Ortho Oracle - orthopaedic operative atlas

Addition of Antibiotics to Cement

 – See: Infection Menu and Wound Management: and Local Antibiotic Delivery for Septic Joints – Discussion:   – basic science:        – useful in treating biofilm;        – references:              – In vitro characteristics of tobramycin-PMMA beads: compressive strength and leaching.                 – Antibiotic bone cement in THA. An in vivo comparison of the elution properties of … Read more

Adamantinoma

– See: Bone Tumor Menu                                                                                                                                                                        – Discussion:     – rare tumor of unknown origin;     – occurs primarily in young males between 10 – 30 years of age (most common after skeletal maturity);     – pts present w/ firm, slowly enlarging mass that produces minimal disability;           … Read more

Acyclovir/Zoviraz

– See: Herpes Simplex Finger Infection – Discussion:     – adult w/ initial Herpes simplex infecction infection:             – 200mg PO q4h while awake (5 caps/day) for 10 days;             – or 5mg/kg IV over 1hr q8hr x 5days, or 1gm/day in 5 divided … Read more

Acute Slip

– Discussion:     – 11% of cases     – occurs following significant trauma, produces sudden onset of pain severe enough to prevent weight bearing;     – pts usually report minimal or no previous symtoms; – Treatment:     – reduction vs. traction:           – gentle repositioning can reduce … Read more

Acute Rheumatic Fever

– Discussion:     – autoimmune reaction ocurring 2-4 weeks after streptococcal infection (URI or tonsillitis);     – ages 5-15 yrs are most susectible; (younger pts are rarely affected)     – diagnosis:             – its rapid response to ASA is almost diagnostic;             … Read more

Acute on Chronic Slip

Clinical Presentation pts recounts h/o aching in hip, thigh, or knee (from chronic slip) along w/ h/o sudden severe pain (from concomitant acute slip); Treatment pin placement: reduction may be obtain by gentle skeletal traction in flexion & internal rotation; – forceful manipulation must be avoided.

Acute Ligament Repair for SLD

by William Mallon MD  – Skin Incision:     – Identification of Radial Nerve:   – Identification of 3-4 Interval:   – Longitudinal Arthrotomy:   – arthrotomy performed just distal to Lister’s tubercle over scapholunate interval;  – this should provide clear exposure of scaphoid and lunate;  – alternatively, a distally based capsular flap can be … Read more

Acumed Bone Graft System

Autogenous bone graft remains the most effective treatment for fracture non unions, pseudoarthroses and for optimizing the success rate of arthrodesis. It is safer and more effective than artificial hydroxyapatite materials or allograft. The Acumed bone graft harvesting instruments facilitates safe, rapid harvest of morsellized autogenous graft through a small skin incision which minimizes the … Read more

Active Abduction View

Discussion may allow use of plain x-rays for dectection of pts with complete Rotator cuff tears; this view showed narrowing of acromiohumeral space to 2 mm or less; view is obtained by having pt actively abduct shoulder to 90 deg and repeating an anteroposterior radiograph

Actinomyces bovis

– enters through an abrasion on the skin, associatted w/ cattle, swine ect; – a granuloma occurs that resembles TB, and a sinus formation results; – the infection may be resent to treatment; – treatment includes penicillin and potassium iodide; – chronic suppurative disease that is notorious for its assoc w/ draining sinuses.; – exudate … Read more