– Graft Selection: – bone patella bone allograft or achilles tendon allograft; – if achilles tendon is used, the free end is secured w/ a locked whip stitch (Krackow stitch); – in the report by Fanelli et al. 1996, there was no disadvantage … Read more
– Tibial Tunnel: – saftey measures: – surgeons who do not perform this operation frequently should use flouroscopy for this tunnel; – apply Jacobs chuck for a preset distance on the guidewire to make it less likely for the wire to pass … Read more
– Discussion: – typically the posterior column remains intact w/ a burst frx; – w/ severe injury, anterior angulation may damage posterior ligamentous ligament complex, creating an unstable burst frx; – w/ further axial loading, inferior facets of upper vertebrae wedge apart superior facets and pedicles of the fractured … Read more
– Anatomy: – three posterior divsions of brachial plexus form posterior cord: (C5 , C6 , C7, C8, T1) – upper subscapular nerve to subscapularis – thoracodorsal to latissimus dorsi – lower subscapular nerve to subscapularis and teres major … Read more
– Discussion: – Anatomy and Function of PCL: – mechanism of injury: – fall on a flexed knee with plantar flexed ankle; – associated injuries: – ACL and collateral ligament injury (knee dislocation); – when PCL injury occurs w/ MCL … Read more
– Discussion: – dx is made when there is posterior instability on exam and a bone fragment was seen on x-ray; – MRI allows determination of the anatomy of the tear (ie femoral or tibial origin); – tibial avulsions: – tibial avulsions … Read more
– See: – Classification and Column Theory – Posterior Wall Fractures – AO Foundation Posterior Column Frx – Discussion: – posterior column extends from obturator foramen thru posterior aspect of the wt bearing dome of acetabulum & then obliquely through greater sciatic notch; – frx of … Read more
– See: – Anterior Approach Shoulder – Post Approach to Humerus – Discussion: – indicated from frx of the scapula, esp when the pathology is posterior; – Technique: – positon the patient in the prone or lateral position; – skin incision is made … Read more
– See: Posterior Approach to the Humerus; – Discussion: – considered to be the most versatile approach to the elbow; – most surgeons use straight longitudinal incision, which avoids olecranon tip, by shifting the incision slightly laterally or medially; – Variations of Posterior Approach: – Transolecranon Osteotomy … Read more
– Discussion: – cervical kyphosis is a general contra-indication for posterior decompression; – Surgical Approach: – prone position using Mayfield head holder w/ neck in neutral; – during operative procedure, erector spinae muscles should not be dissected laterally beyond the facets; – this avoids … Read more