– Discussion: – medial malleolar frx result from direct impact of talus or from tension as talus rotates or moves laterally following fibula; – in children medial malleolus frx may represent supination inversion frx; – injury patterns: – deep deltoid ligament may be torn, leaving malleolus intact; – anterior colliculus may be avulsed by superficial … Read more
– Anatomy: – humeral origin of MCL lies posterior to axis of elbow flexion, creating cam effect; – hence, anterior fibers are stressed in extension & posterior fibers are stressed in flexion; – anterior oblique, posterior oblique ligament, & small transverse ligament are 3 major portions of the … Read more
– 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
– See: Medial Approach: – Discussion: – medial epicondyle is common origin of several flexor muscles of hand and wrist; – when medial epicondyle is frxed, flexor muscles pull fragment distally; – during surgical procedure care must be made to protect ulnar nerve; – Fixation Stratedgy: – … Read more
– See: – Pediatric Elbow Injuries – distal humeral physeal separation – lateral condyle frx, pediatric – supracondylar frx of humerus – Discussion: – third most common pediatric elbow frx (5-10%) (behind supracondylar and lateral condylar fractures); – most common between ages of 9 … Read more
– Discussion: – may begin as a microtear between the pronator teres and the FCR; – often associated w/ ulnar neuritis (see cubital tunnel); – Exam: – tenderness over the origin of the forearm flexors; – resisted pronation and/or flexion will elicit pain in most patients; … Read more
– Discussion: – optimal age for the medial approach: – is of more value in the child younger than 18 months but older than 7 months; – when this procedure is used in infants younger than 7 months, there may be a higher risk of AVN, but some authors feel that the risk of AVN … Read more
– See: Anteromedial Approach – Discussion: – may be used for frx dislocations of talus, traumatic injuries to ankle joint, and osteochondritis dissecans of the talus; – disadvantages: possible to injure the tibial vessels and nerves; – incision: – centered on malleolus & is made … Read more
– Discussion: – allow visualization of medial epicondyle, trochlea, and ulnar nerve are – approach is used for a total elbow arthroplasty; – proximally the interval lies between the brachialis and triceps, where as distally the interval lies between the brachialis and MCL; – avoid … Read more
– Discussion: – may lessen the distraction of the medial arch at the superomedial portion of spring ligament (lessens ligament tension); – may make the achilles tendon a better invertor and less of an evertor of the subtalar joint during walking; – compensates for talo-calcaneal valgus, and may … Read more