Ortho Oracle - orthopaedic operative atlas

Flexion and Extension Views of C-spine

– See:       – Anterior Subluxation:       – Ligamentous Instability: – Discussion:     – the flexed view is usually most helpful in detecting ligamentous injury that is not apparent on the neutral view     – determines the integrity of the supporting soft tissues and ligaments, as well as the … Read more

Finger and Hand Incisions

– See:     – Finger Tip Injuries – Brunner Type Incisions:     – The zig-zag volar-digital incision for flexor tendon surgery. – Midaxial Incision:     – indications: septic arthritis of IP joints and MP joint of thumb;     – site for placing midaxial incision is performed by  flexing finger & marking the … Read more

Finger Tip Injuries

– See:       – Phalangeal Injury – Menu       – Thumb Defects:              – Moberg Flap   – Nail Bed Injuries:          – if injury damages the distal phalanx, particularly when the damage extends into germinal matrix, the nail will probably be irregular and                  … Read more

Finkelstein’s test and the Grind Test

– Finkelstein’s test:     – ask patient to make a fist over his thumb, and ulnarly deviating wrist     – sharp pain at this site is produced by active extension and abduction of the thumb against resistance; – Differential Diagnosis:      – DeQuervain’s tenosynovitis must be differentiated from degenerative arthritis & trapeziometacarpal joint; … Read more

Femoral Reaming: for THR

– Discussion:     – goal: ream close to endosteal cortex, which has strongest cancellous bone;     – enter medullary canal w/ curet, & ensure that there are no perforations;             – this is esp important w/ osteoporotic bone;     – to enlarge medullary canal of diaphysis, use … Read more

Femoral Neck Frx: Acceptable Reduction Parameters

– See:        – x-rays for femoral neck fractures        – technique of closed reduction – Acceptable Reduction:     – poor reduction of femoral neck frx interferes w/ blood supply to femoral head & decreases apposition of bone between bone fragments;     – reduction should leave neck-shaft angle between … Read more

Femoral Neck Frx: Techniques of Closed Reduction

– See: Accetable Reduction Parameters – Discussion:     – always attempt closed reduction before open reduction;     – evaluation of the lateral x-ray after reduction to evaluate posterior comminution of the femoral neck is critical;     – posterior comminution leads to the loss of a butressing effect posteriorly, w/ subsequent loss of reduction … Read more

Femoral Component

– See: Total Hip Replacement Menu – Discussion:     – design considerations      – femoral stem collar     – cemented femoral stems (radiology of cemented femoral stems)      – press fit femoral stems      – femoral component offset             – modular neck:                    – … Read more