– Discussion: – involves vertical loading of calcaneus by talus at crucial angle of Gissane; – usually occurs from a fall from ht landing on heels; – primary fracture line may take one of three paths: – lateral to posterior facet (from impact on pronated foot) – thru posterior facet (neutral foot position) – secondary … Read more
Discussion older names include dolichostenomelia (Greek for long, narrow limbs) and dystrophia mesodermalis congenital, typus Marfanis; inherited as an autosomal dominant trait with variable expressivity. characterized by long, thin limbs and by laxity of ligaments; Pathophysiology dz of collagen synthesis (possibly the alpha subunit) may have abnormal production of collagen type I (and ? type … Read more
– from Johansen, et al. (1990) Skeletal / soft-tissue injury Low energy (stab; simple fracture; pistol gunshot wound): 1 Medium energy (open or multiple fractures, dislocation): 2 High energy (high speed MVA or rifle GSW): 3 Very high energy (high speed trauma + gross contamination): 4 Limb ischemia … Read more
– See: – Exam for Spinal Cord Injury – Head Injury – Neuro Exam Menu – C-spine (initial care): – ensure that patient has adequate C-spine immobilization; – a standard backboard is unsuitable in children since it places the head into extension (pediatric … Read more
– Discussion: – by definition, invovles RTC tears of more than 5 cm and involves more than than one tendon; – further, massive tears cannot be repaired w/o excessive tension after lysis cuff adhesions and release of the coracohumeral ligament; (see cuff mobilization) – Management: … Read more
– Outside Link: – An Approach to the Head Injured Patient by Paul Marik, MD – Trauma Menu: – Spine / C-spine – Orders for the Spine Injured Patient: Anesthesia in the Spinal Cord Injured Patient: Fluids in the Head Injured Pt: Hyperventilation Glasgow Coma Scale Head … Read more
– Discussion: – Luque instrumentation involves sublaminar wiring connected to rods; – for most part, this has been abandoned for idiopathic scoliosis because of the potential morbidity that is associated w/ introduction of sublaminar wires Luque rod instrumentation in the treatment of adolescent idiopathic scoliosis. A comparative … Read more
– See: Lumbar Plexus: – Anatomy: – lumbosacral plexus is derived from L4, L5, S1, S2, S3 & S4 roots, each giving rise to anterior and posterior branches; – anterior branches supply flexor muscles of limb, & posterior branches supply extensor and abductor muscles; – superior gluteal nerve (L4 … Read more
– See: – Burst Fractures – Lumbar vertebrae: – Discussion: – typical injury pattern for burst frxs varies w/ anatomic level; – L1 to L3 pedicles are frequently comminuted or detached; – L4 to L5 frx usually present a consistent pattern: … Read more