– See: – Total Knee Replacement Menu – Axial Alignment – Kinematics of the Knee Joint – Metallurgy: TKR – Rotation of TKR – Unconstrained Prosthesis – Discussion: – inability to achieve precise alignment will ultimately lead to component loosening, the leading cause of TKA failure; – designs with greater conformity between the femoral … Read more
– Discussion: – it has long been recognized that following any significant trauma or elective surgery, the body undergoes a catabolic state, which means that the body’s ability to withstand further stress (such as additional surgery) diminishes with time; – add to this, the effect of immobilization due to pain (pressure sores, atelectasis, poor diet) and … Read more
– see: anesthesia menu – Discussion: – assessment of perfusion: damage control orthopaedics – the most common situation is how to manage the femur fracture in the brain injured patient; – some authors have expressed concern that intraoperative hypoxia and hypotension may commonly occur w/ early IM nail stabilization; … Read more
Current Concepts Review. Treatment of Unstable Fractures of the Shaft of the Tibia. Current Concepts Review. Timing of Operative Treatment of Fractures in Patients Who Have Multiple Injuries. Pelvic and Lower Extremity Trauma–Symposium: Intramedullary Devices for Tibial Fracture Stabilization. The use of a tourniquet when plating tibial fractures. Conservative management or closed nailing for tibial shaft fractures. … Read more
– Discussion: – main goal is to prevent THR dislocation but also to maintain optimal offset; – prior to reducing the hip, ensure that center of femoral head is approximately at level of the greater trochanter; – once trial reduction has been completed, the trial acetabular liner is removed, the … Read more
– Landmarks: – posterior superior iliac spine: forms the superior landmark; – incision starts at the posterior 1/3 of the greater trochanter and extends proximally for 10 cm toward a point 2 fingerbreadths below the PSIS; – this will bring the incision directly over the sciatic notch and will also … Read more
– Discussion: – by definition, is a decrease of more than 5 mm in the verticle distance of the femoral stem; – subsidence of 1 mm or less is within limits of measurement; – subsidence of cement mass & stem or migration of stem into cement mass resulting in more distal position of collar or … Read more
– See: THR dislocation: – Checklist: – need complete muscular relaxation; – irrigate any debris from acetabulum; – Difficult Reduction: – capsule might have to be further released, esp if head and neck segment was short preoperatively; – if reduction is not possible & leg is lengthened, … Read more
(see: Total Hip Replacement Menu) – PreOp: – Theory and Background: – Checklist for THR and Radiographs: – Initial Exposure: – positioning, prepping and antibiotics: – posterolateral skin incision: – incise thru iliotibial band: – split gluteus maximus: – The course of the superior gluteal nerve in the lateral approach to the hip; – identify the … Read more
– positioning and prepping – posterolateral skin incision – incise thru iliotibial band – split gluteus maximus – peel back the trochanteric bursa: – divide trochanteric bursa and sweep it posteriorly to expose vastus lateralis, short external rotators and posterior border of gluteus medius; … Read more