The Hip book

Tumors of Hand and Distal radius

– Adamantinoma – Basal Cell Carcinoma: – Calcinosis – Chondrosarcoma: – the most common bony malignancy in the hand; – CMC Boss: bony growth at bases of second and third metacarpals; – special radiographs can demonstrate the osteophytes, which may be resected if symptoms warrent; – associated with ganglia at least 30% of the time, … Read more

Type II Pilon Frx

– Discussion:     – comprises articular frx w/ articular incongruity but minimal comminution;     – frx extend into the joint distally from a spiral frx of distal tibia     – ankle mortise must be evaluated carefully to determine if fibular frx in question is part of joint injury or merely                 frx assoc … Read more

X rays: for Tibial Frx

– comminution:     – more than 50% cortical comminution is considered significant and increases chance of non union; – displacement:     – > 50% frx displacement will significantly increase risk of non-union, due to instability of frx and predisposition for future displacement (if treated closed); – accetable reduction:     – > 10 deg … Read more

Wound Vac

– Discussion:       – KCI Vacuum Assisted Closure Device: (Company Web Site) and V.A.C.® Therapy Indications and Safety Information      – Soft Tissue Coverage (Austere Environment) – Flaps and Vacuum-Assisted Closure (VAC)       – technique:             – debride all devitalized tissue and contaminated material;             – sterile reticulated … Read more

Wound Closure for TKR

 – Discussion:         – Should Subcuticular Sutures be Avoided in TKR?               – references:                       – Modality of wound closure after total knee replacement: are staples as safe as sutures? A retrospective study of 181 patients.                       – Wound complications in joint arthroplasty: comparing traditional and modern methods of skin closure                       – Staple vs. … Read more

Wound Management

– Menu:      – Antibiotic Beads       – Antibiotic Prophylaxis       – Carrier State      – Contaminated Wound Care       – Debridement of Muscle: (debridement of open tibia fractures);       – Decubitus Ulceration      – Drains and Closure of Wounds      – Fracture Blisters      – Gun Shot Wounds       – Pressure Irrigation   … Read more

Work Up of the Painful Total Knee Arthroplasty

– See: TKR Menu: (Function and Activity after TKR) – Natural History of Painful TKR:     – references:               – Pain and Depression Influence Outcome 5 Years after Knee Replacement Surgery.               – Impact of Psychological Distress on Pain and Function Following Knee Arthroplasty – Potential Causes of TKR failure:     – early failures:     … Read more

Workup for Femoral Shaft Frx

– Trauma Workup        – assessment of perfusion: damage control orthopaedics        – timing of surgery in orthopaedic patients with brain injury        – surgical timing and prevention of pulmonary complications in patients with femur frx  – PreOp Planning for IM Nailing: (IM Nailing Technique)           – Fracture Classification            – Open Femur Frx     … Read more