– See: Methods to Prevent Infection – Skin Preparation Agents: – alcohol: – rapid significant reduction in skin microbial counts is major effect desired; – techni-care: – iodophors: – ioban draping: (3M™ Ioban™) – Risk for infection after anterior cervical fusion: prevention with iodophor-impregnated incision drapes. … Read more
(see also: Osteomyelitis in Sickle Cell Patient) Discussion affects 1% of blacks – is more severe but less common than sickle cell trait (8% prevalence); two main genotypes include Hb S and Hb C forms of disease; crises usually begin at age 2-3 years and may lead to bone infarctions; Sequelae of Sickle Cell growth … Read more
(see also: Physical Exam; Radiographic Studies for the Shoulder) Abductors of the Shoulder Acromioclavicular Joint / Acromioclavicular Joint Separation Acromioplasty Adhesive Capsulitis Anterior Inferior Glenohumeral Ligament Anterior Instability Anterior Shoulder Reconstruction Arteries of the Upper Limb Arthroscopy of the Shoulder Arthodesis of the Shoulder Arthroplasty of the Shoulder Bankart Lesion Blood Supply to the Humerus Biceps Tendonopathy … Read more
– See: – Diff Dx of Shoulder Pain: – Shoulder Examination Tests (from shoulderdoc.co.uk) – History: (questions for modified Simple Shoulder Test); – C-Spine: – r/o radiculopathy as well as axillary nerve hypaesthesia; – Spurling’s manuever: – mechanical stress, such as excessive vertebral motion, may exacerbate … Read more
– Discussion: – indicated for SI joint disruptions and for some sacral fractures; – Operative Technique: – radiographs: – surgical stratedgy: – if anterior pelvic injury: – note that the biggest … Read more
– Discussion: – impingement syndrome describes pain in subacromial space when the humerus is elevated or internally rotated; – during humeral flexion, the supraspinatus tendon and bursa become entrapped between the anteroinferior corner of the acromion (and CA ligament) and the greater tuberosity; – this syndrome is thought to precipitate attritional changes in the rotator … Read more
– See: Total Shoulder Replacement – Technique: – deliver the proximal humerus: – anteriorly dislocate the humeral head by extending, abducting, and externally rotating the arm; – a blunt Homan retractor is then placed behind the humeral head to maintain its dislocated position; … Read more
– Discussion: – its essential to restore anatomic length of humerus to provide proper amount of tension in deltoid so that patient will maintain the ability to forward flex; – in the case of a hemiarthroplasty performed for 4 part frx, length will always have to be regained; … Read more
– Discussion: – normally no communication exists between the shoulder joint and the subacromial bursae; – when radiopaque dye is injected into the shoulder and is subsequently demonstrated in the subacromial bursa, a rotator cuff tear is present; – Indications: – for dx of complete rotator cuff tears, adhesive capsulitis, … Read more
* Arrhythmia: * Consider Sinus Tach due to CHF/Pain/Anxiety * Rx of Cardiogenic Shock * Syncope * Stroke * Rx CHF / SOB – may develop in > 50% of pts, many will resolve within 48 hrs; – this is an acute process, normal heart size, little retention of NaCl/H2O; – CHF is due to … Read more