– See: Medial Approach – Discussion: – allows access to medial malleolar frx; – skin flap, formed with its base posteromedially, usually heals well because of its blood supply from the posterior tibial artery; – saphenous nerve lying adjacent and immediately lateral to saphenous vein must be avoided; – for medial malleolar avulsion fracture: – … Read more
– Definition: – medial plateau of the tibia rotating excessively forward & externally on femur as the joint opens on the medial side; – torn structures: – MCL; – posterior oblique ligament; – ACL; … Read more
– Discussion: – condition is a part of the spectrum of the bowing-pseudarthrosis disorder seen in neurofibromatosis; – tibial pseudarthrosis may be present at birth, or it may present later on following a frx from an anterolaterally bowed tibia; – this disorder should not be confused … Read more
– Discussion: – most important portal, initial site for scope insertion; – structures that are difficult to see: – PCL – anterior portion of lateral meniscus – posterior … Read more
– See: Smith Peterson Approach – Discussion: – major problems with the Watson Jones technique are dealing w/ gluteus medius & minimus, which lie over anteior capsule and must be damaged or cut to obtain adequate exposure; – original Charnely technique used anterolateral approach w/ pt supine, osteotomy of greater troch, … Read more
– Discussion: – allows acces to ankle joint, talus, & other tarsal bones and joints; – it does not allow access to the navicular and 2nd and 1st cuniforms; – avoids all of the important vessels and nerves; – dissection procedes between the peroneus tertius (deep peroneal nerve) and the peroneus brevis (superficial peroneal … Read more
Discussion defined as excessive forward rotation of tibial plateau w/ excessive lateral opening of the joint; there is excessive internal rotation of tibia on femur in flexion; as knee extends, subluxation is reduced by the bony stability, and a jerk is noted which is basis for the pivot shift test; disrupted structures disruption of ACL disruption … Read more
– See: – Anterior Drawer Test – Anatomy: – it connects anterior fibula to neck of talus; – ligament is thickening of ankle capsule that extends short distance from anterior edge of distal part of fibula to talar neck, anterior to its lateral articular facet; … Read more
– See posterior tibial artery – Anatomy: – anterior tibial artery passes from behind through gap above interosseous membrane to enter anterior compartment of leg and supply its muscles; – as it crosses membrane, it gives off a recurrent branch; – ref: The risk of injury to anterior tibial artery in posterolateral approach to … Read more
– Discussion: – strong and well-defined, arise from antero-inferior surface of medial epicondyle and inserts at the sublimis tubercle, adjacent to the joint surface; – primary constraint to valgus instability; – in flexion, MCL provides 54% of valgus stability; … Read more