– see: anesthesia menu – Discussion: – assessment of perfusion: damage control orthopaedics – the most common situation is how to manage the femur fracture in the brain injured patient; – some authors have expressed concern that intraoperative hypoxia and hypotension may commonly occur w/ early IM nail stabilization; … Read more
– See: (Synthes Product Menu) – Reaming and Nailing Maneuver – Intramedullary Nailing – Miss A Nail Technique – Spiral Blade – Incision and Entry into Meduallary Canal – Proximal Inter-Locking – Distal Interlocking
– Company Specific Products: – Innomed Products: – Biomet® Flexible Osteotome System – Screw Drivers: – manufacturer specific screw drivers are necessary to remove the acetabular screws; – High-Speed Drills: – disadvantage: these drills remove bone more easily than they do harder cement; – may be needed to remove distal … Read more
– See: – Distal Femoral Shaft Fractures – Distal Femoral Phyeal Frx – Supracondylar Fractures following TKR – Discussion: – work up for femur fracture – mechanism: axial load to a flexed knee; – Bimodal distribution: – low energy fractures involving older females (often have severe osteoporosis); – high energy fractures involving younger males; – associated … Read more
– See: proximal femoral shaft fractures / – Discussion: – definition: – between lesser trochanter and 5 cm distal, even as far as center of isthmus of the femoral shaft; – technically starts below the lesser tuberosity; – medial and posteromedial cortex is a site of high compressive forces, while lateral cortex experiences high tensile stresses (forces … Read more
– See: Bone Healing w/ Plates – Discussion: – useful in subtrochanteric frxs since it permits insertion of at least two cortical screws into proximal fragment (calcar); – having multiple points of fixation above and below the fracture prevents varus or rotational migration; … Read more
Anatomy axis of femoral neck forms angle of approx 135 deg w/ femoral shaft, and is anteverted from the frontal plane by variable amount (- 4 to 36 deg, average 10 to 20 deg in Caucasians); distinct cortex surrounds the cancellous bone of the neck, the center of which becomes progressively empty with age (Ward’s triangle); center of … Read more
– Discussion: – classifaction and fracture stability – frx stability is based on presence or absence of posteromedial butress; – farther down shaft of femur primary frx is located, greater incidence of delayed union and implant failure; – forces acting on hip joint … Read more
– See: Radiographic Findings – stable intertroch frx is one that when reduced has cortical contact w/o gap medially and posteriorly; – this contact will prevent frx displacement into varus or retro-version when forces are applied to proximal femur; – medial cortices are not comminuted & there is no displaced frx of lesser trochanter
– See: – PreOperative Planning: – preoperative leg length: – acetabulum: – evaluation of cup position: – acetablar component loosening – use a wax pen to mark the tear drop and the superior aspect of the acetabulum, and overlie … Read more