The Hip - book

Medial Compartment of the Knee

– See: Medial Collateral Ligament: – Superficial Layer (Layer I)     – most superficial layer includes the deep fascia that arises from anterior to posterior encases entire medial aspect of             the knee & coalesces w/ hamstring muscles and posteromedial capsule;            – this first layer is superficial to superficial MCL; … Read more

Medial Collateral Ligament

    – Anatomy:       – MCL is composed of superficial & deep portions;     – superficial MCL:          – anatomically this is the second (middle) layer of the medial compartment;          – proximal attachment: posterior aspect of medial femoral condyle;                   – 3.2 mm proximal and 4.8 … Read more

Mechanical Axis

– Discussion:     – mechanical axis refers to the angle formed by a line drawn from the center of the femoral head to the medial tibial spine and a            line drawn from the medial tibial spine and the center of the ankle joint;            – this should not be confused w/ the wt … Read more

Marfan’s Syndrome

Discussion older names include dolichostenomelia (Greek for long, narrow limbs) and dystrophia mesodermalis congenital, typus Marfanis; inherited as an autosomal dominant trait with variable expressivity. characterized by long, thin limbs and by laxity of ligaments; Pathophysiology dz of collagen synthesis (possibly the alpha subunit) may have abnormal production of collagen type I (and ? type … Read more

Management of Vascular Injuries in Knee Dislocation

– See:         – Arteriography         – Arterial Trauma         – Compartment Syndrome         – Knee Dislocation         – Popliteal Artery         – Reperfusion Injury – Discussion:      – note that the worst error to make is to underestimate the need to … Read more

Management of Pulmonary Embolism

– See: – deep venous thrombosis / respiratory failure – Discussion:     – time range of diagnosis of PE following discharge:  14-68 days (JR Lieberman et al);           – ref: Early pulmonary embolism after injury: A different clinical entity?     – in the report by Lawton RL and Morrey BF (1999), the authors advise that patients … Read more

Management of Head Injury

 – Outside Link:        – An Approach to the Head Injured Patient by Paul Marik, MD  – Trauma Menu:          – Spine / C-spine          – Orders for the Spine Injured Patient:    Anesthesia in the Spinal Cord Injured Patient:    Fluids in the Head Injured Pt:     Hyperventilation    Glasgow Coma Scale     Head … Read more

Malposition of the Joint Line

– Discussion:      – see flexion and extension gaps:     – quantification of joint line malposition:              – joint line position lies about 3 cm distal to the medial femoral epicondyle and 15 mm above the fibular head;              – if the opposite knee has … Read more