– See: Anterior Approach to the Humerus Axillary Approach: Posterior Approach Posterior Approach to Humerus Surgical Approach for Proximal Humeral Fractures Positioning and Draping: supine or beach chair; small soft bolster is placed beneath the shoulder blades to protract the shoulder; head is stabilized to prevent hyperextension and subsequent brachial plexus palsy; place patient in … Read more
PreOp Planning consider NG tube and foley catheter; have proper sized C-collar available for post operative care; position: supine w/ halter cervical traction (3-5 lbs) w/ head turned slightly to the right; consider placing a rolled towel between the shoulder blades; prep for iliac crest bone graft; hall burr is helpful for shaping bone graft; … Read more
Discussion lesion labeled annuular tear or internal disruption is based on concept of leaking disc, one which permits the irritating liquid material normally restricted to the center of the disc to come into contact with the innervated tissue; annular tissue that permits egress of this liquid has a poor capacity for healing; at most, a thin layer of scar … Read more
(See also: Annular Tear) Discussion anulus fibrosus makes up peripheral portion of disk structure; composed of fibrocartilage and type I collagen; fibers of anulus run obliquely between vertebrae and are arranged primarily in concentric layers; direction of the fibers in successive layers alternates, w/ one layer crossing another at angles of 30-60 deg; at periphery … Read more
– Treatment Considerations: – it is essential to reduce the dislocation in the ER, so as to avoid tenting of the skin over the anterior tibia; – w/ a trimalleolar frx-dislocation, consider a posterior approach using an antiglide plate and fixation of the posterior malleolar fragment (which can be accomplished through … Read more
Discussion as slip progresses, area of contact between L5 & S1 decreases & body of L5 tilts forward on sacrum; this is referred to as sagittal rotation, angle of slipping, roll, L5/S1 kyphosis, or gibbus; slippage is not present in pts who have mild (grade-I or II) spondylolisthesis, but is more common in pts who … Read more
origin: posterior surface of lateral epicondyle of humerus; insertion: lateral side of olecranon process and posterior surface of proximal portion of ulna; action: extension and pronation of the forearm at the elbow; nerve supply: radial, C5, C6; synergist: triceps brachii The aconeus muscle flap: its anatomy and clinical application.
– Pre-anesthetic Considerations: – in spine injured patients, anesthesia is necessary even if the extremity is insensate inorder to prevent spasm and automatic dysreflexia; – need to monitor for automatic dysreflexia (spinal anesthesia preferred); – be aware that acture high paraplegics, because of generalized venous dilation, … Read more
– Discussion: – non-neoplastic expansile lesion consisting of blood filled spaces separated by connective tissue septa containing bone or osteoid and osteoclast giant cells – etiology unknown – may be primary or secondary; – an uncommon expansile osteolytic lesion of bone consisting of a proliferation of … Read more
– See: – Development & Anomalies of Axis – Dens Frx: – Extension Teardrop Frx of C2 – Hangman’s Frx – Normal Variants: – Discussion: – C2 provides rotation at its superior articulation w/ C1, … Read more