– Discussion: – consistent relationship between cerebral blood flow and intracranial pressure is difficult to demonstrate until levels of 40-50 mm Hg are reached; – well-engineered intracranial-pressure transducers can easily be inserted by the neurosurgeon in the emergency room; – use subdural rather than an intraventricular placement (which could reduce intracranial pressure … Read more
– Discussion: – in normal knees, constant relationship exists between length of patella (LP) and length of the patella tendon (LT); – length of tendon (LT) is measured on its post surface from the lower pole of patella to its insertion on top of tibial tubercle; … Read more
– See: – characteristics of cemented femoral stems – loosening cemented femoral component: – collar: in THR – optimal cementing technique – removal of cemented femoral stems: – Preparation for Insertion: – calcar planer: … Read more
– Technique Considerations: – entry into the medullary canal: – femoral reaming: – broaching for press fit stems: – the last broach in inserted carefully and should advance with each blow of the mallet; – as the broach is … Read more
– Destot’s sign: – superficial hematoma above inguinal ligament or in scrotum or thigh; – may indicate a pelvic fracture, as may a limb-length discrepancy or obvious rotational deformity of the pelvis or lower extremity; – Roux’s sign: – a decrease in the distance from the greater trochanter to … Read more
– See Superior Gluteal Artery: – Discussion: – inferior gluteal artery leaves pelvis below piriformis and above superior gemelli (after passing greater sciatic foramen ); – main trunk of artery is vulnerable as it emerges from beneath lower border of pirformis when pelvic fractures involve greater sciatic notch; – … Read more
– See: innervation muscles lower limb – Discussion: – arises from posterior branches of L5, S1, and S2; – passes from the pelvis below the piriformis muscles in the greater sciatic foramen; – it enters the deep surface of the gluteus maximus muscle, to which it is the sole … Read more
– See: Total Hip Replacement Menu: and see total knee replacement infections – Diagnosis: – diagnosis of septic loosening is initially based on history, x-ray findings, and elevated sed rate; – clincially patients may note increasing pain at both rest and with activity; – despite the variety of tests available, it may be difficult to distinguish … Read more
– See: TKR menu, work up of the painful knee, and prevention of infection and infected THR; – Diagnosis: – early dx of an infected prosthesis requires a high index of suspicion. – infection may cause only knee pain, persistent effusion, or early painless loosening, or more obvious signs, including inflammation, drainage, and sepsis; – classification: (ref: … Read more
– Discussion: – abductor weakness: – to improve abductor function when a femoral component is revised for excessive leg lengthening; – acetabular exposure: – difficult acetabular reconstructions may require wide exposure afforded by trochanteric osteotomy (DDH, prior acetabular frx, and … Read more