Ortho Oracle - orthopaedic operative atlas

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


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 also: 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 rate in children under 10 years of age; triple arthrodesis … 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


– 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

Toxic Child: Onset of Joint Disorders

– Synovial Fluid Exam – Systemic JRA – Septic Arthritis – Leukemia – Systemic Lupus Erythematosus – Reiter’s Syndrome – Reactive Arthritis – Sickle Cell Anemia – Serum Sickness – Acute Rheumatic Fever – Vasculitis:  (H.S.P. / Kawasaki’s) – Inflammatory Bowel Disease