Ortho Oracle - orthopaedic operative atlas

Mobilization of Rotator Cuff for Repair

– Discussion: (RTC menu)     – mobilization is often required for massive tear;     – simply closing extensive tear will not suffice if atrophied muscles are not contracting adequately and if excessive tensions placed on repaired cuff cause reinjury;     – repair of good quality rotator cuff tissue is esp important in achieving an optimal result; … Read more

Misc. TKR articles

Contralateral total hip arthroplasty or ipsilateral total knee arthroplasty in patients who have a long-standing fusion of the hip. Total knee arthroplasty in Charcot and Charcot-like joints. Total knee arthroplasty for tuberculous arthritis Retrieval analysis of porous-coated components for total knee arthroplasty. A report of two cases. Segmental total knee arthroplasty after distal femoral resection … Read more

Miss A Nail Technique: (Special Aiming Arm)

– Discussion:     – Miss A Nail Aiming Jig permits single or dual, 7.0 mm cannulated screw or 6.5 mm cancellous screw fixation of the femoral neck frx before nail insertion, for a sound surgical approach to a demanding clinical situation;      – may be placed anterior (or anterior and posterior) to path of nail;   … Read more

Misc. THR Articles

Contralateral total hip arthroplasty or ipsilateral total knee arthroplasty in patients who have a long-standing fusion of the hip. Intrapelvic migration of total hip prostheses. Operative treatment The use of the McKeever metallic hemiarthroplasty for unicompartmental arthritis. Serum CK-MB is useful in diagnosis of acute myocardial infarction after total hip arthroplasty. Cardiac isoenzyme values after total joint … Read more

Mid-Carpal Instability

– Discussion: (see: dynamic instability);     – type of non dissociative carpal instability;     – capitolunate joint has high potential for instability, since it is mainly stabilized only by radiocapitate ligament (and captiotriquetral ligament, to a lesser degree); (see wrist ligaments);     – may result from malreduced radial styloid frx, or any … Read more

Methods to Prevent Infection

– See: Orthopaedic Infection Menu: and risk factors for TJR infection – Pre-Admission Considerations:         – removal of hardware prior to joint arthroplasty:                 – High incidence of early periprosthetic joint infection following THA with concomitant or previous hardware removal – Hospital and OR Considerations:          – perioperative oxygen          – normothermia:                  – Perioperative normothermia to … Read more

Metatarsus Adductus

– Discussion:     – a condition in which the there is medial displacement of the metatarsals on the cuneiform;     – forefoot is adducted at the tarsal metarsal joint;     – usually seen in the first year;     – is bilateral in 50% of patients may be associated with hip displasia … Read more

Methenamine Hippurate/Hiprex

– similar to Methenamine Mandelate) – these are oral agents used only for suppression or prophylaxis of chronic UTI; – they are absorbed well and are excreted into the urine in high conc. – these agents have no intrinsic antibacterial activity, but at a pH of 5.5 or less, mandelic and hippuric acids are antibacterial and … Read more

Metastatic Breast Cancer

– Discussion:      – metastatic breast disease survival averages 34 months;      – avg life expectancy w/ metastatic disease to bone is > 18 months; – Radiographs:     – permeative destructive lesions of bone;     – permeative destruction of the proximal femur is the most common type of destruction leading to … Read more