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Ampicillin Sulbactam/Unasyn

(see also: Penicillin Family / Ampicillin / Aumentin) Discussion for beta lactamase producing Staph aereus, Eneterococcus, H. influenza, Klebsiella, Proteus mirablis, Bacteroides adult: 1.5-3 gm IM/IV q6hr (2:1 ampicillin sodium:sulbactam) adjust w/ Renal failure; good diffusion from blood into CSF only with inflammation; inflammed meninges: 5-10; peds: Dosed as Ampicillin; supplied: Powder for Injection 1.5 gm, 3.0 … Read more

Young Burgess System

– Discussion:     – w/ Young-Burgess system, stability or lack of stability can be judged fracture pattern, direction of the force of injury, and by knowledge of pelvic ligamentous anatomy;     – in Lateral Compression frx, force of injury is from side & is assoc w/ horizontally oriented pubic frx;     – Lateral Compression Classification: … Read more

X-rays for Femoral Neck Fractures

– See:        – Calcar Femorale:        – Garden I & II:        – Garden III & IV:        – Garden’s Alignment Index:        – Pathologic Hip Fractures:        – Radiology of the Hip:        – Sigh Index – Radiographs:   … Read more

Work Up for Pelvic Fracture

– Trauma Management:     – damage control resusitation             – ref:  Damage-Control Orthopedics Versus Early Total Care in the Treatment of Borderline High-Energy Pelvic Fractures     – fluid management             – hypotension is associated with an increased risk of mortality, ARDS, and multiple organ failure;             – IV access is secured with at least … Read more

Workup for Femoral Shaft Frx

– Trauma Workup        – assessment of perfusion: damage control orthopaedics        – timing of surgery in orthopaedic patients with brain injury        – surgical timing and prevention of pulmonary complications in patients with femur frx  – PreOp Planning for IM Nailing: (IM Nailing Technique)           – Fracture Classification            – Open Femur Frx     … Read more

Work Up and Treatment of Acetabular Frx

– See: Trauma Menu – Discussion:     – note that with acetabular fracture associated with major trauma that there will be 50% chance of            at least one other major injury;            – neuro and head injury (see Glasgow)            – abdominal and chest injury (pulmonary … Read more

Wheeless’ Textbook of Orthopaedics – Journal Watch

Journal of Bone and Joint Surgery Long-Term Results of Treatment of Fractures of the Medial Humeral Epicondyle in Children Operative Treatment of Interdigital Neuroma. A Long-Term Follow-up Study The Effects of Tibial Rotation on Posterior Translation in Knees in Which the Posterior Cruciate Ligament Has Been Cut Patellar Resurfacing in Total Knee Arthroplasty. A Prospective, … Read more

Venous Repair

– Venous Anastomosis: – Discussion:   – thickest layer in the vein is the adventitia and cannot be stripped away from vessel as it can in the artery & therefore need to use gentle          technique in teasing away the excess adventia and trimming it with scissors;   – vessel walls are not as self supporting … Read more