Wheeless' Textbook of Orthopaedics
Presented by Duke Orthopaedics
– Discussion: – KCI Vacuum Assisted Closure Device: (Company Web Site) and V.A.C.® Therapy Indications and Safety Information – Soft Tissue Coverage (Austere Environment) – Flaps and Vacuum-Assisted Closure (VAC) – technique: – debride all devitalized tissue and contaminated material; – sterile reticulated … Read more
– Discussion: – Should Subcuticular Sutures be Avoided in TKR? – references: – Modality of wound closure after total knee replacement: are staples as safe as sutures? A retrospective study of 181 patients. – Wound complications in joint arthroplasty: comparing traditional and modern methods of skin closure – Staple vs. … Read more
– See: TKR Menu: (Function and Activity after TKR) – Natural History of Painful TKR: – references: – Pain and Depression Influence Outcome 5 Years after Knee Replacement Surgery. – Impact of Psychological Distress on Pain and Function Following Knee Arthroplasty – Potential Causes of TKR failure: – early failures: … Read more
– Trauma Workup – assessment of perfusion: damage control orthopaedics – timing of surgery in orthopaedic patients with brain injury – surgical timing and prevention of pulmonary complications in patients with femur frx – PreOp Planning for IM Nailing: (IM Nailing Technique) – Fracture Classification – Open Femur Frx … Read more
– Discussion: – tap pins through soft tissues until they meet bone, and once the wire emerges from the far cortex, it is driven through the soft tissues w/ a mallet; – periarticular insertion – avoid impaling synovium; – in the knee, insert the wire 1 cm below articular surface … Read more
– Exam: – skin abrasion and contussions from direct blows; – r/o compartment syndrome; – ligamentous instability – peroneal nerve function; – Radiographs: – Indications for treatment: – Open Plateau Frx or Frx w/ compartment syndrome; – Articular Surface … Read more
– See: Trauma Menu – Discussion: – note that with acetabular fracture associated with major trauma that there will be 50% chance of at least one other major injury; – neuro and head injury (see Glasgow) – abdominal and chest injury (pulmonary … Read more
– See: – Radiographic Studies – Verticle Fractures of Medial Malleolus – Discussion: – transverse frx of fibula occuring below syndesmosis; – usually there is enough remaining butress of fibula to prevent lateral talar tilt or displacement; – avulsion frx of distal fibula c/w supination/adduction frx; – … Read more
– See: – Antiglide Plate – Lateral Malleolus – Radiographic Studies – Stability of Weber B Fractures – Supination Eversion Injury – Surgical Treatment – Discussion: – Type B: fibula frx at level of syndesmosis-transsyndesmosis; – most common type … Read more
– Discussion: – see: stability of weber b fractures: – isolated Weber B fractures (no medial injury) can be treated w/ a cast if there is upto 3 mm of fibular displacement; – it has been observed that x-rays tend to over-estimate displacement (as compared to … Read more