– Technique: – it is helpful to have the patient paralyzed during the reduction (requires general anesthesia); – anatomic reduction of the condyles is performed first; – remember that the common factor in fixation failure in these fractures is comminution and/or osteoporosis; – best-fit method: … Read more
Discussion adolescent tibia vara (Blount’s disease), results from disordered growth of proximal medial physis & metaphysis; localized varus deformity, often accompanied by medial tibial torsion; caused by osteochondrosis resulting from mechanical stress converting physiologic bowlegs to tibia vara; risk factors: common in blacks & obese children; adolescent Blount’s is less severe and predominately unilateral; Treatment … Read more
– origin: – posterior fibers: ischial tuberosity; – anterior fibers: ramus of ischium and pubis; – insertion: – from a line extending from the greater trochanter along linea aspera, medial suprcondylar line and adductor tubercle on medial condyle of femur; – action: – … Read more
– See: Plantar Muscles of the Foot: – Anatomy: – origin: – oblique Head: the proximal ends ofthe 2nd, 3rd, and 4th metatarsals. – transverse Head: the metatarsophalangeal ligaments of the 3rd, 4th, and 5th toes. … Read more
– See: Bone Tumor Menu – Discussion: – rare tumor of unknown origin; – occurs primarily in young males between 10 – 30 years of age (most common after skeletal maturity); – pts present w/ firm, slowly enlarging mass that produces minimal disability; … Read more
– See: Infection Menu and Wound Management: and Local Antibiotic Delivery for Septic Joints – Discussion: – basic science: – useful in treating biofilm; – references: – In vitro characteristics of tobramycin-PMMA beads: compressive strength and leaching. – Antibiotic bone cement in THA. An in vivo comparison of the elution properties of … Read more
– Discussion: – see Arthrex, Mitek, Linvatec, Smith-Nephew – in choosing a fixation technqiue consider the need for the following: – circumferential (360 deg) healing of graft against tunnel wall (interference screws do not permit this); – bioabsorbable material … Read more
Discussion femoral tunnel tibial tunnel: isometric placement of ACL refers to the concept that a full range of knee can be achieved w/o causing long-term ligament deformation; isometry can not exist because, during ROM, there is no one point on femur that maintains a fixed distance from a single point on tibia; elongation always will … Read more
– Discussion: – anatomy of ACL; – ACL biomechanics; – graft tunnel sites / isometry: – hamstring ACL reconstruction is an alternative to bone patellar bone graft fixation; – size and strength of graft: – double looped hamstring graft is more than twice as … Read more
(see also: Achilles Tendonitis) Discussion ruptures typically occur after age 30, more often in people beyond middle age; rupture at musculous tendinous junction occurs most often in young people, but ruptures near the calcaneus also occur; inciting event may be related to atrophy of the soleus muscle, and commonly occur in weekend athletes; in 5-33% … Read more