– See: Fasciotomy of the Leg – Discussion: – general discussion of compartment syndrome – compartment syndrome following tibia fractures are most common in closed frx (upto 20% of frx) but may also occur following open frx; – references: – Outcome at 12 to 22 years of 1502 tibial shaft fractures – Compartment syndrome in … Read more
– Discussion: – many surgeon use 30 mm Hg as the cut off for performing fasciotomy; – diastolic pressure: (Whiteside’ Theory): – development of a compartment syndrome depends not only on intra-compartment pressure but also depends on systemic blood pressure; – DBP – CP should be greater than 30 – references: – Diastolic … Read more
(See also: Total Hip Replacement Menu) Discussion stress transfer to femur is desirable because it provides physiologic stimulus for maintaining bone mass & preventing disuse osteoporosis; if prosthesis has a collar that is seated on the cut surface of the neck or if there is a layer of cement in contact with the bone and undersurface of the … Read more
– Discussion: – see: Winquist Classification – sign of high energy trauma: more blood loss, systemic complications, and fat embolism syndrome; – all cortical contact is lost; – simple cloverleaf nails are contraindicated w/ type III and IV comminuted frxs because of risk of shortening of frx about nail; – small diameter nails fail to … Read more
assistance provided by: B.L. Allen M.D. R. Feurgeson M.D. J.R. Davids M.D. – See: – Medial Release – Posterior Release – Discussion: – one-stage soft-tissue posteromedial release; – as a prerequisite, the forefoot adductus deformity should be passively correctable to neutral, in order to avoid wound healing problems … Read more
– Positioning: – sterile tourniquet; – supine position, hip bump; – foot bump to hold the knee in hyperflexion; – Incision: – inverted L shaped incision; – transverse limb: – is made … Read more
– Discussion: – Pavlik harness is seldom effective after 6 months of age; – in children between 6 months and 1 year of age, treatment consists of closed reduction w/ GEA following a period of skin traction & (w/ or w/o) adductor tenotomy (to reduce AVN); … Read more
– See: – Impediments to Reduction in DDH – Traction – Discussion: – Pavlik harness is seldom effective after 6 months of age; – in children between 6 months and 1 year of age, treatment consists of closed reduction w/ GEA following a period of skin traction & adductor tenotomy … Read more
– Radiographic Findings: – if possible intertrochanteric fractures should be closed reduced on the fracture table, prior to sterile draping; – allows adjustment of patient position (should it be necessary) and ensures that all equipement is working properly (on occassion frx table will malfunction); – radiographs are taken with special attention to cortical … Read more
– Discussion: – performed as soon a possible ( < 8-12 hrs) – either in OR under GEA (optimal) or in ER w/ sedation if delays are expected; – reduction may be performed w/ flouro, but orthopaedist may find that flouro interferes w/ hip flexion, which frequently is essential to … Read more