By David Ip
The scope of orthopedic wisdom has improved to the sort of measure that it has develop into more and more tricky to take care of a primary seize of the necessary wisdom base. this can be compounded by the point constraints on grownup studying, with the coed or practitioner confronted with ever-increasing calls for on their time. this article is a miles wanted source of orthopedic wisdom, in an effort to end up beneficial not just to those in education but in addition to these confronted via the ever-increasing calls for of certification and recertification examinations. good illustrated and arranged into 8 chapters extending fro. Read more...
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Extra resources for Orthopedic principles--a resident's guide
Acts by decreasing renal excretion and stimulating 1,25-dihydroxy vitamin D, hence increasing GI absorption of calcium. Acts on osteoclasts to release calcium from bone mainly indirectly via osteoblast cells 18 1 Orthopaedic Basic Science and Commmon Injuries n Calcitonin: stimulated by high [Ca]. Acts by decreasing the number and activity of osteoclasts. Osteoclasts have calcitonin receptors and calcitonin will shrink the osteoclast in in vitro experiments n The role of vitamin D was mentioned.
G. 9 Why Occur at the Classic Location? n Classic location ± lateral aspect of the medial femoral condyle and possible role of trauma/impingement n Why this site? g. 11 Diagnosis and Investigation n Most seen initially on X-ray (including a tunnel view is helpful) n Bone scan ± sensitive in diagnosis and follow-up of OCD lesion in children since indicates blood flow (and hence potential of healing). g. 15 Operative Rn n Arthroscopic drilling and fixation ± Based on the theory that the lesion is regarded as a fracture nonunion, works by penetration of the subchondral bone to initiate inflammatory cascade ± Types: antegrade versus retrograde drilling, an undesirable consequence of antegrade drilling, is the creation of permanent drill holes in the articular surface that fill with fibrocartilage [retrograde drilling with bone graft (BG) sometimes advocated for in situ lesions with intact overlying articular cartilage] ± Fixation of osteochondral lesions increase the likelihood of maintaining joint congruity during healing and potential to allow early range of motion (ROM; by means of K-wires, Herbert, Acutrak) ± important to bury screw head n Abrasion chondroplasty and microfracture ± Again, stimulation of cartilage regeneration by penetration of the subchondral bone to release pluripotential stem cells 36 1 Orthopaedic Basic Science and Commmon Injuries ± Subchondral drilling ± fibrin clot formation ± stem cell migration ± chondrocyte differentiation ± repair the defect ± Histology: fibrous or mixed fibro- and hyaline cartilage.
G. g. heavy weight lifting, labourers, farmers, miners, users of pneumatic drills n Normal ageing with superficial fibrillation ± does not appear to cause symptoms or to affect the function of the joint n Isolated cartilage defects can cause pain, effusion and mechanical dysfunction. g. 9 Why Occur at the Classic Location? n Classic location ± lateral aspect of the medial femoral condyle and possible role of trauma/impingement n Why this site? g. 11 Diagnosis and Investigation n Most seen initially on X-ray (including a tunnel view is helpful) n Bone scan ± sensitive in diagnosis and follow-up of OCD lesion in children since indicates blood flow (and hence potential of healing).