Data Trace Editor 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.
– Discussion: – see Arthrex, Mitek, Linvatec, Smith-Nephew – in choosing a fixation technqiue consider the need for the following: – circumferential (360 deg) healing of graft against tunnel wall (interference screws do not permit this); – bioabsorbable material … Read more
Discussion femoral tunnel tibial tunnel: isometric placement of ACL refers to the concept that a full range of knee can be achieved w/o causing long-term ligament deformation; isometry can not exist because, during ROM, there is no one point on femur that maintains a fixed distance from a single point on tibia; elongation always will … Read more
– Discussion: – anatomy of ACL; – ACL biomechanics; – graft tunnel sites / isometry: – hamstring ACL reconstruction is an alternative to bone patellar bone graft fixation; – size and strength of graft: – double looped hamstring graft is more than twice as … Read more
Discussion AC joint is situated between the clavicle and acromion; acromion has two ossification centers which fuse at age 22 yrs; it permits motion in three planes: AP gliding of acromion during protraction & retraction of scapula; tilting of acromion during abduction & adduction of arm; rotation of the clavicle; rotation occurs during abduction & … Read more
used to evaluate the extent of ligament injury to the A-C joint Technique patient is erect; 10 to 20 pound wts (depending on patient size) are looped over the patient’s wrists suspending them from the wrists; these are not to be griped by the patient, as the act of gripping may tense the shoulder muscles … Read more
(see also: Achilles Tendonitis) Discussion ruptures typically occur after age 30, more often in people beyond middle age; rupture at musculous tendinous junction occurs most often in young people, but ruptures near the calcaneus also occur; inciting event may be related to atrophy of the soleus muscle, and commonly occur in weekend athletes; in 5-33% … Read more
note that active plantarflexion may occur due to activity of tibialis posterior, peroneals, and long toe flexors; diagnosis is clinched w/ one of two tests; hyper-dorsiflexion sign the patient is placed in the prone position, and the knees are flexed to 90 deg; the examiner then passively dorsiflexes both feet maximally and compares the injured … Read more
(see also: Achilles Tendonitis) Discussion indications may be indicated in older patients w/ minimally displaced ruptures; note that younger patients w/ expectations of participating in sports such as basketball may not be good candidates for non operative rx; atheletes should not expect to resume full activities for one year; managment short leg cast strategy: SLC … Read more
(see also: Pseudoachondroplasia) Discussion autosomal dominant disorder; arises due to a point mutation for the gene encoding a fibroblast growth factor (Fibroblast growth factor receptor 3) over 80% of all persons with this disorder are born to parents who are not achondroplastic, & such parents rarely have second achondroplastic child; it is presumed in these … Read more