– Discussion: – insert blunt Homan retractors superiorly & inferiorly to obtain exposure of entire superior, posterior, & inferior portions of capsule; – divide exposed portion of capsule along its attachment to femur; – make a longitudinal or T shaped extension of capsular incision along axis of femoral neck, directing incision … Read more
– See: extenal rotators: – Discussion: – divide trochanteric bursa & bluntly sweep it posteriorly to expose short external rotators & posterior edge of medius; – anatomy: – from superior to inferior external rotators include: … Read more
– See: Innervation of Lower Limb Muscles – Anatomy: – from the lumbo-sacral plexus, arises from posterior branches L4, L5, S1; – exits the pelvis and enters the gluteal regioin through the upper margin of the greater sciatic notch, just superior to the piriformis muscle. – it … Read more
(See also: inferior gluteal artery) Discussion major blood supply to gluteus medius and minimus; superior gluteal artery and nerve leave the pelvis above piriformis; emerges above piriformis, after passing thru greater sciatic foramen; once pass the notch, it divides into: superficial branch supplying maximus; deep branch enters deep surface of medius in intermuscular plane … 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: – 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
– 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
– 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