Ortho Oracle - orthopaedic operative atlas

Physical Therapy after TKR

– See: Function and Activity after TKR  – Post Operative ROM:     – most important factor predicting ultimate ROM is range of motion before surgery;             – ref: Range of Motion Correlates with Patient Perception of TKA Outcome.     – patients with significant stiffness before surgery will have the most difficulty gaining range of motion; … Read more

Physiologic Calcium Homeostasis

– Discussion:     – calcium homeostasis is the summation of regulatory feedback systems involved in the control of plasma Ca concentrations;     – despite the small quantity of ionized calcium (as compared to the amount of calcium in bone), calcium is maintained in blood at a closely            regulated concentration;     – rate … Read more

PHYSOSTIGMINE/ANTILIRIUM

Antidote for tricyclic antidepressent, atropine, scopolamine overdose; reversible anticholinesterase;  Adult: .5-2mg IV slowly; 1mg SQ q15min;  Note rapid IV administration associated with convulsions; cholinergic side effects; may cause asystole

Phytonadione/Vit K

– Discussion:      – for correction of PT from: warfarin & hyperalimentation;      – w/ parental treatment, prothrombin deficiency is controled in 4-8hr, normalized in 24 hrs;      – watch for IV anaphyllaxis, give slowly;      – patients who require brief reversal of anticoagulation from warfarin therapy are more easily treated … Read more

Piano Key Test

– Discussion:      – evaluate the freedom of motion in an AP as well as pain an crepitus      – with one hand, firmly stabilize the distal radius;      – w/ other hand, grasp the head of ulna between the thumb and index fingers

Pigmented Villonodular synovitis

Discussion pigmented villonodular synovitis is a slow growing, benign, and locally invasive tumor of the synovium; location: most often involves the knee (also in hip, ankle, elbow, etc.); always consider PVNS in a younger patient with unexplained hip pain; acute episodic attacks of pain and swelling may occur; patients may have mechanical symptoms (locking and … Read more

Physical Exam of DDH

– See: Impediments to Reduction – Early DDH:      – Barlow’s Test      – Ortolani’s test      – Hip Clicks:            – common occurance on physical exam;            – there is no published significance of hip clicks; – Late DDH:     – tightness … Read more

Physical Exam of Sub Talar Joint

– Discussion:     – wt bearing line of the body normally falls medial to the axis of sub talar joint, & therefore, when the patient stands on one foot, the  foot pronates;            – when pt rotates leg externally, heel inverts & wt bearing line moves laterally;     – total … Read more