Term
Age is key factor for chronic problems
Younger <___
_________
________ |
|
Definition
|
|
Term
Age is key factor for chronic problems
Older > ___
____
____
____ |
|
Definition
40
Impingement
Rotator Cuff Tear
Arthritis
Frozen Shoulder |
|
|
Term
| 3 x ray views of the shoulder that need to get? |
|
Definition
AP
axillary lateral
scapular y |
|
|
Term
History
Fell onto shoulder
Older patient low velocity fall onto OSH (outstretched hand) |
|
Definition
| Proximal Humerus Fracture |
|
|
Term
| Proximal Humerus Fracture Physical Exam |
|
Definition
Bruising shoulder region
Bony crepitus |
|
|
Term
| Treatment for Nondisplaced Proximal Humerus Fracture |
|
Definition
|
|
Term
| Tx for displaced Proximal Humerus Fracture |
|
Definition
| ORIF (Open ReductionInternal Fixation. Open reduction internal fixation is a method of surgically repairing a fractured bone) |
|
|
Term
| In a displace fracture, it Must be displaced greater than __ cm or __ degrees angulated in order to be considered a true part |
|
Definition
|
|
Term
| Clavicle Fracture History (3) |
|
Definition
Sport injury fall onto shoulder
MVC or motorcycle (motor-cross)
Bicycle accident |
|
|
Term
| Clavicle fracture Physical |
|
Definition
Bruising
“Knot”
Check skin to make sure not tenting |
|
|
Term
| if clavicle fx is tenting, means.. |
|
Definition
| possibility of becomming an open fracture |
|
|
Term
clavicle fx Treatment
Surgery if: (3) |
|
Definition
Sling or “figure of 8” bandage
Skin tenting
Severe displacement
Failure to heal |
|
|
Term
| Scapula Fx MOA: Usually high energy mechanism (3) |
|
Definition
MVC
Fall from height
Posterior shoulder pain |
|
|
Term
W/ scapula fx, Be worried about ___ or major organ injury
Also __ fractures |
|
Definition
|
|
Term
|
Definition
As long as not an intraarticular glenoid fracture treat in sling usually
Early pendulum exercises – sling for comfort and get arm moving early
Treat other injuries |
|
|
Term
|
Definition
Fell onto arm in abduction external rotation
Football player “arm went dead”
Seizure |
|
|
Term
|
Definition
Feel humeral head — may feel in soft area anterior
Very painful to move arm and decreased ROM |
|
|
Term
| Most common shoulder dislocation? and due to what? |
|
Definition
| Anterior – most common, traumatic |
|
|
Term
| Posterior shoulder dislx – usually following ___ or ___ |
|
Definition
|
|
Term
| How is arm positioned during a posterior shoulder dislx? |
|
Definition
| Arm internally rotated, adducted |
|
|
Term
| how is arm positioned during an anterior shoulder dislx? |
|
Definition
| Arm abducted, externally rotated |
|
|
Term
But with _______ x ray view – can see that golf ball is not sitting on t
Will never miss a dislocation if get this view |
|
Definition
|
|
Term
|
Definition
Immediate reduction easier
Later may need sedation/anesthesia
Get them to relax
Traction – slow, prolonged, gentle
Rotation – internal, alternate
Then put in Sling and start early ROM |
|
|
Term
Shoulder ________– is a humeral disjunction
Shoulder ________– is acromialclavicular disjunction |
|
Definition
|
|
Term
| AC Joint Separation “Shoulder Separation” MOA? |
|
Definition
| Fall onto tip of shoulder |
|
|
Term
|
Definition
Most grade I-III treated nonoperatively (sling)
Reconstruct when greater than 100% displaced or chronic pain |
|
|
Term
| AC JOint Separation Classifications I- VI |
|
Definition
I is a sprain of ac ligament – no true tear
II – sparation – torn ac ligament
III – cc ligaments have also torn along with ac ligament – start seeing elevation of clavicle displaces < 100% width of clavicle
IV – goes posterior
V - superior displacement, to a greater degree than grade 3
VI – goes inferior
Type V – most common – very prominent displacement |
|
|
Term
| Type __ AC joint separation is a sprain of ac ligament – no true tear |
|
Definition
|
|
Term
| Type __ ac joint sparation – torn ac ligament |
|
Definition
|
|
Term
