– Radiographs: – rarely long posterior spike of distal fragment is comminuted; – Fracture Characteristics: – w/ supination external rotation frx, spiral oblique frx usually begins in almost transverse plane distally on anterior surface of the fibula at or just above level of plafond; – it spirals externally, w/ frx exiting … Read more
– See: – Proximal Frx – Distal Frx – Rotational Alignment – Deforming Forces: – muscular forces deform the femur after fracture; – abductor muscles: – abducts proximal femur following subtrochanteric & high proximal shaft fractures; – psoas: – proximal 1/3 frx of shaft are also … Read more
– Discussion: – impediments to reduction: – incarcerated bony fragments which remain attached to lisfranc ligament; – entrapped anterior tibial tendon may occur in the case of a laterally dislocated first metatarsal (homolateral); – key to reduction: … Read more
– See Quads – Origin: – Straight Head: Anterior Inferior Iliac Spine – Reflected Head: Groove on upper brim of acetabulum; – Insertion: Upper border of patella by the ligamentum patella into tibia tuberosity; – Reversed origin-insertion action: Flexes the pelvis on the femur and gives anterior stabilization to the pelvis; … Read more
– Discussion: – normally separates from the anterior tibial artery as it perforates the interosseous foramen; – this branch heads superiorly and in the direction of patellar tendon, supplying the skin overlying patellar tendon, – supplies the anterior aspect of the knee, the superior tibiofibular joint, and the lateral condyle of the … Read more
– Discussion: – effect on tibial bone supply: (see blood supply to the tibia) – unreamed nails theoretically minimizes disruption of the endosteal vasculature; – references: – Early changes in nutrient artery blood flow following … Read more
– See: – Arteriography, Microanastomosis, Pharmocological Agents in Vascular Surgery – Vaccum Assisted Wound Closure Device – Discussion: – w/ severe extremity wounds, early radical debridement combined with early soft tissue coverage (regional or free flap) will decrease wound infection, flap loss, & delayed bone healing; – early coverage … Read more
– See: Radiology of Pediatric Elbow – Discussion: – precise AP & Lateral projections are required to evaluate normal anatomic relationships; – there should be no rotation to the forearm; – AP View: – medial and lateral epicondyles and humeral-ulnar/radial articulation; – carrying angle; … Read more
– See: Pediatric Elbow Injuries – Ossification Centers of the Elbow: – C apetellum (appears age 1-2) – R adial Head (appears age 2-4) – I nteranal epicondyle (appears age 4-6) – T rochlea (appears age 8-11) – O lecranon (9-11 years) … Read more
– Findings: – Assymmetrical osteopenia; – Spine: vertebral compression fractures; – Skull: – so-called salt-and-pepper skull – tiny punched out lesions may be present in the skull, producing so called salt and pepper appearance; – Clavicle: erosion of the … Read more