Hand injuries in children

A 4 year old child presents with a swollen middle finger which is slightly painful. Paronychia or infection of the skin around the nail is a common presentation in children. Sometimes this condition can be caused by a virus and mimics paronychial bacterial infection. It is known as a Herpetic Whitlow, caused by the herpes virus. Simple measures to begin with are to soak the affected finger in luke warm water with a dilute antiseptic such as betadine. If the swelling continues worsening, a doctors visit will determine if the infection needs surgical drainage with intravenous antibiotic treatment.

Finger Injuries in Children

Little kids often get their fingers stuck in doors, gym equipment or jammed in furniture. Sometimes these injuries may result in fractures of growing bones. As in this case were a little girl got her finger caught under a coffee table. The Xrays show a fracture of the distal phalanx of the finger. The photograph shows an open wound of the nail bed. This constitutes an injury that needs to be cleaned in the operating room and the nailbed stitched. The finger will then be dressed and splinted for a couple of weeks. The importance of these injuries relates to an open injury which may if left untreated result in an infection risk to the bone and more importantly the growth plate.

Brachial Plexus Injury

A young 24 year old man sustained a massive injury from a motorbike accident leaving him without the use of his left arm. He was referred to us for possible reconstruction. The nerve roots supplying his shoulder, elbow and part of his arm were avulsed from the spinal cord in the neck. In the video, note the left hand can move but the shoulder and elbow of the left arm do not move. The intraoperative photographs show an amazing view of the C7 spinal root where the nerve has been pulled from. The second and third pics show the nerve anatomy in the arm which is dissected so as to connect functioning nerves to non functioning ones, a process called nerve transfers. In this way we allow muscles i

Intra-Operative View of the Median Nerve

Intraoperative view of the median nerve in the carpal tunnel after the tight overlying fibrous tissue has been released. The red streak is a blood vessel on the nerve. The nerve itself is the lighter structure.

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