Data Trace Editor – debridement was originally described by Napoleon’s surgeon Baron Dominique Jean Larrey; – non-viable muscle can be identified by the 4 c’s (color, consistency, contraction, and circulation); – the best indicator of viability is bleeding during debridement; – non viable muscle can be identified by … Read more
– Discussion: (see osteochondral injury) – these injuries are distinct from degenerative arthritic lesions and management of these lesions should remain distinct as well; – theory is that penetration of subchondral bone causes bleeding from underlying vessels which allows clot formation in the cartilaginous defect and subsequent formation of fibrocartilage; – some argue that subchondral drilling … Read more
(see also tibial fracture menu / general principles of debridement) Debridement of Acute Fractures goal is to avoid tibial infection; timing: (is emergent debridement necessary?) references: The Effect of Surgical Delay on Acute Infection Following 554 Open Fractures in Children. Outcomes in open tibia fractures: relationship between delay in treatment and infection. Treatment of isolated … Read more
– See: DCP 3.5 mm Applied as Self Compression Plate w/ Lag Screw Thru Plate – Discussion: – effect of self compression is used for axial compression of short oblique, or transverse frxs of for example, the forearm, clavicle, and pelvis (tension band plating); – Prerequisites: – plate is contoured to the … Read more
– See: Synthes Plates and Screws:3.5 MM DCP, LC-DCP 3.5 MM LCP 4.5 MM LCP RECONSTRUCTION PLATE – Discussion: – this technique is used in oblique frxs, where optimal stability can be achieved by combining the self compression effect of DCP for axial compression, and the interfragmentary compression of a lag screw; – … Read more
– Discussion: – Pavlik harness is usually not successful in children > 6 months (crawling age); – this is mainly due to increased activity levels of the child as well as the fact that these children begin to learn how to remove the harness; – reduction of … Read more
– See: Total Hip Replacement Menu: – total hip in DDH – acetabular component menu: – crowe classification – Non Anatomic Positioning of the Acetabulum in DDH: (high hip center) – advantages: – technically easier than anatomic placement; – surgeon can … Read more
– Discussion: – trauma workup – bleeding from pelvic fractures – lethal triad: metabolic acidosis (base deficit or serum lactate), hypothermia, and coagulopathy – assessment of shock: – metabolic acidosis: base deficit and serum lactate – contraindications for non emergent orthopaedic surgery: – following all can indicate occult … Read more
– Discussion: – for treatment of clinical spasticity resulting from upper motor neuron disorders such as spinal cord injuries, strokes, cerebral palsy, or multiple sclerosis; – treatment of Malignant Hyperthermia crisis; is a skeletal muscle relaxant; – skeletal muscle relaxant: beginning at 25 mg PO qd, titrate to effect … Read more
Discussion: – Clinical Experience with Daptomycin Treatment of Foot or Ankle Osteomyelitis: A Preliminary Study. – Long-term use of daptomycin for MRSA osteomyelitis and joint infection. – Uncertain efficacy of daptomycin for prosthetic joint infections: a prospective case series. – Clinical experience with daptomycin for the treatment of patients with knee … Read more