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Putti Sign

The Putti Sign is observed when the medial edge of the scapula protrudes above the shoulder joint with shoulder adduction and forced external rotation.. It is often seen in the setting of obstetric brachial plexus palsy. It is due to compensatory scapulothoracic motion to adduct the arm, resulting in elevation of the superomedial border of the scapula into the trapezius,…

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Orthopaedic Mnemonics for Antibiotics

At the "club front door(cell wall) See(C) the VIP" Cephalosporins, Vancomycin, Imipenim, Penicillin. "The pros (protein) buy AT 30, CELL at 50". 30 subunit: (aminoglycoside, tetracycline) 50 subunit: chloraphenicol, Erythromycin, Linezolid, cLindamycin Rifampin: R for RNA DNA transcription: ciprofLOXacin, levofLOXacin. LOX = Level Of tranXription (DNA)

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Degenerative Lumbar Spine

Key Points Back pain worse with leaning forward = discogenic back pain Leg pain worse with leaning forward = herniated disc Back pain worse with extension = posterior elements (spondy) Leg pain worse with extension = stenosis Nicotine has increased effect of disc deterioration Vibratory 4-5 Hz (Truck Drivers) Most disc herniations are L4/5, L5/S1 (90+%) next up is L3/4…

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Degenerative Cervical Spine

Cervical Spondylosis degenerative changes facet arthropathy begins @ 40 years of age, by 60-70 years most men and women have it symptoms can be discogenic neck pain, radiculopathy, and/or myelopathy As disc ages decrease in disk hydration decreased chondroitin sulfate increased keratin sulfate Inflammatory mediators IL-1 TNF-alpha Most common at C5-6, next at C4-5 How to Classify Stenosis acquired or…

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Tibial Shaft Fractures | Lower Extremity Trauma

  Usually classified by location (proximal, middle, distal) AO/OTA Classification of Shaft Fractures (see Figure) proximal, middle, or distal Types A, B, and C Oestern & Tscherne Classification of Soft Tissue Injury (Closed) C-0: little or no soft tissue injury C-I: superficial abrasion C-II: deep, contaminated abrasion with local contusion damage to skin or muscle C-III: extensive skin contusion or crushing…

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Tibial Plateau Fractures | Lower Extremity Trauma

Tibial Plateau Fractures Schatzker Classification I - Lateral plateau split young people with good bone lateral meniscus tear trapped in fracture II- Lateral plateau split-depression valgus blow with axial loading age > 40 III - Lateral plateau depression (tend to be stable) IV - Medial plateau fracture (15% of plateau fractures) less common associated with LCL injury pattern most commonly…

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Patella & Knee | Lower Extremity Trauma

Patella the patella is a pulley, redirecting forces to the tibia your first choice should never be a total patellectomy, as this results in a 33% extension strength loss Classification based on pattern non displaced transverse - can be unstable, especially if gapped proximal pole distal pole stellate vertical - not very unstable Conservative Treatment displaced <2mm at the articular…

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Pars Defects, Spondylolysis, Spondylolisthesis | Lumbar Spine

Lumbar Spine Anatomy lamina superior/inferior articular processes (aka facet joint) spinous process transverse process Scotty dog (on oblique x-rays) - Look for pars defect nose - transverse process front leg - inferior articular process neck - pars interarticularis ear - superior articular process Biomechanics of soccer kick approach limb swing -hyperextension foot plant - hyperextension hip flexion, knee extension, and…

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