– See: – Bone Tumor Menu and Osteosarcoma Demonstration Project – Discussion: – malignant tumor of bone in which neoplastic osteoid is produced by a proliferating spindle cell stroma; – most common primary malignant bone tumor of mesenchymal derivation; – arises in adolescents, and second or third decade; – … Read more
– Discussion: – chronic unreduced dislocations of greater than 6 months duration may involve significant destruction of the humeral head from large Hill Sachs lesions or reverse Hill Sachs defects; – Treatment: – these usually require arthroplasty; – w/ TSR humeral component is placed in 60 – 75 … Read more
– See: Bone Tumor Menu – Discussion: – malignant cartilaginous tumor of bone (3rd most common malignant bone tumor / comprises 20% of malignant bone lesions); – it is less common and less aggressive than osteosarcoma; – staging: – histologic grading is best predictor of stage; – most often presents as … Read more
Cervical Radiculopathy: Diagnosis and Treatment Richard J. Nasca, MD Nasca RJ. Cervical radiculopathy: current diagnostic and treatment options. J Surg Orthop Adv. 2009;18(1):13-18. Introduction: Pain around the shoulder, arm and hand may be caused by irritation or compression of one or more cervical nerve roots. In the majority of patients, the symptoms are of short … Read more
– See: Frx Dislocations of the Hip – Discussion: – because of associated high energy trauma: look for other injuries – vast majority of patients sustained a hip dislocation will have associated injuries; – assoc ligamentous injuries to ipsilateral knee; – associated posterior wall fractures, femoral head, … Read more
– See: shoulder joint menu and arthroscopic RCT repair Fluid Management: Positioning: beach chair position is comfortable for both the patient and the surgeon and allows the option of converting to an open procedure (if necessary); patients need to be seated with the torso raised to 70 deg with a foled sheet placed on the medial … Read more
– See: Arthroscopic Acromioplasty – Lateral portal: – used for visualization of, or for insertion of instruments into, subacromial space, (usually for arthroscopic acromioplasty or for calcific tendinitis); calcific tendinitis); – the key to lateral portal placement is that it must allow triangulation over the entire undersurface of the anterior acromion; – if the portal is … Read more
– Technique: – best visualization of the shoulder joint is through the posterior portal; – portal usually is located 1.5-3 cm distal & 1-2 cm medial to postero-lateral tip of acromion; – further refine the proper location of the portal by finding the soft spot, using deep palpation of the … Read more
– Discussion: – shoulder arthroscopy / acute dislocations / recurrent anterior instability / multidirectional instability / posterior instability – drive through sign: – refers to the ability to pass the arthroscope easily between the humeral head and the glenoid at level of anterior band of inferior glenohumeral ligament; – considered diagnostic of shoulder laxity or instability; – ref: Clinical significance of the arthroscopic … Read more
– See: Open Acromioplasty – Discussion and Indications: – objective good to excellent results may be achieved in over 70% of patients, and subjective satisfactory results are achieved in over 90% of patients; – shoulder arthroscopy is indicated in cases of impingement syndrome and questionable rotator cuff tear repair, since the shoulder … Read more