| Type ___ sc joint separation – cc ligaments have also torn along with ac ligament – start seeing elevation of clavicle displaces < 100% width of clavicle |
|
Definition
|
|
Term
| Type ___ ac joint separation – goes posterior |
|
Definition
|
|
Term
| Type___ ac joint separation - superior displacement, |
|
Definition
V
to a greater degree than grade 3 |
|
|
Term
| Type ___ ac joint separation – goes inferior |
|
Definition
|
|
Term
| Type __ sc joint separation – most common |
|
Definition
|
|
Term
|
Definition
| Major trauma to anterior chest (post) or force to lateral shoulder region (ant) |
|
|
Term
Medial clavicle physis is last to close (fuse) in body, so
could be a medial physis fracture instead of a sc dislocation in ppl < ___
These will often remodel in young folks |
|
Definition
|
|
Term
| SC dislocation tx Anterior |
|
Definition
Often times leave it alone
Cosmetic
Later resection or reconstruction if problems |
|
|
Term
| SC dislocation tx Posterior |
|
Definition
May be causing compression on trachea (dyspnea)
Towel clip and posterior force to shoulder with bump
May require internal fixation with suture
Need cardiovascular surgeon on hand in case toracic vasculature |
|
|
Term
| What are the muscles of the rotator cuff and what are their innervations? |
|
Definition
Supraspinatus -> Suprascapular Nerve
Infraspinatus -> Suprascapular Nerve
Teres Minor -> Axillary
Subscapularis -> Upper and Lower Subscapular
What other muscle is innervated by axillary nerve – deltoid |
|
|
Term
Rotator Cuff Tear
If happens acutely:
Fall on __________
Pain in area under _____
Inability to_____ |
|
Definition
outstretched hand/jam arm into shoulder
acromion
raise arm above head |
|
|
Term
Rotator Cuff Tear
Weakness of motion
Isolate which muscles weak
______--Forward elevation; empty can sign
______—ER(external rotator) weakness
______—Lift off sign/Belly press |
|
Definition
Supraspinatus
Infraspinatus
Subscapularis |
|
|
Term
infraspinatus test of rotator cuff tear
http://www.youtube.com/watch?v=xVQy0qPU3Ho |
|
Definition
|
|
Term
subscapularis belly press test
http://www.youtube.com/watch?v=CbMNv92JnNk&feature=related |
|
Definition
|
|
Term
subscapularis lift off test
http://www.youtube.com/watch?v=Q3gIjMkg91k |
|
Definition
|
|
Term
Rotator Cuff Tear Tx
PT
Surgery |
|
Definition
ROM/pendulum
Strengthening muscles around shoulder
Younger patients
Full thickness tears
Acutely retracted tears
Good tendon and muscles
If an old tear and tendon has atrophied, will try PT first |
|
|
Term
| “I felt a pop right here” |
|
Definition
| proximal biceps tendon rupture |
|
|
Term
|
Definition
| proximal biceps tendon rupture |
|
|
Term
Proximal biceps tendon rupture
Usually ___ patients
Cosmetic deformity
No real change in functional ability |
|
Definition
|
|
Term
| Proximal biceps tendon rupture Tx? |
|
Definition
Nonoperative treatment
PT
Strengthening |
|
|
Term
| Pectoralis Major Tear: ____ Head ruptures off ____ usually |
|
Definition
|
|
Term
| Pecotralis Major Tear MOA |
|
Definition
Weight lifting or sports
Transition of eccentric load to concentric load of bench press
happens when hands are in supination |
|
|
Term
| Pectoralis Major Tear Symptoms: |
|
Definition
Sudden onset of pain and decrease ROM
Distinguish between biceps rupture by location where it occurs
Biceps is higher on humerus
Pe major is lower attachment on humerus and burising will be lower down arm |
|
|
Term
____ – can cause tendinitis
____can also cause tendon ruptures |
|
Definition
|
|
Term
| To see a Pectoralis Major Tear, have the pt_______ |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Brachial Plexus Can be “stretched” or bruised |
|
|
Term
Brachial Plexus Stingers/Burners
Football or similar injury
Direct bruise
Nerves stretched by combination of:
Neck _____
Neck _____
Shoulder ____ |
|
Definition
extension
lateral tilt
depression |
|
|
Term
|
Definition
Sudden pain and tingling down arm
Weakness in upper extremity |
|
|
Term
Stingers are Never in ___!!!
