Data Trace Editor – Discussion: – the two incision (“backdoor”) approach has remained the gold standard for ACL reconstruction, because it is the only technique which can reliably position the femoral tunnel at the 10 o’clock (or 2 o’clock) position (which is necessary for anatomic reconstruction); … Read more
– Discussion: – most common error is non isometric anterior tunnel placement within intercondylar notch rather than at its normal posterior insertion; – ACL graft should pull up into tibial tunnel by about 2mm with extension when fixed on femoral side; – this represents the closest reconstitution of … Read more
– references: – The effect of dynamization on slowing the healing of femur shaft fractures after interlocking nailing. – The treatment of nonunions following intramedullary nailing of femoral shaft fractures. – Healing of 56 segmental femoral shaft fractures after locked nailing. Poor results of dynamization. – Femoral-shaft fractures and nonunions treated with intramedullary nails: The … Read more
– Discussion: – External Fixation – ref: External fixation of pediatric femoral fractures. – IM Nailing: (flexible vs rigid) – avascular necrosis is a reported complication in young adolescents; – consider IM entry point anterior to piriformis fossa; – children w/ coxa … Read more
– Discussion: – child abuse: 30% of femoral frx in children < 4 yrs are 2nd to child abuse; – Over-riding of Fracture Fragments: – in children between the ages of 2-10 yrs, overgrowth averages 0.9 cm; – in kids between 2 & 10 yrs, side to side apposition … Read more
– Discussion: – child abuse: child abuse occurs in 50-80% of children < 2 yrs w/ femoral frx; – limb length inequality are seldom a problem since frx does not shorten excessively; – acceptable reduction: – in children younger than 2 yrs, shortening of … Read more
– Measurement of Length: – its essential to plan ahead to achieve proper leg length; – w/ comminuted frx, use opposite leg to determine leg length; – one method is to obtain long cassette radiograph of opposite side w/ radiographic ruler included on the film; … Read more
– Discussion: – performed to correct either anteversion / valgus deformity of femoral neck in patients w/ dysplasia that reduces w/ abduction and medial rotation; – if hip is not reducible, then open reduction is performed prior to osteotomy; – the procedure is most useful when the acetabular dyspasia … Read more
– Discussion: – physeal bone bridges – methods to estimate growth potential – anatomy of distal femoral physis – distal femoral physis grows roughly at a rate of 9 mm/year (girls finish growing at age 14) – growth arrest, partial or complete, w/ progressive angulation &/or shortening ranges from 30% & 80% of pts; … Read more
– Discussion: – goal: ream close to endosteal cortex, which has strongest cancellous bone; – enter medullary canal w/ curet, & ensure that there are no perforations; – this is esp important w/ osteoporotic bone; – to enlarge medullary canal of diaphysis, use … Read more