– See: Technique of Free Tendon Grafting – Discussion: – prosthetic graft serves as temporary spacer around which a pseudotendon sheath forms, & provides a healthy bed in which to place tendon autograft; – pulleys can be reconstructed at time of insertion of prosthesis – … Read more
– 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
– Evaluate Proximal Stem: – decide whether trochanteric osteotomy is required; – it is essential to avoid a proximal femoral frx while extracting the stem; – direct extraction of a femoral stem can be blocked by excessive cement or proximal bony overgrowth medial to the greater trochanter; … 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
– Discussion: – arises from disruption of the lateral collateral and annular ligaments; – associated conditions: elbow dislocation, radial head excision, coronoid fracture; – diff dx: lateral epicondylitis – LCL anatomy: – lateral collateral ligament consists of a ligamentous expansion proceding down from lateral … Read more
– See: PIN – Inciting causes: – radiocapitellar joint ganglions and synovitis – congenital tightness of ligamentous arcade of Frohse; – include poorly placed screws for fracture fixation – PIN is vulnerable during ORIF of proximal radius; – in 25% … Read more
Discussion: – the hyperextension phase of throwing may be the most important component of internal impingement; – in the late cocking position (abduction, external rotation, extension) may cause the postero-superior edge of the glenoid labrum to become caught between the humeral head and rotator cuff (surface of the infraspinatus and posterior fibers of supraspinatus tendon); – … Read more
– Anatomy: – this nerve is deep motor branch of radial nerve & supplies all of extrinsic wrist extensors except for the ECRL; – radial nerve enters the anterior compartment of the arm lying deeply between brachialis medially & BR & ECRL laterally; – PIN passes thru supinator muscle … Read more
– Discussion: – posterior horn of the medial meniscus is difficult structure to view w/ arthroscope, esp in very tight joints with little valgus laxity; – Positioning: Valgus Stress to the Slightly Flexed Knee: – valgus stress applied to slightly flexed knee (no > 10 deg) combined w/ external rotation of tibia … Read more
– Femoral Tunnel: – goal is to re-create the large anterolateral band of the PCL, which tightens in flexion; – see anatomy of PCL – cortical entry site: – small skin incision is made w/in Langer’s lines, which overlies the vastus medialis oblique insertion into … Read more