Ortho Oracle - orthopaedic operative atlas

Tumoral Calcinosis

– See: Ossification of Soft Tissue and Periosteum: – Discussion:     – heritable dz characterized by periarticular metastatic calcification;     – typically the shoulders and hips are affected most often;     – vascular and visceral calcification does not occur;     – hyperphosphatemia may play a role in this disorder; – Clincal … Read more

Tumors of Soft Tissue

       – Bone Tumors      – Biopsy      – European Cancer Institute – Soft Tissue Sarcomas      – Metastatic Tumors      – MRI      – Stage Classification Tissue type: – Osseous      – Myositis ossificans      – Extraosseous osteosarcoma – Carilaginous:      – Chondroma      – Extraosseous chondrosarcoma      – Synovial Chondromatosis – Fibrous:      – Fibroma      – Fibrosarcoma      – Desmoplastic Fibroma      – … Read more

Treatment: SCFE:

– Discussion:      – acute slip:      – acute on chronic slip:      – chronic slip:      – treatment of is designed to fuse epiphysis on femoral neck which prevents further slipping;      – this usually involves insertion of one or more screws into anterior aspect of  greater trochanter or … Read more

Treatment of DDH: New born (birth to 6 months)

– Discussion:     – treatment is directed at stabilizing hip that has positive Ortolani or Barlow test or to reducing dislocated hip w/ mild to moderate adduction contracture;     – implications of positive Ortolani & Barlow’s Test are different;           – Barlow’s Test identifies unstable hip that requires dynamic … Read more

Treatment of DDH

– See:        – DDH        – Impediments to Reduction in DDH        – Medial Approach to Hip        – Open Reduction        – Pelvic Osteotomy – Treatment Goals:     – goal is to achieve and manitain a concentric reduction of hip joint;     – concave acetabulum cannot develop without concentric force … Read more

Treatment of CDH: Age 18 mo to 36 months

– See: DDH – Clinical Presentation:     – widened perineum, shortened lower extremity, & hyperlordosis of lower spine; – Treatment Considerations:      – after 2 years of age, there is increased risk of AVN & closed reduction is more likely to fail;      – open reduction:            – … Read more

Transfusion Therapy

      – Blood Product Menu:       – pRBC’s / Fresh Frozen Plasma / Platlets / Cryoprecipitate / Transfusion Therapy / Coag Pathway – Indications for Blood Transfusion: – Methods to Decrease Transfusion:     – erythropoietin             – The effects of recombinant human erythropoietin on perioperative transfusion requirements in patients having a major orthopaedic operation.             … Read more

Transfusion Therapy – Aprotinin

               – Aprotinin: – hemostatic agent which regulates the following: – regulates fibrinolysis – intrinsic coagulation pathway – stabilizes platelet function – exhibits anti-inflammatory properties through inhibition of serine proteases; – in the report by JM Murkin MD et al (JBJS May 2000, Vol 82-A, No 5 Page 675), the … Read more

Traction for DDH

– Discussion:     – traction is often required for Pavlik harness treatment failures or for lately diagnosed cases;     – reduction of hip may be difficult in infants w/ delayed diagnosis of DDH;     – in children < 3 years of age, preop traction may decrease avascular necrosis, and may improve chances … Read more

Total Hip Arthroplasty

– See – Total Hip Arthroplasty Anterior Approach – Surgical Technique: (posterolateral approach) – Hip and Knee Infiltration Technique – Local Analgesia Infiltration Techniques – Hip and Knee Arthroplasty – pre op planning: – post operative evaulation of THR: – Acetabular Component – Acetabular Fracture and THR – Approach: – anterior approach – anterolateral approach … Read more