Ortho Oracle - orthopaedic operative atlas

Weber C Fractures

– Discussion:     – Weber C ankle fractures occur above the the syndesmosis and are similar to PER injuries in the            Lauge Hansen classification:     – classification:            – C:    fibula fracture above syndesmosis            – C1  diaphyseal fracture of the fibula, simple   … Read more

WBC Differential

    – See Neutrophils/Left Shift  – Lymphocytes: (24-44%)  – Increased: Measles, German Measles, Mumps, Whooping Cough, Small pox, Chicken pox, Influenza, Hepatitis, Infectious Mononucleosis, Acute Infectious Lymphocytosis in children, Virtually any Viral Infection, Acute and Chronic Lymphocytic Leukemias;  – Decreased: After Stress, Burns, Trauma, Nl variation, Uremia;  – Monocytes (3-7%)  – Increased: Bacterial infection … Read more

Wayne County Reduction

– Discussion:     – Medial cortical overlap technique;     – Kaufer H, et. al. (1974);     – Stover, et al. (1971)     – For unstable intertroch frxs w/ sl medial or posterior instability;     – Reduction w/o medical cortical apposition or overlap is unstable & will result in femoral neck shortening and … Read more

Watson test

– Discussion:     – this manuever helps diagnose SLD but the test is not specific for SLD, because it may reposition entire proximal carpal row if row, rather than the scaphoid;     – manipulation of scaphoid by examiner may reproduce pt’s sensation of instability or even cause subluxation of proximal pole of the scaphoid;     … Read more

Warfarin Interactions and Resistance

– Contraindications same as Heparin:  – ASA (Bleeding)  – w/ hemorrhagic tendencies  – pregnancy  – severe hepatic or renal disease  – severe hypertension  – blood dyscrasis  – Agents which Increase Prothrombin Time:  – Acetaminophren;  – Allopurinol  – ASA – Steroids  – Cimetidine – Indomethacin  – Flaggyl  – Hypoglycemics  – Phenothiazines – Phenylbutazone  – Propylthiouracil  – … Read more

Warfarin induces Skin Necrosis

– microvascular thrombotic process which results in skin necrosis;  – occurs in patients with partial deficiency of protein C within the 1st 1-2 days of warfarin therapy

Warfarin (Coumadin)

Action inhibits Vit K dependent production of clotting factors  mainly inhibits prothrombin (II) and VII but also IX and X  VII (t/2=4-6hrs), IX (t/2=18-24hrs), X (t/2=18-24hrs), II (t/2=18-24)  proteins C (t/2=6 hrs) and S (early);  hence PT increases in 48 hrs 2nd to decr of VII but many days of therapy needed for therapuetic levels … Read more