Indications: Surgical planes: Lowa/Iowa/Weinstein-Ponseti (Anteromedial) Ludloff (Anteromedial) Ferguson (Posteromedial) Developed in 1979 1908 1973 Superficial interval Between sartorius (anterior) and adductor longus (posterior) Between sartorius (anterior) and adductor longus (posterior) Between adductor longus (anterior) and gracilis (posterior) Deep interval Between femoral neurovascular bundle (anterior) and pectineus (posterior) Between pectineus (anterior)…
Tag: Orthopedics
Section Editor: Dr. Sulabh Kumar Shrestha, MBBS, PGY1 Orthopedics
PGMEE, MRCS, USMLE, MBBS, MD/MS
Floating Knee – Quick Review
The term “floating knee,” introduced by Blake and McBryde in 197 is used to describe fractures of the ipsilateral femur and tibia. Fractures can occur anywhere along the femur and the tibia and must occur in both bones to be considered a floating knee injury. Classification of Floating Knee Types…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Ipsilateral Femoral Neck and Shaft Fracture
General Treatment Options 1. Reconstruction/cephalomedullary nail 2. Plate + screw/DHS fixation Other strategies include: Which Fracture First? For a displaced femoral neck fracture, reduction and temporary stabilization with guidewires can prevent further displacement. A practical sequence is: Stabilizing the shaft can facilitate reduction of the displaced neck fracture and help…
Fellowship Blog
Polyethylene Insert Exchange for Acute PJI After TKA: Indications, Timing & Outcomes
Key concept Irrigation and debridement with polyethylene insert exchange (IDPE) or Open debridement and polyethylene insert exchange (ODPE) is a form of DAIR (Debridement, Antibiotics and Implant Retention) used for selected acute periprosthetic joint infections (PJI) after TKA. When to consider and when not to consider IDPE or ODPE? Favorable…
Fellowship Blog
Crescent Fractures (Trans-iliac Fracture Dislocation of Sacroiliac Joint)
Definition: Transiliac fracture dislocation of the SI joint, which combines a ligamentous disruption of the inferior part of the SI joint with a vertical fracture line of the posterior ilium, extending from the SI joint and reaching the iliac crest at different levels. The posterior superior iliac spine (PSIS) remains…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Garden Classification for Neck of Femur fractures
History Classification The Garden classification incorporates displacement, fracture completeness, and relationship of bony trabeculae in the femoral head and neck. Garden I Garden II Garden III Garden IV Displacement None None Partial Complete Fracture completeness Incomplete (medial cortex intact) Complete Complete Complete Relation of bony trabeculae Head and neck trabeculae…
Fellowship Blog
Simultaneous Bilateral Total Knee Arthroplasty (SBTKA): A Practical Perspective
Recently, we operated on a 58-year-old female patient with advanced bilateral knee osteoarthritis (OA). She underwent simultaneous bilateral total knee arthroplasty (TKA) using a medial parapatellar approach. Both femoral components were size 3, tibial components size 3, and a 10mm polyethylene insert was used on each side. Some practical considerations…
Fellowship Blog
Retrograde Percutaneous Screw Fixation of Posterior Column Acetabulum Fracture : C-Arm Views & Technique
Today in the OR, I observed a retrograde percutaneous screw fixation of a left posterior column acetabular fracture in a 63-year-old male. While I wasn’t scrubbed in, it offered a fantastic opportunity to understand the precision and fluoroscopic guidance required for this minimally invasive approach. It is often said that, “Percutaneous fixation is a surgery performed…