– See: – Classification and Column Theory – Posterior Wall Fractures – AO Foundation Posterior Column Frx – Discussion: – posterior column extends from obturator foramen thru posterior aspect of the wt bearing dome of acetabulum & then obliquely through greater sciatic notch; – frx of … Read more
– See: Posterior Approach for Pelvic Frx – Indications for Use: – isolated posterior wall & posterior column frxs; – allows access to posterior column and posterior wall only, but exposure is limited proximally by superior gluteal vessels and greater trochanter; – isolated transverse frx (as well … Read more
– Discussion: – evaluation of the painful hip replacement and exam for THR loosening: – heterotopic ossification: – post op AP & lateral x-rays should include entire length of stem & cement mass; – femur and cement column are inspected carefully and compared w/ previous films for changes indicating component loosening, stem … Read more
– See: – Associated Transverse and Posterior Wall Frx – Classification and Column Theory – Discussion: – most common type of acetabular frx (up to 50% of acetabular fractures will contain a posterior wall fragment); – posterior wall frxs involve the posterior articular surfaces, often w/ retroacetabular … Read more
– Discussion: – refers to the portion of the posterior wall and column at the mid acetabulum lying above the ischial spine; – screws placed in this one are at risk for joint penentration; – anatomic safe zone: – entry point … Read more
– Positioning: – options include positioning with the patient supine – flat on the table or positioning the patient supine with the knee in a leg holder; – supine position: – requires a valgus post, a bump placed under hip, … Read more
– Assess ISS: – w/ multiple injuries (Pelvic Frx) consider supine position and use of universal femoral distractor; – Rotational Alignment – 45 deg Lateral on Flouro Table: – indications: – include ipsilateral femoral and acetabular frx or vertical unstable pelvic fracture; … Read more
– Supine – No Traction: – easiest method is supine position, w/ several rolled towel/blanket bumps placed side by side which elevates the fractured extremity above the other side (which is necessary inorder to get a lateral view on flouro), and which facilitate knee flexion (which is necessary for entry into the … Read more
– See: Osteolysis and Insertion of Polyethylene – Discussion: – originally Charnley used high density polyethylene and later this was changed to ultrahigh molecular weight polyethylene – impact strength of UHMWPE is higher than that for HDPE and the density of UHMWPE is much lower than … Read more
– Discussion: – polymyalgia rheumatica is a clinical syndrome that affects shoulder and hip girdles and causes severe pain and stiffness; – usually pt is in the sixth to seventh decade of life; – diff dx: – frozen shoulder (usually frozen shoulder is not associated w/ an elevated sed … Read more