The Hip book

Hand

Revision Total Knee Replacement:

Revision Total Knee Arthroplasty                                                                                                        – Assistance provided by Michael Berend MD – PreOperative Considerations and Implant Selection:     – work up of the painful TKR: – Surgical Approach: (Surgical Approach for Primary TKR);       – Component Removal:     – prior to component removal, take the knee thru a range of motion and evaluate … Read more

Reversed Obliquity Intertroch Frx

    – See: Unstable Intertrochanteric Fractures – Discussion:     – in reverse oblique fractures, the major frx line extends from proximal-medial to distal-lateral through intertroch-subtrochanteric region;     – marked tendency toward medial dispacement of shaft 2nd hip adductors;            – tendency for medial shaft migration may result in … Read more

Reverse Dorsal Metacarpal Flap

– Discussion:     – dorsal metacarpal vessels contribute to the fascial plexus, which supplies the skin of the dorsum of the hand;     – reverse dorsal metacarpal flap, based on the dorsal metacarpal arteries, can cover small soft-tissue defects in the hand;     – axis of this flap parallels dorsal interosseous muscles; … Read more

Open Repair of Supraspinatus / Infraspinatus Tear

– Rotator Cuff Tear – Discussion:  – arthroscopic repair techniques – clinical outcomes of repair      – indications for RTC tear: – shoulder pain (especially night pain); – symptoms which cause loss of function or quality of life; – failure of NSAIDS and formal physical therapy; – failure of series of marcaine / steroid injections; – full passive ROM pre-op is necessary … Read more

Repair of the Torn Meniscus

– Meniscal Anatomy and Physiology:     – medial meniscus             – bucket handle meniscus tear              – posterior horn tears of medial meniscus      – lateral meniscus             – discoid meniscus     – indications for repair:             – … Read more

Reflex Sympathetic Dystrophy / Complex Regional Pain Syndrome

– Definition:        – “RSD” is an imprecisely used term; has been used to describe changes in soft tissue and bone;        – RSD may not involve the sympathetic nervous system and may not be the consequence of a reflex;        – 1995: IASP Consensus Conference: “Complex regional pain … Read more

Reiter’s syndrome

– See: Spondyloarthropathies – Discussion:     – involves arthritis of large joints (knees & ankles), uveitis, skin lesions, & urethritis, however only a minority will have classic triad of symptoms;           – conjunctivitis is observed early, usually before or at the onset of arthritis;           – … Read more

References for Wound Infection / Healing

Assessment of perfusion in postoperative patients using tissue oxygen measurements. Local heat increases blood flow and oxygen tension in wounds. Effect of electrocautery on wound healing in midline laparotomy incisions. Factors affecting the incidence of postoperative wound infection. Nutritional status: importance in predicting wound-healing after amputation. Doppler-determined segmental pressures and wound-healing in amputations for vascular … Read more