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Pediatric Septic Hip Arthritis: What You Need to Know

Pediatric septic hip arthritis is a serious condition that occurs when bacteria infect the hip joint of a child. It can cause severe pain, swelling, redness and fever, and may lead to permanent damage to the joint or even life-threatening complications if not treated promptly. In this blog post, we

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Two-Stage Revision for Periprosthetic Joint Infection of the Hip: Indications, Contraindications, and Preparation

DR.MOHAMMAD HUTAIF, EMIAL This article discusses the indications, contraindications, and preparation for two-stage revision for periprosthetic joint infection of the hip. It also covers the different types of spacers that can be used during the interval period. INTRODUCTION Total hip

Osteomyelitis

  Exogenous: most common osteomyelitis in adults Acute osteomyelitis from open fracture or bone exposed at surgery Chronic osteomyelitis from neglected wounds: diabetic feet, decubitus ulcers Hematogenous: most common

Infection and Microbiology

Infection and Microbiology Musculoskeletal infections overview Treatment overview Empirical treatment: based on the presumed type of infection as determined from clinical findings and symptoms. Staphylococcus and Streptococcus are the most

Shoulder and Elbow cases massive, irreparable rotator cuff tears

A 70-year-old, right-hand-dominant woman presents to clinic with right shoulder pain and weakness. She has had progressive weakness and severe pain with overhead motions for the last several years to the point where she is no longer able to reach overhead. She endures severe night pain as well.

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You are called by the emergency department to see a 50-year-old male who reported a wound on his leg yesterday. He initially did not have any problems, however in the past 4 hours he has noted increased erythema, pain requiring IV narcotics, and tachycardia. The emergency department asks what

Pediatric orthopedic cases 40

CASE                               40

Hand CASES

CASE 1   A 28-year-old, right-hand-dominant male caught big air going off a jump while snowboarding for the first time. He landed awkwardly on his non-dominant left hand and immediately developed pain. Radiographs were obtained at the slope side indicating multiple fractures in the

Hand CASE 25

CASE                               25

Shoulder and Elbow CASES 1

CASE 1     A 76-year-old, right-hand-dominant man presents to clinic complaining of right shoulder pain. The pain started several months ago, has gotten progressively worse, and is located diffusely over his deltoid region. He has night pain and pain with overhead activity. On

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  CASE 1     A 63-year-old male sustained a hyperextension injury to his neck while diving into a pool. Upon presentation, he reports decreased sensation in his hands and decreased strength in his arms and wrists, but no lower extremity complaints. On motor examination,

Management of the Infected Total Hip Prosthesis: The One Staged Approach

Introduction                        The operative management of periprosthetic infection after total hip arthroplasty (THA) remains a challenge procedure to any arthroplasty surgeon.

Two Stage Revision for Infected Total Hip Replacement

Introduction                        Deep infection (Fig. 40.1) following total hip replacement is a challenging complication for both the patient and the surgeon. The reported risk of

Femoral Head Allograft for Large Talar Defects

INDICATIONS Talar body avascular necrosis with collapse or infection (FIG 1A) is one indication for femoral head allograft. Failed total ankle arthroplasty with insufficient bone remaining for revision (FIG 1B) also warrants a femoral head allograft. Use of a femoral

Treatment of Bone Loss, Avascular Necrosis, and Infection of the Talus with Circular Tensioned Wire Fixators

DEFINITION Talus fractures are high-energy fractures that can have traumatic bone loss, avascular necrosis (AVN), and infected nonunion as the outcome of the injury.1,3,15,23 Acute talar bone loss and subsequent AVN and infection will present a cascade of hindfoot reconstruction

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Anterior Thoracic Corpectomy

DEFINITION Anterior thoracic approaches provide a means of decompression, stabilization, and fusion for a variety of spinal pathologies, such as deformity, trauma, infection, tumors, and disc herniations.     ANATOMY   The thoracic vertebral bodies are heart-shaped

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PREFERRED RESPONSE 3   Improved medical management has changed musculoskeletal outcomes for individuals with hemophilia. Patients with severe hemophilia receiving prophylactic administration of factor VIII may never develop a target joint that requires further orthopaedic intervention.

