Ortho Oracle - orthopaedic operative atlas

Adolescent Blounts Disease

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

Adductor Magnus

– 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: 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

Addition of Antibiotics to Cement

 – 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

ACL Graft Fixation

 – 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

ACL Graft Placement Theory

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

Achilles Tendon Rupture

(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