The Hip - book

DVT & PE arising from Trauma, Pelvic Fractures, and Extremity Fractures

– See: DVT Discussion: – Discussion:     – 30-50 % occurance of DVT in trauma pts w/ lower extremity fractures;     – preexisting conditions such as heart disease, obesity, carcinoma, diabetes, and hypertension could theoretically push the numbers even             higher;     – mortality for pulmonary embolism may approach 10%;     – ref: … Read more

DVT: Intermittent Compression Stockings

– Discussion:     – advantages include relatively low cost, efficacy when worn properly, and safety;     – disadvantages: compliance is not guaranteed;     – if possible, patients should be placed in the intermittent compression stockings, prior to the operative procedure Pneumatic sequential-compression boots compared with aspirin prophylaxis of deep-vein thrombosis after total … Read more

Deep Venous Thrombosis (DVT)

Clinical Signs for DVT exam may be unreliable but positive findings should not be ignored calf tenderness, swelling, fever, & increased pulse rate may be present suggestive exam features for pulmonary embolism sudden decrease in O2 saturation tachypnea, cyanosis, and hypoxia pulmonary consolidation, pleural effusion, wheeze, and cor pulmonale new onset tachydysrhythmia (usually atrial fibrillation) … Read more

Dural Membrane of the Spine

– Discussion:     – spinal dura is separated from inner surface of bones forming vertebral canal by epidural space containing fat and a rich plexus of veins;     – dural sac continues inferiorly to about middle of 2nd sacral vertebra;     – pia mater:             – closely attached … Read more

Dupuytren’s Contracture: Transverse Palmar Incision

– Discussion:     – for pts who have severe involvement, w/MP & PIP Joint contractures as well as fixation of palmar skin & involvement of multiple rays;     – often transverse incisions are left open (McCash (1964) or are covered w/ a full thickness skin graft;     – transverse incision across palm beginning at … Read more

Dupuytren’s Contracture

– See: Surgical Treatment of Dupuytren’s: – Discussion: – originally described by Baron Guillaume Dupuytren in 1831; – ref: Guillaume Dupuytren: His Life and Surgical Contributions – usually appears between age 40 to 60 years; – disease occurs more often and is more severe in males or persons of Northern European Origin; – may be … Read more

Dual X-ray Absorptiometry

– Discussion:     – is the newest and the most precise technique for evaluating osteoporosis, and has emerged as the successor to DPA; – anatomic sites for DXA measurement include: – lumbar spine, proximal femur, forearm and calcaneus; – advantages of an x-ray system over a DPA radionuclide system include: – shortened examination time … Read more

Dual Photon Absorptiometry

– Discussion:     – this technology allows subtraction of soft tissue density from bone density of bone mass of the hip, pelvis, and spine;     – dual-photon absorptiometry uses transmission scanning w/ isotope source that emits two photoelectric peaks;           – it allows(bone density to be measured independently of … Read more