Data Trace Editor – See: Skin Prep – Discussion: (chloroprep) – kills cells by disrupting their cell membranes and precipitating cell contents; – it has extremely low toxicity even when used on the intact skin of new borns; – in comparison to alcohols, antibacterial activity of chlorohexidine gluconate is not as rapid, but the drug remains … Read more
– may be used to control severe HTN which does not respond to Nitroprusside, use Thorazine w/ caution; – begin w/ 2.5 mg IV bolus, repeating prn q 5-10 min to max dose of 15 mg; – must have liter of crystaloid ready for infussion, if profound hypotension occurs; – for psychotic, … Read more
– Agents: – doxorubicin/adriamycin: – cis platin – methotrexate: – Neoadjuvant Chemotherapy: – may facilitate limb salvage surgery by causing significant necrosis of the primary tumor; – protocol: – cis platin: 2 intra-arterial cycles are given at a dose … Read more
– See chemotherapy discussion Neoadjuvant chemotherapy for osteosarcoma of the extremity. Neoadjuvant chemotherapy for nonmetastatic osteosarcoma of the extremities. Adjuvant chemotherapy of high-grade osteosarcoma of the extremity. Updated results of the Multi-Institutional Osteosarcoma Study. Local control and survival from the Cooperative Osteosarcoma Study Group studies of the German Society of Pediatric Oncology and the Vienna … Read more
– Discussion: – in this procedure, a “V” shaped osteotomy of the distal metatarsal is created, which allows the first MT head to be shifted laterally, correcting the abnormal shape from long standing valgus drift; – effect on blood supply: – Circulatory disturbance of the first metatarsal head after Chevron osteotomy as shown by … Read more
(See also: Acetabular Osteotomies) Discussion a acetabular osteotomy salvage procedure which is indicated in patients without a concentrically reducible hip; modified shelf osteotomy above acetabulum w/ medial displacement of acetabulum; distal fragment is displaced medially and upward as osteotomy hinges on the symphysis pubis; hip capsule is interposed between newly formed acetabular roof & femoral head; relies … Read more
– Discussion: – standard forearm flap is vascularized by a pedicle that consists of the radial artery and two vena comitantes that are ligated proximally and turned distally toward the defect in the hand; – it provides a thin, vascularized wound cover and a vascular bed for skin grafting; – … Read more
– Discussion: – type I, type II, and type III are most common; – type IV: – is also referred to as Refsum disease; – associated w/ excess phytanic acid; – type V: – inherited spastic paraplegia with distal weakness in the limbs; – usually presents in the second decade of life or later; – … Read more
– Discussion: – radial styloid frxs most commonly occur from tension forces sustained during ulnar deviation and supination of the wrist; – strong radiocarpal ligament, particularly radioscaphocapitate ligament, avulse radial styloid from metaphysis of the radius; – ligamentous attachments maintains alignment radial styloid to carpus, but styloid may be markedly displaced from … Read more
– See: Anesthesia Considerations and Timing – PreOp Management: – Etiology of Fracture: – arrhythmia: consider continuous monitoring – hypoxia – osteoporosis – pathologic hip fractures – seizure – stroke – … Read more