Argghhhh
Anatomy!
I'll always lose any argument about anatomy
Doesn't the discussion we're having about the number of methods
available simply reinforce the concept that the more ways there are of
doing something means that there is no really good method??
Shane
----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Adrian Fogarty
Sent: 31 January 2006 01:59
To: [log in to unmask]
Subject: Re: Post reduction x-rays for anterior shoulder dislocation
But the muscles that count (the rotator cuff, teres major, most of the
deltoid, long head of biceps, long head of triceps) are equally attached
to
the scapula, so it shouldn't make a difference whether you're moving the
humerus or moving the glenoid; either way you've got to overcome
muscular
resistance, don't you? Doesn't make any sense to me, that idea. After
all,
it's the humeral head that's out of position, not the glenoid. And the
glenoid/scapula is firmly attached to the axial skeleton by even bigger
muscles (which Dave the skeleton may not have any more)!
AF
----- Original Message -----
From: "Shane Curran" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Monday, January 30, 2006 5:27 AM
Subject: Re: Post reduction x-rays for anterior shoulder dislocation
> Rowley
> To understand it get a couple of bones and try it out using whichever
> technique you use
>
> The scap manip technique , instead of pulling the humeral head over
the
> glenoid and aggravating all those large shoulder muscles, slips the
> glenoid under the humeral head
> I best visualized showing some students with the shoulder girdle of
dave
> the department skeleton
>
>
> Shane Curran
>
> Whose preferred technique was scapular manipulation, but has decided
> that with appropriate use of propofol the technique doesn't really
> matter
>
>
>
> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]] On Behalf Of Rowley Cottingham
> Sent: 27 January 2006 00:54
> To: [log in to unmask]
> Subject: Re: Post reduction x-rays for anterior shoulder dislocation
>
> Here's a hint. If you see a doctor either ask for a towel or take a
shoe
> off, run a mile or offer to take over.
>
> Traction forms no part of any sensible way to reduce the shoulder. The
> one
> I'd really like to try but can't get my head round is scapular
rotation.
> That seems nicest by far.
>
> Best wishes
>
>
> Rowley.
>
>
>
> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]] On Behalf Of Doc Holiday
> Sent: 25 January 2006 08:31
> To: [log in to unmask]
> Subject: Re: Post reduction x-rays for anterior shoulder dislocation
>
>
>>Kocher's manoeuvre consists of the patient slowly actively externally
>>rotating their shoulder, flexing to 90 degrees, then internally
> rotating.
>>It is difficult to imagine how this could cause a significant
fracture.
>
> --> I believe a couple on this list have REPORTED seeing #'s, hence no
> --> need
> to imagine...
>
>>The technique of applying traction, flexing the elbow to 90 degrees
and
>>using the forearm as a lever to forcibly produce external rotation was
> not
>>described by Kocher.
>
> --> I neve said it was DESCRIBED by him. I was not there, so I have no
> --> idea
> what he said. I DO, however, know the Kocher method I was shown as a
> junior
> and see people doing now. I have NEVER taught anyone this method, so I
> will
> accept no blame for them doing it this way. You will not believe how
> rare it
>
> is to see it done the way you (and, as you say, Kocher) describe it
> above
|