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samer kareem
1,434 Views · 11 months ago

A talus fracture is a break in one of the bones that forms the ankle. This type of fracture often occurs during a high-energy event, such as a car collision or a high-velocity fall. Because the talus is important for ankle movement, a fracture often results in significant loss of motion and function. In addition, a talus fracture that does not heal properly can lead to serious complications, including chronic pain. For this reason, many talus fractures require surgery.

samer kareem
2,332 Views · 11 months ago

The lateral approach is used for insertion of fixation devices after closed reduction of a proximal femoral fracture. Reduction of a displaced fracture is usually done with a fracture table, or alternatively a large distractor spanning the hip joint. After satisfactory reduction is confirmed by image intensifier, the lateral approach can be used for insertion of a sliding hip screw or multiple screws. The approach provides limited access to the lateral surface of the femur sufficient for hardware placement. The incision can be extended proximally to accommodate a trochanteric stabilizing plate (TSP), or even anteriorly so that it becomes an anterolateral approach with direct, although limited, access to the femoral neck.

samer kareem
1,158 Views · 11 months ago

Our results in this study of MIPO treated with conventional plates are comparable to the results of the femoral shaft fractures treated with intramedullary nailing. The technique can be used for all femoral shaft fractures. Although the biomechanics of the plate fixation are less stable compared to the intamedullary nail, the mechanical stability is stable enough for bone healing. Healing was rapid, and postoperative care was simplified. The two major complications were malalignment and screw breakage. We recommend using at least three separated screws in each fragment to prevent stress on the screw and screw breakage. Intraoperative limb length, axial alignment, and rotation must be carefully assessed to prevent malalignment. The limitations of our study include lack of a comparison group, retrospective data collection, and no randomisation in outcome evaluation

samer kareem
1,167 Views · 11 months ago

The procedure was performed under wrist block regional anesthesia with tourniquet control. A single Chinese finger trap was used on the thumb with 5 to 8 lb of ongitudinal traction. The arm was held down with wide tape around the tourniquet securing it to the hand table to serve as countertraction. A shoulder holder, rather than a traction tower, was used to facilitate fluoroscopic intervention more easily. The Trapeziometacarpal joint was detected by palpation. Joint distension was achieved by injecting 1 to 3 mL of normal saline (Fig. 1). It is important to distally direct the needle approximately 20 degrees to clear the dorsal flare of the metacarpal base and enter the joint capsule. This course should be reproduced upon entering with arthroscopic sleeve/ trocar assembly to minimize iatrogenic cartilage injury. Fluid distention is important to facilitate this. The incision for the 1-R (radial) portal, used for proper assessment of the dorsoradial ligament, posterior oblique ligament, and ulnar collateral ligament, was placed just volar to the abductor pollicis longus tendon. The incision for the 1-U (ulnar) portal, for better evaluation of the anterior oblique ligament and ulnar collateral ligament, was made just ulnar to the extensor pollicis brevis tendon. A short-barrel, 1.9-mm, 30- degree inclination arthroscope was used for complete visualization of the CMC joint surfaces, capsule, and ligaments, and then appropriate management was done, as dictated by the stage of the arthritis detected (Fig. 2A). A full-radius mechanical shaver with suction was used in all the cases, particularly for initial debridement and visualization. Most of the cases were augmented with radiofrequency ablation to perform a thorough synovectomy and radiofrequency was also used to perform chondroplasty in the cases with focal articular cartilage wear or fibrillation. Chondroplasty refers to thedebridement of the fibrillated cartilage to improve vascularity of the cartilage and enhance the growth of fibrocartilage. Ligamentous laxity and capsular attenu- ation were treated with thermal capsulorraphy using a radiofrequency shrinkage probe. We were careful to avoid thermal necrosis; hence, a striping technique was used to tighten the capsule of the lax joints. The striping technique refers to thermal shrinkage performed in longitudinal stripes on the lax capsule, so as to leave vascular zones between the stripes; hence, thermal necrosis is prevented. Arthroscopic stage I disease was characterized by synovitis without any cartilage wear, wherein a synovectomy coupled with thermal capsulor- raphy as described was performed.

samer kareem
1,212 Views · 11 months ago

Open reduction and internal fixation (ORIF) is surgery used to stabilize and heal a broken bone. You might need this procedure to treat your broken thighbone (femur). The femur is the large bone in the upper part of your leg. Different kinds of trauma can damage this bone, causing it to fracture into 2 or more pieces. This might happen to the part of the femur near your knee, near the middle of the femur, or in the part of the femur that forms part of your hip joint. In certain types of femur fractures, your femur has broken, but its pieces still line up correctly. In other types of fractures (displaced fractures), the trauma moves the bone fragments out of alignment. If you fracture your femur, you usually need ORIF to bring your bones back into place and help them heal. During an open reduction, orthopedic surgeons reposition your bone pieces during surgery, so that they are back in their proper alignment. This contrasts with a closed reduction, in which a healthcare provider physically moves your bones back into place without surgically exposing your bone.