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(OBQ15.201) A 52-year-old, right hand dominant man comes for evaluation of right shoulder pain that has been intermittently bothering him for three months. The pain is worse with overhead activities. He denies any history of trauma. His range of forward elevation in the plane of the scapula is

Resection Arthroplasty and Spacer Insertion

DEFINITION Resection arthroplasty and insertion of a spacer is used for the management of chronic deep periprosthetic infection of the hip. This chapter discusses the diagnosis and management of late chronic infections. Acute infections, described in the following text, have a different

Hip Reimplantation Surgery

DEFINITION Hip reimplantation refers to the insertion of another prosthesis after removal of the original, infected prosthesis. This may be performed as a single- or two-staged procedure, using either cemented or uncemented components.     ANATOMY   Hip

Prevention of Complications in Total Hip Arthroplasty

DEFINITION Total hip arthroplasty (THA) is successfully performed around the world for the treatment of arthritis, osteonecrosis, and femoral neck fracture, with predictably excellent results. The criteria for successful THA are no different today than they were 50 years ago: The procedure

Distal Femoral Resections with Endoprosthetic Replacement

BACKGROUND   Ralph C. Marcove (Memorial Sloan Kettering Cancer Center) and Kenneth C. Francis (New York University Medical Center) introduced limb-sparing resection in the early 1970s for the management of malignant bone tumors, initially for osteosarcoma of the distal femur. The

Expandable Prostheses

BACKGROUND     The two most common primary malignant bone tumors, osteosarcoma and Ewing sarcoma, are principally diseases of childhood and adolescence, with 45% of patients younger than 16 years and 17% younger than 12 years at diagnosis.   In the last 30 years, the

Surgical Treatment of Septic Arthritis in the Hand and Wrist

      DEFINITION Septic arthritis is defined as an infection within the closed space of a joint. It is usually acute and purulent secondary to a bacterial infection. It can cause irreversible damage to articular cartilage and therefore warrants prompt treatment

Surgical Treatment of Acute and Chronic Paronychia and Felons

      DEFINITION An acute paronychia is an infection of the soft tissue fold around the fingernail. It is the most common soft tissue infection of the hand. The most common infecting organism is Staphylococcus aureus, although these infections are

Surgical Treatment of Deep Space Infections of the Hand

    DEFINITION Deep space infections occur in one of three anatomically defined potential spaces within the hand. Thenar, midpalmar, and hypothenar spaces Interdigital subfacial web space Parona space—a potential forearm space Thenar space infections are the most

Surgical Treatment of Injection Injuries in the Hand

      DEFINITION Injuries caused by high-pressure injection equipment, which can generate pressures of 2000 to 12,000 pound per square inch (psi),9 are more than sufficient force to break the skin.15 Substances typically injected include grease, paint, paint

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Arthroscopic Treatment of Rotator Cuff Tears

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SPINE A 79-year old man falls sustaining a hyperextension injury to his neck. A lateral radiograph, CT scan and MRI are seen in Figures A through C. On motor examination, he has 3/5 strength in his deltoids, elbow and wrist flexors and extensors. He has 4/5 strength in his hip flexors,

Anterior Drainage of the Septic Hip in Children

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Hip Reimplantation Surgery

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Resection Arthroplasty and Spacer Insertion

      DEFINITION Resection arthroplasty and insertion of a spacer is used for the management of chronic deep periprosthetic infection of the hip. The discussion in this chapter pertains to the diagnosis and management of late chronic infection. Acute

Arthroscopic Treatment of Rotator Cuff Tears

Arthroscopic Treatment of Rotator Cuff Tears Arthroscopic Treatment of Rotator Cuff Tears DEFINITION Rotator cuff disease encompasses a spectrum of disorders ranging from tendinitis to partial and full-thickness tendon tearing. It is the most common shoulder disorder treated by an

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ORTHOPEDIC MCQS WITH ANSWER PEDS 04

ORTHOPEDIC MCQS WITH ANSWER PEDS 04 1.         An 8-year-old boy sustains nondisplaced midshaft fractures of the tibia and fibula after being struck by a car while he was riding his bicycle.  No other injuries are noted, but the patient reports pain

ORTHOPEDIC MCQS WITH ANSWER UPPER LIMB 05

ORTHOPEDIC MCQS WITH ANSWER UPPER LIMB 05     1.      A 36-year-old woman has pain and swelling of the anterior arm after undergoing arthroscopic shoulder surgery 8 months ago.  At the time of the procedure, extensive debridement and synovectomy of

