– Discussion: – contractures and progressive weakness of lower extremities render walking increasingly difficult for patients who have DMD; – average patient is unable to walk effectively by the time that he is ten years old, in the absence of treatment; – age at which walking ceases, however, is … Read more
– Discussion: – adduction contractures of shoulder and flexion contractures of elbow are not a problem in themselves, as muscle weakness renders patient unable to abduct the arm above the level of the shoulder or to extend the elbow against gravity; – pronation contractures of the forearm and flexion contractures … Read more
Discussion progressive paralytic equinovarus is an important reason for gait deterioration in pts w/ DMD; equinus contracture compensates for incr quadriceps weakness & allows knees to lock by enabling wt line to pass in front of knee joint; feet become progressively fixed in equinus & then equinovarus position; posterior tibial muscle retains good f(x) despite … Read more
– See: – Duchenne Muscular Dystrophy – Scoliosis – Discussion: – Discussion: – scoliosis is almost universal in pts who have DMD, and it usually develops after they lose the ability to walk (after age 10 yrs); – early scoliosis develops … Read more
– See: – Q angle – Malalignment of Patella – Discussion: – distal realignment procedures are chiefly indicated in pts w/ patellar subluxation, absence of hyper-laxity, and increased Q angle; – as pointed out by Fulkerson, et al (1990), less than 2% of patients w/ patellofemoral pain will require tibial tubercle transfer; – as noted … Read more
– See: – IM nailing of tibia fractures – menu – tibial plafond fractures – Distal Tibia Fracture: – see: external fixation for distal tibia fracture, outcomes of external fixation vs IM nailing, and plate fixation; – w/ frx extension into the joint, consider placement of percutaneous … Read more
– See: – Distal Radius Frx Menu – External Fixators for Distal Radius Frx – Intra-Articular Fractures of the Distal Radius – Unstable Distal Radius Frx – Radiographs: – scapholunate dissociation – Technique: – first perform closed reduction under … Read more
– See: distal radius fracture menu / percutaneous pin fixation – Discussion: – Kapandji’s Technique / Intra Focal Pin Fixation: – a technique in which pins are inserted into the fracture site which are then used to pry the distal fragment into optimal position; – indicated for extra-articular distal … Read more
– See: Palmar Tilt – Discussion: – frx needs to be reduced prior to skin incisions & Ex Fix application; – longitudinal traction combined w/ thumb pressure and wrist flexion restores palmar tilt; – progressive wrist flexion will not restor palmar tilt until dorsal ligaments begin to tighten … Read more
– See: – Distal Radius Frx Menu – External Fixators for Distal Radius Frx – Intra-Articular Fractures of the Distal Radius – Unstable Distal Radius Frx – Discussion: – clinical outcome studies – Radiographs: – r/o concomitant scapholunate dissociation; – Anatomic Considerations: – die punch fragment: – following fixation of the radial styloid fragment, the … Read more