Data Trace Editor – See: Watson Jones Approach Smith Peterson Approach – Discussion: – in direct lateral approach, a curvilear split is made thru the anterior portion of the gluteus medius and vatus muscles, in order to gain access to the anterior face of the hip joint; … Read more
– Discussion: – forefoot is most commonly affected portion of rheumatoid foot; – forefoot deformities include: – claw toe or hammer toe of lateral four toes; – severe hallux valgus – plantar keratosis beneath subluxed or … Read more
– Discussion: – modified procedure includes release of adductor hallucis, transverse metatarsal ligament, and lateral capsule combined w/ excision of medial eminence and plication of the capsule medially; – this procedure was modified to retain the lateral sesamoid, which helps to prevent hallux varus (which as common w/ original Mcbride bunionectomy); – as this procedure attempts to … Read more
– See: AC Joint – Distal Clavicle Excision: – is often included in the distal clavicular stabilization; – note that in younger patients the AC joint cartilage (and meniscus) is normally wide and therefore, it is not necessary to resect the usual 1 to 1.5 cm of distal clavicle; – Case Examples: … Read more
– See: Monteggia Fractures in Adults – Discussion: – all four types of Monteggia frx dislocation are pertinent to children, including Monteggia equivalents; – diff dx: Monteggia equivalent (w/ fracture of proximal radius rather than dislocation of the radial head); – Classification: – type I: – anterior dislocation of the radial head w/ apex anterior … Read more
* Etiology: Rheumatic fever, Papillary muscle dysfunction, ruptured chordae tendenae, myxomatous degen. of MV & Endocarditis * SG cath shows V waves: – represent regurgitant flow into left atrium; * Physical Exam: – Pansystolic murmur loudest at the apex, – MV click, S3 (more likely w/ severe MR), S4 – Jugular A and/or V waves … Read more
– See Mitral Regurge – Autosomal Dominant Inheritance/ variable inheritance; – thin anxious young female, Chest Pain, fatigue, syncope – may present as TIA, stroke, MI; – Occasionally: Sudden Death, Progressive dyspnea, Fever (Endocarditis) – associated w/ Marfan’s, Ehlers-Danlos – listen for systolic click followed by Systolic murmur – murmur occurs earlier w/ standing & … Read more
– Sampling of Mixed Venous O2: – Shows changes in Arterial oxygenation as the Cardiac Output changes; – Allows calculation of AVo diff and Shunt: (for Respiratory Failure); – PVo2 < 30 mm Hg, prognosis is poor; – Discussion: – normally the Svo2 is about 68 to 77%, w/ a PaO2 to 40 mm Hg; … Read more
– See: – Thumb Soft Tissue Defects – Amputation of Fingers and Hand – Indications and Advantages: – most indicated for amputations distal to thumb IP joint, in which a V-Y flap cannot be used; – may cover upto 1.5 cm palmar defect (but not … Read more
– Discussion: (RTC menu) – mobilization is often required for massive tear; – simply closing extensive tear will not suffice if atrophied muscles are not contracting adequately and if excessive tensions placed on repaired cuff cause reinjury; – repair of good quality rotator cuff tissue is esp important in achieving an optimal result; … Read more