– See: Arteries of the Upper Limb – Discussion: – the axillary artery begins at the first rib as a direct continuation of the subclavian artery and becomes the brachial artery at the lower border of the teres major – artery passes behind pectoralis minor in its course thru axilla & is conveniently described as having 3 … Read more
– See: – Internal Rotation of Knee Joint: – Rotation of Tibial Component: – Correct Rotation: – as a general rule, the tibial componenet should be aligned such that it points to the medial third of the tibial tubercle; – correct rotational positioning of tibial component is best achieved by by aligning intercondylar eminennce of … Read more
– Discussion: – the most common frx of the base of the 5th metatarsal (over 90%); – may be due to pull of the lateral cord of the plantar aponeurosis – most often this frx is extra-articular, w/ the frx lying proximal to the metatarsocuboid joint; – commonly seen in dancers; – frx may be … Read more
– See: Intercondylar Eminence Frx – Discussion: – avulsion frx of tibial tuberosity along w/ a Salter Harris type-III frx of proximal tibial physis; – need to distinguish tibial tubercle avulsion from Osgood-Schlatter disease (which has no physeal involvement); – where as Osgood Schlatter disease involves … Read more
Discussion: – pathogenesis – vascular interruption: – blood supply to femoral head – specific inciting causes – natural history – diff dx: – synovitis; – Idiopathic Transient Osteoporosis of the Hip – femoral neck stress frx – metastatic disease – trochanteric bursitis: – ref: Avascular necrosis of the femoral head presenting as trochanteric bursitis. – … Read more
– Discussion: – local or Split compression frx have centrally depressed fragments; – AVN is diagnosed when serial X-ray show a gradual shrinking of the eleveated fragments until a defect remains; – surgically elevated articular fragments always are avascular; – fortunately most elevated frags regain vascularity before they … Read more
fingings may include osteopenia at frx site & absence of callus; potential for healing is significantly diminished; these require bone grafting & enhanced fixation; Treatment fracture ends of atrophic non union may need to be opened & debrided; typically these fractures will require bone grafting debridement of bone ends may be indicated in atrophic non … Read more
– See: – Occipital-Atlanto-Axial Anomalies: – Anatomy of C1 / C2 – Discussion: – more common children, since the pediatric occipital condyles are small and almost horizontal & lack inherent stability; – this injury is usually but not invariably fatal 2nd to respiratory arrest caused by injury … Read more
– Discussion: – note carrying angle of the elbow (for cubitus valgus); – r/o subluxation: – palpate the nerve in the cubital tunnel and note its mobility; – it is essential to know whether ulnar nerve subluxation is present; – motor … Read more
– Discussion: – in the presence of H.O. the nerve should be placed in the subcutaneous position, since H.O. forms between muscle layers; – sub-muscular transposition (or subQ transposition) is also indicated to relieve tension following ulnar nerve repairs; – is often indicated in revision cubital tunnel surgery; … Read more