– See: Knee Joint Menu – Patient Positioning and Preparation: – positioning: – opposite limb is well padded to prevent potential pressure problems; – operative thigh is placed against an arthroscopy post or is placed in a circular thigh immobilizer; … Read more
– See: TKR Menu – Checklist: – surgical risk assessment – preop cardiology, dental, GI, and urological consults – risk factors for infection: are taken into consideration; – tranexamic acid – anesthesia consult and posting – Pulmonary embolism prophylaxis in more than 30,000 total knee arthroplasty patients: is there a best choice? – autologous blood / … Read more
– Radiographs – History: – note that age, smoking history, and diabetes are all risk factors for skin slough; – Exam: – compartment syndrome – deep central compartment is involved most often in calcaneal frx; – reference: … Read more
– Frx – Menu (See: Post Op Orders) – Axial Skeleton – C-spine – Spine – Pelvis – Upper Extremity – Shoulder – Humerus – Elbow – Wrist – Hand – Lower Extremity – Hip – Femur – Knee – Tibia – Ankle – Foot – Systems – Neuro – Cranio-Maxillo-Facial – Spine – Cardiac … Read more
– Discussion: – is apparent when with stress testing lateral tibial plateau rotates posteriorly in relation to the femur with lateral opening of joint; – atraumatic type: – presents as chronic laxity, often with a varus knee deformity; – this ligamentous laxity often … Read more
– See: Anterior Tibial Artery – Discussion: – posterior tibial artery enters posterior compartment of leg lying posterior to tibialis posterior & enters plantar foot after passing behind medial malleolus; – largest branch is peroneal artery arising high in leg and coursing downward in posterior compartment, lying just medial to fibula; – gives off branches to … Read more
– See: Lateral Approach – Discussion: – allows exposure of the entire distal humerus as well as radial head, radial neck, and biceps tuberosity; – indications for this approach include frxs of distal humerus, old posterior elbow dislocations, radial head frx, radial head excisions, arthroplasties, fixation of distal biceps tendon rupture, and … Read more
– See: Kocher Langenbock for Acetabular Frx – Discussion: – position pt prone, on a radiolucent table; – vertical incision placed 2 cm lateral to posterosuperior spine; – mobilize gluteal muscles from their origins on iliac wing & sacrum; – mobilize piriformis from greater sciatic notch to … Read more
– See: – Malgaigne Fracture – Sacral Fractures – Sacroiliac Fracture Dislocations – cresent fracture – Evaluation of Stability: – as noted by Kellam, et al. (1987), a stable injury is one that can withstand normal physiologic forces w/o excessive deformation; – it … Read more
– See: Autograft Discussion – PreOp Planning: – if patient has undergone previous bone graft harvests, consider CT scan to determine amount of remaining bone left in the crest; – Technique: – ensure that appropriately sized self retaining retractors are available; – straight longitudinal incision is made over posterior superior … Read more