Data Trace Editor – See: Anterior Approach to the Humerus Axillary Approach: Posterior Approach Posterior Approach to Humerus Surgical Approach for Proximal Humeral Fractures Positioning and Draping: supine or beach chair; small soft bolster is placed beneath the shoulder blades to protract the shoulder; head is stabilized to prevent hyperextension and subsequent brachial plexus palsy; place patient in … Read more
PreOp Planning consider NG tube and foley catheter; have proper sized C-collar available for post operative care; position: supine w/ halter cervical traction (3-5 lbs) w/ head turned slightly to the right; consider placing a rolled towel between the shoulder blades; prep for iliac crest bone graft; hall burr is helpful for shaping bone graft; … Read more
Discussion pathoanatomy: fibular collateral ligament is made up of three separate structures; these are not as strong as medial ligaments, since lateral support of ankle is also provide by the fibula; anterior talofibular ligament calcaneofibular ligament posterior talofibular Ligaments cervical ligaments: ref: Elongation behavior of calcaneofibular and cervical ligaments during inversion loads applied in an … Read more
Discussion varus deformity of the ankle may follow distal tibial fracture or distal tibial epiphyseal frx; deformities due to distal tibial epiphyeal injuries are often progressive; deformities due to tibial plafond injuries are usually static (from malreduction at the time of the original procedure); left untreated, the varus deformity may lead to DJD of the … Read more
Discussion annular bands may present clinically with either complete amputation of part of thumb as well as the rest of the hand; constriction bands higher up in the arm, causing severe edema in parts distal to the constriction band; annular bands are often associated w/ acrosyndactyly; annular band syndrome is sporadic, not inherited; inherent in … Read more
Discussion lesion labeled annuular tear or internal disruption is based on concept of leaking disc, one which permits the irritating liquid material normally restricted to the center of the disc to come into contact with the innervated tissue; annular tissue that permits egress of this liquid has a poor capacity for healing; at most, a thin layer of scar … Read more
(See also: Annular Tear) Discussion anulus fibrosus makes up peripheral portion of disk structure; composed of fibrocartilage and type I collagen; fibers of anulus run obliquely between vertebrae and are arranged primarily in concentric layers; direction of the fibers in successive layers alternates, w/ one layer crossing another at angles of 30-60 deg; at periphery … Read more
– Discussion: – w/ an “isolated fibular frx,” the paramount indication of an unstable frx is lateral talar shift (which indicates deltoid ligament injury); – this is manifested radiographically as an increase in the medial clear space; – normally the medial clear space (between talus & medial … Read more
(See also: Antiglide Plate) Discussion position of plate is dependent on level of frx, condition of overlying soft tissues, and the extent of comminution; Posteriorly Positioned Plate see antiglide plate: allows use of a thicker, stronger plate; less risk of wound slough; irritate peroneal tendons; distal screws obtain better purchase, since they engage a thicker part … Read more