Ortho Oracle - orthopaedic operative atlas

Herbert Screw Fixation of Scaphoid Frx

    – Discussion:     – screw is threaded at both ends and can be countersunk beneath articular surface, obviating the need for             removal after frx has healed;     – it is designed to achieve compression by use of a differential thread-pitch between its proximal & distal ends,             and it has guiding jig that maintains … Read more

HEPATITIS B IMMUNE GLOBIN

– For exposure to HBsAg positive materials such as blood contact;  – Adult: 0.06ml/kg IM to maximum of 5ml;  – w/in 24 hr of needle stick exposure;  – w/in 14 days of sexual contact;  – Repeat at 1 and 6 months after exposure;  – Administered in gluteal or deltoid muscle;  – Supplied in vial of … Read more

Henoch Schonlein Purpura

– Discussion:     – a vasculitis of unknown etilogy;     – mean age of onset is 6 years;     – small vessel vasculitis involving:     – skin:          – rash is typically from the waist down;          – rash begins w/ urticaria but quickly turns … Read more

HEMOPHILUS B Conjugate Vaccine (ProHIBiT)

– For routine immunization of children 18 mo  – 5 yrs of age against diseases caused by Haemophilus influenza type B;  – Actions: Hemophilus B conjugate w/ Diptheria toxin; active immunization;  – Dosage: 0.5 ml (25ug) IM in Deltoid or Vastus Lateralis;  – Supplied: Injection 0.25 ug/0.5ml;  – Booster not required;  – Not protective at … Read more

Hemophilic Arthropathy: Pathologic Changes

(see also: coag pathway) Discussion disease is most crippling when repeated bleeding into joint produces arthritis; left untreated most severe hemophiliacs will suffer crippling arthritis in one or more joints by early adolescence; after joint bleed, or hemarthrosis, synovium must absorb degradation products of the blood; repeated hemarthroses will cause synovial hypertrophy and inflammation; some hemophiliacs develop … Read more

Hemophilic Arthropathy: Extraarticular Lesions

– Discussion: – extraarticular bleeding may involve muscles, nerves, blood vessels, and even bones; – slowly expanding hematoma will interfere w/ function & perfusion of surrounding tissues; – intramuscular hematomas that fail to resorb quickly lead to fibrosis, contracture, cyst formation, or myositis ossificans; – bleeding into the calf muscles may cause a severe equinus … Read more

Hemiarthroplasty of the Hip

 – See: Bipolar Arthroplasty: – Discussion: – indications: indicated for patients w/ a femoral neck frx who meet the following criteria: – poor general health thay would prevent a second operation; – pathologic hip fractures: – parkinson’s disease, hemiplegia, or other neurological disease; – physiologic age > 70 yrs; – severe osteoporosis w/ loss of primary … Read more

Hemi-vertebrae & Segmented Vertebrae

– Discussion:      – open disk usually has an active growth plate;      – double hemivertebrae:            – those that are ipsilateral and adjacent to one another are more likely toproduce a progressive scoliosis and require                    arthrodesis;            – two or more hemivertebrae on the … Read more

Hemi-resection Arthroplasty of R-U Joint

    – See:   – Bower’s Procedure – Discussion:     – invovles resection of ulnar articular head, leaving shaft and styloid relationship intact;     – interpositional anchovy of tendon is placed in cavity to limit contact of radial & ulnar shafts which may migrate to each other after this procedure;     … Read more