The Hip - book

Medial Collateral Ligament of the Elbow

– Anatomy:     – humeral origin of MCL lies posterior to axis of elbow flexion, creating cam effect;            – hence, anterior fibers are stressed in extension & posterior fibers are stressed in flexion;      – anterior oblique, posterior oblique ligament, & small transverse ligament are 3 major portions of the … Read more

Medial Condyle Frx in Adult

  – See: Medial Approach: – Discussion:     – medial epicondyle is common origin of several flexor muscles of hand and wrist;     – when medial epicondyle is frxed, flexor muscles pull fragment distally;     – during surgical procedure care must be made to protect ulnar nerve; – Fixation Stratedgy:     – … Read more

Mannitol

– Discussion:     – for reduction of intracranial or intraocular pressure;     – for osmotic diuresis, cerebral edema, ?oliguria, ?anuria, ?myoglobinuria;     – serves as rapid volumeexpander;     – adult: test dose:             – 0.2gm/kg/dose IV over 3-5 min;             – … Read more

Management of Vascular Injuries in Knee Dislocation

– See:         – Arteriography         – Arterial Trauma         – Compartment Syndrome         – Knee Dislocation         – Popliteal Artery         – Reperfusion Injury – Discussion:      – note that the worst error to make is to underestimate the need to … Read more

Mangled Extremity Severity Score (MESS)

                                                                           – from Johansen, et al. (1990) Skeletal / soft-tissue injury      Low energy (stab; simple fracture; pistol gunshot wound): 1      Medium energy (open or multiple fractures, dislocation): 2      High energy (high speed MVA or rifle GSW): 3      Very high energy (high speed trauma + gross contamination): 4 Limb ischemia     … Read more