– See: – Arterial Development: – Components: – inferolateral branch of arteria comitans nervi ischiadici inf gluteal ) – medial femoral circumflex – lateral femoral circumflex – 1st perforating branch of profunda – Discussion: – persisting distal portions of ischiadic artery become peroneal & … Read more
– Discussion: – decreased neck shaft angle from defect in ossification of femoral neck; – it is bilateral in 1/3 to 1/2 of cases; – it can be congenital (noted at birth & differenitated from CDH by MRI), developmental (AD-progressive), or acquired (trauma, LCP, SCFE) – Differential Dx: … Read more
– Discussion: – can reduce back and knee pain; – improved ability to sit for longer periods of time; – increased incidence of dislocation; – indications for conversion: – painful pseudarthrosis – pseudorthrosis rates … Read more
– Discription: – broad cloverleaf shaped plate which is designed to butress comminuted supracondylar fractures; – this plate may be especially indicated for comminuted distal fractures w/ a coronal shear frx; – plate is designed to contour to the lateral aspect of the distal femoral … Read more
– Discussion: – see considerations for sliding screw placement – osseous anatomy of proximal femur dictates where internal fixation device should be placed for maximum purchase in femoral head; – maximum bone density is found in the area where compression & tension trabeculae coalesce in center of head; … Read more
– See: Comminuted Femoral Shaft Fractures – Complications: – compartment syndrome of thigh – femoral IM nail infection – avascular necrosis from IM nailing – femoral non union – Implant failures: – associated w/ either the insertion of a small diameter nail or use of an interlocking … Read more
– See: Fasciotomy of the Leg – Discussion: – general discussion of compartment syndrome – compartment syndrome following tibia fractures are most common in closed frx (upto 20% of frx) but may also occur following open frx; – references: – Outcome at 12 to 22 years of 1502 tibial shaft fractures – Compartment syndrome in … Read more
(See also: Total Hip Replacement Menu) Discussion stress transfer to femur is desirable because it provides physiologic stimulus for maintaining bone mass & preventing disuse osteoporosis; if prosthesis has a collar that is seated on the cut surface of the neck or if there is a layer of cement in contact with the bone and undersurface of the … Read more
– Discussion: – see: Winquist Classification – sign of high energy trauma: more blood loss, systemic complications, and fat embolism syndrome; – all cortical contact is lost; – simple cloverleaf nails are contraindicated w/ type III and IV comminuted frxs because of risk of shortening of frx about nail; – small diameter nails fail to … Read more
– Radiographic Findings: – if possible intertrochanteric fractures should be closed reduced on the fracture table, prior to sterile draping; – allows adjustment of patient position (should it be necessary) and ensures that all equipement is working properly (on occassion frx table will malfunction); – radiographs are taken with special attention to cortical … Read more