– See: Anterior Approach to the Shoulder and Total Shoulder Arthroplasty – Incision: – deltopectoral internval separates plane between axillary innervation (deltoid) and lateral and medial pectoral innervation to pectoralis major (incision should stay just lateral to the axillary skin crease); – ensure that the shoulder is position in neutral rotation and slight … Read more
– Discussion: – classic delta phalanx is characterized by a triangular or trapezoidal shaped bone w/ C shaped epiphyseal plate; – proximal epiphysis curves around from its transverse orientation to a longitudinal one from proximal to distal along one side of the phalanx, thus forming a “C”‘ … Read more
– Discussion: – sacral, ischial, trochanteric, and heel ulcerations are most common; – preventative measures: – turning the patient ever 5 min q 2 hrs of relief may prevent pressure ulceration; – a shift of weight in the wheelchair … Read more
– Discussion: – deep arch is more consistent than superficial palmar arch – deep arch supplies all digits (complete) in about 97% of population; – anatomy: – large deep branch of radial artery, w/ pulsations is felt in anatomic snuff box, passes under snuff box tendons & … Read more
See also: Laeral Compartment Anterior Compartment Superfical Posterior Compartment Discussion contains tibialis posterior, FDL, & FHL; originates primarily from posterior tibia, fibula, & interosseous membrane in proximal 2/3 of leg, these structures are involved in plantar flexion of foot & toes & inversion of foot thru tibialis posterior msucle function; major neurologic structure is posterior tibial … Read more
– Deforming forces: – Biceps brachii and Supinator inserts into the proximal1/3 of the radius; – these muscles are the supinators of the forearm; – Pronator Teres, originating above the elbow medially, inserts into the middle third of the radius; – when frx is … Read more
– See: TKR Infection Menu – debridement w/o component removal: – see debridement and washout of infected THR – IV antibiotic therapy has limited success in treatment of infected TKR; managed with wound debridement, polyethyene exchange, application of temporary antibiotic beads, and IV antibiotics; – acute hematogenous infection: – early acute hematogenous infection … Read more
– Discussion: (see osteochondral injury) – these injuries are distinct from degenerative arthritic lesions and management of these lesions should remain distinct as well; – theory is that penetration of subchondral bone causes bleeding from underlying vessels which allows clot formation in the cartilaginous defect and subsequent formation of fibrocartilage; – some argue that subchondral drilling … Read more
(see also tibial fracture menu / general principles of debridement) Debridement of Acute Fractures goal is to avoid tibial infection; timing: (is emergent debridement necessary?) references: The Effect of Surgical Delay on Acute Infection Following 554 Open Fractures in Children. Outcomes in open tibia fractures: relationship between delay in treatment and infection. Treatment of isolated … Read more
– Discussion: – Pavlik harness is usually not successful in children > 6 months (crawling age); – this is mainly due to increased activity levels of the child as well as the fact that these children begin to learn how to remove the harness; – reduction of … Read more