– Considerations: – see plate fixation theory and bone healing with plate fixation; – candidates for ORIF are humeral shaft frx w/ no comminution w/ enough of an oblique component to allow lag screw fixation; – in contrast, comminuted transverse fractures may be less satisfying for fixation, and may require bone grafting; – w/ transverse … Read more
– Surgical Considerations: – preoperative anticoagulants: – consider use of cell saver; – if patients have a medical condition that requires preoperative anticoagulants, then consider using press fit femoral and acetabular components; – a prerequisite for cementing femoral stems, is the ability to … Read more
– See: – Plantar Fasciitis – Windlass Mechanism – Anatomy: – plantar fascia is a strong layer of white fibrous tissue whose thick central part is bounded by thinner lateral portions; – central portion is attached to the medial calcaneal tubercle; – as … Read more
– Anatomy: – plantar fascia: – plantar muscles of the foot: are arranged in four layers w/ the FDB lying most superficially, just under plantar fascia; – medial and lateral branches of tibial nerve pass superficial to abductor hallucis and the quadratus plantae (w/ exception of 1st branch of lateral … Read more
– Discussion: – one of several causes of heel pain; – the pain is located somewhat more distally than in other causes of heel pain syndrome – symptoms include gradual onset of pain at the origin of the plantar aponeurosis and 1 cm distal to this area … Read more
Origin: there are 3 plantar interossei arising from the base and medial plantar surface of the 3rd, 4th, and 5th metatarsal bones. Insertion: medial side of the base of the 1st phalanx of the same toe and into the tendons of the Extensor digitorum longus. Action: Flex the proximal and extend the distal phalanges … Read more
– See: – Anterior Cruciate Ligament – Anterolateral Rotatory Instability – Clunk Test – Lachman – Losee Test – Reverse Pivot Shift Test – Discussion: – pivot shift assesses degree of incapacitating dysfunction in knee … Read more
– Discussion: (see pilon frx discussion) – fibula is usually fractured above the joint line; – some authors will avoid ORIF of the fibula in these injuries if there is excessive fibular comminution (ie poor chance of good fixation) and if there is excessive varus of the articular surface (ORIF would accentuate the varus); … Read more
– Discussion: – if the tourniquet is used, then it should be left elevated until wound closure is complete (expect wound swelling as soon as the tourniquet is released); – if swelling prevents tension free wound closure, anterior wound may be left open for DPC in 3-5 days when swelling subsides; … Read more