Muscular trauma

[Ronald Simon]

Would try and anatomically repair the muscles. The muscle will not hold 
suture well so i would concentrate on suturing together tendons and 
sheaths where possible. That should approximate muscle bellies pretty 
well. Would then splint the arm for a couple of days and then start 
passive ROM and advance over the next 1-2 weeks.
ron simon

Dean Lutrin wrote:

>Dear listmembers
>
>Something I have thought about but not explored properly... I did a case
>over the weekend of a 50 yr old male who was stabbed over his biceps with a
>beer bottle. He had a 15-20 laceration over the medial bicep area and a
>small laceration at the back as well. The glass had cut the brachial artery
>and the median nerve as well as a whole lot of muscles on the way. The
>arterial and nerve repair went just fine but (as before) I was not quite
>sure what to do with the muscle
>
>Should one - 
>1. attempt a proper anatomic approximation of each muscle?
>2. suture the muscle itself or only the sheath around each named muscle?
>3. Not really bother with too much repair and just 'tack it together?'
>
>Eagerly anticipating your replies...
>
>Cheers
>
>Dean Lutrin
>JHB,SA
>
>--
>trauma-list : TRAUMA.ORG
>To change your settings or unsubscribe visit:
>http://www.trauma.org/traumalist.html
>
>  
>

-- 
Ronald Simon, MD
Dir of Trauma/SICU
Jacobi Medical Center, Rm 1213
Bronx, NY 10461
718 918 5598 phone
718 918 5593 fax