Ortho Oracle - orthopaedic operative atlas

Multidirectional Instability

– Discussion:     – multidirectional instability implies three-way subluxations or dislocations either anteriorly, posteriorly, or inferiorly;     – these patients usually have no true Bankart lesion and incontrast patients have a capacious axillary pouch;             – ref: The Effect of Variation in Definition on the Diagnosis of Multidirectional Instability of the Shoulder.      – … Read more

Negative Influences on Bone Healing:

– Negative influences on bone healing: – NSAIDS: – Effects of short-term treatment with corticosteroids and indomethacin on bone healing. A mechanical study of osteotomies in rats. – Antiinflammatory drug effects on bone repair and remodeling in rabbits. – Selective and Nonselective Cyclooxygenase-2 Inhibitors and Experimental Fracture-Healing. Reversibility of effects after short-term treatment. – Dose and Time-Dependent Effects … Read more

Opening Wedge High Tibial Osteotomy

– Discussion:     – surgical descision making:              – Limb Alignment After Open-wedge High Tibial Osteotomy and Its Effect on the Clinical Outcome              – Opening wedge high tibial osteotomy for symptomatic hyperextension-varus thrust.              – The effect of a proximal tibial medial opening wedge osteotomy on posterolateral knee instability: a biomechanical study. – Osteotomy Options: … Read more

Open versus Arthroscopic Ankle Arthrodesis: A Comparative Study

Foot Ankle Int. 1999 Jun;20(6):368-374   O’Brien TS, Hart TS, Shereff MJ, Stone J, Johnson J   ABSTRACT   BACKGROUND: A retrospective review was undertaken for 36 patients who underwent ankle arthrodesis.   METHODS: Nineteen patients underwent an arthroscopic ankle arthrodesis, and 17 patients underwent an open arthrodesis. Only patients with limited angular deformities were … Read more

Muscle Cramps

             – diff dx:                    – exercise-associated muscle cramping                     – Parkinson’s disease                    – amyotrophic lateral sclerosis                     – peripheral neuropathy                    – lumbar radiculopathy (S1)                    – metabolic myopathies (myopathic disorders)                    – low serum Mg and calcium                    – vitamin D deficiency                    – vascular insufficiency                    – hypothyroidism                    – diabetes mellitus                     – lipid-lowering agents, … Read more

ORIF of Calcaneal Fractures

ORIF of Calcaneal Frx Using Lateral Approach: – Preoperative Planning: – Surgical Stratedgy: – pt in true lateral position – J or L approach w/ subperiosteal dissection off lateral wall, including calcaneo-fibular ligament (sural nerve in flap); – extension from tuberosity to calcaneo-cuboid (watch peroneals) – reduction of critical angle of Gissane/ anterior process to … Read more

MRI: T2 Discussion

– Discussion:       – T2 images have a long TR & long TE;       – used to distinguish normal from abnormal soft tissues;       – tissues w/ short T2 values include ca (cortical bone),  ligaments & tendons;       – tissues w/ long T2 values include neoplasms, inflammation, … Read more

MRI Shoulder: Transaxial View:

– Discussion:     – used to evaluate capsule of shoulder, & glenoid labrum, subscapularis  & long head of the biceps, and the humeral head;     – glenoid labrum produces low signal intensity since it is made of fibrous tissue;     – used for imaging SLAP and Barkart injury     – Hill-Sachs … Read more

MRSA Infections:

– Discussion: (see MSSA)     – true methicillin resistance involves the production of enzymes which are able to maintain cell-wall integrity during growth and division even when beta lactams have inactivated penicillin-binding proteins (ie resistant to penicillins and cephalosporins);       – MSRA of are now present in both large and small non-teaching hospitals and in community … Read more