This means it would not be a stinger
Stingers are only ____ & in __ only!! |
|
Definition
lower extremities
unilateral
UE |
|
|
Term
|
Definition
Treatment is rest until all strength resumes and tingling/numbness resolves
No return to game until completely normal exam |
|
|
Term
Brachial Plexus Rupture Rupture
Severe injury
Devastating
Nerve completely torn
- From spinal cord attachment
- In mid portion of plexus
Recovery questionable and slow
- Surgical repair sometimes possible –results poor |
|
Definition
|
|
Term
| ___ is most commonly dislocated joint |
|
Definition
|
|
Term
| _____is a pathological condition manifesting as pain or feeling of slipping due to excessive translation of humeral head on glenoid during active motion |
|
Definition
|
|
Term
| Continual subluxation = _____ |
|
Definition
|
|
Term
|
Definition
Often following shoulder dislocation(s)
Could be just from repeated subluxations
Often feel shoulder slipping
Often will have pain or weakness
Associated with generalized laxity of ligamentous structures
Swimmers |
|
|
Term
|
Definition
T: Traumatic
U: Unilateral
B: Bankart lesion
S: Surgery often required |
|
|
Term
|
Definition
A: Atraumatic
M: Multidirectional
B: Bilateral
R: Rehab
I: Inferior capsular shift |
|
|
Term
load and shift test
http://www.youtube.com/watch?v=gFzLc8b-cY0 |
|
Definition
|
|
Term
sulcus sign
http://www.youtube.com/watch?v=taN04xR4iAs |
|
Definition
|
|
Term
apprehension and relocation test
http://www.youtube.com/watch?v=9ZU-q0vxDUo&feature=related |
|
Definition
|
|
Term
| with the relocation test, ____ force makes them feel more secure |
|
Definition
|
|
Term
| with posterior rotation test, pt is in ____ & ____rotation |
|
Definition
|
|
Term
| Labrum should be firmly attached to the glenoid – when it is pulled off = ______ |
|
Definition
bankart lesion
Can have a bony or soft tissue bankart |
|
|
Term
| ____ is an injury of the anterior (inferior) glenoid labrum due to repeated (anterior) shoulder dislocation. It is an indication for surgery and often accompanied by a _____, damage to the posterior humeral head. |
|
Definition
Bankart lesion
Hill-Sachs lesion |
|
|
Term
| What nervecan get injured in a distal humerus fracture – ___nerve |
|
Definition
radial
Can get radial nerve palsy |
|
|
Term
Bankart lesion is an injury of the _____ glenoid labrum
Hill-Sachs lesion is damage to the _____ humeral head. |
|
Definition
anterior (inferior)
posterior |
|
|
Term
Instability Treatment
Rehab
Especially _(TUBS or AMBRI)__
Surgery
Failed ___
____ sports
Large ____
Open or arthroscopic |
|
Definition
AMBRI
rehab
Contact
Bankart |
|
|
Term
| SLAP Lesions/Tears stands for... |
|
Definition
| Superior Labrum Anterior to Posterior Tears |
|
|
Term
| _____ is where the long head of biceps tendon attaches |
|
Definition
|
|
Term
|
Definition
| Young patient, often pitcher due to high forces on labrum and biceps |
|
|
Term
|
Definition
Vague deep shoulder pain associated with catching, popping, or locking of shoulder with overhead activities
Pain due to interposition of labrum between humeral head and glenoid |
|
|
Term
Obrien's test
http://www.youtube.com/watch?v=gaDhqFP4lCE |
|
Definition
|
|
Term
| how to test for SLAP tear? |
|
Definition
O’Brien Test – empty can adducted – goes away when supinating hand
Positive apprehension and relocation test |
|
|
Term
| SLAP tear may lack ___ rotation) |
|
Definition
|
|
Term
| what sort of imaging need to order for SLAP tear? |
|
Definition
| MRI arthrography -> may be helpful but not great sensitivity or specificity |
|
|
Term
|
Definition
| Most patients with SLAP tears will respond to conservative (meaning non-surgical) treatments. Any patient with a SLAP tear will be advised to rest after the injury |
|
|
Term
