Data Trace Editor – Discussion: – see tibial non unions – OTA classification: – type I is there is loss of 50% of circumference of bone and less than 2 cm defect; – consider exchange nailing – ref: Critical-sized defect in the tibia: is it critical? Results from the SPRINT trial. – type2 if … Read more
– See Diff Dx – If hypotensive (SBP <90 mm Hg) place in T berg; – If HR < 40/min, ready Atropine 1mg premixed syringe; – consider initial dose of 0.4 or 0.5 mg IV; – if this is not effective consider isoproterenol; – or instead of isoproterenol consider transvenous pacing; – if blood pressure … Read more
– Bone Patellar Bone Repair: – Femoral Tunnel: – Tibial Tunnel: – Tendon Graft: – according to Noyes et. al., strength of 14 mm-wide graft of patellar tendon is approximately 175% the strength of normal Anterior Cruciate Ligament; – semitendinosus graft is approx 75%, gracilis tendon is approx 25%, … Read more
– Non Operative Treatment: – Operative Considerations: – surgical indications: – when deformity has not been treated successfully w/ proper manipulation & serial application of casts, supported by limited operative intervention; – operative timing: – surgical goals: – goal for surgical procedures is concentric reduction of the talonavicular and calcaneocuboid joints; – deformities of the … Read more
– See: – DDH – Impediments to Reduction in DDH – Medial Approach to Hip – Open Reduction – Pelvic Osteotomy – Treatment Goals: – goal is to achieve and manitain a concentric reduction of hip joint; – concave acetabulum cannot develop without concentric force … Read more
– See: DDH – Clinical Presentation: – widened perineum, shortened lower extremity, & hyperlordosis of lower spine; – Treatment Considerations: – after 2 years of age, there is increased risk of AVN & closed reduction is more likely to fail; – open reduction: – … Read more
– See: tibia fracture menu (open tibia fractures); – Discussion: – worst prognostic feature for healing of tibial frxs is infection; – osteomyelitis of tibia & infected non unions are among the most severe complications after tibial frx, & may lead to amputation; – probability of infection is related … Read more
– See: Lisfranc’s Frx – Anatomy of the Midfoot – Radiographs: – w/ questionable injury, consider wt bearing AP view to assess 1-2 interval; – if standing AP is unacceptable to the patient then consider CT scan; – abudction stress AP: … Read more
– Discussion: – mechanism of injury: – distinguish between high velocity injuries verus low velocity injuries (as this reflects incidence of vascular and nerve injuries); – w/ low-velocity knee dislocations occurance of vascular injury is about 5% and nerve injury is about … Read more
Indications for treatment proximal DVT proximal propagation of a distal DVT some authors advocate that isolated asymptomatic distal DVT can be followed on serial Duplex Ultra-sound, and does not require treatment distal DVT will propagate proximally in less than 10-20% of cases, and has a low risk of PE serial ultrasound can be performed on … Read more