(see also: Blair Fusion; Charcot Marie Tooth ; Equinovalgus; Grice Arthrodesis; Kocher approach; Ollier incision; Subtalar Fusion) Discussion results in fusion of subtalar, calcaneocuboid, and talonavicular joints; most effective procedure for fixed hindfoot and forefoot deformities; triple arthrodesis tend to have a high (50%) failure rate in children under 10 years of age; triple arthrodesis … Read more
– See: – Ligaments of the Wrist and RU Joint – Discussion: – is ulnar continuation of distal radius & presents concave surface for articulation w/ lunate & triquetrium; – ular side of the wrist is supported by the TFCC, which articulates w/ both the lunate and the triquetrum; – TFCC is prone to injury due … Read more
– Discussion: – often patients will note pain weeks to months after the cast is removed; – w/ excessive dorsal tilt, will often develop a symptomatic ulnar mid-carpal instability (or carpus adaptive DISI); – in the report by Taleisnik and Watson (1984), the average amount … Read more
– Discussion: – see tibial non unions – OTA classification: – type I is there is loss of 50% of circumference of bone and less than 2 cm defect; – consider exchange nailing – ref: Critical-sized defect in the tibia: is it critical? Results from the SPRINT trial. – type2 if … Read more
– See: Surgical Approach – Treatment Options: – No Reduction – elevation, compression, early ROM (ROWE) – Closed Reduction – Bohler: distraction/M-L – compression – Open Reduction – Palmer: lateral approach (1948) – Goals of Open Reduction: … Read more
Indications for treatment proximal DVT proximal propagation of a distal DVT some authors advocate that isolated asymptomatic distal DVT can be followed on serial Duplex Ultra-sound, and does not require treatment distal DVT will propagate proximally in less than 10-20% of cases, and has a low risk of PE serial ultrasound can be performed on … Read more
– See: Lisfranc’s Frx – Anatomy of the Midfoot – Radiographs: – w/ questionable injury, consider wt bearing AP view to assess 1-2 interval; – if standing AP is unacceptable to the patient then consider CT scan; – abudction stress AP: … Read more
– Discussion: – mechanism of injury: – distinguish between high velocity injuries verus low velocity injuries (as this reflects incidence of vascular and nerve injuries); – w/ low-velocity knee dislocations occurance of vascular injury is about 5% and nerve injury is about … Read more
– See: tibia fracture menu (open tibia fractures); – Discussion: – worst prognostic feature for healing of tibial frxs is infection; – osteomyelitis of tibia & infected non unions are among the most severe complications after tibial frx, & may lead to amputation; – probability of infection is related … Read more
– Discussion: – trapezius and serratius anterior stabilize scapular base from which the arm operates; – trapezius, which arises from spinous processes of cervical and thoracic vertebrae & inserts on spine of scapula and acromion, is innervated by spinal accessory nerve and branches from third … Read more