– See: DDH – Discussion: – provides excellent congruity at site of osteotomy, rapid healing, & intrinsic stability with only minimum internal fixation; – performed through anterior approach; – specially curved gouges are used to divide acetabulum from surrounding pelvis through osteotomy site 15 mm from articular surface; … Read more
– Discussion: – slip of the captial femoral epiphysis occurs with in a narrow window of physiologic maturity of the growing child; – arises from mechanical and constitutional factors; – pts may have underlying endocrine dz (such as hypothyroidism) delayed puberty & bone age; – position of growth plate of proximal femur normally changes from … Read more
– Biomechanics of Screw-Plate Angle – Checklist – Sliding Hip Screw w/ Unstable Frx – High Angle Plates – Low Plate Angle – Nail Placement in Femoral Head and Neck – Screw Length – Sliding Screw Fixation in Femoral Neck Frx – Sliding Screw Fixation … Read more
– Discussion: – sinus tarsi is the depression found on the lateral side of the tarsus and is distal to and on the same level as the lateral malleolus; – on incision of the structures overlying the sinus tarsi – namely, lateral portion of the inferior extensor retinaculum, interosseous talocalcaneal ligament and reflection … Read more
(see also: Osteomyelitis in Sickle Cell Patient) Discussion affects 1% of blacks – is more severe but less common than sickle cell trait (8% prevalence); two main genotypes include Hb S and Hb C forms of disease; crises usually begin at age 2-3 years and may lead to bone infarctions; Sequelae of Sickle Cell growth … Read more
– Discussion: – see discussion shoulder arthroplasty and technical considerations with fracture – operative considerations: hemiarthroplasty vs total shoulder arthroplasty – considered in young pt w/ OA, posttraumatic dz (w/ no have glenoid involvement nor erosion), AVN, or massive RTC tear; – approximate survival rate at 10 years is about 80%; … Read more
– Discussion: – impingement syndrome describes pain in subacromial space when the humerus is elevated or internally rotated; – during humeral flexion, the supraspinatus tendon and bursa become entrapped between the anteroinferior corner of the acromion (and CA ligament) and the greater tuberosity; – this syndrome is thought to precipitate attritional changes in the rotator … Read more
– Classic Neer Impingment Sign: (see impingement syndrome) – is tested by having the patient place his hand on the unaffected shoulder and gradually forward flexing the shoulder; – impingement sign is elicited w/ pt seated and the examiner standing; – scapular rotation is prevented w/ one hand while … Read more
– See: – massive rotator cuff tear – disscussion – shoulder hemiarthroplasty – Discussion: – by definition, a massive RTC tear invovles tears of more than 5 cm and involves more than than one tendon; – further, massive tears cannot be repaired … Read more
– See: – Bursae of the Knee – Septic Arthritis – Diff Dx: – referred pain from the hip – osteochondritis dissecans – traumatic internal derangement – distal femoral or proximal tibial osteomyelitis – septic bursitis: – … Read more