– Factors Related to Extremity Injury: – duration of use; – it is thought that muscles are more sensitive than nerves to duration of tourniquet use; – use of tourniquet for > 2 hours & pressures of > 350 mm of mercury in … Read more
– See: IM Nailing for Distal Tibia Fracture – Discussion: – outcomes: – in a retrospecitive study, external fixation was considered a risk factor for non union (29% non union rate); – Distal tibia fractures: management and complications of 101 cases – reduction: – … Read more
– External Fixation Main Menu – Discussion: – disadvantages of external fixation: – pin tract infections, delayed union / non-union, and malunion; – cosmetic problems; – advantages of external fixation: – technically easy to perform; – no soft tissue stripping; – ease of removing hardware; – comparison of IM nailing vs external fixation – Initial … Read more
– See: Internal Rotation – Discussion: – external-rotation laxity increases w/ knee flexion, w/ largest amount (20 degrees) being seen in the 30-40-deg range of flexion; – external rotation is not directly limited by cruciate ligaments; – only PCL, which becomes taut at 90 deg of flexion, would be expected to … Read more
– See: – Rupture of the Quadriceps – Patellar Tendon Injury – Tibial Tubercle Frx – Discussion: – extensor mechanism includes quadriceps, quadriceps tendon, medial & lateral retinaculum, patellofemoral and patellotibial ligaments, Patellar Tendon (ligament), and tibial tubercle; – superficial location of extensor mechanism make it suseptable to injury; … Read more
– Discussion: – see flexion gap – is space between transverse cut on distal femur & transverse proximal tibial cut while the knee is in complete extension; – while minor loss of knee flexion or mild instability in flexion can be tolerated, priority is always be given to extension gap adjustments; … Read more
– Technique: – patient is placed on a bean bag in a true lateral position; – slightly flexing the knee and placing it on a padded Mayo stand may facilitate positioning; – calcaneus is approached thru an extensile right angled incision, which curves sharply between … Read more
– See: Back Pain in Children – Discussion: – results of exam may be normal in child w/ spondylolysis or mild (Grade-I or Grade-II) spondylolisthesis. – Back: – tenderness to palpation in the low back; – splinting as well as guarding & restriction of side-to-side motion of low back, particularly … Read more
– Clinical Findings: – history: patient may complain of a subjective knee hyperextension sensation, and twisting or pivoting are also difficult; – lack of contained effusion is suggestive of posterolateral capsular injury; – look for diffuse tenderness over the posterolateral joint region, fibular head, and joint line; … Read more
– Discussion: – serial diagnostic exam should take into consideration static deformities of the lower extremities, gait, ROM, tenderness, and knee stability; – in the child w/ a painful knee, it is essential to closely examine the hip as hip pathology can refer pain to the hip; – Examination: – Gait: … Read more