Specialists

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Surgery for Repair of Webbed Fingers or Toes

Repair of webbed fingers or toes is surgery to fix webbing of the toes, fingers, or both. The middle and ring fingers or the second and third toes are most often affected.

Description

This procedure is done using general anesthesia. The patient is asleep and pain-free.

Dr Kevin Yip will mark the areas of […]

Clinical Evaluation-Physical Findings

Distinguishing anterior shoulder pain caused by biceps tendon disorders as opposed to subacromial impingement can be difficult, as these two entities usually co-exist. Although there are some exam maneuvers, which attempt to isolate the biceps tendon, there is still a fair amount of overlap and the definitive diagnosis of isolated biceps tendon pathology is extremely […]

Physical Exam

A thorough physical examination should include careful evaluation of the cervical spine to rule out a neurologic problem such as a herniated cervical disc that can mimic shoulder pathology. This is especially true if a patient presents with bilateral symptoms.

If subacromial impingement is suspected, specific tests should be used and documented. The Neer and […]

Passive supination

Positioning.

The subject stands with the arm hanging and the elbow bent to 90°. The examiner stands in front of the subject. Both hands encircle the distal part of the forearm in such a way that the heel of the ipsilateral hand is placed on the dorsal aspect of the ulna and the fingers of […]

Resisted extension

Positioning.

The subject stands with the arm alongside the body, the elbow flexed to 90° and the forearm in supination. The examiner stands level with the elbow. One hand supports the distal part of the forearm and the other hand is on top of the shoulder.

Procedure.

Resist the subject’s attempt to extend the elbow.

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Passive supination

Positioning.

The subject stands with the arm hanging and the elbow bent to a right angle. The examiner stands in front of the subject. Both hands encircle the distal forearm in such a way that the heel of the ipsilateral hand is placed against the dorsal part of the ulna and the fingers of the […]

Passive pronation

Positioning.

The subject stands with the arm hanging and the elbow bent to a right angle. The examiner stands in front of the subject. Both hands encircle the distal forearm in such a way that the heel of the contralateral hand is placed against the volar part of the ulna and the fingers of the […]

Passive extension

Positioning The subject stands with the arm outstretched. The examiner stands level with the subject’S elbow. One hand stabilizes the elbow,and the other hand grasps the distal forearm.

Procedure:

• To test the range: move hands in opposite directions – distal hand downwards and proximal hand upwards. • To test the end-feel: bring […]

FUNCTIONAL EXAMINATION OF THE ELBOW

PASSIVE TESTS

Passive flexion

Positioning. The subject stands with the arm outstretched. The examiner stands level with the subject’s arm. He places one hand against the back of the shoulder and grasps the distal forearm with the other hand.

Procedure. Bring the hand towards the shoulder,thereby stabilizing the latter, until the movement comes to a […]

Palpation of soft tissue

Over the olecranon lies the olecranon bursa,which is only really palpable when it becomes inflamed and swollen.Keep the subject’s elbow flexed. Palpate for the upper border (apex) of the olecranon. Feel just lateral to this apex for the insertion of the tendon of the triceps muscle. Move the fingers upwards: a broad and flat tendon […]