Ortho Oracle - orthopaedic operative atlas

Anatomic Neck Fracture of Humerus

vascular supply to the humeral head Two Part Articular Segment Displacement fracture plane is through the anatomic (not surgical neck); anatomic neck represents the old eiphyseal plate; surgical neck represents the weakened area below the tuberosities and head approximately 2 cm distal to the anatomic neck; significant chondral defects and minimally separated fragments may go … Read more

Adult Lateral Condyle Fracture

(See: – Pediatric Lateral Condyle Frx) Discussion frxs of lateral condyle that involve capitulum alone or extend medially to involve the lateral portion of trochlea; see capitellum fracture Lateral approach » typically the plate is positioned posteriorly, and can be placed if needed as far as the posterior aspect of the capitellum; remember that the … Read more

Adult Humeral Inter-condylar Fractures

 – Fractures Subtypes:     – capitellar and coronal shear frx – distal humeral frx – lateral condyle frx – medial condyle frx – Muller’s Classfication: – type A: extra-articular fracture; – type B: uni-condylar fracture; – type C: bi-condylar fracture; – controversies: – total elbow replacement – Distal humeral fractures treated with noncustom total elbow … Read more

Adult Humeral Inter-condylar Fractures: Restoration of Frx Anatomy

– Technique:      – it is helpful to have the patient paralyzed during the reduction (requires general anesthesia);      – anatomic reduction of the condyles is performed first;      – remember that the  common factor in fixation failure in these fractures is comminution and/or osteoporosis;      – best-fit method:             … Read more

Adhesive Capsulitis of the Shoulder

– Discussion: – refers to a condition in which the shoulder capsule becomes contracted and thickened; – patients note a dramatic decrease in shoulder ROM; – in many cases there is spontaneous resolution after 1-3 years and motion is re-gained; – associated disorders: – cervical spondylosis – hypothyroidism – ref: Prevalence of hypothyroidism in patients … Read more

Adult Humeral Inter-condylar Fractures: Plate Application

– Technique Considerations: – following restoration of fracture anatomy, contour 1/3 tubular, 3.5 pelvic reconstruction, or 3.5 DCPs, to fit medial and lateral aspect of distal humerus; – the strongest bone lies along medial and lateral columns and therefore the plate screws should be placed here rather than central portion of distal end of the … Read more

Multiple Myeloma

(see also: Bone Tumor Menu) Discussion myeloma is malignant tumor of plasma cells arising from a single clone; multiple myeloma accounts for > 40% of primary malignant tumors of bone. it is most common malignant primary tumor of bone may arise as single intraosseous tumor but more often it develops as multiple painful lesions throughout … Read more

Fractures of the Humerus Menu

  Anterior Approach to Humerus Anterior Approach to Shoulder Arteries of the Upper Limb Blood Supply to the Humerus Classification of Proximal Humeral Fractures Condylar Fractures Distal Humeral Fractures Holstein Lewis Fractures Humerus Humeral Shaft Fracture Non Union of Humeral Fractures Pediatric Humeral Frx Posterior Approach to Shoulder Posterior Approach to Humerus Posterolateral Approach to the Distal … Read more