Muscular trauma

[Ronald Simon]

Passive movt should not be a problem. It is the active movt that would 
leave me worried that the muscle would tear and separate.
ron

Dean Lutrin wrote:

>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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>>
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