Ortho Oracle - orthopaedic operative atlas

Technique of Blade Plate Insertion

– Discussion:  – 1st guide wire marks femoral anteversion;  – 2nd guide wire marks direction of seating chisel and should be driven into the femoral neck parallel to 1st guide wire;  – note that because the greater trochanter lies slightly posterior to the femoral neck, the guide wire needs to be placed slightly anterior to … Read more

Talocrural Angle

– See: Radiographs of the Ankle – Discussion:     – tibiotalar articular surface usually has slight lateral tilt, avg 3 deg;     – empirical axis is in sl varus position, as indicated by talocrural ang; – Mortise View:     – talocrual anlge is formed by:     – line drawn parallel to … Read more

Tarsal Coaliltion

– See: – Talocalcaneal Coalition – Calcaneonavicular Coalition – Discussion: – coalition between tarsal bones is frequent cause of painful flatfoot (pes planus) in the older child or adolescent; – tarsal coalition may be osseous, cartilaginous, or fibrous. – calcaneonavicular coalition bar is most common, followed by middle facet of talocalcaneal coalition joint; – single … Read more

Tarsal Navicular

(see also: Accessory Navicular; Kohler’s Disease I) Anatomy navicular joins in front w/ medial, intermediate, & lateral cuneiform bones, which articulate anteriorly w/ first, second, and third metatarsals; navicular provides insertion for tibialis posterior; blood supply to the navicular bone is radial and extraarticular & is subject to loss both at time of injury & … Read more

Tarsal Tunnel Syndrome

– Tarsal Tunnel Syndrome: – compression syndrome of the tibial nerve in the tarsal tunnel; – tarsal tunnel is formed by the flexor retinaculum behind and distal to the medial malleolus; – inciting causes: – lipoma, ganglia, or neoplasms within the tarsal tunnel; – an accessory flexor digitorum longus muscle is a common cause; – … Read more

Techique of Total Nail Plate Avulsion

– Technique:     – preoperative considerations;     – goal is to separate the nail atraumatically from the bed and the proximal nail fold;     – insert freer elevator or fine nosed hemostat under the edge of the nail plate and push proximal;           – a plane of cleavage … Read more

Technetium 99m

– Discussion:     – over the course of several hours, half or more of the dose accumulates in bone, and the remainder is excreted in urine;     – images obtained over 2-4 hours (half life of technetium is 6 hours);     – increased uptake in immature bone and metabolically active bone, or … Read more

Technical Failures Causing Loosening

– See:     – Radiographic Evaluation of Cemented Femoral Components:     – Exam for THR Loosening: – Discussion:     – failure to remove soft cancellous bone from medial surface of femoral neck, so column of cement does not rest on dense cancellous or             cortical bone & … Read more

Talipes Equinovarus / Clubfoot

– Discussion:     – congenital clubfoot is a structural foot deformity that is present at birth;     – there is in utero malalignment of the talocalcaneal, talonavicular and calcaneocuboid joints;     – articular malalignments are fixed by contracted joint capsules, ligaments, and contracted foot and ankle tendons;     – may be … Read more