ORTHOPEDIC MCQS WITH ANSWERS ONLINE SPINE 06

ORTHOPEDIC MCQS WITH ANSWERS ONLINE SPINE 06   1.      Figures 1a and 1b show the sagittal T2- and T1-weighted MRI scans of a 25-year-old intravenous drug abuser who has low back pain that is increasing in intensity.  Laboratory studies show a WBC count of

ORTHOPEDIC MCQS WITH ANSWERS ONLINE FOOT AND ANKLE 06

ORTHOPEDIC MCQS WITH ANSWERS ONLINE FOOT AND ANKLE 06 1.      Figures 1a and 1b show the clinical photograph and oblique radiograph of a 52-year-old man who has plantar first metatarsal pain.  A felt pad in the shoe proximal to the area of pain has failed to provide

ORTHOPEDIC MCQS with Answers ONLINE BASIC 06

ORTHOPEDIC MCQS with Answers ONLINE BASIC 06 1.      A 20-year-old woman with a history of subtotal meniscectomy has a painful knee.  What associated condition is a contraindication to proceeding with a meniscal allograft?

ORTHOPEDIC MCQS ONLINE PEDIATRICS 07

ORTHOPEDIC MCQS ONLINE PEDIATRICS 07 1.      A pediatric orthopaedic surgeon refers a child to a neurologist.  The neurologist’s office requests the office records of the pediatric orthopaedic surgeon.  To maintain Health Insurance Portability and

ONLINE ORTHOPEDIC MCQS UPPER LIMB08

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ONLINE ORTHOPEDIC MCQS FOOT0 9

ONLINE ORTHOPEDIC MCQS FOOT0 9   1.        Figure 1 shows the radiograph of a 60-year-old woman who underwent a previous operation for great toe pain 20 years ago.  She has had increasing pain over the past 5 years and now reports pain with any

ONLINE ORTHOPEDIC MCQS SPINE0 9

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Orthopedic MCQS online Shoulder and Elbow

Orthopedic MCQS online Shoulder and Elbow  1- Figures 1 and 2 show the current radiographs of a 25-year-old skier who presents 2 weeks after undergoing open reduction and internal fixation (ORIF) of a right elbow fracture dislocation. On examination, he has a well-healed posterior incision

Orthopedic MCQS online Hip and knee

Orthopedic MCQS online Hip and knee  1- Commercially available polymethylmethacrylate cement formulations vary in the consistency of the material as part of its inherent properties. What is the clinical difference between high- and low-viscosity cement

Spine structured oral questions2: Infection (epidural abscess)

Spine structured oral questions2: Infection (epidural abscess) EXAMINER: A 68-year-old man with a past history of a lung tumour 10 years ago presents following a fall with a 4- week history of worsening thoracic back pain. Back pain is a common presenting complaint to general practitioners and

KNEE Structured oralexamination question3: Infected total knee arthroplasty ( TKA )

KNEE Structured oralexamination question3: Infected total knee arthroplasty ( TKA ) Figures 3.3a and 3.3b Anteroposterior (AP) and lateral radiographs of left TKA. EXAMINER: A 78-year-old lady who underwent left TKA 2 years ago is re ferred to your Painful Arthroplasty Clinic

Hand and wrist: Answers MCQS EMQS

Hand and wrist: Answers MCQs d.      Central slip rupture. Swan neck deformity is secondary to an imbalance between flexors and extensors with a variable contribution from the intrinsic muscles. Central slip rupture is the cause of a Boutonnière

Hand and wrist: MCQ AND EMQ Questions

Hand and wrist: MCQ AND EMQ Questions MCQs Which of the following is not a cause of a swan neck deformity? Mallet deformity. Flexor tendon tenosynovitis. Volar plate rupture. Central slip rupture. Lateral band subluxation. When performing a replant of an

Structured Hip oral examination question 1

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Hip structured oral questions

Chapter Hip structured oral questions 2   All viva questions outlined here are examples of actual questions asked in the FRCS (Tr & Orth) exam. Currently each viva question lasts 5 minutes and examiners are advised against switching to another topic earlier even if a candidate

Hands and Paediatric Orthopaedics

viva Hands and Paediatric Orthopaedics    Hands and Paediatric Orthopaedics  Section 1 Hands Viva 1  What is the likely diagnosis?  What are the risk factors for this condition?  What are the two main

SSEE

Figures 1 and 2 show the current radiographs of a 25-year-old skier who presents 2 weeks after undergoing open reduction and internal fixation (ORIF) of a right elbow fracture dislocation. On examination, he has a well-healed posterior incision without any signs of infection. He

