– Discussion: – includes ankle disarticulation, removal of malleoli, & anchoring heel pad to the wt bearing surface) allows execellent gait with a cosmetic prosthesis; – symes amputations will not heal w/o palpable posterior artery pulse; – surgery may be performed in 2 stages; – most common … Read more
– See: syndesmotic sprain – Anatomy: – syndesmosis is made up of anterior-inferior tibiofibular ligament, interosseous ligament, and posterior-inferior fibular ligaments, inferior transverse tibiofibular ligament, and interosseous ligament; – these stabilize the mortise by opposing the fibula in the fibular notch (incisura fibularis tibiae); – section of the anterior tibiofibular ligament results in diastasis of … Read more
– See: Technique of Snydesmotic Fixation – Discussion: – if only syndesmotic ligaments are divided (w/ fibula & collateral ligaments intact) there will be no widening of mortise or lateral displacement of talus; – compressing the fibula and tibia above the ankle elicits tenderness at the syndesmosis, implies injury to the … Read more
– Discussion: – fractures of the sustentaculum tali result from landing on the heel combined with severe inversion of the foot; – inversion of foot produces acute pain just below the medial malleolus; – pain may be accentuated by passive hyperextension of the great toe; – this fracture may be mistaken for an ankle fracture; … Read more
– See: Gait Menu: and Muscle Activity During Gait – Discussion: – during swing, the ankle dorsiflexes by the concentric contraction of anterior tibialis muscle; – all other muscles are silent; – momentum generated by the gastrocsoleus and hip flexors at terminal stance carries the leg forward – during initial swing … Read more
– Function: – references: – The effects of implant design on range of motion after total knee arthroplasty. Total condylar versus posterior stabilized total condylar designs. – Total condylar knee replacement. A study of factors influencing range of motion as late as two years after … Read more
Discussion is preferred by many for use in older children and adolescents; skeletal traction is applied w/ Steinman pin inserted thru distal femur; see: insertion technique knee should be flexed 30 deg to relax the hamstrings; deformity: w/ mid shaft frx, there is tendency is toward posterior angulation; to restore the normal anterior bowing of … Read more
– Discussion: – fractures of the sustentaculum tali result from landing on the heel combined with severe inversion of the foot; – inversion of foot produces acute pain just below the medial malleolus; – pain may be accentuated by passive hyperextension of the great toe; – this fracture may be mistaken … Read more
– Discussion: – bluntly split gluteus maximus proximally in direction of its fibers & coagulate any vessels w/in substance of muscle; – note that muscle does not have to be split in line w/ incision, but can be split in line w/ its fibers in a direction superior to skin incision; … Read more
– Main Menu: – PreOp Planning – radiographs and templating – Surgical Exposure: – Patient Positioning, Preping, Draping – Anterior Longitudinal Midline Approach – Deep Articular Exposure – Patellar Eversion: – Patella: – patellar resurfacing – prior to patellar resurfacing, determine the propensity for the native patella to subluxate; – if subluxation is present (tibial component … Read more