– See: Phalangeal Injury – Discussion: – takes advantage of stabilizing forces of flexor & intrinsic on phalanges with the MP joint held in 90 deg flexion; – intact dorsal extensor mechanism functions as “tension band” to palmar cortex, and helps maintain the reduction; – digital rotation … Read more
– Discussion: – see flexion gap – is space between transverse cut on distal femur & transverse proximal tibial cut while the knee is in complete extension; – while minor loss of knee flexion or mild instability in flexion can be tolerated, priority is always be given to extension gap adjustments; … Read more
– Discussion: – in elderly pts w/ comminuted frx, excision of up to 50% of olecranon can be well tolerated (no instability) – if distal surface of semilunar notch of ulna & coronoid are not injured upto 80% of olecranon may be excised w/o producing instability; – … Read more
Discussion – descision to excise the head of the radius depends associated elbow injuries as well as severity of radial head frx; – it has been determined that the stabilizing effect of radial head comes into play only when the MCL ligament has been disrupted, which explains why excision of radial head (w/ … Read more
– Technique: – patient is placed on a bean bag in a true lateral position; – slightly flexing the knee and placing it on a padded Mayo stand may facilitate positioning; – calcaneus is approached thru an extensile right angled incision, which curves sharply between … Read more
– See: Back Pain in Children – Discussion: – results of exam may be normal in child w/ spondylolysis or mild (Grade-I or Grade-II) spondylolisthesis. – Back: – tenderness to palpation in the low back; – splinting as well as guarding & restriction of side-to-side motion of low back, particularly … Read more
– Clinical Findings: – history: patient may complain of a subjective knee hyperextension sensation, and twisting or pivoting are also difficult; – lack of contained effusion is suggestive of posterolateral capsular injury; – look for diffuse tenderness over the posterolateral joint region, fibular head, and joint line; … Read more
– Discussion: – serial diagnostic exam should take into consideration static deformities of the lower extremities, gait, ROM, tenderness, and knee stability; – in the child w/ a painful knee, it is essential to closely examine the hip as hip pathology can refer pain to the hip; – Examination: – Gait: … Read more
– Inspection: – look at shoes for signs of abnormal wear; – inspect standing foot and ankle alignment from behind; – note arch height; – Assessment of Gait: – always examine the soles of the patient’s shoes for signs of asymmetrical wear; – look for … Read more
– See: – Knee Exam – Patellar Malalignment – Exam: – hemarthrosis – ligamentous laxity: – persons at risk for patellar instability may exhibit generalized ligamentous laxity & poorly developed vastus medialis; – if hyperlaxity is present, consider collagen disorder … Read more