| Impingement: _____ of acromion undersurface causes irritation to the underlying cuff tendons causing symptoms |
|
Definition
|
|
Term
| Space for rotator cuff decreases from spurs on ___ or ___ bursa. Can see surface rough and worn from years of rubbing Same applies to the tendons of the rotator cuff . Rope and rock = ______ |
|
Definition
acromion
inflamed
impingement |
|
|
Term
|
Definition
Patient complains of dull ache worse in evenings. Pain location generalized
Worst with overhead activity
Hurts to sleep on
Hurts to get things out of cabinet |
|
|
Term
neer's sign
http://www.youtube.com/watch?v=k21FNtBjQ14 |
|
Definition
|
|
Term
hawkins test
http://www.youtube.com/watch?NR=1&v=2mSv7gLXyYg |
|
Definition
|
|
Term
|
Definition
flat, curved & hooked
curved and hooked associated w/ predisposition for impingement |
|
|
Term
|
Definition
Rest
Analgesics
Exercises
-> Stretching
-> Strengthen
Injection (cortisone may weaken tendon and lead to rupture so counsel patient and slow rehab)
Surgery
-> Persistent
-> Excise and/or smooth acromion |
|
|
Term
| _______ Can lead on to degenerative rotator cuff tears over time—partial thickness and full thickness eventually |
|
Definition
|
|
Term
|
Definition
|
|
Term
Pain and restricted GH joint motion
Pain can be severe
One shoulder diagnosis where patient is in tears when examining them and often have to stop the exam |
|
Definition
| Frozen Shoulder “Adhesive Capsulitis” |
|
|
Term
| Frozen Shoulder “Adhesive Capsulitis” causes? |
|
Definition
Associated with
trauma to chest
breast surgery
**DM
thyroid disease
Usually women menopausal age
Hormones??
Can be men |
|
|
Term
| Differentiate between Frozen Shoulder and RCT by lack of ___ |
|
Definition
|
|
Term
| if PROM of shoulder blocked at 30 degrees – it will be ___ or___ |
|
Definition
| frozen shoulder or arthritis of shoulder |
|
|
Term
| Differentiate between frozen shoulder and arthritis by lack of ___ |
|
Definition
| significant arthritis on x-ray |
|
|
Term
|
Definition
NSAIDs
Pain meds to sleep
PO or Injection Cortisone
Physical therapy/exercises
Usually burns out on own
Manipulation?
Lysis of adhesions with scope |
|
|
Term
| Loss of articular cartilage of humeral head and/or glenoid |
|
Definition
| Degenerative Joint Disease |
|
|
Term
Degenerative Joint Disease
_________ pain
Decreased ROM - what type? |
|
Definition
Progressive
passive and active |
|
|
Term
| Degenerative Joint Disease Radiographs show loss of ___ & ___ |
|
Definition
| joint space and osteophytes |
|
|
Term
| Degenerative Joint Disease Versus frozen shoulder will show ____ |
|
Definition
|
|
Term
| Degenerative Joint Disease Versus rotator cuff tear will have ___ |
|
Definition
|
|
Term
|
Definition
NSAIDs
Avoid activities that hurt shoulder
?PT
Steroid shots
Joint Replacement |
|
|
Term
| Degenerative Joint Disease = |
|
Definition
|
|
Term
Nerve Entrapment Problems
Where nerve passes through awkward place
____ tendons
____ bone
____ ligaments |
|
Definition
|
|
Term
| Nerve Entrapment Problems Usually goes beyond the ___ |
|
Definition
|
|
Term
Thoracic Outlet syndrome: Compression or pinching of ___ and/or ____
Over ___ rib (or ___ rib if present)
Behind_____ muscle and in front of ___ |
|
Definition
subclavian artery
brachial plexus
1st
cervical
anterior scalene
middle scalene |
|
|
Term
| Thoracic Outlet syndrome Symptoms |
|
Definition
Arm ache
Numbness, fatigue, aching with overhead work
Numbness ulnar nerve area (little, ring finger) |
|
|
Term
Adson's test
http://www.youtube.com/watch?v=z5uIH69ke4E |
|
Definition
|
|
Term
| How to Diagnose thoracic outlet syndrome? |
|
Definition
Symptoms, examination
Electromyogram/nerve conduction study |
|
|
Term
| Thoracic Outlet syndrome Differential |
|
Definition
