– Evaluate for: – lateral talar shift: – medial clear space – deltoid injury – fibular shortening; – talocrural angle – tibiofibular line – fibular rotation, or lateral displacement; – tibiofibular line – syndesmotic integrity (see radiographs) – talar tilt: (stability) – osteochondral lesions of talus – Discussion: – fibular length, talar tilt, talar … Read more
– See: Ankle Sprains – Discussion: – indications: – clinical symptoms are chief indications (radiographic findings may or may not correlate w/ the severity of the sprain and ankle dysfunction; – associated injuries: – longitudinal tear of the peroneus brevis: – contra-indications: – fixed heel varus; – obese patients; – Radiographs: … Read more
– See: Watson Jones Approach Smith Peterson Approach – Discussion: – in direct lateral approach, a curvilear split is made thru the anterior portion of the gluteus medius and vatus muscles, in order to gain access to the anterior face of the hip joint; … Read more
– Discussion: – forefoot is most commonly affected portion of rheumatoid foot; – forefoot deformities include: – claw toe or hammer toe of lateral four toes; – severe hallux valgus – plantar keratosis beneath subluxed or … Read more
– Discussion: – modified procedure includes release of adductor hallucis, transverse metatarsal ligament, and lateral capsule combined w/ excision of medial eminence and plication of the capsule medially; – this procedure was modified to retain the lateral sesamoid, which helps to prevent hallux varus (which as common w/ original Mcbride bunionectomy); – as this procedure attempts to … Read more
– See: Monteggia Fractures in Adults – Discussion: – all four types of Monteggia frx dislocation are pertinent to children, including Monteggia equivalents; – diff dx: Monteggia equivalent (w/ fracture of proximal radius rather than dislocation of the radial head); – Classification: – type I: – anterior dislocation of the radial head w/ apex anterior … Read more
* Etiology: Rheumatic fever, Papillary muscle dysfunction, ruptured chordae tendenae, myxomatous degen. of MV & Endocarditis * SG cath shows V waves: – represent regurgitant flow into left atrium; * Physical Exam: – Pansystolic murmur loudest at the apex, – MV click, S3 (more likely w/ severe MR), S4 – Jugular A and/or V waves … Read more
– See: – Thumb Soft Tissue Defects – Amputation of Fingers and Hand – Indications and Advantages: – most indicated for amputations distal to thumb IP joint, in which a V-Y flap cannot be used; – may cover upto 1.5 cm palmar defect (but not … Read more
– Discussion: (RTC menu) – mobilization is often required for massive tear; – simply closing extensive tear will not suffice if atrophied muscles are not contracting adequately and if excessive tensions placed on repaired cuff cause reinjury; – repair of good quality rotator cuff tissue is esp important in achieving an optimal result; … Read more
Contralateral total hip arthroplasty or ipsilateral total knee arthroplasty in patients who have a long-standing fusion of the hip. Intrapelvic migration of total hip prostheses. Operative treatment The use of the McKeever metallic hemiarthroplasty for unicompartmental arthritis. Serum CK-MB is useful in diagnosis of acute myocardial infarction after total hip arthroplasty. Cardiac isoenzyme values after total joint … Read more