– Discussion: – results from a defect is somatic mutation in the gene coding for alpha subunit of Gs, the G protein that stimulates cAMP formation; – overproduction of cAMP, causes overexpression of c-fos, which regulates proliferation and differentiation of osteoblasts and osteoclasts; – results in … Read more
– Discussion: – for iron defficiency anemia; – adult: 300mg PO qd/tid with meals; – will turn stools and urine dark; can cause GI upset; con-stipation; – sulfate form contains more elemental iron per dosage unit than gluconate (some tolerate gluconate better); – peds: prophylaxis: … Read more
– Discussion: – child abuse: 30% of femoral frx in children < 4 yrs are 2nd to child abuse; – Over-riding of Fracture Fragments: – in children between the ages of 2-10 yrs, overgrowth averages 0.9 cm; – in kids between 2 & 10 yrs, side to side apposition … Read more
– Discussion: – child abuse: child abuse occurs in 50-80% of children < 2 yrs w/ femoral frx; – limb length inequality are seldom a problem since frx does not shorten excessively; – acceptable reduction: – in children younger than 2 yrs, shortening of … Read more
– Measurement of Length: – its essential to plan ahead to achieve proper leg length; – w/ comminuted frx, use opposite leg to determine leg length; – one method is to obtain long cassette radiograph of opposite side w/ radiographic ruler included on the film; … Read more
– Discussion: – performed to correct either anteversion / valgus deformity of femoral neck in patients w/ dysplasia that reduces w/ abduction and medial rotation; – if hip is not reducible, then open reduction is performed prior to osteotomy; – the procedure is most useful when the acetabular dyspasia … Read more
– See: – x-rays for femoral neck fractures – technique of closed reduction – Acceptable Reduction: – poor reduction of femoral neck frx interferes w/ blood supply to femoral head & decreases apposition of bone between bone fragments; – reduction should leave neck-shaft angle between … Read more
– See: Accetable Reduction Parameters – Discussion: – always attempt closed reduction before open reduction; – evaluation of the lateral x-ray after reduction to evaluate posterior comminution of the femoral neck is critical; – posterior comminution leads to the loss of a butressing effect posteriorly, w/ subsequent loss of reduction … Read more
– See: Avascular Necrosis following Femoral Neck Fracture – Discussion: – usually non unions are apparent w/in one year of femoral neck frx; – incidence ranges from 10 to 30%; – only 1/3 of pts w/ AVN will require additional surgery where as – 3/4 patients with … Read more
– See: – Total Hip Replacement Menu: – Acetabular Bone Grafting: – Allografts – Discussion: – indicated for pts w/ severe osteolysis or for femoral shaft fractures; – in younger pts, structural allografting may eventually allow some … Read more