Ortho Oracle - orthopaedic operative atlas

Hip Frx: Angle of Guide Pin Insertion

– Considerations:     – select point on lateral side of shaft of femur midway between anterior & posterior cortices at the midpoint of the lesser trochanter;           – if pins are inserted below the level of the lesser trochanter, a stress riser will be created in cortical bone;     … Read more

Hip Joint Arthroscopy

Hip Arthroscopy (see also hip joint and hip capsule) Indications evaluation of hip pain – candidates are patients with nonspecific radiographic findings and reproducible, functionally-limiting exam findings; false negative rate of plain x-ray, bone scan, CT, arthrogram, and routine MRI has been quoted as high as 80% in some patient populations. gadolinium enhanced MRI demonstrated a … Read more

Hip Dislocation

– Discussion:     – dislocate the hip posteriorly by flexing, adducting, and gently  internally rotating the hip;          – this may drive the femur against posterior edge of acetabulum;     – place bone hook beneath femoral neck at level of lesser troch. to  gently lift the head out of the acetabulum;   … Read more

High Ulnar Nerve Lesions

– See:     – Tendon transfers:     – Nerve Repair:     – Combined Injuries of the Median and Ulnar Nerves: – Discussion:     – ulnar innervated intrinsic muscles of hand, FCU, & FDP units to ring & little fingers & part of long finger;     – functional deficit:     … Read more

High Median Nerve Lesions

– See:       – Entrapment of Median nerve  at the Elbow and Forearm:       – Combined Injuries of the Median and Ulnar Nerves:       – Median Nerve       – Nerve Repair – Deficit:     – loss of pronation of forearm, wrist flexors, index & long finger … Read more

Herpes Simplex Finger Infections

– See: Diff Dx of Hand Infections – Discussion:       – most often involves the tip of the digit;       – occurs from contact w/ oral tracheal secretions and self inoculation (common w/ dentists);       – incubation period from two to 14 days;       – characterized by … Read more

Hemangioma of Soft Tissue

– See:      – Calcinosis:      – Hemangioma of bone – Discussion:     – a benign, vascular tumor that occurs in children, usually in limbs or trunk;     – hemangioma may be congenital, appearing as solitary tumor that infiltrates local tissue & adjacent neurovascular structures;     – most common form … Read more

Hand & Wrist in Arthrogryposis

– Discussion:     – hands of wrists in arthrogryposis are marked by weak muscles, stiff MP & IP joints, adducted thumb, and flexed and ulnar-deviated wrist;     – hand that has pinch and grasp is best left untreated;     – sublimis release>           – for flexion of proximal … Read more