The Hip - book

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

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

Throwing Injuries

– See:       – Throwing Elbow:                – MCL of elbow:               – Diff Dx Pediatric Throwing Elbow       – Throwing Shoulder: Throwing Guidelines:     – 8-10 year olds: 37 to 67 pitches in approximately 1.5 to 2.5 games per week.     – 11-12 year olds: 50 to 86 pitches in approximately 1.5 to 2.5 games … Read more

Thrombocytosis

Platelets: 150,000-450,000 uL;  – Increased:        – Sudden Exercise, after Trauma        – Bone Fr(x), after Asphyxia        – Post Surgery (esp Splenectomy)        – Acute Hemorrhage        – Polycythmia vera        – Primary Thrombocythemia        – Leukemias        – Post Partum        – Carcinoma   Digital Ischemia Due to Essential Thrombocythemia: A Case Report

Thrombolytic Therapy

– See:       – Coag Path       – Deep Venous Thrombosis       – Endothelium       – PT/PTT       – Pharmocological Agents in Vascular Surgery       – Pulmonary Embolism       – Vascular Problems of the Wrist and Hand Acute lower limb ischemia: failure of … Read more

Thrombocytopenia/Platlet Dysfunction

– See: – Bld Prod Menu / – Platlet Transfusion – Discussion:   – manifestations: – vessel or platlet abnormalities: – these present with petechiae, purpura, or easy bruising; – bleeding characteristically occurs superficially (bleeding from mucus membranes or from IV sites); – bleeding from scury shows perifolicular hemorrhages, gingival bleeding, and intramuscular hematomas;     … Read more

DVT Treatment – Thrombolytics

Tenecteplase (TNKase) modified version of alteplase with longer half-life, so it can be given as a single bolus over 5-second infusion availability – 10 mL syringe indication (non-comprehensive) reduce mortality associated with acute myocardial infarction Urokinase (Abbokinase) used clinically as a thrombolytic agent, often referred to as a “blood clot buster” drug availability – in … Read more

THR: Wound Closure

    – place leg on padded Mayo stand in 10 deg of abduction to relieve tension on the thing and the tensor fascia lata;     – deep soft tissue repair:            – repair of posterior capsule and reattachment of the external rotators (which may help to decrease posterior dislocation); … Read more

Three Part Fracture Dislocation

– See: Three Part Fracture – Discussion:     – includes large proximal fragment created by frx of surgical neck of humerus;     – some capsular tissue is almost always retained on large head fragment ensuring its viability;     – if head fragment is displaced anteriorly, greater tuberosity is usually frxed, whereas lesser tuberosity … Read more