Ortho Oracle - orthopaedic operative atlas

Double Row RTC Repair

– see arthroscopic repair – Single Row Technique:       – one row of anchors is placed in the greater tuberosity usually lateral to the rotator cuff footprint – references: – Comparative Analysis of Single-Row Versus Double-Row Repair of Rotator Cuff Tears – Arthroscopic Transosseous Rotator Cuff Repair – Arthroscopic Rotator Cuff Repair Using a Tension Band … Read more

Down’s Syndrome: Orthopaedic Considerations

– Associated Conditions:     – ligament laxity     – hypotonia     – mental impairment     – heart disease (50%)     – endocrine disorders (hypothyroidism and diabetes)     – premature aging     – spinal abnormalities:            – atlantoaxial rotatory subluxation in Down’s syndrome                  – evaluated … Read more

Doxepin/Sinequan

– Tricyclic Antidepressant; – Usual daily dose: 75-300 mg/day; – Note Side Effects: Sedation: +++;Insomnia: 0; Anticholinergic: ++; Orthostatic-Hypotension: +++; Nausea: 0

Doxorubicin/Adriamycin

– See: Chemotherapy Agents:  – Indications:  – acute leukemias and malignant lymphomas; non-Hodgkin’s lymphomas and Hodgkin’s disease; ca of the ovary; breast; sm cell of lung;  – Sarcomas: Osteogenic sarc, Ewing’s, and soft tissue sarcomas;  – Metastatic ca of Breast, ca of bladder, bronchogenic ca, neuroblastoma;  – Precautions:  – care should be taken to avoid … Read more

Dorsal Interossei

    – See: Intrinsic Muscles of the Hand; – Origin: each from the 2 metacarpal bones between which it inserts; – Insertion:     – superficial belly:          – inserts onto the lateral tubercle at the base of the proximal phalanx (proximal phalanges of 2nd, 3rd, and 4th digits)                  to function as … Read more

Dorsal Interossei of Feet

– See: Plantar Muscles of the Foot:  Origin: there are 4 dorsal interossei which arise by double pennate fibers from the bases and sides of the bodies of adjacent bones.  Insertion: base of the proximal phalanx and aponeurosis of the tendons of the Extensor digitorum longus.  The first dorsal interosseus              (arising from the 1st an … Read more

Dorsal Scapular Nerve

(See also: brachial plexus) Anatomy dorsal scapular nerve to both rhomboids is typically derived from C5 neve close to intervertebral foramen and runs downward and backward thru or across surface of middle scalene, parallel to & below accessory nerve; it then passes medial to or thru levator scapulae (to which it may give a branch) and descends on the … Read more

Dorsal Wrist Pain

Diff Dx Ganglionic cyst probably the most common cause of dorsal wrist pain (when obvious causes such as frx or SLD have been ruled out); in the study by Steinberg and Kleinman (1999), 18 out of 21 patients with dorsal wrist pain had an occult scapholunate ganglion; result from cystic degeneration within scapholunate ligament and … Read more

Dorsalis Pedis Fasciocutaneous Flap

– See: Reconstructive Foot Surgery – Discussion:     – is used for coverage of distal tibia and ankle;     – during dissection paratendon is left over the extensor tendon, allowing donor site to do welll, with skin graft;     – to avoid devascularizing foot, the posterior tibial artery must be intact

Double Bundle ACL

 – many techniques described with one or two tibial and one or two femoral tunnels  – much biomechanical data confirms that both bundles are necessary to restore             – ACL function                   – main findings are that PL bundle contributes to rotational stability closer to full extension                            – Distribution of in situ forces in the anterior … Read more