Throwing Shoulder
– See: throwing injuries: and elbow throwing injuries – Phases of Throwing: – wind up – early cocking: deltoid and rotator cuff are active; – late cocking phase: – muscle activity: – shoulder is placed in … Read more
Muscles Tendons
Thumb CMC Joint Instability
– See: CMC Joint Arthritis CMC Instability in the Metacarpals Dislocations of the Thumb MP Joint – Discussion: – dorsal instability is usually due to disruption of the dorsal radial ligament; – dorsal-radial ligaments connects the trapezium to the dorsal radial side of the … Read more
Thumb Deformities in RA
– See: – CMC Joint Instability – Gamekeeper’s thumb – Phalangeal Injury – RA Thumb Tendon Ruptures – Trapezium – Pathologic Findings: – boutonniere deformity – most common thumb deformity in RA; – flexion … Read more
Throwing Injuries
– See: – Throwing Elbow: – MCL of elbow: – Diff Dx Pediatric Throwing Elbow – Throwing Shoulder: Throwing Guidelines: – 8-10 year olds: 37 to 67 pitches in approximately 1.5 to 2.5 games per week. – 11-12 year olds: 50 to 86 pitches in approximately 1.5 to 2.5 games … Read more
THR: Trial Reduction and Determination of Leg Length
– Discussion: – main goal is to prevent THR dislocation but also to maintain optimal offset; – prior to reducing the hip, ensure that center of femoral head is approximately at level of the greater trochanter; – once trial reduction has been completed, the trial acetabular liner is removed, the … Read more
THR: Wound Closure
– place leg on padded Mayo stand in 10 deg of abduction to relieve tension on the thing and the tensor fascia lata; – deep soft tissue repair: – repair of posterior capsule and reattachment of the external rotators (which may help to decrease posterior dislocation); … Read more
Three Part Proximal Humerus Fractures
– See: Three Part Fracture Dislocation and Four Part Fracture – Discussion: – tuberosity frag + displaced surgical neck fragment; – unstable shafts may be driven into mass of deltoid muscle & may be anterior to the proximal fragment; – poor bone contact will lead to delayed or nonunion in most cases; – subtypes: – greater … Read more
THR: Skin Incision for Posterolateral Approach
– Landmarks: – posterior superior iliac spine: forms the superior landmark; – incision starts at the posterior 1/3 of the greater trochanter and extends proximally for 10 cm toward a point 2 fingerbreadths below the PSIS; – this will bring the incision directly over the sciatic notch and will also … Read more
THR: Trial Reduction
– See: THR dislocation: – Checklist: – need complete muscular relaxation; – irrigate any debris from acetabulum; – Difficult Reduction: – capsule might have to be further released, esp if head and neck segment was short preoperatively; – if reduction is not possible & leg is lengthened, … Read more
THR: Posterolateral Approach
(see: Total Hip Replacement Menu) – PreOp: – Theory and Background: – Checklist for THR and Radiographs: – Initial Exposure: – positioning, prepping and antibiotics: – posterolateral skin incision: – incise thru iliotibial band: – split gluteus maximus: – The course of the superior gluteal nerve in the lateral approach to the hip; – identify the … Read more