Ortho Oracle - orthopaedic operative atlas

Wound Closure Initial Wound Care of Tibial Fractures

– Technical Considerations:          – consider debriding the wound with a separate set of surgical instruments / drapes          – exposure: extend the traumatic incision longitudinally in order to fully expose zone of injury;          – pressure irrigation         – debridement of open tibia fractures         – Arguments for Leaving Wound Open w/ Delayed Closure:           … Read more

Inferior Gluteal Artery

– See Superior Gluteal Artery: – Discussion:     – inferior gluteal artery leaves pelvis below piriformis  and above superior gemelli (after passing greater sciatic  foramen );     – main trunk of artery is vulnerable as it emerges from beneath lower border of pirformis when pelvic fractures involve greater sciatic notch;     – … Read more

Inferior Gluteal Nerve

– See: innervation muscles lower limb – Discussion:     – arises from posterior branches of L5, S1, and S2;     – passes from the pelvis below the piriformis muscles in the greater sciatic foramen;     – it enters the deep surface of the gluteus maximus muscle, to which it is the sole … Read more

Infections of the Hand

– See: Work Up and Treatment:      – Bacteriology of Hand infections      – Bite Wounds      – Clenched Fist Injury      – Collar Button Abscess      – Felon      – High Pressure Injection Injuries      – Infectious Flexor Tenosynovitis      – Lumbrical Muscle Sheaths      – Mid palmar space      – Kanavel’s signs   … Read more

Infectious Tenosynovitis: Closed Drainage

  – Technique:  – goal is to establish closed continuous drainage thru flexor sheath;  – tourniquet should be used;  – incision & drainage of flexor tendon sheaths are performed from both proximal and distal ends;  – palmar incision:  – transverse incision is made just proximal to distal palmar crease, over the infected tendon;  – spread … Read more