Re: Distension of joint capsule

Luciano Nebiante PGCertSAS — Tue, 24 Apr 2012 20:15:09 GMT

Hi Nicola,

many thanks for your reply and advise.

As I said the hyperextension is only light, and hopefully it will heal with a bit of more time. Didn't take xray in extension though.

At the moment the infection of the skin is not completely under control, so a possible surgical stabilization is still not advisable I think.

But will see how this case is progressing. Referral may be an option if this case will require surgical stabilization.

Thanks again.

Re: Distension of joint capsule

Nicola Lawlor — Tue, 24 Apr 2012 14:29:12 GMT

I assume the degloving is the same limb as the carpal hyperextension - if so not surprising he will not weight bear properly if at all on this at the moment. You also need to check is the neurology of the leg comprimised though as sometimes they will hold the limb a little strangely if there is nerve damage.

I am not sure how you are managing the degloving? I would be keeping it dressed at this point and debriding (wet to dry dressings) and making a plan for the longer term once you are past this point. Within the dressing you could incorporate a splint to support the carpus - personally I like using Vet-Lite and making a back splint to custom fit the dressing (it moulds in hot water), but I would also be questioning what you are going to do with the hyperextension injury in the longer term as the chance of this healing is likely to be very poor without surgical stablisation. Have you taken x-rays with the limb in extension to show the instability clearly? I don't know your personal skills but would very much recommend seeking a specialist opinion on this injury if you are not confident in dealing with this.