Spine
Tillaux Fracture:
– Discussion: – SH III frx involving avulsion of anterolateral tibial epiphysis; – occurs in older adolescents, after the middle and medial parts of epiphyseal plate has closed, but before the lateral part closes (usually 12 to 15 yrs of age); – because, this frx occurs in … Read more
Tibial Tunnel for ACL Reconstruction
– Discussion: – considerations for graft placement – optimal graft angle – land marks for graft entry point – determination of graft length – retention of remnant ligament: – ref: Anterior cruciate ligament reconstruction with remnant preservation: a prospective, randomized controlled study. – Transtibial Technique: – tibial tunnel guide is … Read more
Tibial Plafond Fracture
– Discussion: (w/ assistance and narration by Dr Kyle Dickson MD) – term pilon (hammer) fracture was introduced to describe these compression injuries by Destot in 1911; – ref: High-energy tibial pilon fractures: an instructional review. – frx components: – combination of ankle frx & distal tibial metaphyseal frx, usually w/ intra articular comminution; – frx … Read more
Tibial Extramedullary Guides
– See: Preparation for Proximal Tibial Cut: – Discussion: – intrameduallary & extrameduallary systems are available for aligning the proximal tibial cut; – IM system is less accurate, particularly when tibia has varus bow and may lead to excessive cement column; – ref: Extramedullary … Read more
Throwing Shoulder
– See: throwing injuries: and elbow throwing injuries – Phases of Throwing: – wind up – early cocking: deltoid and rotator cuff are active; – late cocking phase: – muscle activity: – shoulder is placed in … Read more
THR: Skin Incision for Posterolateral Approach
– Landmarks: – posterior superior iliac spine: forms the superior landmark; – incision starts at the posterior 1/3 of the greater trochanter and extends proximally for 10 cm toward a point 2 fingerbreadths below the PSIS; – this will bring the incision directly over the sciatic notch and will also … Read more
THR: Osteolysis
– See: Total Hip Replacement Menu – Discussion: – most common complication in total hip arthroplasty and most common cause of component failure; – osteolysis is a time dependent process which arises from inflammatory reaction against polyethylene particulate debris; – patho-biology: – osteolysis is … Read more
THR: Acetabular Reaming
– Patient Position: – ensure that patient has not rotated anteriorly, for this may allow acetabular component to be placed in retroverted position; – ensure that patient’s torso is not tilted inferiorly (as can occur from a bean bag), as this can cause reaming in an excessive … Read more
Thoracolumbar Scoliosis
– Choices for Instrumentation: – Zielke Instrumentation: – used for treatment of rigid or mobile lumbar or thoracolumbar Scoliosis w/ lordosis; – CD instrumentation: – for patients who have a mobile lumbar or thoracolumbar curve; … Read more