– Wrist: – exam: flexed & ulnarly deviated – synovectomy: – synovectomy is most indicates before joint changes occur; – flexion deformity: – 30 deg wrist flexion deformity can be treated by serial splinting & casting; … Read more
– Discussion: – length & alignment are restored by use of femoral distractor in saggital plane, w/o need for fracture table; – this permits hip and knee to be flexed on the table during nailing; – the distractor may be particularly suited to poly trauma patients; – disadvantage … Read more
– Criteria for Unstable Frx: – Neurologic deficit; – Posterior Element Injuries; – Loss of more than 50% of anterior vertebral body height; – Greater than 25 to 35 deg of kyphosis; – Thoracolumbar burst frx: – angulation of thoracolumbar … Read more
– See: Radiographic Imaging – Discussion: – unstable scaphoid fractures not only impact the potential for healing with non operative treatment, but they also impact on the position of healing (and possible scaphoid non union or malunion); – indicators of instability: – trans-scaphoid perilunate dislocation; … Read more
– Displaced Extra-Articular Fractures – Spiral oblique of Proximal Phalanx: – is inherently unstable, and requires internal fixation – reduction can be obtained – attempt 2 or 3 K wires; – Transverse Frx at Neck of Proximal Phalanx: – common in children – “Booby – trap – fracture” – angulation is between 60 and 90 … Read more
– See: – Radiographic Findings – Sliding Hip Screw w/ Unstable Frx – Discussion: – it is important prior to reduction to distinguish between unstable and stable frx intertroch fractures; – w/ cortical instability on one side of frx owing to cortical overlap or destruction, frx … Read more
– Discussion: – unicompartmental arthroplasty serves a specific nitch for knees that are too severe for arthroscopic management of medial DJD (see mosaicplasty) but are not severe enough for total knee replacement; – best indications: – UKR for patients with partial thickness cartilage loss in the affected compartment. – The implications of … Read more
– See: – Facet Joint Injuries – Hyperflexion Injuries – Oblique projections; – Pillar View – Discussion: – simple unilateral facet dislocation is often a stable injury, eventhough there is disruption of the posterior ligament complex (involved joint capsule, posterior longitudinal ligament, … Read more
– See: RU joint – Discussion: – refers to impingement of the ulnar head against the carpi which can lead to TFCC tears and lunotriquetral ligament attrition; – lunotriquetral ligament attrition may occur from compression and translation shear as the lunate becomes impinged against the ulnar head; – causes: … Read more
– Discussion: – impingement of distal ulna on carpi which may arise from positive ulnar variance or non union of distal ulnar frx; – positive ulnar varience leads to loading of the ulnocarpal joint and resultant LT disruption, lunate chondral lesion, and TFCC tears; – diff dx: (ulnar sided … Read more