– Discussion – Examination of Patellofemoral Joint – exam considerations: – generalized hyperlaxity – femoral anteversion – vastus medialis obliquus atrophy – genu valgum – external tibial torsion – patellar dysplasia – trochlear dysplasia – patella alta – pes planus – Radiographic Features: (see: radiographic evaluation of the knee) – lateral view – look for … Read more
– Discussion: – occur as the result of repetitive loading below yeild strength & are most common in lower extremity (metatarsals > calcaneus > tibia); – Matheson, et al.: 370 athletes with stress fractures tibia (49.1%), tarsals (25.3%), metatarsals (8.8%) and bilateral stress fractures in 16.6% of cases; – focal structural … Read more
– Discussion: – stress shielding is the redistribution of load (and consequently stress onthe bone) that occurs when the femoral head is replaced by the femoral component of a total hip replacement; – stress on proximal 10 cm of femoral cortex is reduced, because much of the load bypasses this region and … Read more
– see 2 stage hip spacer – Discussion: – staged revision w/ antibiotic spacer: (see antibiotics in cement and local antibiotic delivery for septic joints) – debridement of components is followed by 6 weeks of IV antibiotics; – it is essential that all foreign material including cement be … Read more
– See: Radiographic Findings – stable intertroch frx is one that when reduced has cortical contact w/o gap medially and posteriorly; – this contact will prevent frx displacement into varus or retro-version when forces are applied to proximal femur; – medial cortices are not comminuted & there is no displaced frx of lesser trochanter
– See: – PreOperative Planning: – preoperative leg length: – acetabulum: – evaluation of cup position: – acetablar component loosening – use a wax pen to mark the tear drop and the superior aspect of the acetabulum, and overlie … Read more
Discussion conditions include: AS Reiter’s Syndrome Psoriatic Arthritis Inflammatory Bowel Disease typically involves the axial skeleton; affected areas heal w/ fibroblastic proliferation followed by new bone formation; pathogenesis of these disorders is unknown except for Reiter’s syndrome, which is generally believed to result from aberrant host response to a pathogenic microorganism; Labs RF is negative; HLA-B27 phenotype: … Read more
– See: Spondyloepiphyseal Dysplasia Tarda: – Discussion: – a type of short trunk disproportionate dwarfism, in which there is involvement of the vertebra and epiphyseal centers; – can be transmitted as autosomal dominant trait, although most cases arise as random mutations; – symptoms include delayed developmental milestones, diminished endurance, and … Read more
– Discussion: – permits the guided insertion of a cannulated blade thru the nail and into the femoral head,at one of three angles to accommodate anatomic or fracture variations; – angle options: – key onto proximal nail end, adapting the nail slot to accept the spiral blade … Read more