The Hip - book

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Scurvy

– Discussion:     – disease that can affect intracellular biosynthesis of collagen is scurvy, which is caused by Vit C (ascorbic acid) deficiency;     – specific defect appears is an inability of the tissue to hydroxylate proline (inadequate conversion of proline into hydroxyproline in collagen             fibers), & there is also decreased hydroxylation of lysine; … Read more

Scoliosis in the CP Child

– See: Cerebral Palsy: – Non Operative Treatment:     – many patients can achieve functional sitting with body jackets or molded wheelchair inserts; – Surgical Treatment:      – spine is instrumented from upper thoracic area to the sacrum;      – rods may be secured to the pelvis using the Galveston technique;     … Read more

Screws

– See:  Lag Screws  – Discussion:     – screw most commonly used is the machine screw, threaded from the headto  tip and with a blunt end;           – to insert these into bone, a preliminary drill hole must be made;           – following this, threads may … Read more

Screw Fixation of Acetabular Components

– See: Acetabular Component Menu Discussion it is controversial as to whether screws are necessary in THR, and there are relative advantages and disadvantages; cups should be designed with only 2-3 holes so as to maximize the porous coating surface and to minimize conduit for osteolysis; acetabular cup insertion: advantages of screw insertion: theoretically, screw … Read more

Scoliosis in Juveniles

– Discussion:     – by definition juvenile scoliosis develops before age 10;     – majority of idiopathic curvatures are right thoracic curves;     – left thoracic scoliosis is unusual;     – clinically, juvenile scoliosis shows slow progression prior to age 10, but after age 10 rapid progression may be found;     … Read more

SCFE: Should the Contralateral Hip be Pinned?

– Controversies: Should the Contralateral Hip be Pinned?     – many surgeons note that it is difficult to maintained close follow up of the contra-lateral (un-pinned) hip which can often slip despite               good compliance on the part of the patient;     – consider prophylactic pinning of the contralateral hip in patients at high … Read more

Sciatic Nerve

     – Anatomy: – arises from lumbrosacral plexus: L4, L5, S1, S2, S3; – nerve emerges from pelvis below piriformis & enters thigh between ischial tuberosity & greater trochanter; – in 10% of patients, the sciatic nerve is separated in greater sciatic foramen by all or part of the piriformis; – sciatic nerve is … Read more

Scheuermann’s Kyphosis

Scheuermann’s Kyphosis (SK): Incidence: 1-10% prevalence in adolescent population. Rare in patients under 10 years. Associated conditions: Spondylolysis – occurs in 6% of population with SK and scoliosis. Scoliosis occurs in 25% of population with SK. Demographics: Usually detected at puberty in skeletally immature adolescents. Males are twice as likely to develop SK than females; … Read more

SCFE: Reduction vs Pinning in Situ

– Discussion:     – arguments for closed reduction:          – closed reduction reduces the severity of the slip and facilitates screw placement;          – references:                – Slipped capital femoral epiphysis. The case for internal fixation in situ.         … Read more