Discussion AC joint is situated between the clavicle and acromion; acromion has two ossification centers which fuse at age 22 yrs; it permits motion in three planes: AP gliding of acromion during protraction & retraction of scapula; tilting of acromion during abduction & adduction of arm; rotation of the clavicle; rotation occurs during abduction & … Read more
(see also: Achilles Tendonitis) Discussion ruptures typically occur after age 30, more often in people beyond middle age; rupture at musculous tendinous junction occurs most often in young people, but ruptures near the calcaneus also occur; inciting event may be related to atrophy of the soleus muscle, and commonly occur in weekend athletes; in 5-33% … Read more
(see also: Pseudoachondroplasia) Discussion autosomal dominant disorder; arises due to a point mutation for the gene encoding a fibroblast growth factor (Fibroblast growth factor receptor 3) over 80% of all persons with this disorder are born to parents who are not achondroplastic, & such parents rarely have second achondroplastic child; it is presumed in these … Read more
(See also: Rotator cuff) origin: infraspinatus fossa of scapula insertion: posterior aspect of greater tuberosity of humerus, capsule of shoulder joint; demensions: infraspinatus has been shown to average 29 mm wide, with a mean medial-to-lateral width of 19 mm action: extension, horizontal extension and lateral rotation of humerus at the shoulder joint. the infraspinatus is the … Read more
Discussion arises from median nerve, 5 cm above medial epicondyle; runs on volar surface of FDP and along interosseous membrane between ulna & radius; supplies FPL, lateral half of FDP, & pronator quadratus; may supply sensory branches to distal ru and carpal joints; variations: martin gruber anastomosis occurs in 10-15% of all forearms and in … Read more
(see also: acetabular component) Discussion it is essential to have optimal acetabular exposure; once acetabular exposure is achieved, then note native acetabular anteversion; Exposure for hips w/ severe osteoarthritis (or w/ heavily scarred hips) it may be necessary to fully release the quadratus femoris, and a portion of the gluteal sling; because the majority of … Read more
Total Hip Replacement Menu » Acetabular Component Revision » Discussion indications: salvage device for use in cases of pelvic discontinuity where a stable socket cannot be wedged between the anterior and posterior columns; classification of bone defects and bone grafting options: in almost every case, bone graft is morcelized and placed behind the cup; in … Read more
THR menu / Revision THR acetabular component Discussion note that some of the problems seen in dysplasia are frequently encountered in revision THR; indications for acetabular revision: sepsis, component malposition, impingement, polyethylene wear, pelvic osteolysis, recurrent dislocation, progressive protrusio, and component loosening; evaluation of the painful THR examination: examination for loosening previoius incisions; contracture of … Read more
Discussion restoration of normal hip center in acetabular reconstruction encourages restoration of normal biomechanics; placing the socket laterally creates increased joint reactive force, and placing it directly superior requires the use of a long neck prosthesis to restore abductor moment arm; long neck prosthesis will develop increased lateral bending stresses, adapting to the activities of … Read more
Discussion general discussion: clinical and radiographic findings Surgical Technique Subacromial Decrompression Arthroscopic Distal Clavicle Excision: Open Clavicle Excision: Surgical Technique: Modified Weaver Dunn Procedure: Complications lateral elevation of the clavicle: lateral elevation is often associated w/ pain; ref: Sequential Resection of the Distal Clavicle and Its Effects on Horizontal Acromioclavicular Joint Translation references: Complications after … Read more