– See: – Avulsion Fracture – Comminuted Fractures – Fracture Dislocations – Oblique Fractures – Surgical Approach: – Discussion: – transverse frx enters semilunar notch, & amount of separation of is influenced by the pull of triceps muscle … Read more
– Evaluation of Muscle: – about 5% of shoulders that have had an anterior dislocation will sustain a irrepairable injury to the subscapularis, which will contribute to further instability; – in this case, a pectoralis transfer would be indicated; – Preparation: – identify the anterior humeral circumflex … Read more
– See: – Safe Zone of Pin Insertion Wires Insertion Techniques – Wire Characteristics: – in general 1.5 to 1.8 mm wires need no incision or drill sheath, but larger, 2.0 wires may be inserted w/ sheath through incision; – larger diameter wires will increase … Read more
– Discussion: – upper trunk brachial plexus injuries are common football tackling injuries, which may be refered to as “stingers;”; – named for temporary sensation that radiates from the shoulder to the hand; – most often involves C5 and C6 nerve roots, which make up the upper trunk of the brachial plexus … Read more
– Discussion: – used to evaluate capsule of shoulder, & glenoid labrum, subscapularis & long head of the biceps, and the humeral head; – glenoid labrum produces low signal intensity since it is made of fibrous tissue; – Hill-Sachs lesion, seen as a notched defect of flattening of humeral … Read more
– Discussion: – type of supracondylar fractures that occurs within joint capsule; – most commonly occurs w/ osteoporotic bone; – Treatment: – nondisplaced frxs are treated w/ splinting or percutaneous pinning; – displaced frx will require ORIF; – consider molding … Read more
– Discussion: – often more stable than pure perilunate dislocation if waist frx is transverse and the scapholunate ligament has remained intact; – it is usually more unstable than an isolated scaphoid frx because of ligament damage; – consider internal fixation for the scaphoid frx and a capsular repair … Read more
– Discussion: – if secondary frx line travels parallel w/ plantar aspect of foot, exiting at posterior border of the calcaneus, tounge frx will develop; – secondary fracture line extends posteriorly from superior part of primary frx line (at crucial angle), creating 1 single posterior, superior, & lateral fragment; – hence, the coronal fracture occurs posterior to … Read more
– Discussion: – toxic shock is an acute febrile syndrome that was originally described in association with the use of highly absorbent tampons but is now recognized to occur as a postoperative complication of many different surgical procedures; – toxins produced by staphylococcus aureus (or streptococcus) are probably responsible for this syndrome; … Read more
– Exposure of the Subscapularis: – the upper portion of the subscapularis tendon is exposed by partial release of the CA ligament off the coracoid, by placement of a Homan retractor directly above the coracoid, and by abduction and external rotation of the arm; – the upper portion of the … Read more