– Discussion: – restoration of heel width / height requires reduction of tuberosity fragment to sustentacular fragment; – generally the tuberosity fragment needs to be brought out of varus and a medially displaced position; – key toreduction of sustentaculum talus fragment, which is almost … Read more
– Preoperative Planning: – Surgical Stratedgy: – pt in true lateral position – J or L approach w/ subperiosteal dissection off lateral wall, including calcaneo-fibular ligament (sural nerve in flap); – extension from tuberosity to calcaneo-cuboid (watch peroneals) – … Read more
– Fracture Fixation: – plate fixation: – 3.5 mm reconstruction plate, Synthes 3.5 mm calcaneal plates, or a flattened 3.5 mm 1/3 tubular plate; – as noted by Carr, et al, in an cadaveric model, the … Read more
– Technique: – 5 cm incision is made over the fracture site, in a direction perpendicular to the platysma fibers; – incise thru the platysma muscle with care to avoid the underlying supra-clavicular nerve; – mobilize the supraclavicular nerve if it is found; – … Read more
– Origin: flexor retinaculum and tubercle of trapezium bone; – Insertion: radial side of entire length of first metacarpal bone; – Action: flexes & abducts first metacarpal w/ medial rotation at hand; – Synergists: abductor pollicis, adductor pollicis; – Nerve: Median, C8 > T1; – Discussion: … Read more
– see distal radius fracture menu (volar Barton’s frx) – orif of distal radius fractures – Surgical Approach: – standard volar approach: – most indicated for simple extra articular fractures and when there is absence of ulnar comminution / displacement: – incision starts at thenar crease of palm, curves toward middle of forearm, w/ … Read more
origin: hamulus of the hamate bone and flexor retinaculum; insertion: entire length of ulnar border of 5th metacarpal; action: flexes and slightly rotates the 5th metacarpal; helps to cup the palm of the hand; synergists: flexor digiti minimi brevis, abductor digiti minimi; nerve supply: deep palmer branch of ulnar nerve, C7, C8, T1 … Read more
– See: Hallux Valgus: – for mod hallux valgus in younger pts (HVA < 30 & IMA < 13-15 deg); – usually no pin or screw fixation is required; – no shortening of metatarsal will occur; – if a Silver Procedure is being performed, concomitantly, the excised medial eminence can be fashioned into a trapezoidal … Read more
– Technique: – there are two approaches that allow decompression of PIN: anterior and posterior (see Henry and Thompson); – Henry’s mobile wad (brachioradialis, ECRL , and ECRB) serves as the focal area for orientation; – anterior approach is more advantages since is allows decompression of all points of … Read more
– See: – Percutaneous Pin Fixation – Type III Supracondylar Frx – Indications: – vascular injuries – inadequate reduction; – brachialis may become interposed at frx site or by proximal humeral frx fragment button-holed thru brachialis (see physical exam); … Read more