Exploration of radial nerve and lateral cutaneous nerve of forearm and DCP implant removal
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Learn the Exploration of radial nerve and lateral cutaneous nerve of forearm and DCP implant removal surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Exploration of radial nerve and lateral cutaneous nerve of forearm and DCP implant removal surgical procedure.
Any surgical procedure puts peripheral nerves at risk of injury. This may occur during the surgical approach, or by retractors and other instrumentation used during the procedure. Nerves may become entrapped or tethered around implants or in the surgical scar.
Patients typically present with signs and symptoms of nerve injury. Involvement of a sensory nerve, as in the following case, may be associated with pain, parasthaesia and reduced sensation. Left untreated, signs of chronicity may develop with central sensitisation and upregulation of pain pathways including psychological sequelae.
Early diagnosis and appropriate intervention in these patients can be rewarding.
The following technique describes my approach to the diagnosis and surgical management of a patient who was referred following injuries to the radial nerve and lateral cutaneous nerve of forearm during open reduction and internal fixation of the radius and ulna.
The decision about whether to proceed to surgical exploration should be made by a surgeon with experience in treating peripheral nerve disorders. It is largely based upon the history and clinical findings but may be aided by neurophysiology, radiology and physiotherapy. The use of targeted peripheral nerve blocks can be invaluable.
When exploring peripheral nerves in such a scenario, the peripheral nerve surgeon should be prepared for all eventualities, including the potential need to excise and graft a neuroma and in the use of adjuncts including nerve allograft and nerve wraps.
Readers will also find of interest the following published techniques on OrthOracle, which explain some of the additional techniques referred to in this section.
Author:Tahseen Chaudhry, FRCS Orth, Consultant in hand and peripheral nerve surgery
Institution: University Hospital Birmingham, Birmingham, UK.
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- The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
- You’ll need to tick the box to confirm this has been done and can do this immediately if you have already read the op tech.
- The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
- There are four possible answers of which one is correct (or on occasion more correct) than the others.
- There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
- The course is completed once all the lessons are read and quizzes submitted and passed.
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The pass mark is 75%.
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- Once these have been read you can re-do just the questions you failed on.
- Once you have passed the quiz you can return at a future stage & resit .
- Operation Quiz – 1 CPD point
- Surgical steps Quiz – 1/4 CPD point
- Implants Quiz – 1/4 CPD point
- Problem case Quiz – 1/2 CPD point
One CPD point equates to one hour of academic activity
Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.
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