– Discussion: – bone provides and environment that significantly alters interaction between bacterial and host defenses in favor of the invader; – bone contains numerous microscopic channels, the walls of which are impermeable to such host defenses as the large molecules of immunoglobulins; – bacteria, once gaining a foothold in these … Read more
– See: DDH – Discussion: – indicated for residual dysplasias in adolescents and young adults; – allows both anterior and lateral rotation as well as medialization of the hip; – can expect good improvement in the center edge angle (avg correction of 31 deg); – does not … Read more
– See: Garden Alignment Index – Garden I: – incomplete or impacted fracture, in which the trabeculae of the inferior neck are still intact; – femoral head is tilted in a posterolateral direction, causing vaglus angulation at the frx site; – non surgical treatment: – … Read more
– See: Garden Alignment Index – Garden III: *** – complete fracture with partial displacement; – “if it needs a reduction, then its a type III fracture;” – frequently there is shortening and external rotation of distal frag; – retinaculum of Weitbrecht remains attached to, & maintains … Read more
– See: – Garden I & II – Garden III & IV – Discussion: – refers to the angle of the compression trabeculae on AP view relative to the longintudinal axis of the femoral shaft and the angle of compression trabeculae on the lateral view relative to the femoral shaft; – on the AP this … Read more
– Vessel Exposure: Exposure of the donor vessels is optimized with the use of a large self retaining retractor superior in the wound as well as the Charnley retractor. The microscope is brought in to perform the anastamosis. The vein is coupled first. This prevents any bleeding which could obscure the field if the … Read more
– Positioning and Prepping: The patient is placed on a beanbag support in the lateral position. The entire axilla to foot area is prepped with betadine solution. A waterproof stockinette is used on the lower extremity with a sterile tourniquet in place at the thigh. Betadine impregnated vidrapes are used to isolate the hip and … Read more
– Technique: When the lateral femur is exposed, a 3 mm guide pin is placed into the center of the necrotic area. Care must be taken, particularly on the lateral view, that there is enough room in the neck on both sides of the guide pin to pass a 21 mm reamer if needed. The … Read more
– Discussion: – Fibular Harvest: – Hip Preparation: Various methods have been advocated for the treatment of acascular necrosis of the hip in the young patient. From the literature an operative treatment for the symptomatic hip is the conservative method of management. Reports on core decompression, osteotomies, electrical stimulation, and bone grafting have been difficult … Read more