– Location of Frx: – distal 1/3 : 75% – middle 1/3 : 18% – proximal 1/3: 7% – Surgical Approach: – Proximal Radius Fx (Thompson) – Distal Radius Fx (Henry) – Comminution: – side of comminution may dictate plate placement; – comminution involving more than 1/3 of circumference of shaft may necessitate bone grafting; … Read more
– Discussion: – often occurs as a result of degenerative disc disease and facet deficiency; – it is often associated w/ intersegmental instability and w/ central stenosis; – more commonly involves older black females and diabetics (affects females 6 times as much as males); – involves L4-L5 … Read more
– Fractures Subtypes: – capitellar and coronal shear frx – distal humeral frx – lateral condyle frx – medial condyle frx – Muller’s Classfication: – type A: extra-articular fracture; – type B: uni-condylar fracture; – type C: bi-condylar fracture; … Read more
– Discussion: – anesthesia: insist on general anesthesia rather than regional anesthesia for the following reasons: – it is essential that the patient not move during delicate portions of the case; – it is often helpful to paralyze the patient during the fracture … Read more
– Technique: – it is helpful to have the patient paralyzed during the reduction (requires general anesthesia); – anatomic reduction of the condyles is performed first; – remember that the common factor in fixation failure in these fractures is comminution and/or osteoporosis; – best-fit method: … Read more
– indicated for PSVT; – if arrhythmias are not due to reentry involving the AV node or sinus node (eg, atrial flutter, atrial fibrillation, atrial or ventricular tachycardias), adenosine will not terminate the arrhythmia but may produce transient AV or ventriculoatrial block that may clarify dx; – Dose: – half-life of adenosine is less than … Read more
– Discussion: – adolescent tibia vara (Blount’s disease), results from disordered growth of proximal medial physis & metaphysis; – localized varus deformity, often accompanied by medial tibial torsion; – caused by osteochondrosis resulting from mechanical stress converting physiologic bowlegs to tibia vara; – risk factors: common in blacks & obese children; … Read more
– Discussion: – adolescent bunion is present if IM angle > 10 deg & HV angle > 20 deg; – moderate deformity: HV of 25 – 40 deg, – severe deformity: HV of more than 40 deg; – in … Read more
– See: SC Joint Injury – Medial SC Joint Injury: – injury is due separation of proximal clavicular physis rather than dislocation; – need to determine if proximal clavicular metaphysis (distal fragment) is anterior or posterior; – anterior and superior displacement of medial end of clavicle or x-ray appearance … Read more
– Technique – decreases interscalene space by tensing anterior and middle scalenes; – arm of the affected side placed on the sitting patients thigh with forearm supinated; – turn head to the affected side; – extend neck and hold breath; – positive test is obliteration … Read more