Ortho Oracle - orthopaedic operative atlas

Physical Exam

Presence of Shock Inspection Palplation: symphysis, pubic rami, iliac crests, sacroiliac; bimanual compression & distraction of the iliac wings, & abduction & adduction of the hip should be done to detect instability; manual traction can aid in the determination of vertical instability grasp both legs and pull one caudad while pushing the other cephalad Neurologic Injury … Read more

Post op X-Rays for THR

– See: – Bone Scans following THR: – Post Op Evaluation of THR: – Discussion: – post op AP & lateral x-rays should include entire length of stem & cement mass; – femur and cement column are inspected carefully and compared w/ previous films for changes indicating component loosening, stem failure, trochanteric problems, or infection; – Radiographic … Read more

Congenital Muscular Torticollis

Discussion results from fibrosis of sternal head; can result from unilateral shortening of sternocleidomastoid, commonly associated with fibrosis of the muscle; may also involve the platysma and scalene muscles; birth trauma, occlussion of venous flow, or hematoma results in fibrosis of muscle & palpable mass noted w/in first 4 wks of life; nontender enlargement may … Read more

Discogenic Pain

Discussion when the innervated ligamentous layer of the outer annulus fibrosis is stretched because of segmental instability, pain results; acute sprain probably represents partial tearing of annular tissue; if annular tissue becomes weakened to the point of allowing nucleus to protrude beyond the normal confines of the annulus, it may actually be a prelude to … Read more

Toe Walking:

Discussion main causes of toe walking are idiopathic toe walking and cerebral palsy history may include continuous toe walking vs normal gait followed by delayed toe walking by age 2 yrs; idiopathic toe walking is often caused by a congenitally short heelcord or an overactive calf muscle; heel cord lengthening may be an option after … Read more

Foot

The Most Up-to-Date Book on ESWT A Accessory Bones of the Foot Accessory Navicular Achilles Tendinitis Akin Procedure Amputation of Foot and Ankle Anterior Impingement Snydrome of Ankle Arthrodesis of First MTP Joint Avulsion of Base of 5th Metatarsal B Bunionette C Calcaneus Calcaneal Apophysitis Calcaneovalgus Foot Cavovarus Foot Cheilectomy of First MTP Chevron Osteotomy … Read more

Plates for Fracture Repair

– See: Orthopaedic Trauma Implants: Know Your Implants (from Synthes web site) – Discussion:      – Bone Healing w/ Plates     – Characteristics of Metal Implants      – concepts:           – tension side of the fracture:                  – when plating a fracture the plate should be applied to tension … Read more