpose of collaborating both mental and physical aspects of treatment. Wilson, White, and Hamilton (2013, p. 149) specified that, “Many clients of general