Data Trace Editor Discussion cardiopulmonary problems (thoracic curves > 60-65 deg alter PFT’s; curves > 90 deg may cause myelopathy & may affect mortality; progression is unlikely in curves < 30 deg single major thoracic curves > 60-80 deg are likely to increase in size even after growth was complete; rate of progression is about one degree per … Read more
– See: Pediatric Radial Neck Frx – ORIF of radial neck frx in adults: – similar principles as radial head frx – see: posterolateral approach: – consider the new precontoured radial head locking plates; – careful not to injure posterior interosseous nerve – safe zone: – radial head is covered by cartilage on 360 degrees of … Read more
(See: – Pediatric Lateral Condyle Frx) Discussion frxs of lateral condyle that involve capitulum alone or extend medially to involve the lateral portion of trochlea; see capitellum fracture Lateral approach » typically the plate is positioned posteriorly, and can be placed if needed as far as the posterior aspect of the capitellum; remember that the … Read more
– Technique: – it is helpful to have the patient paralyzed during the reduction (requires general anesthesia); – anatomic reduction of the condyles is performed first; – remember that the common factor in fixation failure in these fractures is comminution and/or osteoporosis; – best-fit method: … Read more
– Discussion: – anesthesia: insist on general anesthesia rather than regional anesthesia for the following reasons: – it is essential that the patient not move during delicate portions of the case; – it is often helpful to paralyze the patient during the fracture … Read more
– Fractures Subtypes: – capitellar and coronal shear frx – distal humeral frx – lateral condyle frx – medial condyle frx – Muller’s Classfication: – type A: extra-articular fracture; – type B: uni-condylar fracture; – type C: bi-condylar fracture; – controversies: – total elbow replacement – Distal humeral fractures treated with noncustom total elbow … Read more
– Discussion: – often occurs as a result of degenerative disc disease and facet deficiency; – it is often associated w/ intersegmental instability and w/ central stenosis; – more commonly involves older black females and diabetics (affects females 6 times as much as males); – involves L4-L5 … Read more
Location of Frx distal 1/3 : 75% middle 1/3 : 18% proximal 1/3: 7% Surgical Approach Proximal Radius Fx (Thompson) Distal Radius Fx (Henry) Comminution side of comminution may dictate plate placement; comminution involving more than 1/3 of circumference of shaft may necessitate bone grafting; bone grafting should be away from interosseous membrane to decrease risk for … Read more
– See – Pediatric Both Bone Frx – Deforming Forces – Discussion of Blount Fractures – Implants for Fractures of the Radius and Ulna – Plating Techniques – Indications for Operative Treatment: – all displaced, unstable fractures of the radius and ulna in adults; – radial shaft fractures: all displaced fractures of the radius with … Read more
Technique decreases interscalene space by tensing anterior and middle scalenes; arm of the affected side placed on the sitting patients thigh with forearm supinated; turn head to the affected side; extend neck and hold breath; positive test is obliteration of the radial pulse; Hyperabduction maneuver tests for compression against axillary pulley which consists of pectoralis … Read more