The Hip - book

Compartment Syndrome

 – Discussion:     – pathophysiology:      – compartment syndrome is elevation of interstitial pressure in closed fascial compartment that results in microvascular compromise;     – as duration & magnitude of interstitial pressure increase, myoneural function is impaired & necrosis of soft tissues eventually develops;     – intracompartmental pressure:         … Read more

Compartment Syndrome Pressure Monitoring

– Discussion:     – many surgeon use 30 mm Hg as the cut off for performing fasciotomy;     – diastolic pressure: (Whiteside’ Theory):             – development of a compartment syndrome depends not only on intra-compartment pressure but also depends on systemic blood pressure;             – DBP – CP should be greater than 30                    – references:                            – Diastolic … Read more

Collar: in THR

(See also: Total Hip Replacement Menu) Discussion stress transfer to femur is desirable because it provides physiologic stimulus for maintaining bone mass & preventing disuse osteoporosis; if prosthesis has a collar that is seated on the cut surface of the neck or if there is a layer of cement in contact with the bone and undersurface of the … Read more

Colles’ Fracture

– See:  Distal Radius Frx Menu / Intra-Articular Fractures of the Distal Radius – General Discussion:     – frx was described by Abraham Colles in 1814, originally described as low energy extra articular frx of distal radius occuring in elderly individuals; – frx is typically dorsally displaced and angulated; – mechanism: – fracture is also caused by … Read more

Comminuted Femoral Shaft Fractures – Type IV

– Discussion: – see: Winquist Classification – sign of high energy trauma: more blood loss, systemic complications, and fat embolism syndrome; – all cortical contact is lost; – simple cloverleaf nails are contraindicated w/ type III and IV comminuted frxs because of risk of shortening of frx about nail; – small diameter nails fail to … Read more

Collagen Disorders

– Discussion:     – the biosynthesis of collagen involves many complex processes that are subject to biologic control;     – these processes can be disrupted at any point by metabolic disorders such as:           – scurvy;           – lathyrism;     – genetic collagen diseases: … Read more