The Hip - book

IntraOperative Reduction of Proximal Humerus Fracture

– Discussion:         – proximal first or screw insertion method – goal is bring frx out to length (anatomically reduced) and to have the plate optimally positioned (not too proximal /not too distal);         – disimpaction:                 – longitudinal traction to limb is applied                 – periosteal elevator is inserted into the fracture gap to … Read more

Reduction of Ankle Syndesmosis

– Discussion:      – note that the main displacement of the fibula is posterior (not lateral);      – reduction is achieved w/ IR of ankle & manual translation of fibula in an anterior direction until it reaches anterior tubercle of tibia;      – fibular fracture is reduced & provisionally transfixed to the tibia w/ horizontal 1.6 mm … Read more

Ref for Clubfoot

Dogma Disputed: On the Pathogenesis of Clubfoot. Current Concepts Review.  Treatment of Congenital Club Foot. Current Concepts Review.  Operative Treatment of Congenital Idiopathic Club Foot. A reappraisal of metatarsus adductus and skewfoot. Results of surgical treatment of talipes equinovarus congenita. Arteriography in club foot. Surgical management of resistant congenital talipes equinovarus deformities. Plantar release in … Read more

References for Myocardial Infarction

Serum CK-MB is useful in diagnosis of acute myocardial infarction after total hip arthroplasty.  Surveillance for postoperative MI after noncardiac operations.   Effect of early intravenous heparin on coronary patency, infarct size, and bleeding complications after alteplase thrombolysis: results of a randomised double blind European Cooperative Study Group trial.  Effects of prophylactic antiarrhythmic drug therapy in … Read more

Reduction of Spondylolithesis

– Discussion:     – progression of severe slips after apparently solid in situ arthrodesis has led some to consider reduction and instrumentation for              spondylolithesis;     – another rationale for reduction of the slip is improvement in cosmetic appearance of the trunk;     – slip angle:             – … Read more

Reduction of Surgical Neck Fractures

– Reduction of the Displaced Fracture:     – if anterior angulation is > 45 deg, forward elevation will be limited;     – gentle traction w/ flexion and some adduction is usually all that is needed to position arm in pivotal portion so that it can be impacted under head;     – gental … Read more

Reduction: Posterior Dislocation

– Discussion:    – w/ pt in supine position, lateral traction is applied, followed by external rotation to relax the posterior capsule;    – posterior pressure is then placed on humeral head to affect reduction;    – after reduction, arm is gently abducted in external rotation and placed at side;    – following reduction, downward … Read more

Reduction of Pelvic Volume from Pelvic Fractures

– Discussion:            -see AP injuries and vascular injuries from pelvic fracture           – anatomic reduction and stabilization of pelvic frx prevents continued blood loss by reducing bleeding from fracture fragments                     and from and injured sacral venous plexus which has the effect of reducing pelvic volume;           – pelvic volume can be closed down by wrapping sheet around pelvis, and then sequentially … Read more