Ortho Oracle - orthopaedic operative atlas

Bone Scan for Scaphoid Frx

– Discussion:     – radionuclide imaging was performed 2-3 hours after administration of technetium-99m methylene diphosphonate, 4 days after injury;     – false-positive rate: 6-16%     – false-negative rate:   0% Can a day 4 bone scan accurately determine the presence or absence of scaphoid fracture?

Bone Scan in Non Cemented THR

    – See:  – General Discussion of Bone Scans:  – Bone Scans in THR: – Discussion:  – evaluation of of porous coated prosthesis may require a different interpretation from cemented THR;  – bone & fibrous tissue ingrowth into porous acetabular & intertrochanteric surfaces may cause findings unrelated to complications;  – with loosening there is … Read more

Bone Scan: in THR

– See: Total Hip Replacement Menu:           – General Discussion of Bone Scans: – Normal THR:     – normal study (minimal reative bone formation) may be expected from months to a year after placement;     – area of lesser trochanter to midshaft of prosthesis usually becomes normal in about … Read more

Bone-Scanning for Diagnosis of AVN

Discussion for detection of AVN, technetium-99 methylene-diphosphonate bone-scanning is a useful technique; bone-scanning may be less sensitive in the detection of AVN at early stage of the disease or when both hips are involved symmetrically; reactive of bone at the edge of the infarcted segment will show an increased uptake of the isotope on the … Read more

Bone and Fracture Healing

– See: Bone Topics    – Discussion:     – woven bone healing:           – ref: Distal radial fractures heal by direct woven bone formation     – stages of enchondral bone healing:           – hematoma / inflammation:                  – shortest stage of fracture healing                  – disruption of vascular flow through the marrow and periosteum … Read more

Bone Healing w/ Plates

– Discussion:     – see fracture healing menu and plate biomechanics menu and bone healing with locking plates     – where bone is under compression w/ no gap, dead bone is reabsorbed, & resorption cavities, produced by cutting cones of              osteoclasts, traverse the fracture plane;     – clinically the ideal result of rigid plating should … Read more

Bone Marrow

– Discussion:     – bone marrow signal on T1- and T2 vary with age     – in adults,  tumor invading bone marrow will show decreased signal on T1, in contrast to normally high signal-intensity bone marrow;            – its imporant to note that traumatic, inflammatory, and neoplastic disorders will … Read more

Bone multicellular units

– Discussion:     – generalized pathologic processes in bone can be best understood by understanding how these processes alter the normal sequence of            bone remodeling as described in the previous chapter;     – bone remodeling occurs in local groups of osteoblasts and osteoclasts called bone multicellular units (BMU);     – each unit … Read more

Bone Grafting for Scaphoid Nonunion / Malunion

    – See: Scaphoid Frx Menu: – scaphoid nonunions: – Discusssion: – bone grafting may be indicated for scaphoid malunion or non union; – malunion: – indicators of scaphoid malunion: classic findings are a dorsal humpback deformity and DISI deformity; – indications for bone grafting include radiographic deformity along with pain, weakness, and loss … Read more