– Putti Platt: – tightening, & realigning of subscapularis which partially limits external rotation; – anterior capsule is also realinged and reenforced; – subscapularis is divided 2.5 cm from its insertion; – anterior shoulder capsule is opened in same plane as tendon is divided allowing joint to … Read more
– See: Pediatric Femoral Frx Menu – Discussion: – timing: – Immediate single-leg spica cast for pediatric femoral diaphysis fractures. – contraindications: – unacceptable shortening or angulation; – open fractures; – thoracic or intra-abdominal trauma; … Read more
– Discussion: – mixture of benign stromal tissue – large vascular lacunae separated by septa in which numerous giant cells are found & & filled with clotted blood (blood-filled spaces with bland fibrous connective tissue septa) that resembles cranberry sauce; – cavernous spaces vessel lack walls & … Read more
– See: rheumatoid arthritis – Discussion: – rheumatoid cervical spine: – ensure that anesthesia is prepared for possible need for bronchoscopic intubation; – total hip arthroplasty in rheumatoid arthritis: (see total hip replacement); – protrusio acetabuli is common and is often … Read more
– Timing: – references: – Decompression and stable internal fixation of femoral neck fractures in children can affect the outcome. – Femoral Neck Fractures in Pediatric Patients: 30 Years Experience at a Level 1 Trauma Center. – Fractures of the hip in children and adolescents. – Earlier Time to … Read more
– Dislocation of Hip: – hip dislocation in children w/ myelomeningocele may either teratological or paralytic (which is due to muscle imbalance); – paralytic dislocation: – hip dislocation occurs because of paralysis of the hip abductors and extensors w/ unopposed hip flexors and adductors; … Read more
– Discussion: (see limb development); – at 4 to 6 gestational weeks, the hip joint develops from the cartilaginous anlage; – by 7 weeks a cleft develops between precartilagenous cells which are programmed to form the femoral head and acetabulum; … Read more
– Discussion: – hip fusions acn occur spontaneously following childhood sepsis or after ORIF of acetabular fractures (secondary to heterotopic bone). – they also occur spontaneously due to ankylosing spondylitis; – surgical fusions are performed for young adults with advanced arthritis; – indications: … Read more
– See: TKR following HTO: – Discussion: – indications for HTO: – associated conditions: – posterolateral corner deficiency – osteoarthritis of the knee: – motivation for procedure: – narrowed medial cartilaginous space may regenerate (and associated degenerative features may reverse) if weight bearing stresses are partially shifted from the medial to the lateral side of the … Read more
– Diff Dx: slipped vertebral apophysis – Discussion: – disc herniation is uncommon in children; – herniations are most common at the disc spaces between the fourth and fifth lumbar vertebrae & between 5th lumbar and 1st sacral vertebrae; – Clinical Findings: – children experience little or no back … Read more