Operative Techniques for Hip Frx: Pins
– See: – Nail Placement and Depth – Cannulated Screws
Hip
Open Reduction for DDH
Open Reduction for DDH – Inidications: – older age: – attempts at closed reduction should be limited to children who are less than three years old; – once children begin to walk, there is decreased chance for successful closed reduction & increased risk of AVN; … Read more
Open Reduction of Femoral Neck Fracture
– See: – Closed Reduction – X-rays for Femoral Neck Fractures – Indications: – w/ failure to obtain a closed reduction persists, esp in younger pt or older child, then open reduction is considered; – Posterior Approach: – in young pt requiring ORIF of a displaced femoral neck frx, consider … Read more
Open Reduction of Posterior Frx Dislocations of the Hip
See: Posterior Frx Dislocations of the Hip – Indications: – irreducible dislocation: – due to soft tissue interposition (ligamentum teres, capsule, labrum, piriformis, ect.); – incongruent joint: – due to intra-articular bone and cartilage fragments; … Read more
Open Fractures of the Tibia
– Discussion: – see open frx menu, tibia fracture menu and infections of the tibia – Initial Treatment and Timing of Surgery: – preoperative antibiotics; – therapeutic doses of ancef and tobramycin for 3 days are appropriate; – w/ contamination consider … Read more
Open Fractures
– Discussion: – fracture types: open tibia fractures, open fractures of femur – treat all open fractures as an emergency; – perform thorough initial eval to dx other life-threatening injuries: (see trauma management); – open joint injuries – gun shot wounds – controversies: non operative treatment: – Nonoperative … Read more
Obturator Artery
– Discussion: – artery arises from the internal iliac artery in the pelvis; – in the pelvis, it sends a branch to the obturator internus muscle; – as vessels emerge from obturator canal, they divide into anterior and posterior branches that, instead of continuing down thigh, circle … Read more
Obturator Externus
Origin: the margin of bone immediately around the medial side of the obturator foramen, from the rami of the pubis and the inferior ramus of the ischium; Insertion: posterior aspect of the greater trochanter; Action: External Rotation of femur at the hip; (see external rotators) Synergists: Periformis, Gemellus Superior, Gemellus Inferior, Obturator … Read more
Obturator Internus
– See: External Hip Rotators; – Anatomy: – origin: inferior medial surface of the obturator foramen and the quadrilateral surface; – insertion: after passing thru the lesser sciatic notch, it inserts on the superior posterior aspect of the greater trochanter of the femur; – action: outward rotation of the … Read more
Obturator Nerve
– Anatomy: – formed from anterior branches of L2, L3, L4 (see innervation of muscles of the lower limb) – largest nerve formed from anterior divisons of lumbar plexus ; – roots unite within the posterior part of psoas, & then descends thru psoas & runs downward over sacral … Read more