– Discussion: – type of open wedge innominate osteotomy which extends and retroverts acetabulum around fixed axis; – osteotomy redirects entire acetabulum so that its roof covers femoral head both anteriorly and superiorly; – extends and retroverts acetabulum around fixed axis; – in … Read more
– See: – Posterior Pelvic Injuries – Sacral Fractures – cresent fracture: (iliac fracture) – Fixation Techniques: – SI joint dislocation: posterior screw fixation: – Kellum et al 1987, unstable SI joint dislocations can produce long term pain in 60% that are treated non operatively … Read more
– See: – Posterior Pelvic Injury: – Sacroiliac Fracture Dislocations: – Sacral Stress Fractures: – Anatomy of Sacrum: – Classification: – zone I: – frx across sacral ala can cause L5 nerve root impingement; – about 6% … Read more
– See: neurological exam: – Discussion: – sacral segments must be carefully examined for sensation & motor power; – scaral sparing is evidenced by perianal sensation, rectal motor function, and great toe flexor activity; – in patient w/ an apparent complete neurologic injury, any sensory awareness distally or scant … Read more
– Discussion: – insufficiency frxs of sacrum and pelvis may be confused w/ metastatic lesions, especially if bony resorption occurs at frx ends; – these injuries may also occur in patients with known malignant disease who have a sudden onset of pain in the lower back, hip, or groin; … Read more
– See: Extensor Mechanism Injuries of the Knee: – Discussion: – rupture of quadriceps tendons is most common in the 6th & 7th decades, and is probably associated w/decreased vasculature; – Male:female 8:1 – more common w/ cortisone injections, diabetes, chronic renal failure; hyperthyroidism, and gout; – … Read more
– Discussion: – main function of the tibialis posterior is to invert the subtalar joint, which helps to stabilize the transverse tarsal joint during rheumatoid hindfoot; – pathophysiology: – degenerative tears usually occur distal to the medial malleolus, in a region which coincides with relative hypovascularity and sharp turn of the tendon from a verticle to … Read more
– Discussion: – response to sympathetic blockade is best diagnostic test for RSD; – over 2/3 of patients will obtain significant relief; – patient is given at least two successful stellate ganglion blocks; – if patient has had a technically successful sympathetic block, and does not obtain significant relief, then the … Read more
– See: RU joint – Discussion: – involves resection of ulnar articular head, leaving shaft and styloid relationship intact; – in cases of distal radial malunion, a Bower’s hemiarthroplasty may be indicated to restore passive pronation and supination of the forearm; – this procedure should be considered before performing … Read more
– Discussion: – a wafer of up to 2-4 mm of distal ulnar head is removed, while the styloid process TFCC, and attatched ligaments remain attached; – the procedure is contra-indicated if more than 4 mm of positive variance; – may be indicated for symptomatic … Read more