Ortho Oracle - orthopaedic operative atlas

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

Dorsal Approach to the Wrist

– See Compartments: I, II, III, IV, V,VI and approach to the distal radius; – Technique: – straight dorsal incision centered over the wrist; – because the skin is loose over the dorsum of the wrist, contractures are uncommon; – incise skin and subcutaneous tissue down to the retinaculum; – careful to preserve dorsal veins and … Read more

Dorsal Dislocation of the PIP joint

– See:        – Differential Dx of PIP Injuries        – Fracture Dislocations of the PIP Joint        – Phalangeal Injury – Discussion:     – anatomy of the injury:          – volar plate is always detached (usually  from middle phalanx) in PIP dorsal dislocations;               … Read more

Dorsal Intercalated Segment Instability: (DISI)

– See: – Carpal Instability – Kinematics of the Wrist – Discussion: – lunate will tend to flex w/ loss of ulnar ligamentous support from the triquetrum; – lunate extends when there is loss of radial ligamentous stability; – DISI may arise as a result of: – scaphoid frx; – scapho-lunate dissociation; – perilunate dislocation … Read more

Dobutamine/Dobutrex

– See:  – Inotropic Agents  – Inotropic agent (not vasoconstrictor); – Useful in pt w/ poor CO output, elevated left ventricular filling pressures (PAOP > 18mm Hg), & marginal systemic blood pressures;  – For Shock syndrome as result of MI, endotoxins, trauma, Renal failure;  – Selective B1 stimulator;  – Causes direct iotropic stimulatorwith reflex vasodilation … Read more

DOCUSATE CALCIUM (SURFAK)

– For constipation prone patients (bedrest, medications);  – Acts as stool softener;  – Adults: 240 mg PO qd; – Peds: >6yrs: 50-150 mg PO qd;  – Supplied: Caps: 50mg, 240mg;  – COLACE:  – Adults: 50-250 mg PO bid;  – Peds: <3yrs: 10-40 mg / 24 yrs PO divided qd/qid;  – 3-6 yrs: 20-60 mg/24hrs PO … Read more