Justarose
Guest
seems simple enough ...but I am stuck
POSTOPERATIVE DIAGNOSES:
1. Left third palmar mass.
2. Stenosing tenosynovitis, left third finger.
PROCEDURE PERFORMED: Left third palmar mass excision with A1 pulley release.
Following successful administration of anesthesia, the left upper extremity was prepped and draped in a clean and sterile fashion after administration of a digital block. We then held the arm against gravity and insufflated the tourniquet to 250 mmHg, and I used the palmar flexion crease and incorporated that into my incision and under loupe visualization dissected down through the A1 pulley. I found a large retinacular cyst coming just distal to the A1 pulley. I found the radial and ulnar digital nerves and protected these. I then incised the A1 pulley and removed the retinacular cyst. The FDS tendon was a bit frayed, but overall in good condition. It was normal in appearance. I copiously irrigated the wound and closed with 5-0 Prolene stitch. A bulky dressing with Coban was applied, and the patient was awoken from anesthesia having tolerated the procedure well and was transferred to the recovery room in a stable condition. Our sponge, instruments, and needle counts were correct at the completion of the procedure.
I am just really confused on this ...his ops always do that to me .. thanks for your help !
POSTOPERATIVE DIAGNOSES:
1. Left third palmar mass.
2. Stenosing tenosynovitis, left third finger.
PROCEDURE PERFORMED: Left third palmar mass excision with A1 pulley release.
Following successful administration of anesthesia, the left upper extremity was prepped and draped in a clean and sterile fashion after administration of a digital block. We then held the arm against gravity and insufflated the tourniquet to 250 mmHg, and I used the palmar flexion crease and incorporated that into my incision and under loupe visualization dissected down through the A1 pulley. I found a large retinacular cyst coming just distal to the A1 pulley. I found the radial and ulnar digital nerves and protected these. I then incised the A1 pulley and removed the retinacular cyst. The FDS tendon was a bit frayed, but overall in good condition. It was normal in appearance. I copiously irrigated the wound and closed with 5-0 Prolene stitch. A bulky dressing with Coban was applied, and the patient was awoken from anesthesia having tolerated the procedure well and was transferred to the recovery room in a stable condition. Our sponge, instruments, and needle counts were correct at the completion of the procedure.
I am just really confused on this ...his ops always do that to me .. thanks for your help !