– Clinical Findings: – history: patient may complain of a subjective knee hyperextension sensation, and twisting or pivoting are also difficult; – lack of contained effusion is suggestive of posterolateral capsular injury; – look for diffuse tenderness over the posterolateral joint region, fibular head, and joint line; … Read more
– Discussion: – serial diagnostic exam should take into consideration static deformities of the lower extremities, gait, ROM, tenderness, and knee stability; – in the child w/ a painful knee, it is essential to closely examine the hip as hip pathology can refer pain to the hip; – Examination: – Gait: … Read more
Ewing’s sarcoma. Prognostic factors, disease control, and the reemerging role of surgical treatment. Limb reconstruction with vascularized fibular grafts after bone tumor resection. Fractures of long bones previously treated for Ewing’s sarcoma. The cellular biology of bone tumors. Pelvic Ewing’s sarcoma. Advances in treatment. Second cancers in long-term survivors of Ewing’s sarcoma. The role of surgical … Read more
– See: – Brachial Plexus – Neuro Exam – Management of Spinal Cord Injury: – Assess for Spinal Shock & Sacral Sparing – bulbocavernosus – anal sphincter S-3 – bladder sphincter S-2 – FHL S-1 – level of a spinal cord … Read more
– Chronic Injury: – flexion deformity of PIP & an extension deformity at DIP joint; – MCP hyperextension deformity; – after the central slip has been disrupted for some time, there will be volar migration of lateral bands, and contracture of oblique retaincular lig. – after the lateral bands … Read more
– See: – PE of C-Spine: – Neuro Exam – Inspection: (scoliosis, thoracic kyphosis, lumbar lordosis, zoster ect.) – ROM: – extension: Phalen’s test (lumbar stenosis) – flexion: – frequently assessed by patient’s ability to touch the floor; … Read more
– See: Bone Tumor Menu – Discussion: – prevalence: – it represents approx 7% of all primary bone malignancies; – second most common primary malignant bone tumor (behind osteosarcoma) (2.1 per 1 million children) – Ewing’s sarcoma is more common in males and is rare in blacks; – … Read more
– Discussion: – in polio, paralytic equinovalgus deformity results from paralysis of tibialis anterior and posterior, together w/ unopposed action of peronei and triceps surae; – os calcis is everted and is displaced laterally and posteriorly; – sustentaculum tali can no longer function as calcaneal buttress for talar head, which shifts medially and into equinus; … Read more
– See: ankle equinus: cerebral palsy – Discussion: – more common in spastic hemiplegia, and is caused by overpull of of the tibialis posterior and/or anterior tibial tendons; – try to determine which of these muscles is more pathologically involved; … Read more
– Femoral Exposure: – femur is exposed by placing a medium Homan retractor under femoral neck & 2nd under quad. femoris & levering down on fascia lata; – leg is held in adduction, flexion and internal rotation such that tibia is vertical; – remove any remaining … Read more