The Hip - book

Type I Transepiphyseal Separation

– Discussion:     – least common pediatric femoral neck frx (about 7%);     – capital femoral epiphysis may stay w/in acetabulum but in 50% of cases the capital fragment is dislocated;     – tends to occur in infants and young children;     – this injury may be the result of a … Read more

Total Shoulder Replacement

– Discussion:     – see shoulder replacement discussion (total shoulder vs hemiarthroplasty vs reverse arthroplasty)     – the indications for total shoulder arthroplasty (versus hemiarthroplasty) are controversial;            – there is some controversy regarding pain relief and component survivorship;            – Gartsman GM, et al (2000), the authors compared hemiarthroplasty (24 … Read more

Tuberculosis

Discussion although the disease is generally more likely to be chronic, acute mycobacterial arthritis has been reported; periarticular bone lesions may accompany the synovial involvement; pulmonary tuberculosis is evident in only half the patients with skeletal involvement; pulmonary TB signs vary with stage of dz, few early on; later high fever, wt loss, prolonged, productive … Read more

Triple Arthrodesis

– See: – Blair Fusion – Charcot Marie Tooth – Equinovalgus – Grice Arthrodesis – Kocher approach – Ollier incision – Subtalar Fusion – Discussion: – results in fusion of subtalar, calcaneocuboid, and talonavicular joints; – most effective procedure for fixed hindfoot and forefoot deformities; – triple arthrodesis tend to have a high (50%) failure … Read more

Trigger Finger / Tenosynovitis

– See: – Phalangeal Injury – Congenital Trigger Thumb – Rheumatoid Trigger Finger – Discussion: – results from localized tenosynovitis of superficial and deep flexor tendons adjacent to A1 pulley at a metacarpal head; – inflammation causes nodular enlargement of tedon distal to pulley; – occurs most often in middle or ring fingers (occassionally in … Read more

Trapezium

– See:       – Blood Supply to the Wrist       – Thumb Deformities in Rheumatoid Arthritis       – Thumb Fractures – Discussion:     – articulates w/ thumb;     – move distal to snuff box to snuffbox to palpate trapezium-thumb articulation;     – trapezium-thumb articulation is saddle … Read more

Transient Synovitis

– Discussion:     – relatively short lived acute inflammatory process;     – usually seen in boys aged 2 to 10 years;     – frequently follows an upper respiratory tract infection;     – most common cause of painful hips in childhood;     – is a diagnosis of exclusion;     – … Read more

Total Shoulder Arthroplasty: Glenoid Component

– Discussion:     – operative considerations: hemiarthroplasty vs total shoulder arthroplasty     – anatomy:           – normal population, glenoid version: from 5 deg of anteversion to 15° of retroversion, with an                     avg preop retroversion range from 1 deg to 6 deg;            – surgical goal of resurfacing is to place the glenoid in 0° … Read more