– Discussion: – intimal injury occurring with fractures may be extensive, & full extent of the injury may be evident only after arteriotomy; – intimal injury may be manifested as intimal frx w/ thrombosis, intimal dissection, or a subintimal hematoma, which can all lead to occlusion of the artery; – Repair: … Read more
– Discussion: – as with all femur fractures be sure that a femoral neck fracture is not present; – Operative Technique: – position: – supine with several folded sheets placed underneath the injured thigh and knee; – the injuried thigh must be … Read more
– Ender nails introduced in 1970; – nails backing out of the medullary canal – perforation of nails thru the femoral head – external rotational deformity at the fracture site – distal migration – ref: – The use of Ender’s … Read more
– Discussion: (see IM Nailing of subtrochanteric fractures) – a type of intramedullary device (designed for intertrochanteric and subtrochanteric fractures) which allows controled sliding of the femoral head screw within the IM nail glidign hole; – advantages of IM device: – IM nail with interlocking reconstruction … Read more
– Discussion: – frx occur as a result of a fall – from direct and indirect forces; – occurs along lines between greater and less trochanters; – theoretically extracapsular, however, it is not always possible to distinguish betwee intertroch and basilar femoral neck frx; – extracapsular intertroch frx occur thru cancellous bone, which has an … Read more
– Discussion: – one of most common knee injuries in children; – most common in children between ages of 8-14 yrs; – usually result from avulsions of anterior intercondylar eminence from pull of ACL; – fragment of tibial spine may be non displaced, or … Read more
– Destot’s sign: – superficial hematoma above inguinal ligament or in scrotum or thigh; – may indicate a pelvic fracture, as may a limb-length discrepancy or obvious rotational deformity of the pelvis or lower extremity; – Roux’s sign: – a decrease in the distance from the greater trochanter to … Read more
– Technique Considerations: – entry into the medullary canal: – femoral reaming: – broaching for press fit stems: – the last broach in inserted carefully and should advance with each blow of the mallet; – as the broach is … Read more
– Anterior Talar Impingement Syndrome – Avascular Necrosis and Salvage of Talus Fractures – Blood Supply to Talus – Congenital Vertical Talus – Talar Head Frx – Fractures of the Talar Neck: – Hawkins Classification: – Type I Talar Fractures – Type II Talar Fractures – Type III Talar Fractures – Hawkins Sign – Lateral … Read more
– Discussion: – see: femoral non unions / osteomyelitis – three types of infection: – infection of the soft tissues; – infection of the fracture site – infection of the entire marrow cavity:(rare but serious and may require AKA); – infection usually develops with in 3 weeks of IM nailing; – look for continuous deep thrombing pain, which … Read more