Data Trace Editor – 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
– 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
– See: Three Part Fracture Dislocation and Four Part Fracture – Discussion: – tuberosity frag + displaced surgical neck fragment; – unstable shafts may be driven into mass of deltoid muscle & may be anterior to the proximal fragment; – poor bone contact will lead to delayed or nonunion in most cases; – subtypes: – greater … Read more
– Discussion: – by definition, is a decrease of more than 5 mm in the verticle distance of the femoral stem; – subsidence of 1 mm or less is within limits of measurement; – subsidence of cement mass & stem or migration of stem into cement mass resulting in more distal position of collar or … Read more
– See: THR dislocation: – Checklist: – need complete muscular relaxation; – irrigate any debris from acetabulum; – Difficult Reduction: – capsule might have to be further released, esp if head and neck segment was short preoperatively; – if reduction is not possible & leg is lengthened, … Read more
– Landmarks: – posterior superior iliac spine: forms the superior landmark; – incision starts at the posterior 1/3 of the greater trochanter and extends proximally for 10 cm toward a point 2 fingerbreadths below the PSIS; – this will bring the incision directly over the sciatic notch and will also … Read more
(see: Total Hip Replacement Menu) – PreOp: – Theory and Background: – Checklist for THR and Radiographs: – Initial Exposure: – positioning, prepping and antibiotics: – posterolateral skin incision: – incise thru iliotibial band: – split gluteus maximus: – The course of the superior gluteal nerve in the lateral approach to the hip; – identify the … Read more
– See: – operative considerations for hip dyplasia – reaming technique: – component insertion: – component position: – screw placement: – acetabular component revision: – bone grafting for acetabular defects: – … Read more
– Discussion: – anesthesia considerations: – note that with spinal anesthesia, the table will be tilted reverse trendelenburg inorder to prevent high spinal (this will have the effect of predisposing for vertical cup position if note remedied; – note that leg lengthening is more common with spinal vs general; … Read more
– positioning and prepping – posterolateral skin incision – incise thru iliotibial band – split gluteus maximus – peel back the trochanteric bursa: – divide trochanteric bursa and sweep it posteriorly to expose vastus lateralis, short external rotators and posterior border of gluteus medius; … Read more