– Stage I: – edema and hemorrhage: – reversible lesion usually seen in the second and third decade; – exam: – palpable tenderness over the greater tuberosity at supraspinitus insertion – palpalble tenderness along the anterior edge of the acromion; … Read more
– Discussion: – following lengthening or rupture of tibialis posterior, pt will develop fixed hindfoot deformity w/ hindfoot valgus and forefoot in abduction; – if site of maximal deformity is at talonavicular joint, then an isolated talonavicular or talonavicular & calcaneocuboid may be performed; – sub-talar arthrodesis: – w/ more … Read more
– See: – Primary Flexor Tendon Grafting – Pulley Reconstruction – Prosthetic Grafts – Discussion: – indicated for delayed or neglected flexor tendon injuries, tendon rupture following previous attempted repair, and in some cases is indicated for zone II tendon injuries; – probably in most cases, … Read more
– Discussion: – inflammation causes tenosynovitis and elongation; – hindfoot remains supple and is reducible; – pt has flexible flat foot, & w/ removal of weight, foot resumes its normal arch; – it is essential to distinguish the supple type II lesion from the type III lesion … Read more
– Discussion: – involves injury to distal tibial ephiphysis, & are due to plantar hyperflexion or external rotation force; – presents as SH II, SH III, or SH IV type injury of distal tibia which may disrupt articular surface as well as physis; – Salter Harris III: … Read more
– See: rupture of tibialis posterior – Dicussion: – tendinitis is present but tendon remains at its normal length; – in a young patient consider accessory navicular; – Non Operative Treatment: – arch supports, rubber-soled shoe w/ quarter-inch medial heel, sole wedge, UCBL; – immobilization in a … Read more
– Criteria for Stable Burst Frx: – neurologically intact; – posterior arch remains intact: – pedicle widening implies post arch disruption w/ instability; – less than 25 to 35 deg of kyphosis; – less than 50% anterior body height collapse: – Discussion: … Read more
– Discussion: – key to stability of ankle mortise is posterior syndesmotic ligament complex, ligament or posterior tibial tubercle or malleolus; – presence of a posterior lesion always indicates degree of instability, whether or not the medial structures are disrupted; – no matter what mechanism, instability must be assumed … Read more
– Discussion: – muscular stabilizers – static stabilizers – stabilizers include: glenoid, glenoid labrum, negative intraarticular pressure, glenohumeral capsular ligaments, rotator cuff and scapular muscles; – stabilizers include glenohumeral size, posteriorly angulated glenoid & humeral head, & functional muscle control (most important); – structure that is most responsible for preventing anterior glenohumeral … Read more
– Discussion: – uncommon congenital anamoly which arises from interruption of normal caudal migration of the scapula; – deformity is characterized by elevation & medial rotation of inferior scapula; – involved scapula is both smaller and more cephalad than normal; – in 30% of pts, the scapula … Read more