– Pin Diameter and Length: – pins should be at least 5 mm in diameter (such as the Orthofix 6/5 mm self tapping screws); – resistance to cephalad displacemnt could be approximately doubled by using 5 mm vs. 4 mm half pins for iliac wing fixation, & is further enhanced by adding … Read more
– Pediatric Acetabular Fractures – Discussion: – characteristics of pediatric pelvic fracture: – in the report by Silber JS, et al, the authors identified 166 consecutive pelvic fractures; – physes were scored as open, narrowed, or closed; … Read more
(see: juvenile RA menu) Discussion definition: < 4 involved joints. most frequently encoutered subgroup, accouting for 30-40% of JRA; peak age is 2-4 years more common in girls (4x) differential dx Clinical Presentation> begins w/ incidious onset which can be painless swelling, warmth, and restriction of motion are common sx; knee, ankle, and elbow (& … Read more
– Discussion: – Pavlik harness is a dynamic flexion abduction orthosis used to treat DDH in infants up to 6 months of age; – harness usually leads to stability of reduced hip w/ in 4 wks, but its use should be continued until clinical exam & x-rays of hip are normal; … Read more
– See: General Discussion – Hyperparathyroidism – incidence of hip frx is about 10%; – in younger pts with good bone stock, consider ORIF; – in elderly pts consider primary THR; – note, however, when when hyperparathyroidism occurs as a consequence of renal … Read more
– See: Impediments to Reduction – Discussion: – dislocated femoral head: – femoral head and neck remain anteverted and in the valgus position; – is pulled proximally & laterally by hip abductors; – becomes misshapen & flattened; … Read more
– Pathoanatomy: – osteophytosis occurs as result of breakdown in the out annular fibers of annulus fibrosis; – disk material stretching & displacing these fibers, causing stress at ligamentous attachments leading to formation of osteophytes; – osteophytes collects initially extend horizontally; … Read more
– Discussion: – preadolescents w/ spinal cord injury have > 95% prevalence of scoliosis & 50% of pts have a pelvic obliquity; – progressive kyphoscoliosis results from effects of gravity & loss of spinal musculature; – up to 2/3 of these patients will requre arthrodesis to prevent severe curve progression; – Non Operative … Read more
– See: – Total Hip Replacement Menu: – Acetabular Component Revision: – Acetabular Defects Grafting Options: (frozen allograft) – Dysplastic Hip: – Acetabular Radiographic Evaluation – Posterior … Read more
– See: THR Main Menu and Radiographic evaluation of THR – Discussion: – normal gait adaptions: – trendelenburg limp after THR is a clinical sign of gluteal insufficiency; – static trendelenburg sign: drop of the pelvis on the contralateral side while the individual stands on the operative side; – many patients will compensate for … Read more