– See: – Adult Upper Limb Arteries: – Discussion: Upper Limb Development; – subclavian artery projects into the early upper limb bud & forms subclavian-axillary-brachial trunk; – its distal portion becomes interosseous artery that initially supplies plexus of arteries in the primitive hand; … Read more
– Discussion: – in middle of the arm, ulnar nerve pierces medial intermuscular septum and descends in front of the medial head of the triceps; – in 70-80% of individuals, nerve passes under arcade of Struthers; – the arcade is a thin aponeurotic band extending from medial head of … Read more
– A: Extra-articular (Transverse) – B: Unicondylar fracture – subdivided into lateral condyle sagittal, and medial condyle saggital and coronal; – deforming forces: gastrocnemius – of special importance is B III (Coronal or Hoffa fracture), where only soft tissue attachment is the posterior capsule, that behaves … Read more
– Discussion: – usually involves a supination-adduction injury; – frequently does well w/ closed reduction; – if frx in fibula is transverse, it is type I avulsion fibular frx; – since syndesmotic ligaments are intact, ankle mortise is also stable; – type A: fibula fracture … Read more
– Discussion: – is taken in line with the long axis of the foot; – entire fibula should be included if there is lateral joint tenderness above the joint line; – this view is used to evaluate medial & lateral malleolus anterolateral tibia and proximal fibula; – osteochondral frx of distal tibia and talus; … Read more
– See: – Radiographic Evaluation – Blood Supply to Talus – Discussion: – may occur following talar neck fractures or may be atraumatic (from SLE, diabetes, MS ect); – absence of subchondral bone atrophy in talar dome on x-ray after 6 weeks following fracture implies AVN (see Hawkins Sign); – however, there is not direct correlation between development of AVN … Read more
– Discussion: – fibular plate can be positioned posteriorly as an antiglide plate to resist proximal migration and rotation of distal fragement; – the antiglide plate is chiefly indicated for Weber B fractures; – advantages: – distal screws obtain better purchase, since … Read more
– Definition: – medial plateau of the tibia rotating excessively forward & externally on femur as the joint opens on the medial side; – torn structures: – MCL; – posterior oblique ligament; – ACL; … Read more
– See: Medial Approach – Discussion: – allows access to medial malleolar frx; – skin flap, formed with its base posteromedially, usually heals well because of its blood supply from the posterior tibial artery; – saphenous nerve lying adjacent and immediately lateral to saphenous vein must be avoided; – for medial malleolar avulsion fracture: – … Read more
– See: Smith Peterson Approach – Discussion: – major problems with the Watson Jones technique are dealing w/ gluteus medius & minimus, which lie over anteior capsule and must be damaged or cut to obtain adequate exposure; – original Charnely technique used anterolateral approach w/ pt supine, osteotomy of greater troch, … Read more