Data Trace Editor – 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
– Discussion: – consequences of anterior instability include Bankart lesion, Hill Sachs lesion, erosion of the anterior glenoid, loose body formation, and stretching of the joint capsule; – features: – degree of trauma involved – distinguish between traumatic dislocations and recurrent … Read more
– History and Exam: – fracture of the scaphoid is suspected w/ fall on an outstretched hand; – snuff box tenderness (see clinical differential diagnosis:) – scaphoid impaction syndrome – tenderness to palpation over scaphoid tuberosity and/or proximal pole just distal to Lister’s tubercle; … Read more
– Trauma Management: – damage control resusitation – ref: Damage-Control Orthopedics Versus Early Total Care in the Treatment of Borderline High-Energy Pelvic Fractures – fluid management – hypotension is associated with an increased risk of mortality, ARDS, and multiple organ failure; – IV access is secured with at least … Read more
– See: brachial plexus – Discussion: – hx: persistant pain > 6 months: (poor prognosis); – diff dx: – breast cancer (lower plexus and painful) – radiation therapy (upper plexus and painless) – … Read more
– See: Trauma Menu – Discussion: – note that with acetabular fracture associated with major trauma that there will be 50% chance of at least one other major injury; – neuro and head injury (see Glasgow) – abdominal and chest injury (pulmonary … Read more
– History and Physical: – time of injury and symptoms; – exact position of hand (finger flexion) during the injury – kanavel’s signs: – used to distinguish deep infectious tenosynovitis from superficial cellulitis; – pain w/ finger extension may … Read more
– Exam: – skin abrasion and contussions from direct blows; – r/o compartment syndrome; – ligamentous instability – peroneal nerve function; – Radiographs: – Indications for treatment: – Open Plateau Frx or Frx w/ compartment syndrome; – Articular Surface … Read more
– Discussion: – tap pins through soft tissues until they meet bone, and once the wire emerges from the far cortex, it is driven through the soft tissues w/ a mallet; – periarticular insertion – avoid impaling synovium; – in the knee, insert the wire 1 cm below articular surface … Read more
– Type I: – comminution is minimal or there is no comminution at frx site – Type II: – comminution involves a fragment larger than that in type I but has at least 50% of the circumference of the cortices of two major frx fragments intact; … Read more