– Discussion: – two sites have been proposed for nail entry: – tip of the greater trochanter and the piriformis fossa; – Entry thru Piriformis Fossa; – main advantage a colinear trajectory with the long axis of the femoral shaft – accurate positioning of the entrace hole is critical. … Read more
– See: adult femoral and acetabular anteversion – Discussion: – femoral version is defined as the angular difference between axis of femoral neck and transcondylar axis of the knee; – excessive femoral anteversion (medial femoral torsion) is most common cause of in-toeing that first presents in early childhood; – … Read more
– Discussion: – femoral version is defined as the angular difference between axis of femoral neck and the transcondylar axis of the knee; – excessive femoral anteversion (medial femoral torsion) is most common cause of in-toeing that first presents in early childhood; – it is twice as common in girls as … Read more
– Discussion: – FES results when embolic marrow fat macroglobules damage small vessel perfusion leading to endothelial damage in pulmonary capillary beds leading to respiratory failure and ARDS like picture; – ref: Early-Onset Fat Embolism Syndrome. A Case Report – risk factors for FES: – … Read more
– Anatomy: – external rotators of thigh include (from superior to inferior) – Piriformis – conjoined tendons: – Gemellus Superior – Obturator Internus … Read more
– Discussion: – methods to enhance fixator stability; – in the report by Minor T, et al, 37 femoral shaft fractures, in 33 pediatric patients, were treated with unilateral external fixation after reduction from 1992 through 1998 (ages from 4 to 14 years); – average follow-up was 3 years, … Read more
– Discussion: – see flexion gap – is space between transverse cut on distal femur & transverse proximal tibial cut while the knee is in complete extension; – while minor loss of knee flexion or mild instability in flexion can be tolerated, priority is always be given to extension gap adjustments; … Read more
– Clinical Findings: – history: patient may complain of a subjective knee hyperextension sensation, and twisting or pivoting are also difficult; – lack of contained effusion is suggestive of posterolateral capsular injury; – look for diffuse tenderness over the posterolateral joint region, fibular head, and joint line; … Read more
– Discussion: – serial diagnostic exam should take into consideration static deformities of the lower extremities, gait, ROM, tenderness, and knee stability; – in the child w/ a painful knee, it is essential to closely examine the hip as hip pathology can refer pain to the hip; – Examination: – Gait: … Read more
– See: Bone Tumor Menu – Discussion: – prevalence: – it represents approx 7% of all primary bone malignancies; – second most common primary malignant bone tumor (behind osteosarcoma) (2.1 per 1 million children) – Ewing’s sarcoma is more common in males and is rare in blacks; – … Read more