samer kareem
1,248 Views · 11 months ago

An arthroscopic meniscectomy is a procedure to remove some or all of a meniscus from the tibio-femoral joint of the knee using arthroscopic (aka 'keyhole') surgery. In a complete meniscectomy the meniscus including the meniscal rim is removed. A partial meniscectomy involves partial removal of the meniscus. This may vary from minor trimming of a frayed edge to anything short of removing the rim. This is a minimally invasive procedure often done as day suas an outpatient in a one-day clinic [1] This procedure is performed when a meniscal tear is too large to be corrected by a surgical meniscal repair.[1] When non-operative therapy provides some degree of symptom relief over the long-term, these benefits may wane with continued meniscal degeneration. In such patients, arthroscopic partial meniscectomy can be effective in improving patient quality of life.

samer kareem
1,962 Views · 11 months ago

Boxer’s Knuckle is an injury to the structures around the first knuckle of a finger, also known as the metacarpophalangeal joint (MPJ). The skin, extensor tendon, ligaments, joint cartilage, and the bone of the metacarpal head may all be involved. Repeated impacts to the extensor tendon over the knuckle causes Hypertrophic Interstitial Tendonosis, or HIT Syndrome. This is a thickening, weakening, inflammation, and scarring of the extensor tendon.

samer kareem
1,426 Views · 11 months ago

Biceps tenodesis is a common procedure performed for tendinopathy of the long head of the biceps brachii (LHB). Indications include partial-thickness LHB tear, tendon subluxation with or without subscapularis tear, and failed conservative management of bicipital tenosynovitis. Biceps tenodesis may also be performed for superior labrum anterior to posterior tears.

samer kareem
2,623 Views · 11 months ago

... Orthopedics & Sports Medicine Our Services Where Does it Hurt? SNAPPING SCAPULA SYNDROME PDF Icon PRINTABLE BOOKLET A PATIENT'S GUIDE TO SNAPPING SCAPULA SYNDROME INTRODUCTION The scapulothoracic joint is located where the shoulder blade (also called the scapula) glides along the chest wall (the thorax). When movement of this joint causes feelings or sounds of grating, grinding, popping, or thumping, doctors call it snapping scapula syndrome. Snapping scapula syndrome is fairly rare. When it happens, the soft tissues between the scapula and the chest wall are thick, irritated, or inflamed. Snapping scapula syndrome can also happen if the bones of the shoulder blade or rib cage grate over one another. This guide will help you understand what causes snapping scapula syndrome how doctors treat this condition ANATOMY What parts of the body are involved in this condition? The shoulder is made up of three bones: the humerus (upper arm bone), the clavicle (collarbone), and the scapula(shoulder blade). Two large muscles attach to the front part of the scapula where it rests against the chest wall. One of them, called the subscapularis muscle, attaches over the front of the scapula where it faces the chest wall. The serratus anterior muscle attaches along the edge of the scapula nearest the spine. It passes in front of the scapula, wraps around the chest wall, and connects to the ribs on the front part of the chest. A bursa is a fluid-filled sac that cushions body tissues from friction. A bursa sits between the two muscles of the scapula. There is also a bursa in the space between the serratus anterior muscle and the chest wall. When bursa sacs become inflamed, the condition is called bursitis. Scapulothoracic bursitis refers to inflammation in the bursa under the shoulder blade. This type of bursitis is most common in the upper corner of the scapula nearest the spine. It also occurs under the lower tip of the scapula. In either case, it can cause the sounds and sensations of snapping scapula syndrome. A person can have bursitis in the joint without any grinding or popping. Related Document: A Patient's Guide to Shoulder Anatomy CAUSES What causes this condition? Snapping scapula is caused by problems in the soft tissues or bones of the scapula and chest wall. It can start when the tissues between the scapula and shoulder blade thicken from inflammation. The inflammation is usually caused by repetitive movements. Certain motions of the shoulder done over and over again, such as the movements of pitching baseballs or hanging wallpaper, can cause the tissues of the joint to become inflamed. In other cases, the muscles under the scapula have shrunk (atrophied) from weakness or inactivity. The scapula bone then rides more closely to the rib cage. This means the scapula bumps or rubs on the rib bones during movement. Changes in the alignment or contour of the bones of the scapulothoracic joint can also cause snapping scapula. When a fractured rib or scapula isn't lined up just right, it can cause a bumpy ridge that produces the characteristic grind or snap as the scapula moves over the chest wall.

