– Discussion: – remove residual cancellous bone along medial aspect of neck w/ broaches; – begin w/ broach at least two sizes smaller than anticipated stem; – procede w/ consecutively larger broach sizes up to but not exceeding size of the last axial reamer; … Read more
– Broaching: – broaching for cementless stems – is usually started w/ the smaller broach or w/ broach 2 sizes smaller than templated during preop planning – determination of anteversion – exposure considerations: – with smaller incisions, there will be a tendency of the broach to abraid … Read more
– See: X-rays of the Foot – Broden’s View: – used to better visualize the subtal joint; – pt is supine w/ knee slightly flexed and supported by sandbag; – foot rests on the film cassette with neutral dorsiflexion; – entire lower leg and foot is internally rotated 45 deg; – central beam directed toward … Read more
– Box Cut: – ensure that box cutting jig is placed flush on anterior and distal femoral surfaces; – box cutting jig is centered over the intercondylar notch (or IM drill hole); – if the knee has … Read more
– See: – Arteries of the Upper Limb; – Profunda Brachi; – Anatomy: – brachial artery originates at the lateral border of teres major muscle & courses down anterior humerus posterior to bicipital aponeurosis; – brachial artery has three main braches, of which profunda brachi … Read more
– See Bone Topics: Calcaneus Capitate Clavicle Coracoid Process Femur Fibula Foot Hamate Humerus Lunate Navicular Olecranon Patella Pisiform Radius Sacrum Scaphoid Scapula Sesamoid Bones (Foot) Sesamoid Bones (Hand); Talus Tibia Trapezium Triquetrium Ulna
– Assessment of Reduction: – amount of radial bow is determined by drawing a line from the biciptial tuberosity to the ulnar aspect of the distal radius; – at the point of maximal radial bow, measure the distance of a line drawn perpendicular to the first line; – Frx Malunion: … Read more
– Technique: – at this point, No 2 Ethibond stay sutures will have already been passed thru drill holes made in each bone plug; – proposed tibial bone plug should have an additional stay suture passed thru the bone-tendon interval (as a safety feature should the interference screws … Read more
– Discussion: – there is inherent graft weakness during period after implantation when allograft& autograft tissues undergo necrosis, revascularization, and cellular proliferation; – weakest link initially is graft fixation site; – it is important to achieve strong fixation initially; … Read more
– See: Bone Topics – Discussion: – woven bone healing: – ref: Distal radial fractures heal by direct woven bone formation – stages of enchondral bone healing: – hematoma / inflammation: – shortest stage of fracture healing – disruption of vascular flow through the marrow and periosteum … Read more