Everything 1 Flashcards
What tendon inserts into the great toe sesamoids?
Flexor hallux brevis
stimulates bone formation by reducing oxygen concentration and increasing local tissue pH
Direct Current
stimulates bone formation by affecting synthesis of cAMP, collagen, and calcification of cartilage
Alternating Current
stimulates bone formation by causing calcification of fibrocartilage
Pulsed Electromagnetic Fields
The best lab value to determine VitD deficiency
25-Hydroxycholecalciferol
described sunderland classification of nerve damage
1 - axonal block 2- all layers intact, wallerian degeneration 3- endoneurium disrupted 4- perineurium disrupted 5- epineurium dsirupted
EMG findings for neurapraxia, axonotmesis, neurotmesis
Insertional , spontaneous, minimal activities
insertional:
- normal with neurapraxia and inreased with other 2
spontaneous
- silent with neuropraxia, fibrillations/positive sharp waves for other 2
- no minimal activity for any
Z plasty types and assoc increases in length
60 degree-> 75% increase in length
45- 50%
30 - 25%
How to address midfoot OA of the lateral column operatively
DO NOT FUSE
arthroplasty or interposition
What sets up the navicular to AVN and stress fx?
relatively avascular centrally
nonop option for refractory Achillese pain suspected to be from paratenon (no pathology noted on imaging)
Brisement procedure - injection of saline under the paratenon to help break up adhesions
Advanced imaging discrepancy for OCD talus
MRI when plain films are normal but you suspect OCD
CT when you can see on plain films (allows accurate measurement of size and predictive value of drilling)
RA pt’s do better with this vs a pantalar arthrodesis
better with BKA
Avoid pantalar arthrodesis at all costs
Often they will require TAA and triple arthrodesis
Management for hemangioma in skin of infant
tell parents 70% regress by 7 yo and 90% by 9 yo
Management for dorsal triquetrial avulsion fx
- what ligaments attached ?
What if they have persistent pain after immobilization
SAC 4-6wks
- dorsal intercarpal, dorsal radiocarpal
- lunotriquetrial ligament
May have disrupted one of the ligaments that attaches
Time frames for
- when to get to pelvic fractures
- when to convert femoral exfix to IMN
- when to convert tibia exfix to IMN
traditionally wait 5-7 days to do pelvic fx’s but people are doing then sooner now
femur -> within 3 wks
tibia -> within 1-2 wks
Definition of SIRS
- temp
- HR
- RR
- PaCO2
- WBC
temp > 38 or < 36 HR > 90 RR > 20 PaCO2 < 32 WBC > 12k or < 4k
Graft options for the following gaps
< 5cm
> 10cm
< 5cm -> cancellous autograft +/- Masquelet
> 10cm -> bone transport
5-10 can do either
Rate of movement for bone transport
1mm/day
majority of compartment syndrome of the butt is from ?
- how to decompress?
vascular injury
KockerL approach
View needed to view
- AIIS pin placement
- anterior column screw
- “down the wing” for ensuring pins of screws are in the table of the ilium
AIIS pin - OO out
Anterior column -
Differences in blood supply of flexor tendons
- distal to MCP be proximal
Distal - in tendon sheeths. Main supply via synovial diffusion thru parietal parade in
- second and less is via vinculae
Proximal - no sheeths, direct blood supply
Comanagement protocols for Hip fx’s in elderly have shown to
Improve mortality Decrease LOS Decrease complications Decrease readmissions Improve ambulatory status at time of discharge
HAVE NOTE shown-> improvement in surgical blood loss, time to surgery, inpatient mortality
