Data Trace Editor Dr. Mangal Parihar – Discussion: EMG monitoring of patients undergoing lengthening has shown that up to 80% of patients undergoing lengthening show electromyographic changes of neural injury, in spite of no clinical signs. This fact must be remembered especially when large lengthenings are being planned. The patient must have a proper evaluation of the motor … Read more
Dr. Mangal Parihar – Discussion: Proper limb positioning taught early on minimizes the chances of contractures developing later. The commonest cause of a flexion deformity is the tendency to keep a pillow lengthwise under a tibial frame. This causes flexion at the knee. This should be prevented by repeatedly correcting the tendency and keeping an … Read more
Dr. Mangal Parihar – Discussion: Distraction gap increasing as desired & progressive Correction of deformity. The first few days of distraction does not result in distraction of the corticotomy site, especially in patients with congenital conditions. This is because the first 2 to 3 mm is spent in overcoming tight musculature and fascial structures. Beyond … Read more
Dr. Mangal Parihar – Discussion: Practically every patient needs to be taught weight bearing ambulation after the fixator is put on. It is not enough to tell them to bear full weight. There is a natural wariness to bear full weight on a limb that has just been operated, which is compounded by the pain … Read more
– See: Safe Zone of Pin Insertion – Discussion: – whether a ring or unilateral fixator is used, there is some evidence that a better regenerate is formed with the use of titanium half pins rather than transfixation wires; – ref: Limb lengthening by callus distraction (callotasis). – … Read more
– Discussion: – an overuse phenomenon which is common in runners (more common w/ downhill running); (see running injuries) – pts usually have pain over lateral femoral epicondyle, which is caused by inflammation resulting from friction as iliotibial band slides over condylar prominence; – syndrome may be more common in … Read more
– Discussion: – ilioinguinal nerve originates from first lumbar root (L1 ); – emerges from lateral aspect of Psoas muscle, and passes around posterior abdominal wall over quadratus lumborum and Iliacus; – it then travels under external oblique, enters inguinal canal & descends to supply sensory fibers to skin of … Read more
– See: Watson Jones Approach – Discussion: – frx of anterior column & some anterior column-posterior hemitransverse frx are approached using ilioinguinal approach; – ilioinguinal approach can give simultaneous access to both anterior & posterior portions of the pelvic ring; – medial portion of this approach … Read more
– Discussion: – arises from T12 & L1; – emerges from lateral border of Psoas & passes over Quadratus Lumborum to penetrate transverse abdominal muscle near the iliac crest; – nerve supplies anterior cutaneous branch to skin of suprapubic region
– Discussion: – approach is similar to Smith Peterson; – provides exposure to the outer aspect of the iliac bone and gives exposure of the anterior and posterior columns; – extended iliofemoral approach provides best access to both column fractures (esp w/ greater sciatic notch involvement) & allows best … Read more