– Discussion: – strong and well-defined, arise from antero-inferior surface of medial epicondyle and inserts at the sublimis tubercle, adjacent to the joint surface; – primary constraint to valgus instability; – in flexion, MCL provides 54% of valgus stability; … Read more
– Discussion: – anterior injury may be through symphysis or thru pubic rami unilaterally or bilaterally; – symphysis disruption may also occur with pubic rami fractures; – posterior injury: degree of SI joint disruption depends on the energy sustained during the trauma; … Read more
– See: Anterior Plate Fixation Methods – Indications: – open book pelvis injury w/ greater than a 2.5 cm pubic diastasis; – note that fixation of pubic rami fractures can be much more complex than the fixation of a simple diastasis; – controversies: – posterior injury and need for … Read more
– See: – Arteries of the Upper Limb – Anatomy: – branch of axillary artery – smaller than PHCA; – passes laterally around front of surgical neck of the humerus – major blood supply to humeral head is from AHCA; – humeral head is … Read more
– Bony Impingement: – pts who have persistent pain in anterior aspect of ankle & who have anterior tibiotalar spur evident on a lateral roentgenogram need additional diagnostic evaluation and management; – extreme dorsiflexion required by the demiplie position in ballet can lead to impingement of anterior lip of … Read more
– Discussion: – Anterior Talofibular ligament is the primary restraint in anterior drawer test; – testing of ankle in 10 deg of plantar flexion results in greatest amount of translation, although one cadaveric study showed that maximum anterior excursion occurs in dorsiflexion; – injury of the calcaneofibular lig does not increase amount of the anterior drawer; … Read more
– Exposure: – similar to the ilioinguinal approach: – it is necessary to expose the iliac crest & SI joint including the ala of sacrum; – ensure that the patient is on a flouro table and that patient’s pelvis is distal to the main table support … Read more
– See: intercondylar eminence frx; – Discussion: – pediatric ACL injuries – Transphyseal ACL reconstruction: – references: – Transepiphysial fixation of anterior cruciate avulsion in a child. Report of a complication and review of the literature. – Transepiphyseal Replacement of the Anterior Cruciate Ligament in Skeletally Immature Patients. A preliminary … Read more
– See: Autograft Discussion – Anterior Crest: Corticocancellous Graft: – position in the supine position with bump under the hip; – make an incision along the undersurface of the anterior crest, beginning about 2 cm posterior to the ASIS which continues a distance of about 7 cm; … Read more
– See: Autograft Discussion – Technique: – the middle crest is quite thin and can be easily shattered; – subperiosteaally, dissect the abdominal musculature and iliacus from the inner wall; – after the tendinous decussation of the gluteal and abdominal muscles has been incised along the supero-lateral aspect of the … Read more