The Hip - book

DVT/PE Prophylaxis in THR

div class=”mh-row clearfix”> h1>/h1> div class=”bodycopy”>hr size=”3″/> – See strong>a href=”/joints/hip/total-hip-arthroplasty/”>Total Hip Replacement Menu:/a>/strong> br/> br/> strong>- Discussion:/strong> (strong>a href=”/ortho/deep_venous_thrombosis”>general discussion of DVT/a>/strong>) br/>     – 40-60% of THR patients who do not receive prophylaxis will get a DVT (dependment on imaging method); br/>            – ref: Significance of deep … Read more

Deep Venous Thrombosis (DVT)

Clinical Signs for DVT exam may be unreliable but positive findings should not be ignored calf tenderness, swelling, fever, & increased pulse rate may be present suggestive exam features for pulmonary embolism sudden decrease in O2 saturation tachypnea, cyanosis, and hypoxia pulmonary consolidation, pleural effusion, wheeze, and cor pulmonale new onset tachydysrhythmia (usually atrial fibrillation) … Read more

DVT: Intermittent Compression Stockings

– Discussion:     – advantages include relatively low cost, efficacy when worn properly, and safety;     – disadvantages: compliance is not guaranteed;     – if possible, patients should be placed in the intermittent compression stockings, prior to the operative procedure Pneumatic sequential-compression boots compared with aspirin prophylaxis of deep-vein thrombosis after total … Read more

DVT & PE arising from Trauma, Pelvic Fractures, and Extremity Fractures

– See: DVT Discussion: – Discussion:     – 30-50 % occurance of DVT in trauma pts w/ lower extremity fractures;     – preexisting conditions such as heart disease, obesity, carcinoma, diabetes, and hypertension could theoretically push the numbers even             higher;     – mortality for pulmonary embolism may approach 10%;     – ref: … Read more


– See:       – DVT: General Discussion:       – TKR menu: – Discusion:     – prevalence of deep-vein thrombosis after primary total knee arthroplasty has been reported to be higher than that after primary THR;           – calf-vein thrombosis in patients treated with total knee arthroplasty … Read more

DVT (Deep Venous Thrombosis) – Diagnosis

Clinical signs Clinical signs are unreliable but should not be ignored Calf tenderness, swelling, fever, and increased pulse rate may be present Work up for DVT arterial blood gas/pulse oximetry coagulation labs (for HCT & platelet count) prothrombin time (PT)/partial thromboplastin time (PTT) fibrinogen CBC EKG and CXR (if PE is suspected) D-dimer level below … Read more

Cast Treatment of Tibial Fractures

– Indication for Closed Treatment:    – indications — These are based on “personality” of the fracture as described by Nicoll EA (1964)           –  he listed factors favoring union:           – displacement: if the fracture fragments on are or can be opposed to 25% in a transverse fracture, casting or bracing is permissible             – more than 50% initial frx … Read more

Calcitonin Salmon/ Calcimar / Miacalcin Nasal Spray

– Dosing:     – contraindicated w/ clinical allergy, must periodically examine urine sediment with chronic use;     – for symptomatic Paget’s Disease of bone, hypercalcemia, post-menopausal osteoporosis (in addition to supplemental calcium,             adequate vitamin D intake, and adequate diet);     – osteoporosis:             – may be … Read more

Baker’s Cyst / Popliteal Cysts

– Discussion:     – a type of cyst which results from egress of fluid through a normal communication of a bursa (semimembranosus or medial             gastrocnemius bursa) or may be caused by herniation of the synovial membrane through the joint capsule;     – symptoms develope most often in bursa beneath the medial head of gastrocnemius … Read more