| Pancoast syndrome (tumor of upper lung invading 1st rib and brachial plexus) – get chest x-ray |
|
|
Term
| Thoracic Outlet syndrome Tx |
|
Definition
Avoid overhead work
Exercises
Surgery
Controversial
If cervical rib present, resect it |
|
|
Term
|
Definition
| Get AP, lateral, and oblique x rays of the elbow |
|
|
Term
| Fat pad and sail sign around a fracture of the ____ on an x-ray – can see the fracture ~14 days later |
|
Definition
|
|
Term
| Sudden force overload with elbow midflexed |
|
Definition
|
|
Term
Distal Biceps Rupture
Middle aged males
Acute pain in _________
Swelling, bruising |
|
Definition
|
|
Term
Distal Biceps Rupture
Weakness in _____ and especially _____ |
|
Definition
|
|
Term
|
Definition
| Treatment is operative reattachment |
|
|
Term
triceps rupture
_____ avulsion or rupture is rare |
|
Definition
|
|
Term
| Often piece of bone is avulsed in a _____ rupture |
|
Definition
|
|
Term
|
Definition
Pain, swelling, bruising posterior elbow
May be associated with olecranon bursitis |
|
|
Term
|
Definition
X-ray for bone piece
MRI for confirmation and check for retraction |
|
|
Term
|
Definition
Surgically reattached with transosseous tunnels and suture
Chronic injuries may require allograft |
|
|
Term
| 2nd most common major joint dislocation |
|
Definition
|
|
Term
| Elbow Dislocation is Usually a ______ dislocation |
|
Definition
|
|
Term
|
Definition
|
|
Term
the direction of the dislocation is determined by where the ___ fragment is in relation to the ___ fragment
If tibia is behind where is is supposed to be in relation to femur = ____ dislocation |
|
Definition
distal
proximal
posterior |
|
|
Term
With elbow dislocation, Examine and record ___ function before any treatment
If fresh and x-ray shows no fracture, can be reduced with simple traction distally and gentle elbow ____
If reduced, test motion, stability, nerve function |
|
Definition
|
|
Term
“Nursemaid’s elbow”
In toddler, adult pulls child up by wrist with elbow ___
Child experiences immediate pain and won’t use arm
Holds arm across body in _____ ________position |
|
Definition
|
|
Term
|
Definition
| X-ray not needed with typical history and findings |
|
|
Term
| nursemaids elbow is a dislocation of the ___ |
|
Definition
|
|
Term
|
Definition
Firm, quick supination with elbow flexed
May happen in x-ray department if x-rays are ordered |
|
|
Term
| With distal humerus fracture, Check ___ nerve function, then ____, and Usually refer to orthopedic surgeon |
|
Definition
|
|
Term
|
Definition
Fall onto elbow directly
Ice skating |
|
|
Term
|
Definition
|
|
Term
|
Definition
Fall onto outstretched hand
Painful motion |
|
|
Term
| The radial head should point directly at the ____ in all views. |
|
Definition
capitellum
The rounded protuberance at the lower end of the humerus that articulates with the radius. |
|
|
Term
|
Definition
If minimally displaced, can be treated with short term (1-3 day) splint for pain then start range of motion exercises and sling only
With more displacement may require surgery |
|
|
Term
|
Definition
|
|
Term
| Lateral epicondylitis “Tennis Elbow” is Chronic degeneration of ___ |
|
Definition
| ECRB (extensor carpi radialis brevis) |
|
|
Term
| Lateral epicondylitis “Tennis Elbow” MOA |
|
Definition
Lateral elbow pain
Repetitive wrist (extension) activity
Racquet sports |
|
|
Term
tennis elbow
Physical Exam
Palpate maximum pain at ___
Resisted finger or wrist ____ - maybe b/c of pain |
|
Definition
lateral epicondyle
extension |
|
|
Term
| tennis elbow Often poor mechanics of ___ in tennis and is also common in ___ |
|
Definition
|
|
Term
|
Definition
Rest
Activity modifications
Therapy
Counterforce bracing
Wrist splint
Injection (steroids or platelet rich blood)
Healing properties of plasma is spinned down and injected into are to help generate tendon to heal
