Ortho Oracle - orthopaedic operative atlas

V. Axial Skeleton Injuries in an Austere Environment – II (continued)

V. Axial Skeleton Injuries in an Austere Environment (continued) CPT Jeanne Patzkowski, M.D. CPT Chad Krueger, M.D.     A. Describe the initial management, resuscitation, and stabilization of pelvic fractures   III. Resuscitation             A. Mortality rates as high as 40% with hemodynamic instability                         1. major cause of death in first 24 hours: exsanguinating … Read more

V. Axial Skeleton Injuries in an Austere Environment – I

CPT Jeanne Patzkowski, M.D. CPT Chad Krueger, M.D.     A. Describe the initial management, resuscitation, and stabilization of pelvic fractures   Pelvic Fractures I. Epidemiology             A. High energy mechanism of injury requires instantaneous deceleration of 30 mph to injure pelvic ring             B. Large association with other injuries including head, chest, abdomen, and extremity trauma … Read more

Complications of Blood Transfusion

– Blood Product Menu:       – pRBCs – Fresh Frozen Plasma – Platlets – Cryoprecipitate – Transfusion Therapy – Coag Pathway – Acidemia and Hyperkalemia: from massive transfusions;     – massive transfusion: transfusion of pRBC >6-8 units, must also provide platlets;             – 8 units platlets for ea 10-12 units pRBC’s … Read more

Transposition of Radial Nerve for ORIF of Humerus Fracture

Discussion: Transhumeral Anterior Radial Nerve Transposition to Simplify Anticipated Future Humeral Reconstruction. Transfracture medial transposition of the radial nerve associated with plate fixation of the humerus. Medial transposition of the radial nerve in steel plate internal fixation of lower segment fracture of humerus Trans-fracture transposition of the radial nerve during the open approach of humeral … Read more

Vascular Injuries from TKR

Anastomosis of Lower Limb Arteries – Pseudoaneurysms:      – may present as compartment syndrome or DVT      – references:             – Embolization of traumatic pseudoaneurysms after total knee arthroplasty.             – Popliteal pseudoaneurysm after total knee arthroplasty secondary to intraoperative arterial injury with a surgical pin: review of the … Read more

Function and Activity after TKR:

See: Physical Therapy after TKR and Work Up of Painful TKR – Rising from Chair:      – Persistence of altered movement patterns during a sit-to-stand task 1 year following unilateral total knee arthroplasty. – Golf:      – Golf after total knee arthroplasty: do patients return to walking the course? – Workers Compensation:      – Total knee … Read more

Shoulder Arthroplasty – Mobilization and Repair of Subscapularis

– Discussion:        – subscapularis anatomy: mobilization (360 deg release):        – mobility of the subscapularis can be limited by adhesions to conjoined muscles, coracoid, glenoid, and capsule;        – releases are required order to liberate subscapularis circumferentially about its long axis;         – muscle should be fully mobilized off of the anterior glenoid;        – … Read more

Post Renal Azotemia

div class=”mh-row clearfix”> h1>/h1> div class=”bodycopy”>br/> hr size=”3″/>br/>   – r/o lower UT obstructionbr/>   – If bladder obstruction presentbr/>       * expect Uo > 400 mlbr/>       * pt to be relievedbr/>       * Regularly flush Foley w/ 20-30ml NS; ensure free urine flow;br/>   – If patient … Read more