Ortho Oracle - orthopaedic operative atlas


– Discussion:     – anterior SI ligaments are stretched;     – radiographs show slight (< 2 cm) widening of the pubic symphysis and often imperceptable widening of the SI joint;     – results from low energy forces Surgeon Variability in the Treatment of Pelvic Ring Injuries Stress radiograph to detect true extent of … Read more

Anterior Wall Fractures

– Discussion:     – anterior wall frx involve central portion of anterior column & involves iliopectineal line is involved;     – associated injury: anterior hip dislocation; – Technique of Fixation:     – anterior wall fractures are approached thru Ilioinguinal Approach w/ supine positioning;     – traction removes femoral head from the … Read more

Classification of Anterior Posterior Compression Injuries

– Seee: Anterior Pelvic Injuries – Discussion:     – symphyseal diastasis and/or longitudinal rami fractures;     – these injuries result from relatively anterior or posterior forces applied to the anterior or posterior superior iliac spine areas;     – this gives rise to forces that tend to disrupt anterior pelvis, either by fracturing … Read more

Anterior Pelvic Frx: Anterior Plate Fixation Options

  – Two Hole Implants:     – two hole plate, usually a 4.5 mm, is fixed to the superior surface of the symphysis with two             6.5 mm cancellous screws immediately adjacent to the symphysis pubis;     – screws are inserted on the anterosuperior surface of the pubis on either side of the symphysis             … Read more

Anterior Pelvic Injuries: Open Surgical Approach w/ Plates

  – See: Anterior Plate Fixation Methods – Indications:     – open book pelvis injury w/ greater than a 2.5 cm pubic diastasis;     – note that fixation of pubic rami fractures can be much more complex than the fixation of a             simple diastasis;     – controversies:             – posterior injury and need for … Read more

Anterior Column of the Acetabulum

– See: Classification and Column Theory – Discussion:     – anterior column extends from symphysis pubis & obturator foramen thru               acetabulum to ASIS and up through iliac crest;     – anterior column is less frequently fractured than posterior column due to frequency               of posteriorly directed forces;     – frxs of the anterior … Read more

Amphotericin B/Fungizone

for severe systemic fungal infections; dose: 0.25mg/kg IV over 6hrs initially (infusion .1mg/ml); gradually increase dose as tolerated up to 1-1.5mg/kg/24hrIV over 6hr; note hypersensitivity, caution with nephrotoxic/antineoplastic agents; monitor blood, liver, and renal function, discontinue therapy if BUN >40mg/dl, Creatinine >3.0mg/dl, or if liver function test abnormalities are noted; should be delivered via Central … Read more

Acetabular Exposure and Preparation for Reaming

(see also: acetabular component) Discussion it is essential to have optimal acetabular exposure; once acetabular exposure is achieved, then note native acetabular anteversion; Exposure for hips w/ severe osteoarthritis (or w/ heavily scarred hips) it may be necessary to fully release the quadratus femoris, and a portion of the gluteal sling; because the majority of … Read more