Sunday 10 October 2021

Breaking News: FUNNY BONES, fragment #1 (upper limb fractures)

CURRENT CONTENTS:
Background reading: "The Orthopedic Surgeon".
Fractured wrist (distal radius)
Scaphoid fracture
Anatomic snuffbox
Hook of the hamate
Olecranon ('funny bone')
Bone alignment
Heterotopic Ossification
(for continuation, see the link below)


BACKGROUND READING To start, let's reconsider a verse that first appeared on our blogpost "Doctors and their Practices". You can get more information on this topic here:
Authors' Note: 
orthopod: a casual name for the orthopedic surgeon (surgical bone specialist).  For many sites in the upper and lower limbs where trauma has resulted in fracture with angulation or rotation of the fragments, surgical treatment ('ORIF', or Open Reduction, Internal Fixation) has become the standard of treatment. 


Authors' Note: Modern orthopedic treatment of displaced limb fractures often attains the aims of stability and appropriate alignment through the surgical technique of internal fixation. Injured limbs have then undergone the dual trauma of both the original injury and the surgical correction. But, with all the parts back in place and correctly aligned, the patient can work with a physiotherapist to regain range-of-motion, muscle agility and strength


Authors' Note: Injuries to the metacarpal bones, such as knuckle fractures, are most common in injuries occurring with the closed fist, e.g. a punch thrown in a fistfight. In fact, an isolated fracture of the head of the fifth ('pinky'-side) metacarpal is known as a boxer's fracture. 
  On the other hand, fractures of the wrist (including the distal ends of the radial and ulnar bones of the forearm and eight intrinsic small carpal bones) are most commonly caused by a fall on the outstretched hand. Of all of these, fractures of the distal radius, sustained when attempting to break a fall, are by far the most common.


Authors' Note:
AVN: medical initialism for avascular necrosis, lethal damage to bone tissue resulting from traumatic interruption of its blood supply; the scaphoid bone of the wrist is particularly susceptible. The human skeleton has two boat-shaped small bones, one each in the ankle (tarsal) and wrist (carpal) areas. The Latin-derived term navicular ('boat-like'), is applied to either bone, whereas its Greek-derived analogue scaphoid, particularly favored in recent decades, is applied only to the wrist bone. How did Eric know that it was his scaphoid that he had fractured? See the verse anatomical snuffbox.





Authors' Note: The hamate bone, one of eight small bones of the human wrist, has a prominent hook, or hamulus, that provides some protection to the ulnar nerve as it proceeds down the arm to supply the fourth and fifth fingers. A 'hairline fracture' of this bony process (outcropping), not an uncommon injury in golfers, baseball players and hockey slap-shooters, may result in continuing pain. Frequently, the injury is not detected on initial x-rays, but may show up on computed tomography (CT), a bone scan, or on follow-up wrist X-rays.



                                                                                verse finally accepted April 2023, #112902 
Authors' Note:

funner: a neologism for 'fun-seeker', as used here; also, a disputed equivalent to the comparative expression 'more fun’

  The olecranon is the boney process (extension) of the forearm's ulna that extends into the elbow joint. Fractures of the olecranon are moderately common, due to direct trauma (fall on the elbow), but even more so due to indirect trauma (transmission of intense force with a fall on the outstretched hand). Owing to the proximity of the ulnar nerve, a broken funny bone may be associated with numbness and tingling extending into the fingers.

  Such injuries have bedevilled joggers and elite athletes, but recently have become more common with the popularity of personal electric transport devices. Surgical treatment is generally required for these fractures that often have displaced bone fragments. 



Authors' Note: Modern orthopedic treatment of displaced limb fractures often attains the aims of stability and appropriate alignment through the surgical technique of internal fixation. Injured limbs have then undergone the dual trauma of both the original injury and the surgical correction. But, with all the parts back in place and correctly aligned, the patient can work with a physiotherapist to regain range-of-motion, muscle agility and strength. 


Authors' Note: 

 (HET-uhr-oh-top-ic, as here, or het-uhr-oh-TOP-ic)

      Usually asymptomatic, new bone formation in extra-skeletal sites seems to occur after physical or surgical trauma, particularly in the lower limbs following joint replacement. Occasionally, within several weeks after the inciting episode, tenderness and swelling near major joints may occur, needing to be differentiated from venous blockage, and requiring bone scanning for detection, as initial radiographs may be negative; this variant syndrome is known as myositis ossificans. Rarely, in progressive cases, surgery is eventually required to allow mobility at affected joints.

Part #2 of this collection of illustrated poems will feature fractures of the trunk and lower limb (leg). The editors apologize for the long wait, but the good news in 2022 is that this collection is now available! Click HERE
Here's a LIST OF LINKS to collections of intriguing poems (over 160 of these!) on medical/dental topics that can now be found on various posts. 

DIRECTION FOR WEB-TRAVELLERS: 
To resume daily titillations on our blog "Daily Illustrated Nonsense", click HERE. Once you arrive, you can select your time frame of interest from the calendar-based listings in the righthand margin, and check the daily offerings for any month in the years 2020 to the present. (As of September 2022, there are 1000 entries available on the Daily blog, and most of these are also presented here on "Edifying Nonsense" in topic-based collections.)

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