samer kareem
2,194 Views · 11 months ago

Glomus tumors are rare soft tissue neoplasms that typically present in adults (ages 20-40 years) as small, blue-red papules or nodules of the distal extremities, with most cases involving subungual sites. These tumors are typically painful, often causing paroxysmal pain in response to temperature changes or pressure. Glomus tumors are thought to arise from the glomus body, a thermoregulatory shunt concentrated in the fingers and toes. Most lesions are solitary and localized to cutaneous sites; however, generalized glomuvenous malformations, or multiple glomangiomas, have also been described, and may have extracutaneous involvement.

samer kareem
1,756 Views · 11 months ago

Educational video describing injection techniques for painful conditions of the foot and ankle.

samer kareem
1,120 Views · 11 months ago

Arthrocentesis involves both the puncture of a joint and the aspiration of its synovial fluid. It is typically used to make an accurate diagnosis of a painful, warm, swollen joint. Removal of excess fluid can be therapeutic. Analysis of the removed fluid helps to decipher its etiology. [1]

samer kareem
1,696 Views · 11 months ago

Compartment syndrome can develop in the foot following crush injury or closed fracture. Following some critical threshold of bleeding and/or swelling into the fixed space compartments, arterial pulse pressure is insufficient to overcome the osmotic tissue pressure gradient, leading to cell death. The complicating factor is related to the magnitude of the force of the crush injury. The amount of swelling or bleeding has to be sufficient to impair arterial inflow, while not being of sufficient magnitude to produce an open injury, which decompresses the pressure within the affected compartments. When the injury is open, we then attribute the late disability primarily to the crushing injury to the involved muscles.

samer kareem
1,266 Views · 11 months ago

A cervical herniated disc may be treated by removing part of the disc through a small incision (microdiscectomy). If this is done from the back (posteriorly) rather than from the front of the neck, a spinal fusion is not necessary. The alternative is an anterior cervical discectomy and fusion procedure.

samer kareem
1,041 Views · 11 months ago

Sialendoscopy can be both diagnostic and therapeutic. It is complementary to diagnostic techniques such as plain radiography, ultrasonography, computed tomography (CT), magnetic resonance sialography, and conventional sialography, all of which are traditional, time-tested methods for evaluating the salivary ductal system

samer kareem
1,527 Views · 11 months ago

This procedure, and other types of soft palate surgery, targets the back of the roof of your mouth. It involves removing and repositioning excess tissue in the throat to make the airway wider. The surgeon can trim down your soft palate and uvula, remove your tonsils, and reposition some of the muscles of the soft palate. UPPP and other soft palate procedures are the most common type of surgery for sleep apnea. But UPPP alone is unlikely to cure moderate to severe sleep apnea. It may be combined with surgeries that target other sites in the upper airway.

samer kareem
1,525 Views · 11 months ago

This patient had a history of herpes and had a previous corneal transplant that subsequently became opacified. There was also a previous Baerveldt implant placed into the anterior chamber. This surgery consists of Baerveldt tube being moved from the anterior chamber to posterior chamber, removal of failed graft, placement of temporary keratoprosthesis, pars plana vitectomy and corneal transplant. Jeffrey Liebmann, MD. Mark Speaker, MD. Uri Shabto, MD. Christopher Teng, MD.

samer kareem
1,844 Views · 11 months ago

Earlobe surgery or repair is a reconstructive plastic surgery procedure performed to restore the appearance of earlobes that have been torn or stretched due to ear tearing, trauma, or piercing, including the insertion of ear gauges. This can also be called earlobe reconstructive surgery or split earlobe repair .

samer kareem
2,356 Views · 11 months ago

This is a 60 year man having large swelling of size 7cm x 5 cm behind neck for one year. Patient complained pain and tenderness over local area for 7 days and came to us.On examination punctum found in the centre of swelling and fluctuation positive.Infected sebaceous cyst diagnosis made. /nIncision and drainage surgery done under local anesthesia.all infected pultaceous material evacuated.Pus culture sent and antibiotics given as per sensitivity report./nPatient improved with daily dressing.

samer kareem
1,410 Views · 11 months ago

An abscess is an infectious process characterized by a collection of pus surrounded by inflamed tissue. [1, 2] Abscesses can form anywhere in the body, from a superficial skin (subcutaneous) abscess to deep abscesses in muscle, organs, or body cavities. Patients with subcutaneous skin abscesses present clinically as a firm, localized, painful, erythematous swelling that becomes fluctuant (see the image below).




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