– Discussion: – flexion contractures of PIP joint are more difficult to correct; – flexion deformities of PIP joint may be caused by contracture of a diseased central cord (which is an extension of palmar pre-tendinous cord); – PIP join contracture may be presaged by development of firm, fixed … Read more
– Anatomy: – origin: anterior surface of sacrum between and lateral to anterior sacral foramen, capsule of sacroiliac articulation, margin of the greater sciatic foramen, and sacrotuberous ligament; – insertion: superior border of greater trochanter of femur; – action: external rotation of hip & … Read more
– See: Pilon Frx Menu – External Fixation: – external fixation applied medially and across the ankle can protect the articular reconstruction and prevent collapse; – external fixation across the ankle can restore length (thru distraction) w/ or w/o fibular fixation; – Technique of External Fixation … Read more
– Restoration of Length: – may be obtained w/ use of femoral distractor or external fixator placed in distal 1/3 of the tibia and the talus or calcaneus; – two pins are placed perpendicular to the anatomic axis and therefore parallel with the joint surfaces of the tibia; – … Read more
– See: Function and Activity after TKR – Post Operative ROM: – most important factor predicting ultimate ROM is range of motion before surgery; – ref: Range of Motion Correlates with Patient Perception of TKA Outcome. – patients with significant stiffness before surgery will have the most difficulty gaining range of motion; … Read more
Discussion pigmented villonodular synovitis is a slow growing, benign, and locally invasive tumor of the synovium; location: most often involves the knee (also in hip, ankle, elbow, etc.); always consider PVNS in a younger patient with unexplained hip pain; acute episodic attacks of pain and swelling may occur; patients may have mechanical symptoms (locking and … Read more
– Discussion: – its essential to consider the differential dx and to examine the patient from the neck down to the finger tips; – in taking the history, be sure to inquire as to whether the patient’s main complaint is hand/wrist pain versus paresthesias; – it is also important … Read more
– Signs and Symptoms: (see C-spine Exam) – pain is earlly symptom, which may be ischemic in origin; – Myelopathy: – characterized by weakness (upper > lower extremity); – ataxic broad based suffling gait, sensory changes; – rarely urinary retention; – myelopathy hand: … Read more
– Dicussion: – assess for swelling and tenseness of the forearm compartments; – assess carrying angles of the affected and non affected arms; – r/o neurologic deficits – median nerve injuries are more often associated w/ posteromedial displacement; – … Read more
– See: Impediments to Reduction – Early DDH: – Barlow’s Test – Ortolani’s test – Hip Clicks: – common occurance on physical exam; – there is no published significance of hip clicks; – Late DDH: – tightness … Read more