Ortho Oracle - orthopaedic operative atlas

Acetabular Component Loosening

(see also: acetabular component Loosening of Press Fit Acetabular Components (press fit acetabular components) normal bone ingrowth generally for bone ingrowth to occur, the component must lie with 50 micrometers of the acetabulum, inorder for host bone ingrowth to occur; as noted by Bloebaum RD, et al (1997), bone ingrowth into component averages only 12%, … Read more

Accessory Navicular

Discussion accessory navicular is an accessory ossicle of the foot which is located on the medial side of foot, proximal to the navicular and in continuity with the tibialis posterior tendon; approximately 2-12% of people may have this ossicle; accessory navicular generally does not ossify until 9 years of age, and in about one half … Read more

Accessory Bones of the Foot

most common accessory bones os trigonum os tibiale externum (accessory navicular) os peroneum (lateral aspect of cuboid) os vesalianum (base of 5th metatarsal) less common accessory bones os supratalare (antero-supero aspect of talus) os supranaviculare (superior aspect of navicular – seen on lateral) processus uncinatus (at intersection of navicula, 2nd and 3rd cuniform) os intercuneiforme … Read more

Acceptable Reduction for Pediatric Both Bone Forearm Frx

(see also: Technique of Reduction) Discussion initial considerations angular / rotational deformity: (growth will not correct rotational deformity) age distance from physis direction of angulation amount of deformity bayonette apposition generally bayonette opposition will require operative reduction (either closed with a Kapandji K wire levering technique or in some situations, an open reduction and fixation … Read more

AC Joint Separation

Discussion tears of AC & CC ligaments (from fall on tip of shoulder) allows upper limb to drop away from clavicle, producing separation of AC joint; differential diagnosis distal clavicular physeal separation childhood equivalent of AC separation; atraumatic AC joint laxity (from ligamentous laxity) Classification Rockwood Classification type I sprain of joint with out a … Read more

AC Joint Arthrosis / Open Distal Clavicle Excision

Discussion general discussion: clinical and radiographic findings Surgical Technique Subacromial Decrompression Arthroscopic Distal Clavicle Excision: Open Clavicle Excision: Surgical Technique: Modified Weaver Dunn Procedure: Complications lateral elevation of the clavicle: lateral elevation is often associated w/ pain; ref: Sequential Resection of the Distal Clavicle and Its Effects on Horizontal Acromioclavicular Joint Translation references: Complications after … Read more

Absent Thumb

Discussion total absence of the thumb may be an isolated anomaly, but it is often associated with some other congenital malformation; absent thumb may be inherited as autosomal dominant or may be sporadic; absent thumb is frequently observed in Holt-Oram syndrome, Fanconi’s anemia, and ring D chromosome abnormalities; absent radius is almost always associated with … Read more

Above the Knee Amputation

  (see also: AKA Prosthesis, Amputations in the Diabetic Patient Discussion average AK amputee walks 43% slower and expends 89% more kcal/min than the normal person; if proximal circulation is adequate, a longer anterior muscle flap may be left and the combination myodesis- myoplasty technique is used; ability to ambulate with a prosthesis depends heavily … Read more

Above Knee Amputation Prosthesis

Discussion it is important that knee joint is extended throughout stance phase; this means that the components are assembled so that a straight line extended fromthe "trochanter" will pass anterior to the knee and through the ankle; friction is adjusted to help control the amount of knee flexion and to help decelerate the shank; mechanical … Read more

Above Elbow Amputation

(see also: Upper Extremity Prosthetics) Surgical Considerations consider the Marquardt Osteotomy of the Humerus: supracondylar, to put 15-20 deg of posterior angulation at this site, to facilitate suspension and provide rotational control; distal piece must be at least 5 cm long; stagger the median and ulnar nerve resection levels to avoid a large confluent neuroma