– See: Total Hip Replacement Menu: and see total knee replacement infections – Diagnosis: – diagnosis of septic loosening is initially based on history, x-ray findings, and elevated sed rate; – clincially patients may note increasing pain at both rest and with activity; – despite the variety of tests available, it may be difficult to distinguish … Read more
– See: tibial fracture menu and infection menu – Discussion: – by definition involves a tibia fracture infection that has gone on to non union; – by definition, infected non union is a Cierney IV osteomyelitis, meaning that the fracture is unstable before and after the debridement; – infected non union … Read more
– Discussion: – abductor weakness: – to improve abductor function when a femoral component is revised for excessive leg lengthening; – acetabular exposure: – difficult acetabular reconstructions may require wide exposure afforded by trochanteric osteotomy (DDH, prior acetabular frx, and … Read more
– Discussion: – see pediatric femur frx – commonest site of fracture of the femoral shaft is in its middle third, where normal anterolateral bowing of diaphysis is at its maximum; – torsional force produced by indirect violence results in a long spiral or oblique frx, whereas a transverse frx … Read more
– Technique: – at a point 3-5 cm above post. tip of greater troch., an incision is made which extends obliquely (proximally & posteriorly) for 10 cm; – for obese pts begin incision well above greater troch. (7-10 cm) & again extend proximally and posteriorly; … Read more
– Discussion: – IM nailing of Intertrochanteric fractures – Synthes Trauma Menu / Proximal Femoral Products – nails designed for trochanteric entry and rigid fixation into the femoral head are optimally used; – indications: – interlocking nails have been used for subtroch frx when lesser trochanter remains attached to the proximal … Read more
– See: Watson Jones Approach – Discussion: – frx of anterior column & some anterior column-posterior hemitransverse frx are approached using ilioinguinal approach; – ilioinguinal approach can give simultaneous access to both anterior & posterior portions of the pelvic ring; – medial portion of this approach … Read more
– Discussion: – an overuse phenomenon which is common in runners (more common w/ downhill running); (see running injuries) – pts usually have pain over lateral femoral epicondyle, which is caused by inflammation resulting from friction as iliotibial band slides over condylar prominence; – syndrome may be more common in … Read more
Origin: superior 2/3 of the iliac fossa, internal border iliac crest, anterior sacroiliac, lumbosacral and iliolumbar ligaments, ala sacrum; Insertion: Lesser trochanter of femur and for a short distance below along medial border of the shaft; Action: Flexes thigh at the hip, minimal activity on lateral rotation of the thigh; Reversed origin-insertion action: when the … Read more
– Discussion: – medial displacement osteotomy to stabilize unstable 4 part intertrochanteric frx; – in 4 part frx, adductors tend to displace frx into varus secondary to lack of medial cortical opposition; – disadvantages: – in a biomechanical study by Chang, el al., it … Read more