– Discussion: – among most frequent limb anomalies is partial or total absence of fibula; – it is most common long bone deficiency and is the most common skeletal deformity in the leg; – most often is unilateral; – paraxial fibular hemimelia is the … Read more
– See: EMG Menu: – Discussions: – fibrillations are action potentials that arise spontaneously from single muscle fibers; – these usually occur rhythmically and are though to be due oscillations of the resting membrane potential in denervated muscles; – are typically biphasic or triphasic waveforms that are distinguished from … Read more
– Presentation: – shortened first toe is characteristic in fibrodysplasia ossificans progressiva; – recognition of this consistent foot deformity can help in the early diagnosis; – torticollis is common; – Radiographs: – see ossification of soft tissue: – ossification, which occurs in the fascia and … Read more
– See: – Fibroma – Desmoplastic Fibroma – Soft Tissue Menu – Discussion: – refers to multiple fibrous benign tumors which are locally aggressive; – these are more aggresive than solitary fibroma; – these lesions often develope in the proximal limbs or the trunk; – in abdomen, the tumor is called a desmoid tumors; – … Read more
– See: TKR Menu / Supracondylar Femur Frx – Discussion: – known risk factors include notching of the femur, osteoporosis, and excessive polyethylene wear (w/ subsequent osteolytic defect) – other risk factors include osteonecrosis of the femur; – ref: Morphologic analysis of periprosthetic fractures after hip resurfacing arthroplasty. – Radiographs: – often oblique radiographs are needs … Read more
– Discussion: – most common error is non isometric anterior tunnel placement within intercondylar notch rather than at its normal posterior insertion; – ACL graft should pull up into tibial tunnel by about 2mm with extension when fixed on femoral side; – this represents the closest reconstitution of … Read more
– Discussion: – advantages of femoral shaft reaming: – avoids potential mis-sizing of nail diameter (which can occur when non-reamed nails are inserted); – reaming may carry bone graft particulate into the fracture site; – faster union may be achieved in … Read more
– Discussion: – the two incision (“backdoor”) approach has remained the gold standard for ACL reconstruction, because it is the only technique which can reliably position the femoral tunnel at the 10 o’clock (or 2 o’clock) position (which is necessary for anatomic reconstruction); … Read more
– Discussion: – physeal bone bridges – methods to estimate growth potential – anatomy of distal femoral physis – distal femoral physis grows roughly at a rate of 9 mm/year (girls finish growing at age 14) – growth arrest, partial or complete, w/ progressive angulation &/or shortening ranges from 30% & 80% of pts; … Read more
– See: Accetable Reduction Parameters – Discussion: – always attempt closed reduction before open reduction; – evaluation of the lateral x-ray after reduction to evaluate posterior comminution of the femoral neck is critical; – posterior comminution leads to the loss of a butressing effect posteriorly, w/ subsequent loss of reduction … Read more