Ortho Oracle - orthopaedic operative atlas

Arcade of Struthers

– Discussion:     – in middle of the arm, ulnar nerve pierces medial intermuscular septum and descends in front of the medial head of the triceps;     – in 70-80% of individuals, nerve passes under arcade of Struthers;     – the arcade is a thin aponeurotic band extending from medial head of … Read more

Arcosyndactyly

– Classification:     – Type I:           – conjoined finger tips with well formed webs w/ normal depth;           – treatment involves separation and contouring of the tips of the digits;           – partial digit ablation may be required;     – … Read more

APC II

– Discussion:     – involves tearing of both anterior SI ligaments of floor of pelvis (sacrotuberous and sacrospinous);     – involves a widened anterior SI joint  & injury to anterior ring (usually a symphysis diastasis) best seen on the Inlet view;     – may be bilateral or unilateral;     – this … Read more

APC III

– Discusison:     – w/ application of severe AP force, hemipelvis rotates externally until posterior iliac wing contacts posteior sacrum;     – continued force rips posterior SI ligaments, completely dissconecting hemipelvis from the sacrum;     – APC III have highest rate of assoc injury, including retroperitoneal bleeding;     – by definition then, an … Read more

Application of Hex Nut Compression

– Discussion:     – in most cases, antegrade screw insertion across the fracture site, will result in fracture site compression;     – once the medial threads have passed the fracture site, fracture compression usually takes place;     – remove one of the two hexagonal nuts, and then advance the remaining screw up … Read more

Approach to Distal 1/3 of Radius through an Anterolateral Incision

– See:     – Plating Techniques – Technique:     – incision begins in front of radial styloid process, extending proximally in straight line along anteromedial border of the brachioradialis;     – brachioradialis is reflected laterally to expose superficial radial nerve in proximal portion;            – avoid injury this nerve as … Read more

Approach to Thoracolumbar Spine

– Positioning:  – foley and appropriate IV access established;  – place patient into left lateral decubitus position (L side up)  – break table in the middle;  – Incision and Exposure:  – incision is made along 10th rib which then curves along anterior abdomen as appropriate (based on size of patient);  – 10th rib is identified, … Read more

AP View of Pelvis

See also: X-rays for THR X-rays for Femoral Neck Fractures Discussion this view should demonstrate the iliac bone, sacrum, pubis, ischium, femoral heads and necks, and greater or lesser trochanters; arcuate, iliopubic, ilioischial, and acetabular teardrop lines, sacral foramina, & SI joint should be scrutinized carefully and identified in a systematic manner; patient is supine with the … Read more

AP View of the Wrist

– See: – PA View – Radial Inclination – Discussion: – AP has the dorsum of the hand touching the film, with the x-ray beam passing palmar to dorsal, whereas in a PA film, the palmar surface lies flat on the film and the x-ray beam passes from the dorsal to palmar surface; – palmar … Read more