Muscular trauma

[Dean Lutrin]

Ron, thanks for the reply - any certainty about the decision to splint just
for a couple of days? Do you not think that one needs to splint for quite a
bit longer before starting passive movements?

dean

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Ronald Simon
Sent: Monday, November 27, 2006 9:39 PM
To: Trauma & Critical Care mailing list
Subject: Re: Muscular trauma

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
>
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>

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


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