The Hip - book

Inferior Gluteal Nerve

– See: innervation muscles lower limb – Discussion:     – arises from posterior branches of L5, S1, and S2;     – passes from the pelvis below the piriformis muscles in the greater sciatic foramen;     – it enters the deep surface of the gluteus maximus muscle, to which it is the sole … Read more

Inflammatory Bowel Disease

– See: Spondyloarthropathies – Discussion:     – associated with a peripheral arthritis, which reflects activity of bowel disease;     – frequently associated with erythema nodosum;     – large joint oligoarthritis occurs in 10 to 20 % of pts, usually during flares of the bowel disease;     – fevers, synovitis, & vesiculopustular … Read more

Risk Factors for Infection in TKR:

– Discussion:           – methods to prevent infection           – report by by Peersman G, et al .                   – comorbidities that were statistically significant in increasing the risk of infection were prior open surgical                               procedures, immunosuppressive therapy, poor nutrition, hypokalemia, diabetes mellitus, obesity, and                               a history of smoking.           – prevalence of infection after … Read more

Infections of the Foot

– Diabetic Foot Infection – Deep Puncture Wound:     – puncture wounds most often result in staph aureus infections (most common organism), or pseudomonas infection (most common gram negative organism);            – staph aureus is the most common organism in soft tissue infections, where as pseudomonas is the most common cause … Read more

Infections of the Hand

– See: Work Up and Treatment:      – Bacteriology of Hand infections      – Bite Wounds      – Clenched Fist Injury      – Collar Button Abscess      – Felon      – High Pressure Injection Injuries      – Infectious Flexor Tenosynovitis      – Lumbrical Muscle Sheaths      – Mid palmar space      – Kanavel’s signs   … Read more

Infectious Tenosynovitis: Closed Drainage

  – Technique:  – goal is to establish closed continuous drainage thru flexor sheath;  – tourniquet should be used;  – incision & drainage of flexor tendon sheaths are performed from both proximal and distal ends;  – palmar incision:  – transverse incision is made just proximal to distal palmar crease, over the infected tendon;  – spread … Read more

Laboratory Findings for Infected Total Knee Replacement:

– See Laboratory Finding in Infected THR Discussion:     – WBC      – ERS     – IL-6     – C-reactive protein            – references:                     – Mark B. Coventry Award: Synovial C-reactive Protein: A Prospective Evaluation of a Molecular Marker for Periprosthetic Knee Joint Infection                      – C reactive protein and skin … Read more

Infected Total Knee Joint

  – See: TKR menu, work up of the painful knee, and prevention of infection and infected THR; – Diagnosis: – early dx of an infected prosthesis requires a high index of suspicion. – infection may cause only knee pain, persistent effusion, or early painless loosening, or more obvious signs, including inflammation, drainage, and sepsis; – classification: (ref: … Read more