– 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: – straight leg raising, by itself, can produce pain from a variety of sources, including myogenic pain, ischial burisitis, annular tear, and hamstring tightness, as well as herniated disc; – the critical distinction is made by the sciatic stretch test; – this test is … Read more
– Discussion: – is a coagulase negative, gram positive organism; – has emerged as one of the most common organisms in total joint infections (and in other implanted devices); – it is often minimally toxic (as compared to other bacterial infections), and many patients will have minimal symptoms of infection; … Read more
– See: – Gait Menu: – Orthotics for the Foot – Discussion: – stance phase represents about 60% of the gait cycle, swing 40%; – normal gait is symmetric & thus, relationship between swing and stance phases of each leg are consistent; … 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
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
– Discussion: Split Compression / Type II Fractures: – split fragment from articular surface along w/ depressed area similar to that of local compression frx; – lateral wedge frx is combined w/ varying deg of depression of adjacent remaining wt bearing portion of lateral tibial plateau; – depression is usually located anteriorly or centrally; … Read more
– Discussion: Tibial Plateau Frx Menu – in most split frxs, large articular frag has separated in coronal plane from posterior portion of medial tibial plateau; – fragment rarely separates from lateral plateau or from anterior aspect of either plateau; – 22% of these frxs will also have assoc intercondylar eminence … Read more