The Hip - book

Thyroxine / Synthroid / Levothyroid

– Discussion:      – for hypothyroidism (otherwise healthy): 100ug/day, initially,      – maintenance dose: 100-200ug/day over 3 week period;      – in elderly: 25ug/day initially, increasing by25ug/day at 4 week intervals; – Labs: thyroid panel __________________________________ Wound complications in thyroxine-supplemented patients following foot and ankle surgery.

Thyroid Storm

– Discussion:     – look for fever, severe tachycardia, dehydration, & mental abnormalities;    – thyroid storm is rare and precipitated by infection, trauma, surgery, labor and delivery, or radiation thyroiditis; dz procedes to death;  – Treatment:     – immediate therapuetic approach: propanolol;    – propanolol also blocks the conversion of T4-to- T3;     – will … Read more

THYROID STIMULATING HORMONE (TSH)

Adult <10 uU/mL; Male >60yr 2-7.3 uU/mL Female >60yr 2-16.8 uU/mL Note: Serves as a Screening Test for Hypothyroidism; Increased: Primary Hypothyroidsim Decreased: Primary Hyperthyroidism, rarely Secondary Hypothyroidism (Pituitary Insufficiency)

Thumb Swan Neck Deformity

– See:     – Phalangeal Injury     – Finger Swan Neck Deformity – Discussion:     – this deformity is more common in OA than in RA;     – deformity results from CMC joint dz (where as boutonniere deformity is mainly at MCP joint);     – result is erosion of articular … Read more

Thumb CMC Joint Instability

– See:          CMC Joint Arthritis          CMC Instability in the Metacarpals          Dislocations of the Thumb MP Joint – Discussion:     – dorsal instability is usually due to disruption of the dorsal radial ligament;           – dorsal-radial ligaments connects the trapezium to the dorsal radial side of the … Read more

Total Shoulder Replacement vs Hemiarthroplasty

– Operative Considerations: hemiarthroplasty vs total shoulder arthroplasty:      – preoperative planning must take the following in consideration: status of rotator cuff, bone stock, asymmetric wear, and type and                extent of soft tissue contractures;      – expectations:             – patients should not generally expect to achieve elevation … Read more