– 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
– Discussion: – anterior facet articulates w/ head of talus; – concave in shape and usually located just lateral to the middle facet; – anterior and middle facets are often congruent; – Radiology: – slightly concave, frequently is confluent w/ the middle one; … 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: 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
– See: Anterior Approach to Cervical Spine: – Discussion: – Smith Robinson disectomy & block fusion is preferred over Cloward dowel for involvement of one or two interspaces; – for multi-level spondylosis & myelopathy, w/ more extensive anterior decompression involving excision of osteophytes & multiple vertebrectomies, a strut graft fusion … Read more
– See: Classification and Column Theory – Discussion: – anterior column extends from symphysis pubis & obturator foramen thru acetabulum to ASIS and up through iliac crest; – anterior column is less frequently fractured than posterior column due to frequency of posteriorly directed forces; – frxs of the anterior … Read more
– See: Ligamentous Instability: – Discussion: – antatomic structures in the anterior column that resist compression forces are the vertebral body centrum and intervertebral disc; – structures that counter act tensile forces in anterior motion segment are anterior longitudinal ligament and the annulus fibrosis; – stable injuries to anterior column … Read more
– Discussion: – most indicated for unstable burst frxs w/ cord impingement caused by bone fragments off the postero-superior vertebral body; – allows most direct visualization for decompression of thecal sac; – visceral and vascular structures may be injured, & this approach carries the greatest potential morbidity; – … Read more
– See: Anterior Approach to the Humerus Axillary Approach: Posterior Approach Posterior Approach to Humerus Surgical Approach for Proximal Humeral Fractures Positioning and Draping: supine or beach chair; small soft bolster is placed beneath the shoulder blades to protract the shoulder; head is stabilized to prevent hyperextension and subsequent brachial plexus palsy; place patient in … Read more