– Discussion: – multiple approaches can be used, but a medial approach is easiest w/ knee in extension as the patella can be rocked up anteriorly to aid in entry; – if pt will allow the knee to be flexed to 45 deg., then do so; – palpate the inferomedial and inferolateral borders … Read more
– Discussion: – Q angle is the angle formed by a line drawn from the ASIS to central patella and a second line drawn from central patella to tibial tubercle; – an increased Q angle is a risk factor for patellar subluxation; – normally Q angle is 14 deg for … Read more
– See: Phalangeal Injury Menu: – Discussion: – fractures of the proximal phalanx are potentially the most disabling fractures in the hand; – direct blows tend to cause transverse or comminuted frx, where as twisting injury may cause oblique or spiral fracture; – proximal fragments are usually … Read more
– See: proximal phalangeal fractures: – Disscusion – indicated for unstable frx of base, shaft, and neck; – K wire characteristics: – use 0.035 or 0.045 inch wires, depending on the size of the phalanx – holding power of the wires: … Read more
– Discussion: – function of the PTFJ – accept 1/6 the axial load of the leg – resist torsional stresses originating from the ankle – resist tensile forces created with weight bearing – resists lateral bending forces – subluxation is common in preadolescent … Read more
– See: Congenital Pseudarthrosis of Tibia – Classification into “Stiff” and “Lax” Pseudoarthrosis: – stiff pseudoarthrosis: – bone ends are hypertrophic – hypertrophic non union should first be compressed for 2-3 weeks, followed by gradual distraction; – Lax Non Union: – lax nonunion … Read more
– Discussion: – frx of proximal tibial metaphysis are rare; – valgus greenstick fractures usually occur between 3-6 yrs of age; – cortex is slightly opened on the medial side; – distal fragment is angulated lateralward; – Non Operative Treatment: – usually treated with closed … Read more
– See: – Defects of the Fibula: – Van Nes Rotational Plasty: – Discussion: – a development defect of the proximal femur recongnizable at birth; – 3rd most common longitudinal deficiency of lower extremity; – abnormality ranges from hypoplasia of entire femur to … Read more
– Sequence of Injury: – medial side is injuried first; – transverse frx of medial malleolus or disruption of deltoid ligament; – anterior tibiofibular ligament disruption; – external rotation then results in rupture of the anterior tibiofibular ligament or its bony insertion; … Read more
– Anatomy: (see forearm flexors) – origin: – humeral head: medial epicondyle of humerus & common flexion tendon; – ulnar head: medial side of coronoid process of ulna; – insertion: middle 1/3 of lateral surface of … Read more