Ortho Oracle - orthopaedic operative atlas

Mechanism of ACL Tear

– See: Biomechanical Role: – Discussion:     – ACL tears most often occur during football and basketball in younger patients, and occur most often from skiing injuries in older patients;     – substantial anterior tibial shear forces that stress ACL are produced from quadriceps contraction, esp in 0-30 deg of extension;     … Read more

Mechanism of Calcaneal Frx

 – Discussion:  – involves vertical loading of calcaneus by talus at crucial angle of Gissane; – usually occurs from a fall from ht landing on heels;  – primary fracture line may take one of three paths:  – lateral to posterior facet (from impact on pronated foot)  – thru posterior facet (neutral foot position)  – secondary … Read more

MEAN CELL VOLUME (MCV)

Male 80-94 fL; Female 81-99 fL; Increased: Megaloblastic anemia (B12, Folate), Macrocytic anemia, Reticulocytosis, Down’s syndrome, Chronic Liver dz, ETOH; Decreased: Iron Deficiency Anemia, Thalassemia, occassionally w/ Lead poisoning

Measures of Clotting Cascade

– See: clotting cascade – Prothrombin Time (PT) 11.5-13.5 sec – PT is used to evaluate extrinsic clotting mechanism: I, II, V, VII, X; – Prolonged: – coumadin; – vit K deficiency; – fat malabsorption – liver dz – Partial Thromboplastin TIME (PTT) 27-38 sec; – tests intrinsic & common coag pathways (XII, XI, IX, … Read more

Mastocytosis

– Discussion:     – characterized by increased numbers of mast cells in vicera, principally liver, spleen, GI tract, and lymph nodes;     – skin may show numerous hyperpigmented macules that reflect dermal mast cell accumulation;     – symptoms of systemic mastocytosis are largely attributable to release of mediator substances from mast cells and include generalized puritis, … Read more

Martin Gruber Anastomosis

– Discussion:     – motor nerve may cross over from the median to ulnar nerve in the forearm; (motor connections but not sensory connections);     – it occurs in two patterns:     – from median nerve in proximal forearm to ulnar nerve in middle to distal third of forearm, & from AIN to … Read more

Matriectomy: for Nail Pathology

– Discussion:     – indicated for chronic ingrown toe nails or for any condition in which the nail shape is thickened and distorted; – Surgical Matriectomy:     – excision of matrix w/ scapel may be used but has high complication rate;     – for adequate exposure of the entire germinal matrix, two oblique … Read more

MAPROTILINE/LUDIOMIL

    for depressive neurosis; manic depressive illness; major depressive disorder; anxiety associated with depression;  Dosage: Outpatient (mild to moderate depression):75mg PO qd in single or divided doses for 2 weeks; increase in 25mg increments until satisfactory response;  Inpatient (severe depression):100-150mg/day in single or divided doses; maximum recomended dosage is 300mg/day;  Note: this is contraindicated … Read more

MAO Inhibitors

– See:       – Isocarboxazid/Marplan       – Tranylcypromine/Parnate       – Phenelzine/Nardil – Discussion:     – can potentiate the depressive effects of narcotics;     – can cause fever and seizures when administered to a patient receiving MAOI;     – the pressor effect of indirectly acting agents such … Read more