The Hip - book

Operative Timing for Club Foot Deformity

– Discussion:       – best time to do the operative procedure is debatable;       – although some surgeons have recommended that the surgical release be done within the first few days or weeks of life, it is generally              agreed that this is not advisable;     … Read more

Open Excision of Distal Clavicle

– See: Distal Clavicle Excision – main discussion Discussion:      – consider excising only 1 cm of the distal clavicle; – excision of the distal 1.5-2.0 cm of the clavicle ensures that impingement will not occur (excision of this fragment may cut trapezoid ligament); – the remaining conoid ligament is sufficient to anchor the distal clavicle to … Read more

Opening Wedge Proximal Metatarsal Osteotomy

 – See: Hallux Valgus:  – for mod hallux valgus in younger pts (HVA < 30 & IMA < 13-15 deg);  – usually no pin or screw fixation is required;  – no shortening of metatarsal will occur;  – if a Silver Procedure is being performed, concomitantly, the excised medial eminence can be fashioned into a trapezoidal … Read more

Operative Checklist

  Clickable Image Map: – Trauma Systems: Neuro (see Glasgow) Cranio-Maxillo-Facial Cardiac Respiratory Renal Vascular Compartments Hepatic Coag X-rays and Template Planned Incision Consent Bone Graft Open vs Closed Reduction Anesthesia & Cardiology Consults Prophylactic ATB DVT prophylaxis Posting Blood & Cell Saver Implant Selection Positioning Table type and Flouro – Initial Orders: – NPO … Read more

Operative Decompression of the PIN

– Technique:     – there are two approaches that allow decompression of PIN: anterior and posterior (see Henry and Thompson);     – Henry’s mobile wad (brachioradialis, ECRL , and ECRB) serves as the focal area for orientation;     – anterior approach is more advantages since is allows decompression of all points of … Read more

Open Reduction for DDH

Open Reduction for DDH – Inidications:     – older age:          – attempts at closed reduction should be limited to children who are less than three years old;          – once children begin to walk, there is decreased chance for successful closed reduction & increased risk of AVN; … Read more

Open Reduction: Supracondylar Frxs

– See:        – Percutaneous Pin Fixation        – Type III Supracondylar Frx – Indications:     – vascular injuries     – inadequate reduction;           – brachialis may become interposed at frx site or by proximal humeral frx fragment button-holed thru brachialis (see physical exam);         … Read more