Discussion arises from median nerve, 5 cm above medial epicondyle; runs on volar surface of FDP and along interosseous membrane between ulna & radius; supplies FPL, lateral half of FDP, & pronator quadratus; may supply sensory branches to distal ru and carpal joints; variations: martin gruber anastomosis occurs in 10-15% of all forearms and in … Read more
Myopathic Disorders » Muscle Fiber Types » Biochemistry of Skeletal Muscle Contraction Muscle Contraction Depolarization Metabolic Sequence Calcium Regulation of Muscle Contraction Histology of Skeletal Muscle Chemistry of Skeletal Muscle Muscle Cramps » Extra cellular Matrix composed of many different molecular components, consisting mostly of collagens, proteoglycans, and glycosaminoglycans Matrix metalloproteinases enzymes that digest collagen … Read more
(see also: acetabular component) Discussion it is essential to have optimal acetabular exposure; once acetabular exposure is achieved, then note native acetabular anteversion; Exposure for hips w/ severe osteoarthritis (or w/ heavily scarred hips) it may be necessary to fully release the quadratus femoris, and a portion of the gluteal sling; because the majority of … Read more
Total Hip Replacement Menu » Acetabular Component Revision » Discussion indications: salvage device for use in cases of pelvic discontinuity where a stable socket cannot be wedged between the anterior and posterior columns; classification of bone defects and bone grafting options: in almost every case, bone graft is morcelized and placed behind the cup; in … Read more
THR menu / Revision THR acetabular component Discussion note that some of the problems seen in dysplasia are frequently encountered in revision THR; indications for acetabular revision: sepsis, component malposition, impingement, polyethylene wear, pelvic osteolysis, recurrent dislocation, progressive protrusio, and component loosening; evaluation of the painful THR examination: examination for loosening previoius incisions; contracture of … Read more
Discussion total absence of the thumb may be an isolated anomaly, but it is often associated with some other congenital malformation; absent thumb may be inherited as autosomal dominant or may be sporadic; absent thumb is frequently observed in Holt-Oram syndrome, Fanconi’s anemia, and ring D chromosome abnormalities; absent radius is almost always associated with … Read more
(see also: AKA Prosthesis, Amputations in the Diabetic Patient Discussion average AK amputee walks 43% slower and expends 89% more kcal/min than the normal person; if proximal circulation is adequate, a longer anterior muscle flap may be left and the combination myodesis- myoplasty technique is used; ability to ambulate with a prosthesis depends heavily … Read more
(see also: Upper Extremity Prosthetics) Surgical Considerations consider the Marquardt Osteotomy of the Humerus: supracondylar, to put 15-20 deg of posterior angulation at this site, to facilitate suspension and provide rotational control; distal piece must be at least 5 cm long; stagger the median and ulnar nerve resection levels to avoid a large confluent neuroma
Discussion (see also: rotator cuff) abduction of shoulder is a smooth, integrated motion which has been termed scapulohumeral rhythm by Codman; disruption of this smooth motion is important since asymmetrical movement usually indicates a chronic pathological disorder of the shoulder; there is a 2:1 ratio of movement in GHJ & scapulothoracic joints; clavicle also plays … Read more
Anatomy extensor tunnel I: origin: small facet of ulnar side of the radius near its middle; on lateral side of dorsal surface on body of the ulna just below the insertion of anconeus & interosseous membrane; tunnel: travels thru the first extensor compartment; insertion: most often this tendon inserts onto the APB muscle or it … Read more