Probably not an inflammatory problem so steroids aren’t working that well
Surgery: debride ECRB |
|
|
Term
|
Definition
|
|
Term
| the most common problem in golfers is |
|
Definition
|
|
Term
| Medial Epicondylitis Degeneration of ___(latral side) or __(medial side) |
|
Definition
PT (pronator teres)
FCR (flexor carpi radialis) |
|
|
Term
Medial Epicondylitis Physical
Elicit pain just distal to ___ worse with resisted wrist ___ and forearm ___ |
|
Definition
med epicondyle
flexion
pronation |
|
|
Term
|
Definition
Rest
NSAIDs
Injection
Surgery - rarely |
|
|
Term
elbow arthritis is Usually post-_____
Previous ___
Previous ___ |
|
Definition
traumatic
fracture
dislocation |
|
|
Term
| elbow arthritis Can be primary arthritis w/ no history of trauma (3) |
|
Definition
|
|
Term
|
Definition
Rest
NSAIDs
Injection
Surgery |
|
|
Term
| Someone spending a lot of time on their elbow or overuse can cause ____ |
|
Definition
|
|
Term
| gout in elbow can cause ___ |
|
Definition
|
|
Term
|
Definition
Rest and pressure bandage
Aspiration/injection
Surgery
Resect bursa |
|
|
Term
Ulnar Nerve Entrapment sites (3)
which is the most common? |
|
Definition
thoracic outlet
cubital tunnel
guyon's canal
Cubital tunnel syndrome is most common and occurs at elbow |
|
|
Term
Cubital Tunnel Syndrome
Anatomy of Ulnar Nerve at Elbow
Exposed to trauma because of ____ location
bumping, pressing on table or arm rest, driving car
Stretched by anatomy and position
holding telephone receiver, sleeping
with elbow flexed |
|
Definition
|
|
Term
Cubital Tunnel Anatomy
Ulnar nerve it goes behind ___ and needs to goes between ___ & ____ |
|
Definition
medial epicondyle
FCU & Medial triceps |
|
|
Term
Cubital Tunnel Symptoms
___/__ pain - can radiate to shoulder
Numbness in __ & ___ fingers |
|
Definition
Forearm/elbow
ring and little
all of little finger and half of ring finger on both the dorsum and palm of hand |
|
|
Term
cubital tunnel
Findings
Tender ulnar nerve
Weakness ___ muscles
___ of hand muscles |
|
Definition
|
|
Term
Tinel’s sign
http://www.youtube.com/watch?v=VtrC9dnVrrQ |
|
Definition
cubital tunnel
(percussion nerve causes electric shock like sensation) |
|
|
Term
cubital tunnel Weakness
___ muscles, most noticeable 1st _____ |
|
Definition
Interosseous
dorsal interosseous |
|
|
Term
|
Definition
X-rays to rule out bony prominences
EMG/nerve conduction studies to confirm at level of elbow
Double crush |
|
|
Term
|
Definition
Prevent external pressure
Splint elbow in extension at night
Pillow splint
Surgery |
|
|
Term
radial tunnel syndrome
Radial nerve can be entrapped just like ulnar nerve
____ at radial head
Recurrent _____ radial artery vessels
ECRB
______—where enters supinator muscle
Supinator muscle |
|
Definition
Fibrous bands
leash of Henry
Arcade of Frohse |
|
|
Term
radial tunnel syndrome
Pain distal to ___ &____
No __ or ____ dysfunction
Consider in DDx of ______ |
|
Definition
joint and ECRB
motor or sensory
lateral epicondylitis |
|
|
Term
|
Definition
|
|
Term
Radial tunnel PE
Tenderness to palpation along radial tunnel
Pain with resisted ___ finger ___ or resisted forearm ___ with elbow extended |
|
Definition
middle
extension
supination |
|
|
Term
|
Definition
|
|
Term
|
Definition
Rest and observation – may recover spontaneously (6-12 weeks)
Can consider injection
Surgery to decompress |
|
|
Term
pronator syndrome
____ Nerve compression at ____
Pain in volar proximal forearm with repetitive motion
Paresthesias in radial ___ digits
Rare to have ___ weakness |
|
Definition
|
|
Term
pronator syndrome PE
Resisted forearm ___
Extreme elbow ___ |
|
Definition
|
|
Term
| pronator syndrome imaging |
|
Definition
|
|
Term
|
Definition
| Nerve exploration and decompression often necessary |
|
|
