– Discussion: – anatomy of ACL; – ACL biomechanics; – graft tunnel sites / isometry: – hamstring ACL reconstruction is an alternative to bone patellar bone graft fixation; – size and strength of graft: – double looped hamstring graft is more than twice as … Read more
Discussion AC joint is situated between the clavicle and acromion; acromion has two ossification centers which fuse at age 22 yrs; it permits motion in three planes: AP gliding of acromion during protraction & retraction of scapula; tilting of acromion during abduction & adduction of arm; rotation of the clavicle; rotation occurs during abduction & … Read more
used to evaluate the extent of ligament injury to the A-C joint Technique patient is erect; 10 to 20 pound wts (depending on patient size) are looped over the patient’s wrists suspending them from the wrists; these are not to be griped by the patient, as the act of gripping may tense the shoulder muscles … Read more
(see also: Achilles Tendonitis) Discussion ruptures typically occur after age 30, more often in people beyond middle age; rupture at musculous tendinous junction occurs most often in young people, but ruptures near the calcaneus also occur; inciting event may be related to atrophy of the soleus muscle, and commonly occur in weekend athletes; in 5-33% … Read more
note that active plantarflexion may occur due to activity of tibialis posterior, peroneals, and long toe flexors; diagnosis is clinched w/ one of two tests; hyper-dorsiflexion sign the patient is placed in the prone position, and the knees are flexed to 90 deg; the examiner then passively dorsiflexes both feet maximally and compares the injured … Read more
(see also: Achilles Tendonitis) Discussion indications may be indicated in older patients w/ minimally displaced ruptures; note that younger patients w/ expectations of participating in sports such as basketball may not be good candidates for non operative rx; atheletes should not expect to resume full activities for one year; managment short leg cast strategy: SLC … Read more
(see also: Pseudoachondroplasia) Discussion autosomal dominant disorder; arises due to a point mutation for the gene encoding a fibroblast growth factor (Fibroblast growth factor receptor 3) over 80% of all persons with this disorder are born to parents who are not achondroplastic, & such parents rarely have second achondroplastic child; it is presumed in these … Read more
– Normal Hip Development: (limb development and pediatric anteversion); – at 4 to 6 gestational weeks, the hip joint develops from the cartilaginous anlage; – by 7 weeks a cleft develops between precartilagenous cells which are programmed to form the femoral head and acetabulum; – by 11 weeks, the hip … Read more
– Graft Entry Point: – because the slope of the intercondylar notch will vary from 26 to 44 deg, the tibial tunnel should be accordingly positioned between the anterior third and the midpoint of the saggital length of the tibia; – referenced off the PCL: – this … Read more
– Determination of Graft Length: – if a “two incision – backdoor” technique is used, it is usually not necessary to measure graft length; – whether the graft is slightly long or slightly short, it is usually very easy to move the graft slightly proximally or distally (through both … Read more