Ortho Oracle - orthopaedic operative atlas

Transaxial View of the Shoulder

– Discussion:     – used to evaluate capsule of shoulder, & glenoid labrum, subscapularis  & long head of the biceps, and the humeral head;     – glenoid labrum produces low signal intensity since it is made of fibrous tissue;     – Hill-Sachs lesion, seen as a notched defect of flattening of humeral … Read more

Total Shoulder Arthroplasty: Glenoid Component

– Discussion:     – operative considerations: hemiarthroplasty vs total shoulder arthroplasty     – anatomy:           – normal population, glenoid version: from 5 deg of anteversion to 15° of retroversion, with an                     avg preop retroversion range from 1 deg to 6 deg;            – surgical goal of resurfacing is to place the glenoid in 0° … Read more

Discogenic Pain

Discussion when the innervated ligamentous layer of the outer annulus fibrosis is stretched because of segmental instability, pain results; acute sprain probably represents partial tearing of annular tissue; if annular tissue becomes weakened to the point of allowing nucleus to protrude beyond the normal confines of the annulus, it may actually be a prelude to … Read more

Congenital Muscular Torticollis

Discussion results from fibrosis of sternal head; can result from unilateral shortening of sternocleidomastoid, commonly associated with fibrosis of the muscle; may also involve the platysma and scalene muscles; birth trauma, occlussion of venous flow, or hematoma results in fibrosis of muscle & palpable mass noted w/in first 4 wks of life; nontender enlargement may … Read more

Throwing Injuries

– See:       – Throwing Elbow:                – MCL of elbow:               – Diff Dx Pediatric Throwing Elbow       – Throwing Shoulder: Throwing Guidelines:     – 8-10 year olds: 37 to 67 pitches in approximately 1.5 to 2.5 games per week.     – 11-12 year olds: 50 to 86 pitches in approximately 1.5 to 2.5 games … Read more

Three Part Proximal Humerus Fractures

– See: Three Part Fracture Dislocation and Four Part Fracture – Discussion: – tuberosity frag + displaced surgical neck fragment; – unstable shafts may be driven into mass of deltoid muscle & may be anterior to the proximal fragment; – poor bone contact will lead to delayed or nonunion in most cases; – subtypes: – greater … Read more