Ortho Oracle - orthopaedic operative atlas

Anterior Approach to the Hip (Smith Petersen)

– See: Watson Jones Approach – Discussion: – Smith Petersen improved & revived the anterior iliofemoral approach; – entire ilium and hip joint can be reached thru iliac part of incision; – w/ this approach there is a need for extensive detachment of tendinous insertions & retraction of muscle, w/ potential damage to femoral artery and … Read more

Anterior Column of the Acetabulum

– See: Classification and Column Theory – Discussion:     – anterior column extends from symphysis pubis & obturator foramen thru               acetabulum to ASIS and up through iliac crest;     – anterior column is less frequently fractured than posterior column due to frequency               of posteriorly directed forces;     – frxs of the anterior … Read more

Antegrade IM Nailing Technique for Femoral Shaft Fracture

– Discussion: – retrograde IM nailing – Workup for Femoral Shaft Frx – PreOp Planning: – rule out femoral neck fracture: – Is Reconstruction Nailing of All Femoral Shaft Fractures Cost Effective? A Decision Analysis. – Diagnosis of femoral neck fracture associated with femoral shaft fracture: blinded comparison of computed tomography and plain radiography. – IM nailing of … Read more

Anterior Approach to Shoulder

– See: Anterior Approach to the Humerus Axillary Approach: Posterior Approach Posterior Approach to Humerus Surgical Approach for Proximal Humeral Fractures Positioning and Draping: supine or beach chair; small soft bolster is placed beneath the shoulder blades to protract the shoulder; head is stabilized to prevent hyperextension and subsequent brachial plexus palsy; place patient in … Read more

Ankle Arthrodesis

(see also: Sub-Talar Fusion, Tibial-Talar-Calcaneal Fusion Discussion and Outcomes: optimal position for fusion see gait and role of ankle joint in gait ref: Ankle arthrodesis. Long-term follow-up with gait analysis. Exam: perform an Allen test for the foot vasculature; note function of posterior tibial pulse while the dorsalis pedis pulse is occluded and vice versa; … Read more

Aneurysmal Bone Cyst

– Discussion:     – non-neoplastic expansile lesion consisting of blood filled spaces separated by connective tissue septa containing bone or osteoid              and osteoclast giant cells     – etiology unknown     – may be primary or secondary;     – an uncommon expansile osteolytic lesion of bone consisting of a proliferation of … Read more

Anatomy of Sacrum

– Discussion:     – upper end of sacrum, base of triangle, is directed forward & upward;     – in middle is upper surface of body of the first sacral vertebra;     – its anterior border forms the sacral promontory.     – it is concave & fairly smooth on its pelvic surface, … Read more

Anatomy of Femur

– See: Arterial supply to Femur – Embryology of Proximal Femur: – upper end consists of head, neck, & greater & lesser trochanters at junction of the neck with the body; – develops from 4 separate ossification centers; – head forms roughly two-thirds of sphere whose surface is articular  except for fovea capitis femoris where … Read more

Anatomy of Proximal Humeral Physis

Discussion proximal humerus ossifies from four centers: head, shaft, and both tubercles, which unite at age 19 to 20; frx in adult life tend to occur along old epiphyseal lines; depression between tubercles, bicipital groove, contains long head of biceps; tubercles also serve as points of insertion for rotator cuff, w/ subscapularis inserting on lesser … Read more