– Surgical Considerations for Specific Diseases and Conditions: – Medical Assesment: – surgical risk assessment – risk factors for infection: are taken into consideration; – anesthesia consult and posting – anesthesia, medical consderations, and timing for … Read more
– Discussion: – consider photographs for documentation; – consent should explain possibility of long term nail disfigurement; – instruments: – freer septum elevator, dental spatulas, fine hemostats, beaver blade, small currette, single and double pronged skin hooks; – an easy way of applying … Read more
– IM Nailing Technique – Open Femur Frx – Radiographs: – look for evidence of a pathologic lesion on x-ray, noting that it would be disasterous if a nail were driven through an occult osteosarcoma or chondroscaroma; – AP pelvis: (rule out concomitant injuries) – Hip Dislocation … Read more
– Discussion: – arises from thickening and contracture of pretendinous bands: – inserts into skin distal to MP joint & into tendon sheath does not cause N/V displacement, but is responsible for MP flexion deformities which can be predictably corrected by surgical excision; – at a point just distal … Read more
– See: Hypoplastic Thumb: – Discussion: – a rudimentary thumb w/ no or very little metacarpal & no or very few muscles is categorized as a floating thumb. – such a floating thumb may have all assoc. abnormalities & syndromes of true hypoplastic thumb and the absent thumb. – Radiographs: – … Read more
– Discussion: – pretendinous bands arise from the palmar fascia as strips of tissue which extend toward the bases of the digits; – the neurovascular bundle will lie on either side of the pre-tendinous bands; – at a point distal to the distal palmar crease, the … 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: – tibial component – proximal tibial cut – extra-medullary cutting guide; – Discussion: – viewed in saggital plane, line drawn between anterior & posterior rims of the tibial plateaus is approx 10 deg posteriorly; – this radiographic tilt does not take the menisci into … 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
– 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