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24 Cards in this Set
- Front
- Back
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Classification tibial inter condylar eminence |
Myers and McKeever 1. Minimal/no displacement 2. Elevated anteriorly with posterior hinge 3. Complete displacement
Goal: reduce fragment as well as possible
M&M recommend ORIF for 2&3 |
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Describe technique for ORIF displaced tibial eminence #'s |
Medial para patellar approach Expose tibial spine, meniscus & ACL & removal any entrapment Nonabsorbable suture or wire through distal ACL brought out distalky through holes drilled in prox tibial epiphysis avoiding physis
Arthroscopy technically challenging, use ACL guide
Account & Willis - ligament based or # based methods of fixation
Mal/non united #'s cause pain/instability & lack of extension
ORIF or femoral notch plasty |
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Complications of SH3/4 distal tibia |
Growth arrest Peripheral growth arrest from avulsion of perichondral ring Resultant angular deformity |
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What is an osteoblasts? |
Concerned with bone formation Derived from local mesenchymal precursors Form rows of cuboidal cells where new bone formed (trab/have radian systems) Rich in Alk phos Produce type 1 collagen & non village nous proteins for mineralisation bone matrix |
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What is an osteocytes? |
OB either remains as quiescent lining cell or becomes resting osteocytes In bone lacunae ? Function Osteocytic osteolysis - PThH & Ca ion transport |
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Osteoclasts? |
Principle mediators of bone resorption Large multinucleated cells derived from Mono cytic precursors Attracted by chemotaxis to prepared surfaces Ruffled border is zone of attachment to bone OC bone resorption carried out by lysosomal enzymes Resorption surfaces - how ships lacunae |
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New bone formation occurs... |
1. Endochondral ossification Ossification of proliferating cartilage Physis or bone repair 2. Membranous ossification Direct Ossification Sub periosteal new bone |
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Wolffs law |
Architecture. & bone mass is adjusted to withstand forces imposed upon it By functional need or gravity |
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What is a TCC? |
Composite anatomically conforming below knee cast that is applied over minimal padding often encoding the toes |
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How does TCC work? |
Redistribution of high pressure areas under forefoot & mid foot which can cause ulceration |
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Use of TCC in Charcot |
Oedema control & structural protection of bone & joint disintegration in Charcot arthropathy |
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Indications of TCC use |
Brodsky grade 1 ulcers (ambulatory treatment of uninflected forefoot & mid foot plantar ulcers)
Stage 1&2 eichenholtz
Post op following ORIF/reconstruction for late deformities |
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Critical plantar pressure for ulcer formation? |
990kPa
Armstrong 1997 |
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Critical plantar pressure for ulcer formation? |
990kPa
Armstrong 1997 |
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Ulcer classification |
Wagner 0, I,II, III, IV, V 0,I& II suitable for TCC
Brodsky 0-3 grade A-D ischaemic classification |
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Definition of osteogenic |
Directly provides cells which go on to produce bone Eg Bone marrow aspirate & autologous BG Osteoprogenitor cells can proliferate & differentiate to OBs & OC's |
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Definition of osteogenic |
Directly provides cells which go on to produce bone Eg Bone marrow aspirate & autologous BG Osteoprogenitor cells can proliferate & differentiate to OBs & OC's |
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Definition of osteoinductive |
Factors which induce progenitor cells down a bone forming lineage Eg BMP |
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Definition of osteogenic |
Directly provides cells which go on to produce bone Eg Bone marrow aspirate & autologous BG Osteoprogenitor cells can proliferate & differentiate to OBs & OC's |
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Definition of osteoinductive |
Factors which induce progenitor cells down a bone forming lineage Eg BMP |
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Definition of osteoconductive |
Serves as a scaffold onto which new bone can form Eg demineralised bone matrices |
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Definition of allograft |
Tissue harvested from a cadaver, processed & then implanted into another individual of the same species |
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Definition of allograft |
Tissue harvested from a cadaver, processed & then implanted into another individual of the same species |
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Sign in SCH# |
Pucker sign |
