– Discusssion: – remove 1-2mm of bone using the intramedullary guide. – be aware of the preoperative flexion stability and ROM in choosing posterior slope; – for example, if the knee was unstable in flexion preoperatively, 0 degrees posterior slope may help reduce some of the flexion gap; … Read more
– Discussion: – quick femoral bone cuts by eye: – usually the femoral bone under the prosthesis will be soft, and will impact when the femoral trial is applied; – therefore, there is no need for time consuming bone cuts, when “eyed cuts” are just as good; – the main issue … Read more
Revision Total Knee Arthroplasty – Assistance provided by Michael Berend MD – PreOperative Considerations and Implant Selection: – work up of the painful TKR: – Surgical Approach: (Surgical Approach for Primary TKR); – Component Removal: – prior to component removal, take the knee thru a range of motion and evaluate patellar tracking and … Read more
– See: Unstable Intertrochanteric Fractures – Discussion: – in reverse oblique fractures, the major frx line extends from proximal-medial to distal-lateral through intertroch-subtrochanteric region; – marked tendency toward medial dispacement of shaft 2nd hip adductors; – tendency for medial shaft migration may result in … Read more
– See: Axillary Approach to the Shoulder – Indications: – most often used for Bankhart repairs for anterior shoulder dislocations; – Positioning: beach chair w/ full access to posterior aspect of shoulder; – Incision: – incision is placed in major axillary skin fold; – skin incision begins in the axilla and is centered over pectoralis … Read more
– Discussion: – this sign is positive in pts with acute or chronic posterolateral instability of the knee; – knee begins in flexion while an external rotation and valgus stress are applied; – supine – valgus stress … Read more
– Discussion: – indicated for disruption of anterior pelvic ring frx: (APC II)when conditions for open forms of fixation are not optimal; – serve as an alternative to standard plating techniques for pubic ramus fixation; – in the case of pubic ramus frx in addition to symphysis dislocation, the retrograde screw is … Read more
– Discussion: – may be indicated for: – combined fractures of the femoral neck and shaft and for distal femoral fractures; – multi-trauma patient (procedure can be performed in supine position on regular flouro table); – obese patients (starting hole is not a problem); – advantages: – avoids damage to the blood supply to the … Read more
– Discussion: – dorsal metacarpal vessels contribute to the fascial plexus, which supplies the skin of the dorsum of the hand; – reverse dorsal metacarpal flap, based on the dorsal metacarpal arteries, can cover small soft-tissue defects in the hand; – axis of this flap parallels dorsal interosseous muscles; … Read more
– Discussion: – defect in anteromedial portion resulting from posterior shoulder dislocation; – management of this injury is determined by both the size of impression defect & time locked posterior dislocation has been present; – Non Operative Treatment: – if < 20% of joint surface is involved, joint usually … Read more