– See: subtalar arthrodesis – Primary Fusion: – indicated for fractures w/ more than 3 parts; – restores length of gastrocnemius-soleus complex – corrects flat foot – relieves the narrow peroneal space; – in the presentation by Infante AF, et al (15th Annual Meeting of the Orthopaedic Trauma Association 1999), the authors advocate immediate subtalar … Read more
– See: – Ulnar Nerve: – Anatomy & Sites of Compression of Cubital Tunnel: – Surgical Considerations: – transposition can entail subQ or submuscular transposition with excision of medial intermuscular septum, and release of arcade of Struthers; – in the presence of H.O. the nerve should be … Read more
– Discussion – Examination of Patellofemoral Joint – exam considerations: – generalized hyperlaxity – femoral anteversion – vastus medialis obliquus atrophy – genu valgum – external tibial torsion – patellar dysplasia – trochlear dysplasia – patella alta – pes planus – Radiographic Features: (see: radiographic evaluation of the knee) – lateral view – look for … Read more
– See: Sub-Talar Joint – Discussion: – involves dislocation of distal articulations of talus at both talocalcaneal & talonavicular joints; – ankle joint is undisturbed; – distinguish between medial and lateral subtalar dislocation; – method of reduction is different w/ each type … Read more
– See: – Sub Talar Dislocation – Subtalar Fusion – Transverse tarsal joint – Triple Arthrodesis – Discussion: – anatomy: – axis of rotation: – axis of subtalar joint is approx 42 deg upward from the horizontal in saggital plane & 16 to 23 deg medial to midline of foot in transverse plane; – upward … 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
– Midfoot Fatigue Fractures: – fatigue frx are rare in midfoot (of these frx in navicular are most common); – radiographs & bone scan are necessary to make the diagnosis; – treatment involves eliminating athletic activity until healing is complete, which often takes several months; – Metatarsal Stress Frx: … Read more
Co-Authors: Milford H. Marchant Jr., M.D.; Mark E. Easley, M.D.; James A. Nunley II., M.D. Osteochondral Lesions of the Talus Review Etiology – Primary Causes – Trauma – Ischemic Necrosis – Embolic phenomenon – Ossification Defects – Predisposing Factors – Endocrine Disorders – Peripheral vascular disease – Genetic Predisposition? – 10-25% Bilateral Lesions Evaluation – … Read more
– Theory: – flexor-pronator muscles arising from medial epicondyle are transposed to more proximal point on the humerus so that their moment for elbow flexion is incresed enough to permit active control; – muscles originating from the medial epicondyle (Pronator Teres, FCR, PL, & FCU) must have normal or … Read more