– See: Synthes Hybrid Fixator – Discussion and Initial Considerations – Operative Technique: – may be combined w/ circular wire fixators; – reduction: – in most cases, the fracture should be reduced prior to fixator application; – planning the configuration: … Read more
– Engaging the Nail Jig: – position the insertion block on to the proximal end of the nail; – position insertion handle onto insertion block so it will be medial to tibia for nail insertion and precise placement of proximal locking; – note that the proximal nail tip … Read more
– Discussion: – includes ankle disarticulation, removal of malleoli, & anchoring heel pad to the wt bearing surface) allows execellent gait with a cosmetic prosthesis; – symes amputations will not heal w/o palpable posterior artery pulse; – surgery may be performed in 2 stages; – most common … Read more
– See: syndesmotic sprain – Anatomy: – syndesmosis is made up of anterior-inferior tibiofibular ligament, interosseous ligament, and posterior-inferior fibular ligaments, inferior transverse tibiofibular ligament, and interosseous ligament; – these stabilize the mortise by opposing the fibula in the fibular notch (incisura fibularis tibiae); … Read more
– See: Technique of Snydesmotic Fixation – Discussion: – if only syndesmotic ligaments are divided (w/ fibula & collateral ligaments intact) there will be no widening of mortise or lateral displacement of talus; – compressing the fibula and tibia above the ankle elicits tenderness at the syndesmosis, implies injury to the … Read more
– Discussion: – fractures of the sustentaculum tali result from landing on the heel combined with severe inversion of the foot; – inversion of foot produces acute pain just below the medial malleolus; – pain may be accentuated by passive hyperextension of the great toe; – this fracture may be mistaken for an ankle fracture; … Read more
– See: Gait Menu: and Muscle Activity During Gait – Discussion: – during swing, the ankle dorsiflexes by the concentric contraction of anterior tibialis muscle; – all other muscles are silent; – momentum generated by the gastrocsoleus and hip flexors at terminal stance carries the leg forward – during initial swing … Read more
– Function: – references: – The effects of implant design on range of motion after total knee arthroplasty. Total condylar versus posterior stabilized total condylar designs. – Total condylar knee replacement. A study of factors influencing range of motion as late as two years after … Read more
– Discussion: – is preferred by many for use in older children and adolescents; – skeletal traction is applied w/ Steinman pin inserted thru distal femur; – see: insertion technique – knee should be flexed 30 deg to relax the hamstrings; – … Read more
– Discussion: – fractures of the sustentaculum tali result from landing on the heel combined with severe inversion of the foot; – inversion of foot produces acute pain just below the medial malleolus; – pain may be accentuated by passive hyperextension of the great toe; – this fracture may be mistaken … Read more