Data Trace Editor – See: TKR Infection Menu – debridement w/o component removal: – see debridement and washout of infected THR – IV antibiotic therapy has limited success in treatment of infected TKR; managed with wound debridement, polyethyene exchange, application of temporary antibiotic beads, and IV antibiotics; – acute hematogenous infection: – early acute hematogenous infection … Read more
– 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
– for allergic reactions; – antihistamine, – antiserotonin; – Adult: 4mg PO tid, to maximum 0.5mg/kg/day; – Note: Anticholinergic side effects and drowsiness common
– Urine and Blood glucose q6hr (simulataneous) for 24 hr; – then Blood and Urine Glucose q afternoon; – TPN qd – Stict I & O (See CHF) – Body Wt.