– See: IM Nailing for Distal Tibia Fracture – Discussion: – outcomes: – in a retrospecitive study, external fixation was considered a risk factor for non union (29% non union rate); – Distal tibia fractures: management and complications of 101 cases – reduction: – … Read more
– External Fixation Main Menu – Discussion: – disadvantages of external fixation: – pin tract infections, delayed union / non-union, and malunion; – cosmetic problems; – advantages of external fixation: – technically easy to perform; – no soft tissue stripping; – ease of removing hardware; – comparison of IM nailing vs external fixation – Initial … Read more
– Discussion and Indications: – definitive stabilization of frx may be achieved w/ external fixation in certain rotationally unstable but vertically stable injuries; – relative contraindication is iliac wing fractures; – antero-posterior compression injuries: – external fixation is most applicable to stable “open book” … Read more
– See: – Rupture of the Quadriceps – Patellar Tendon Injury – Tibial Tubercle Frx – Discussion: – extensor mechanism includes quadriceps, quadriceps tendon, medial & lateral retinaculum, patellofemoral and patellotibial ligaments, Patellar Tendon (ligament), and tibial tubercle; – superficial location of extensor mechanism make it suseptable to injury; … Read more
– See: Extensor Tendon Lacerations: – the extensor apparatus is a “plexus of tendons with an aponeurotic sheet.” – from Stack, 1962. MP Joint Level: – extensor digitorum communis: (at the MP joint) – there may be some adhesion to the joint capsule, but there is … Read more
– Clinical Findings: – history: patient may complain of a subjective knee hyperextension sensation, and twisting or pivoting are also difficult; – lack of contained effusion is suggestive of posterolateral capsular injury; – look for diffuse tenderness over the posterolateral joint region, fibular head, and joint line; … Read more
– Discussion: – implantation of epithelioid tissues into deeper areas as a result of penetrating trauma; – often the inciting trauma occurs well into the past (patients may or may not remember); – mass is often mildly painful but is non tender, most often lies on … Read more
– See: – Composition – Lab tests; (same as TPN) – Discussion: – elemental diets are most indicated in patients with severe mucosal disease (Inflammatory Bowel disease), short bowel syndrome, proximal pancreatic fistula, pancreatic insufficiency; – enteral nutrition is not safer than TPN – because of aspiration … Read more
– See: Burn Management: – Discussion: – these burns are always much worse than they appear, and the big mistake is to underestimate their severity; – deeper tissues receive more damage and burn injury than superficial tissues; – consider using arteriography to help … Read more
– Clinical Presentation: – sudden onset of pain, pallor, paresthesias, variable paralysis, and absence of distal pulses; – only 15% of all arterial emboli lodge in the upper extremity; – sudden atraumatic onset in conjunction with atrial fib or recent MI strongly implicates an embolic event; – … Read more