– See: – Epiphyseal Artery – Metaphyseal Artery – Periosteal Artery – Discussion: – nutrient artery enters into the diaphysis of long bones through an oblique canal; – direction of canal is determined by relative amount of growth that has occurred at … Read more
– Discussion: – occurrence of syndesmosis injury with Weber B / SER fractures – references: – Intraoperative diagnosis of syndesmosis injuries in external rotation ankle fractures. – Syndesmotic instability in Weber B ankle fractures: a clinical evaluation. … Read more
– Discussion: – abnormally narrow intercondylar notches have been shown to correlate directly with an increased incidence of ACL tears; – w/ excessive internal rotation of the femur, the ACL may be ruptured as it impinges on the edge of the intercondylar notch; – notchplasty is used to widen the anterior portion and recess of the … Read more
– Discussion: – Non Union – General Discussion: – definition of fracture union: defined as bridging callus (ideally both cortices) on 2 orthogonal views with the disappearance of fracture lines – care must be taken not to mistake a pseudoarthrosis for a simple hypertrophic nonunion; – treatment of … Read more
– Avulsion frx of lateral malleolus (Weber A) – frequently does well w/ closed reduction; – w/ lateral and oblique medial malleolus injuries; – pronation of foot & abduction will reduce frx; – however, is an unstable pattern which requires operative Rx; – SER/Weber B: … Read more
– Discussion: – also known as fibrous cortical defect; – most common bone lesion (40% children); – it results from defect of periosteal cortical bone development which leads to failure of ossification; – natural history: – lesion typically develops in childhood … Read more
– Discussion: – few indications, except in elderly and osteoporotic patients w/ low energy extra-articular fractures; – these fractures have a high rate of hardware failure w/ operative treatment; – unfortunately, non operative treatment in elderly patients can also be associated w/ a … Read more
– See: – Humeral Fracture Non Union – Tibial Non Unions – Femoral Shaft Non Union – Discussion: – see bone healing and bone blood supply – definition: fracture that lacks potential to heal without further intervention – frx of shaft of long bone should not be considered nonunion until at … Read more
– Total Femoral Replacement: – indications: reconstruction following tumor resection – technique: – lateral position on a bean bag – begin proximally with a posterior approach to the hip – divide fascia laterally over femur and continue proximally to … Read more
– Discussion: – most common tumor that causes skeletal metastasis in children; – frequency of neuroblastoma is about 1 per 100,000 persons; – originates in neural-crest cells of sympathetic nervous system; – majority of patients have tumor involvment of regional lymph nodes or have metastasis to … Read more