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  Figures 1 and 2 show the current radiographs of a 25-year-old skier who presents 2 weeks after undergoing open reduction and internal fixation (ORIF) of a right elbow fracture dislocation. On examination, he has a well-healed posterior incision without

2021 SHOULDER AND ELBOW MCQS FREE

SHOULDER AND ELBOW MCQS FREE  2021 1- Figures 1 and 2 show the current radiographs of a 25-year-old skier who presents 2  weeks after undergoing open reduction and internal fixation (ORIF) of a right elbow fracture dislocation. On examination, he has a well-healed posterior

Pediatric Orthopaedic MCQS Self-Assessment Examination 2020

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Self-Assessment Examination 2020 Adult Spine MCQS

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Foot and Ankle free MCQS2020 Online

Foot and Ankle free MCQS2020 Online               Question 1 of 100 Figures 1 through 3 are the standing radiographs of a 52-year-old woman with symptomatic hallux valgus in the setting of pes planus and hypermobility of the

UPDATED ORTHOPEDIC MCQS

1) What percentage of patients will complain of knee pain at the time of union of a tibial shaft fracture treated with a reamed intramedullary nail?  1. <10%  2. 10-33%  3. 33-50%  4. 50-75%  5. >75%  Corrent answer:

Foot and Ankle FREE ORTHOPEDICS MCQS Question 11

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FREE Orthopedics MCQS 2022 1401-1450

FREE Orthopedics MCQS 2022 1401-1450 1401. (1755) Q4-2152: Prolonged nonsteroidal anti-inflammatory drugs (NSAIDs) cure which of the following lesions: 1) Osteosarcoma 3) Osteoblastoma 2) Osteoid osteoma 5) None of the above 4) Osteochondroma An average

ORTHOPEDICS HYPERGUIDE 2022 MCQ1051-1100

ORTHOPEDICS HYPERGUIDE 2022 MCQ1051-1100   1051. (332) Q3-447: While he is working, an industrial worker sustains a puncture wound to the plantar aspect of his foot. He suspects the wound was caused by a sharp protruding nail that penetrated his sneaker. The most likely organism

ORTHOPEDICS HYPERGUIDE MCQ 701-750

ORTHOPEDICS HYPERGUIDE MCQ 701-750   701. (1068) Q2-1375: The skin over the anterior distal thigh above the patella is innervated by which of the following sensory segmental levels: 1) T12 3) L2 2) L1 5) L4 4) L3 The skin over the thigh is innervated by

ORTHOPEDICS HYPERGUIDE MCQ 501-550

ORTHOPEDICS HYPERGUIDE MCQ 501-550   501. (3903) Q1-7783: What is the reported incidence in the literature for a satisfactory outcome following open rotator cuff repair: 1) Less than 60% 3) Between 70% and 80% 2) Between 60% and 70% 5) Greater than

ORTHOPEDICS HYPERGUIDE MCQ 401-450

ORTHOPEDICS HYPERGUIDE MCQ 401-450   401. (3244) Q1-4067: In patients with sickle cell disease, what are the most commonly affected locations for osteonecrosis: 1) Distal radial and distal humerus 3) Distal femur and proximal tibia 2) Head of femur and head of

ORTHOPEDICS HYPERGUIDE MCQ 201-250

ORTHOPEDICS HYPERGUIDE MCQ 201-250 201. (1793) Q1-2192: The best position for hip arthrodesis is: 1) Neutral abduction/adduction, 20° to 30° flexion, and neutral internal/external rotation 3) Neutral abduction/adduction, full extension, and neutral

Drainage of Paronychia

Drainage of Pus in the Hand Hand infections are an important source of patient morbidity. They cause an enormous loss of time from work and can produce permanent deficits in hand function.42 Until recently, the availability of more prompt medical care and the administration of antibiotics had

Orthopaedic Infections And Osteomyelitis

INTRODUCTION The first descriptions of infections date back to the early Sumerian carvings, when the tenets of treatment were irrigation, immobilization, and bandaging.82 In these early times, the practice of infection and wound care was essentially an art and there was very

FACTORS AFFECTING THE RATE OF HEALING OF A FRACTURE 1 TYPE OF BONE Cancellous bone (spongy bone) Healing in cancellous bone is generally well advanced 6 weeks from the time of the injury, and protection of the fracture can almost