Ortho Oracle - orthopaedic operative atlas

ACL Graft Fixation

 – Discussion:     – see Arthrex, Mitek, Linvatec, Smith-Nephew     – in choosing a fixation technqiue consider the need for the following:              – circumferential (360 deg) healing of graft against tunnel wall (interference screws do not permit this);              – bioabsorbable material … Read more

ACL Graft Placement Theory

Discussion femoral tunnel tibial tunnel: isometric placement of ACL refers to the concept that a full range of knee can be achieved w/o causing long-term ligament deformation; isometry can not exist because, during ROM, there is no one point on femur that maintains a fixed distance from a single point on tibia; elongation always will … Read more

Acromioclavicular Joint

Discussion AC joint is situated between the clavicle and acromion; acromion has two ossification centers which fuse at age 22 yrs; it permits motion in three planes: AP gliding of acromion during protraction & retraction of scapula; tilting of acromion during abduction & adduction of arm; rotation of the clavicle; rotation occurs during abduction & … Read more

Achilles Tendon Rupture

(see also: Achilles Tendonitis) Discussion ruptures typically occur after age 30, more often in people beyond middle age; rupture at musculous tendinous junction occurs most often in young people, but ruptures near the calcaneus also occur; inciting event may be related to atrophy of the soleus muscle, and commonly occur in weekend athletes; in 5-33% … Read more

Achilles Tendon Rupture: Non Operative Treatment

(see also: Achilles Tendonitis) Discussion indications may be indicated in older patients w/ minimally displaced ruptures; note that younger patients w/ expectations of participating in sports such as basketball may not be good candidates for non operative rx; atheletes should not expect to resume full activities for one year; managment short leg cast strategy: SLC … Read more

Achondroplasia

(see also: Pseudoachondroplasia) Discussion autosomal dominant disorder; arises due to a point mutation for the gene encoding a fibroblast growth factor (Fibroblast growth factor receptor 3) over 80% of all persons with this disorder are born to parents who are not achondroplastic, & such parents rarely have second achondroplastic child; it is presumed in these … Read more

ACID PHOSPHATASE

Radioimmunoassay (RIA) determination usually specific for prostate; not a screening test; Increased: Carcinoma of the prostate (usually metastatic), prostatic surgery or trauma; Rarely increased w/ infiltrative bone dz (Gaucher’s dz, myeloid leukemia), prostatitis, or benign prostatic hypertrophy;