– Discussion: – Total Shoulder Arthroplasty: (considerations: hemiarthroplasty vs TSA) – Reverse arthroplasty – Indications: – indicated for end stage DJD or RA shoulder involvement; – contra-indications to shoulder arthroplasty include combined rotator cuff / deltoid paralysis and recent joint infection; – in these rare circumstances, arthrodesis may be considered; – may occur as … Read more
– Discussion: – this is probably an under rated procedure in terms of its indications; – surgical indications: – hallux valgus + 2nd toe amputation: – great toe is stabilized in part by the presence of 2nd toe; – when it is absent, a hallux valgus valgus deformity is best treated by arthrodesis of first … Read more
– Thumb MP Joint: Tension Band Technique: – needs to be fused in 10-20 deg flexion, 20 deg pronation, and 20 deg of abduction; – tension band can neutralize the distraction force of the finger flexors (which are stronger than extensors and therefore cause distraction); – dorsal incision is … Read more
Discussion used to retard the progression of rheumatoid arthritis; may substitute for methotrexate or sulfasalazine; liver enzymes should be monitored during treatment; loading dose: 100 mg PO qd for 3 days followed by maintenance dose of 20 mg PO qd; this medication can be given to patients recieving non steroidals and/or steroids
– Discussion: – serves as screening test for collagen vascular dz and lupus; – fluorescent antinu-clear antibody test: (FANA) – indirect immunofluorescence assay is the initial screening test used to detect ANAs; – testing for specific auto-antibodies: – if … Read more
– See: Hyperflexion Injuries – Discussion: – partial or complete tear of posterior ligaments w/ varying degrees in widening of the interspinous and interlaminar spaces, as well as subluxation, but not dislocation of Facet Joint; – hyperflexion sprain injury may include mild anterior subluxation of involved vertebral body; – this subluxation … Read more
– Bony Impingement: – pts who have persistent pain in anterior aspect of ankle & who have anterior tibiotalar spur evident on a lateral roentgenogram need additional diagnostic evaluation and management; – extreme dorsiflexion required by the demiplie position in ballet can lead to impingement of anterior lip of … Read more
– See: Anterior Approach to the Humerus Axillary Approach: Posterior Approach Posterior Approach to Humerus Surgical Approach for Proximal Humeral Fractures Positioning and Draping: supine or beach chair; small soft bolster is placed beneath the shoulder blades to protract the shoulder; head is stabilized to prevent hyperextension and subsequent brachial plexus palsy; place patient in … Read more
Discussion varus deformity of the ankle may follow distal tibial fracture or distal tibial epiphyseal frx; deformities due to distal tibial epiphyeal injuries are often progressive; deformities due to tibial plafond injuries are usually static (from malreduction at the time of the original procedure); left untreated, the varus deformity may lead to DJD of the … Read more
– Discussion: – select appropriately sized 6.5 mm or 7.0 mm canulated screw (threads must cross the frx site); – consider direction of maximal deformity and displacment; – guide wire insertion (for cannulated screw insertion); – K wire is inserted from deep w/ in sinus … Read more